Androgenic alopecia is the most common cause of hair loss among both men and women. “Men can begin to see the effects of male pattern baldness in their early 20s and often seek help at that time,” says Jeffrey Epstein, MD, a facial plastic surgeon with offices in New York City and Miami, and spokesman for the International Alliance of Hair Restoration Surgeons. “With men we often use a combination of medical and surgical treatments. To help younger men hang on to the hair they have, we prescribe medications such as Propecia (finasteride) and low level laser therapy (LLLT). For women, who comprise about 30% of our practice, we combine Rogaine (minoxidil) and LLLT treatments. Shampoos such as Nizoral (ketoconazole dandruff shampoo, McNeil) or Nioxin can help clean up the scalp and perhaps improve the effectiveness of other treatments.”
John Kahen, MD, founder and medical director of Beverly Hills Hair Restoration, says shampoos that inhibit DHT “show fairly positive effects on my patients suffering from hair loss.” He also recommends minoxidil and vitamins targeted to hair and nail growth.
Dr. Weiss encourages all of his patients to use minoxidil and finasteride if they can. “These medications not only help patients hold on to existing hair but can help improve the quality of hair growth, even for patients after transplant surgery,” he says. He also recommends vitamins such as BioSil and Viviscal to support the overall quality of hair growth.
“I like Propecia for older men with more advanced hair loss who may be thinking about hair transplantation but aren’t ready yet,” says Dr. Urato. “It helps them preserve the hair they have and can give them a small amount of regrowth, about 15%. I am less likely to suggest it to younger men because of its side effects.”
Low Level Laser Therapy (LLLT): “We are thrilled with LLLT,” says Dr. Urato. “It is safe, safe, safe and it works, works, works. I’ve used several devices but my favorite is the iGrow (Apira Science). It’s easy to use, but I am frank about expectations. LLLT won’t suddenly produce luxurious hair growth, but it can help patients keep what they do have and add on average 20% regrowth. Most women are thrilled with the responses they get. During the first month they are relieved that their hair is no longer falling out as it was and then during the next few months they begin to see new growth. Fewer than 2% express dissatisfaction.”
A randomized, blinded study of the iGrow Hair Growth System published in the October 2014 issue of Lasers in Surgery and Medicine compared 24 female patients treated with iGrow to 18 patients treated with a sham device. The iGrow produced a 37% increase in hair growth, significantly higher than the sham device. The iGrow System is FDA approved for both men (January 2013) and women (December 2014).
“We have been using LLLT for years, especially in the post-op care of transplant patients,” says Dr. Giannotto. “Healing is quicker and graft growth is accelerated. LLLT as a stand-alone program is a wonderful way to help stop the progression of hair loss in men and women. It can also be used as a preventive measure in patients just beginning to notice hair loss. The original FDA study showed that 87% of men using LLLT stopped the progression of their hair loss. My patients love the program.”
Platelet Rich Plasma (PRP): “I have performed countless platelet rich plasma (PRP) procedures in my clinic over the past two years generating successful results. PRP is truly an innovation to the world of hair restoration,” says Dr. Kahen. “I also use PRP therapy in conjunction with my hair restoration surgery procedures. It helps patients recover quicker while also creating more density and speeding up the hair growth process. PRP is more appropriate for patients with androgenic alopecia.”
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