Androgenetic alopecia is the loss of hair which is hormonal dependent. There might be a history of baldness in the family but in many cases the affected person might be the first one to stand out with a hair loss pattern matching this entity.
It is important to note that the sensitivity of hair follicles to the hormones is not the same everywhere in the body! For example, it is generally seen that with age, the number of follicles in the scalp progressively decreases while the facial hair and other body hair are not affected. Even in the scalp, the anterior hairline and the vertex are most commonly affected leaving the hormonally resistant hairs over the back of the scalp intact. This process not only affects the number of follicles but also the quality of hair as well in that the hair becomes thinner and more prone to fall.
There are very few things that can be done to counteract androgenetic alopecia. Minoxidil can be used to delay the loss of hair and it leads to the growth of new hair unfortunately the quality of which is not very much acceptable as it is thin. There are some new products that have come out in the market to counteract hair fall but how much these are effective needs to be seen. Ultimately, when hair fall has stabilized or has progressed to such an extent that it affects the appearance of a person and affects his confidence, a hair transplantation surgery is indicated.
Because this condition affects millions, there are naturally thousands of products claimed to produce excellent results and prevent hair loss as also grow new hair! However, nearly all of these products do not work and may in fact be harmful in the long run! The foremost of these are a host of ayurvedic products composed of a mixture of oils. Next, comes claims from dermatologists regarding mesotherapy and the injection of growth factors and stem cells to recreate new follicles. The reader is referred to the leading journals indexed in Pubmed to find out if these claims are really true! Unfortunately, mesotherapy causes fibrosis under the scalp which adversely affects the results of future hair transplant. Therefore, it is advisable not to go in for any of these treatments, rather keep your money safe for hair transplantation.
Hair transplantation is the only definite management for androgenetic alopecia at present. In this procedure, hormonally resistant hair from the back of the scalp is taken and implanted into the area of hair loss. These hairs maintain their original characteristics due to the phenomenon of “donor dominance” and therefore grow like normal hair and can be cut and shampooed. The hair growth is therefore permanent in most cases. There are 2 ways in which the follicles can be isolated: the more common is the FUT or strip technique in which a strip of scalp skin is taken and the follicles are isolated under magnification by experienced technicians. In the less common FUE technique, a machine is used to extract follicles from the back of the scalp after shaving off the whole area. This method is less commonly used as it is time consuming and there can be a considerable loss of follicles during the harvesting process due to damage. Therefore, FUT remains the procedure of choice for surgeons worldwide.
The author, Dr. Souvik Adhikari, is a consultant Cosmetic & Plastic Surgeon based in Kolkata. He has wide experience in hair transplantation and all of his patients are extremely satisfied with the outcome of their procedure. For more information, please check his website: