A 25-year-old male is having continued hair loss despite using minoxidil and Deutomix. He wants to know another alternative from taking these medications. Dr. Amiya Prasad, a hair restoration specialist, explains that male patter hair loss or male pattern baldness is a genetic trait which runs in families and has variable expressions. It's not a direct dominant or recessive trait and can affect only certain siblings - one can have lots of hair while another can have tremendous hair loss. In the United States, the drugs that are approved for hair loss are finasteride and minoxidil. Finasteride is a 1 mg tablet that is taken daily and is used to inhibit an enzyme called 5-alpha reductase. 5-alpha reductase converts testosterone to dihydrotestosterone (DHT). Dihydrotestosterone will affect susceptive hair follicles which will then thin and eventually disappear. Minoxidil is a topical that is available over the counter. However, minoxidil does not stop the progression of hair loss. Finasteride can slow down the progression because it's working systemically from the inside in a specific way. Unfortunately, a significant percentage of men do not respond to finasteride. At this time, many men in their 20s and 30s are concerned about reports of long-term sexual side effects, so they refuse to take it altogether. The traditional alternative is to do a hair transplant. A hair transplant is a surgical relocation of hairs that are resistant to hair loss which are located at the back of the scalp called the donor area. Genetically resistant hair means hair from this area will never fall out - no matter how long one lives, the hair will remain in place. Unfortunately, the donor area is limited and there are just a few hairs that a surgeon can move. In general, it is more acceptable to have hair loss in men in their 30s, 40s or 50s. In Dr. Prasad's experience in 20 years of practice, men in their 20s expect to have a lot more hair volume. The Rule of Decades, a rule of thumb in hair restoration, states for men in their 20s, 20% will have hair loss while 80% will have a lot of hair. Even with transplant, a person won't get the volume they desire and will only have a limited amount of hair. In addition, nothing is stopping the progression of hair loss, therefore a person will continue to lose hair and eventually, their transplant area or donor area will be tapped out. In Dr. Prasad's practice, he has had tremendous success with a method of restoring thinning hair called Hair Regeneration. This concept is something that he developed over several years and has been very successful in treating male and female pattern hair loss using a material called extracellular matrix. He developed a process of protocol and a method that combines platelet-rich plasma and extracellular matrix. Platelet-rich plasma is the patient's own blood that is spun down to concentrate the platelets and growth factors when separated from red blood cells. Extracellular matrix is derived from pig bladder which is used traditionally for would healing. It happened to be a remarkable serendipitous observation that when used for the benefit of a hair transplant incision, the area of hair that was not transplanted which was thinning actually became thicker. For the past 3-5 years of data, Dr. Prasad has had limited need for reinjection. He has close to a 100% success rate for male pattern hair loss. Dr. Prasad does not negate the potential of hair transplants which he does perform, but in his practice he has shifted philosophy. He has been helping a lot of his patients by not having a hair transplant but rather to do injections and see how much volume of hair is restored through this method. If they still want to transplant, then he can be more strategic. One should remember that they are dealing with a limited donor area, so by strategically restoring hair which is limited in terms of the coverage, they can actually get significant coverage by doing a non-surgical treatment through this injection. Unfortunately, hair loss is an area where a lot of predatory behaviors occur where people are offering supplements and miracle treatments and all kinds of gimmicks and gadgets that don't work. Hair Regeneration is something that has tremendous data about and Dr. Prasad thinks this person will benefit from learning more about it.

• published: 23 Jul 2014
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