After a particularly hectic Saturday morning when Dr Narendra Patwardhan checked as many as 11 patients with hair loss, he simply deferred the remaining appointments and wished he could take on a more challenging case. The number of patients with hair loss has increased over the years and out of 10 new patients at least eight are men. What is disturbing is that a sizeable number of them are in their 20s and 30s seeking hair restoration surgery, says the president of the Association of Hair Restoration Surgeons of India.
Telogen Effluvium – a typical hair loss condition among youngsters is characterised by diffused hair shedding. It is a reactive process caused by a metabolic condition or hormonal stress or by medications. Generally, the recovery is spontaneous, occuring within six months. However, the vast majority of hair loss cases fall into the male (androgenetic) or female (pseudoandrogenetic) pattern baldness. This is caused by the effect of the hormone that leads to gradual and progressive hair loss. While medication like minoxidil does help, hair transplants or hair restoration surgeries are now the norm.
With 60-70 patients being examined for hair loss on a daily basis, Patwardhan says the major reasons are iron deficiency, lack of sunlight (vitamin D-3), stress, irregular diets, hormonal changes and related diseases like thyroid and diabetes. There has been a rise in the number of young men with hair loss. They are mainly from the IT sector. Out of 100 patients, at least 30 are from this group and the ages vary from 25 to 35 years. I have had frantic parents calling me several times to provide some solution, he adds.
In a month I do take on six-eight patients for hair restoration surgery but this is a tedious method and, like pregnancy, patients need to wait for the hair to grow, he explained. The surgery process could take around six hours under local anaesthesia for the follicular unit transplant (FUT). A small strip of hair bearing scalp is removed from the back and side of the head and these hair usually grow throughout a lifetime.
The donor region is stitched in such a way that a narrow scar is produced but is hidden by overlying hair. Special instruments are used to make small slits in the bald area and the grafts are then inserted. The growth of the transplanted hair starts in about six weeks and continues for nine months to a year.
Another technique, the follicular unit extraction (FUE), too, is fast evolving and is being adopted quite regularly. In this, a small round punch is used to extract follicular units from a patient’s bald resistant donor areas one at a time. These 1, 2, 3 and 4 groupings (called follicular unit grafts) are then transplanted into a patient’s balding areas. It may cost Rs 80/100 per graft in the FUE technique method while the Strip (FUT) method may cost Rs 80,000 onwards.
It is normal to lose 50-100 strands in a day. But the patient may have lost at least 30-60,000 hair by the time they require a hair transplant, says Dr Rajesh Rajput, founder president of the Association of Hair Restoration Surgeons of India and who has performed more than 5,000 hair transplants in the last 20 years.
Dr Rajput has, however, also done a study which shows cyclical medicine helped in improving hair count and hair calibre and in which control of hair loss was better. Promoting hair growth requires supplementation of certain minerals, vitamins, amino acids, and antioxidants, as well as control of sebum secretion and anti-dandruff treatment. However, there are drawbacks to using vitamins, minerals, and amino acids together. Excess of vitamin A and E lead to improper keratinization of hair and cause hair loss. Absorption of minerals and vitamins is dependent on their relative deficiency in the body; iron and calcium given together reduce the absorption of one another, he explained.
In a study of 500 patients, Dr Rajput combined the use of antioxidants, iron, calcium, zinc, amino acids and Vitamins E, D and C with minoxidil and finasteride to control hair loss, reverse miniaturization and achieve new hair growth within two to four months. The study was published in Hair Transplant International Forum and showed the combination treatment of drugs worked. The patients were followed up for two years and there was a definite improvement, he said.
Everyone wants to look good and advertisements promising that crowning glory and increased confidence at work lure several potential customers. This has also led to several mushrooming hair transplant clinics. There is simply no data and no checks on this, says Patwardhan who admits that the association receives complaints about non allopathic doctors who have been performing these surgeries. ens