The choice of the appropriate hair loss treatment is based on correct registration of the patients’ medical history and proper diagnosis, which should be particularly thorough, both by clinical examination and laboratory examination, if deemed necessary.
The medical history will provide valuable information such as the start time of the hair loss, the speed of its manifestation, the type and extent of the thinning, possible co-existence of pathological conditions associated with hair loss (e.g. hypothyroidism, autoimmune diseases, anaemia, etc.); the family history, if any, is also a key factor.
Especially in the case of androgenetic alopecia, the existence of a positive family history on the part of the father or mother, or both, is considered to set the diagnosis of the disease and determines its future development to a large extent. In doubtful cases, particularly in women, in very young people, or in particular cases of alopecia (e.g. cicatricial alopecia), the diagnosis and the choice of the appropriate treatment may be aided by special examinations, such as the classic trichogram, the phototrichogram, and blood tests. Additionally, it is now possible to determine the patient’s genetic hair loss profile through the study of dozens of genes that are associated with the process of hair loss, by specific genetic screening of the patient’s DNA.
Hair Loss Treatment – Classification
Hair loss treatment can be divided into two major categories: conservative treatment and surgical treatment.
Conservative hair loss treatment includes all the non-invasive methods, such as
- treatment with low power laser (LLLT or Lasercomb)
- PRP (Platelet Rich Plasma) therapy
- support treatments with nutritional supplements, lotions, shampoos, etc.
Conservative pharmaceutical treatment of hair loss is done with two main substances: minoxidil, which prolongs the anagen phase of the hair, and finasteride, which has an antiandrogen action and inhibits the testosterone derivatives that are regarded responsible for the onset of hair loss. This category also comprises a new substance, dutasteride, which is considered to have stronger androgenic effects than finasteride. Apart from the specific hair loss medication, there are also non-specific treatments such as the application of topical corticosteroids on the scalp to fight the inflammation that causes degeneration of hair follicles. Non-specific treatment is mainly applied in cases of hair loss due to obscure causes, where there is no curative therapy, e.g. in cases of diffuse alopecia, cicatricial alopecia or alopecia areata.
Hair loss treatment with LLLT laser can be successfully used in cases of incipient or medium androgenetic alopecia, and in cases of diffuse alopecia. It works by improving the local blood supply to the scalp and by increasing the energy production of the hair follicles cells, resulting in better nourishment of hair.
Hair loss treatment with PRP (Platelet Rich Plasma) is a new, very promising treatment based on the exploitation of the healing and growth forces of the patient’s own body. With this method, the platelet-rich plasma from the patient’s own blood is stimulated to produce protein growth factors, which in turn activate the stem cells towards the production of new cells and the development of hair follicles.
Many products can be used to support conservative hair loss treatment, such as shampoos, lotions or ampoules with nutritive ingredients, dietary supplements with vitamins, minerals, amino acids etc. In general, the effectiveness of these agents in hair loss treatment is controversial, but a proper and balanced diet, rich in fiber and vitamins, especially of the B group, trace elements such as zinc, and natural products like aloe, are considered to contribute to the proper nutrition and health of hair. Also, people with sensitive, thin and weak hair with a family history of hair loss are generally recommended to use mild shampoo with a neutral pH, suitable for daily hair washing.
Surgical treatment of hair loss consists in hair transplantation which is applied in moderate or advanced cases of hair loss, where there are visible and well-defined areas creating an aesthetic problem. There are currently two main techniques: FUT or strip technique, for which an entire strip of skin is obtained from the donor area situated on the back of the scalp, resulting in permanent scarring, and the more modern FUE technique, for which individual follicles are harvested from the donor area, without leaving any scars. The results of hair transplantation are permanent, but it is extremely important to follow a proper conservative treatment in order to maintain the existing hair.