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All About Hair

Cosmetic Surgery November NewsletterA common complaint seen in cosmetic medicine is either too much or too little hair. Unwanted body hair is an issue for both men and women. Conversely, thinning hair on the scalp and eyelashes, and sometimes brows is also a significant complaint for both sexes as well. Here’s a quick guide to treatment of both problems.

An Approach to Hair loss

Why am I losing Hair?

There are different reasons for loss of scalp hair. If you are noticing a change in the volume or amount of hair, it’s worth taking this up with your GP. Loss of hair, called Alopecia, is divided by skin specialists into scarring and non-scarring types. An initial assessment should involve a doctor looking at your scalp to determine which kind you have. Scarring alopecia is rare, and difficult to treat as the hair follicles themselves are damaged in this condition. This can happen for a variety of reasons, and can be associated with systemic illnesses, so this kind of alopecia usually requires a medical work up which may include blood tests and a biopsy of your scalp.
Non Scarring alopecia is much more common, and the commonest form is associated with hormonal changes of aging, and referred to as androgenetic.
There are other causes of non-scarring hair loss, so an examination is important.

What is the commonest pattern of hair loss?

Men typically have a pattern of thinning and loss on the sides, top and front, with a fringe preserved in the back and over the ears. Women have more diffuse thinning at the top with relative preservation at the front.

Should I have any tests done?

Common things which can mimic this typical form of hair loss include thyroid dysfunction, anemia, and poor nutrition, so sometimes blood tests for what looks like routine hair loss is still appropriate.

How Can the Commonest form if Hair Loss be treated?

The treatment for significant age-related hair loss may include a topical prescription medication called minoxidil. When this fails, men can also consider oral prescription with Propecia. Side effects of these drugs need to be discussed with your doctor. While evidence for other treatments is less robust, many skin specialists also recommend the use of oral supplements, like Anacaps or Viviscal, especially when thinning is just starting. Additionally, there is some evidence to suggest that Injected Platelet Rich Plasma may also be effective.

Is Treatment of hair thinning or loss in lashes and Brows treated similarly?

With age it’s also common to notice thinner shorter and fewer eyelashes. Of course the look of lashes can be improved with temporary false lashes, but while these can look good, they can also be irritating, lead to infection, and also cause further thinning and loss of one’s natural lashes, ie they can worsen the problem. Latisse, also called Bimatoprost, is a topical medication applied to the lid at the base of the lashes nightly that has been shown in studies to grow longer, darker and thinner lashes. It may also be helpful for thinning brows, though this is not an officially approved use of the drug. Side effects of Latisse can include occasional irritation or pigment changes, or dry eyes.

Too Much Hair

Excessive, dark and coarse hair on the face of body is a very common cosmetic issue. Temporary fixes include such as bleaching, chemical removal, tweazing or waxing, more long-lasting treatments include electrolysis and laser hair removal.

What is Electrolysis?

In electrolysis a small needle is inserted in a hair follicle and an electric current is passed through it, damaging the follicle.

What is Laser Hair Removal?

In this form of hair removal, laser energy is passed over an area of skin, and is absorbed by the pigment, called melanin, in multiple hair follicles, damaging them

What are the Advantages and Disadvantages of Electrolysis?

Electrolysis can treat all skin and hair types, even grey hair. If done repeatedly and in the hands of an experienced practitioner, it can remove hair permanently. However, it requires lengthy sessions as one follicle is treated at a time; thus, it is often not recommended for large areas like chest, backs or legs. It can require many sessions, sometimes as many as 30 for a given area, and can thus often work out to be much more expensive in the long term than laser hair removal. It involves a needle, so it is invasive, and therefore painful, and it is often carried out by non-medical practitioner, so there is the concern about possible side effects which can include infection and scarring.

What are the Advantages and Disadvantages of Laser Hair Removal?

Laser hair removal treats many hair follicles over large areas at once, thus it is fast, sessions often taking no more than 30 minutes. Laser hair removal permanently reduces hair growth in a treatment area in 3 to 8 sessions. It treats dark coarse hair on light skin best, with subsequent regrowth typically being much lighter in color and thinner/wispier in texture. The best laser hair machines can now also successfully remove hair in virtually all skin types, and over a range of hair color. Laser hair removal is also often offered by non-medical practitioners, and in these cases, there can also be risk of injuries, including burns. At MCSC laser hair treatments are only administered in patients after assessment by our physician, Dr. Weinberg, and carried out by our medical aesthetician or trained nurse under his direction, thus side effects are few. Disadvantages are that in some patients, while hair growth is permanently reduced it is not completely eliminated, and maintenance treatments are needed one or twice a year. Laser hair removal cannot succeed in removing grey hair, thus it’s best to take advantage of laser hair before your hair color is lost. Laser Hair Removal is very cost effective.

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