COSMETIC TOWN JOURNAL



Expert Doctor

Androgenic Alopecia Treatments

Posted November 05, 2019

Amir Yazdan, MD

Corona Del Mar, CA

androgenic alopecia

Androgenic alopecia, which is also known as pattern baldness, is a genetically determined and progressive form of hair loss occurring on the scalp. The precise causes of androgenic alopecia are not fully understood, but sensitivity to the actions of dihydrotestosterone (DHT) in the hair follicles is known to be a major factor. Androgenic alopecia is most often used to refer to male-pattern hair loss as androgens and they are a type of male hormone. As such, female-pattern hair loss is a more appropriate term to describe progressive hair loss in women. Treatment for androgenic alopecia consists of both surgical solutions and medical therapies that can help men and women of all ages slow or reverse hair loss at the temples and crown.

Am I a Good Candidate for Androgenic Alopecia Treatment?

GOOD CANDIDATES for androgenic alopecia treatments are:

  • Patients with hairline recession that is visible in the frontal, crown or central areas
  • Patients with diffuse thinning of the scalp
  • Patients experiencing progressive follicle miniaturization and loss

Patients who are NOT GOOD CANDIDATES include:

  • Patients with diffuse unpatterned alopecia
  • Patients experiencing hair loss suddenly and dramatically
  • Patients with diseases of the scalp or with rare dermatological conditions
  • Very young (under 20) and very old (over 70) patients

How is Androgenic Alopecia Treatment Performed?

Treatment for androgenic alopecia consists of either surgical solutions or medical therapies.

Surgical solutions for pattern baldness are typically classed under two types:

FUE and Strip surgeries are minimally invasive outpatient procedures performed under local anesthesia. Hair transplant surgery uses a patient’s own natural DHT-resistant terminal hairs to restore the thinning or balding areas on the scalp.

With the FUE procedure, hair follicles are removed one-by-one from the donor site. The hair follicles are then transplanted individually to the thinning or balding areas of the temple or crown. If done by a master hair restoration specialist, this method leaves no visible linear scar. 

With the FUT or strip method, a thin strip of scalp is removed from the back of the head containing numerous hair follicles. These follicles are then transplanted one-by-one into the balding area. This method leaves a very thin linear scar at the back of the head which is rendered non-visible once the hair grows back.

A hair transplant will normally take five to eight hours to perform.

Medical therapies for the treatment of androgenic alopecia may be classified into four types:

  • Minoxidil (Rogaine)
  • Finasteride (Propecia)
  • Platelet Rich Plasma (PRP) with ACell
  • Low level laser therapy

Minoxidil, finasteride and low level laser therapy are the only FDA-approved medical hair restoration treatments currently available on the market.

  • Finasteride is a prescription medication for men and it is administered orally. Research has indicated that the majority of men who use the medicine consistently demonstrate a deceleration in hair loss and a re-growth of withering follicles.
  • Minoxidil is an over-the-counter topical medication. Research has indicated that the majority of men who use the medicine consistently demonstrate a “slowing down” in their hair loss and a re-growth of miniaturized follicles.
  • Platelet Rich Plasma (PRP) with ACell involves drawing a small amount of blood from the patient’s body and processing it in a centrifuge in order to extract a rich plasma serum. This serum is then injected into various strategic recipient sites on the scalp. PRP is loaded with growth factors that promote rapid angiogenesis and localized cell growth which can increase both the size and healthiness of hair follicles that have begun to shrink as a result of androgenetic alopecia.
  • Low level laser therapy involves the use of a laser comb, helmet or brush that is administered on the scalp for a period of 15-30 minutes a day. Light from the laser beam helps stop hair shedding and loss by increasing the metabolism of the follicles and stimulating protein production.

What is the Cost of Androgenic Alopecia Treatments?

  • The cost of FUE and FUT surgery depends on the number of grafts needed, the desired density of the hair, the size of the balding area, the skill of the surgeon and the geographic location where the surgery will be performed. In general, the cost is anywhere from $4000-$20,000.
  • The final cost of Platelet Rich Plasma (PRP) with ACell depends on the number of treatments desired and if the doctor charges per single treatment of if a “bundle package” is offered. Overall, the cost is $800-$1200 per treatment.
  • The cost of low level laser therapy depends on the device used and whether the treatment is done at home or at a clinic. Laser light device prices range from $300-$3000.
  • The cost of minoxidil (Rogaine) varies by the brand, dosage and supplier and can be anywhere from $10-$20 for a month’s supply.
  • Finasteride (Propecia) also depends on the brand, dosage and supplier and costs in the range of $20-$180 for a month’s supply.

Recovery and Downtime

The RECOVERY time for hair transplant patients is very minimal. Most patients resume normal activity within a day or two. Beyond this, there is no significant DOWNTIME to be observed. Tiny crusts will form where the transplants have been placed and they usually shed within four to seven days. The small hairs in the newly transplanted grafts normally shed two to four weeks after the procedure and permanent hair growth begins in eight to 12 weeks.

The RECOVERY time for PRP patients is minimal to none. A patient may resume all work or social activities immediately after the treatment

Results

Hair transplant (surgical solution) patients should expect significant cosmetic hair growth within six months and full hair growth within nine to 12 months. One or two procedures are usually enough to treat a specific area of hair loss. Potential future hair loss is taken into account when any hairline work is performed. The initial consultation between the patient and surgeon helps to individualize the procedure to the patient. The final results of FUE and FUT are permanent.

Medical therapies to treat androgenic alopecia consistently demonstrate a deceleration in hair loss and a re-growth of miniaturized follicles. These therapies are extremely powerful and reliable tools to increase follicular density and decelerate hair shedding and loss. Medical therapies also delay the need for additional surgery.

Limitations of Androgenic Alopecia Treatments

The limitations are mainly found in the surgical options:

  • Surgeons are limited in the amount of grafts they can place in a single day since they have to take great care not to damage the follicles    
  • A surgeon can only harvest the donor area so many times before the donor area starts to thin out and cannot be effectively used anymore

Risks of Androgenic Alopecia Treatments

Surgical option risks include:

  • Scarring
  • Redness
  • Shock Loss
  • Swelling
  • Skin irritation

Medical therapy risks include:

  • Minoxidil may cause skin irritation and light headedness
  • Finasteride may cause sexual dysfunction
  • Platelet-rich plasma therapy may cause swelling in the scalp as well as redness

Find an Expert Androgenic Alopecia Specialist

It is of the utmost importance for patients to research and find an experienced and technically advanced hair restoration specialist to diagnose and treat androgenic alopecia. A veteran hair transplant physician or surgeon will be able to accurately assess and evaluate the individual dermatological needs of a patient and make a treatment plan according to the specific needs of the person.

Article Last Updated on November 05, 2019