Hair Restoration Research Articles

A Scientific Hypothesis on the Role of Nutritional Supplements for Effective Management of Hair Loss and Promoting Hair Regrowth

A Scientific Hypothesis on the Role of Nutritional Supplements for Effective Management of Hair Loss and Promoting Hair Regrowth

Hair Restoration in Cranial Surgery Patients

1. Parsa Mohebi, MD, FISHRS (info{at}parsamohebi.com) 1. Los Angeles, California, USA 2. William R. Rassman, MD 1. Los Angeles, California, USA Scalp scars can be a huge burden in patients who already have associated and complicated health challenges. For the neurosurgical patient,

Calendar of Hair Restoration Surgery Events

Calendar of Hair Restoration Surgery Events

Analysis of the changes in scalp hair angles: In vivo and in vitro comparison before and after tumescence.

To estimate the hair shaft exit angles and also to check the effect of tumescence on the hair angles. Ten patients undergoing first session of strip hair restoration were included. The strip was marked at the level of external occipital protuberance and superior nuchal line. Three hairs were marked, one near upper end, one near lower end, and one in the middle. About 10 mL of 0.5% xylocaine with adrenaline was used with the needle in the subdermal level. The hair angles were measured. After the strip harvest, small slivers were prepared and photographed. The hair shaft exit angles of the three hairs were calculated using the computer software. The Kruskal-Wallis test and multiple comparisons (Bonferroni's correction) were used to analyze the data statistically. The mean age of the patients was 23.4 years. The average preinjection (in vivo) hair angle was 52.82° with 52.96° in upper hairs (43.2° -61.2° ), 51.77° in middle hairs (43.4° -61.3° ), and 53.72° in lower hairs (38.4° -61.3° ). The average postinjection (in vivo) hair angle was 65.34° with 65.05° in upper hairs (55.1° -86.4° ), 65.63° in the middle hairs (56.4° -71.2° ), and 65.35° in the lower hairs (51.3° -75.2° ). Similarly, the postexcision (in vitro) hair angles was 71.91° with 70.83° in upper hairs (range, 56.8° -95.7° ), 72.19o in middle hairs (64.3° -78.5° ), and 72.71° in the lower hairs (63.9° -81.4° ). The proper assessment of hair angles is very important and can be altered by the injection technique.

Voluntary registers no longer have gravitas

Journal of Aesthetic NursingVol. 7, No. 3 EditorialFree AccessVoluntary registers no longer have gravitasCheryl BartonCheryl BartonSearch for more papers by this authorCheryl BartonPublished Online:4 Apr 2018https://doi.org/10.12968/joan.2018.7.3.125AboutSectionsPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareShare onFacebookTwitterLinked InEmail There was a markedly mixed response to the long-awaited launch of the Joint Council for Cosmetic Practitioners (JCCP) last month. The House of Lords reception saw the great and the good of the aesthetic sector gathered together to congratulate and applaud themselves, while also recognising the implementation of an education framework for non-surgical cosmetic practice and hair restoration surgery, published by Health Education England, and adopted by the JCCP and its sister organisation, the Cosmetic Practice Standards Authority.The overarching principle of the JCCP is to oversee both patient safety and public protection within the non-surgical cosmetic sector in the UK. It claims to be the recognised self-regulator of the field, the point of access for the public seeking information about aesthetic treatments and, where appropriate, the organisation with which to raise concerns about practitioners and their services. At last, an organisation putting patients first, with safety at the top of its agenda—who in their right mind would want to argue with that?Except something of a backlash ensued just as the JCCP launched; many aesthetic doctors, dentists and nurses were very unhappy indeed at being ‘lumped together on a register with hairdressers, nail technicians and beauticians’. They maintained that this new voluntary register, rather like previous voluntary registers, founded on self-regulation, simply does not go far enough in protecting the public.Just last month, we have witnessed failures of two cosmetic voluntary registers. First, BBC News (Roberts, 2018) reported the failings of the Breast and Cosmetic Implant Registry, launched in October 2016 following the Poly Implant Prothèse (PIP) breast implant scandal. This was followed by the removal of Professional Standards Authority accreditation from another voluntary register, Treatments You Can Trust.The JCCP register has several parts, however it is the inclusion of beauticians who are setting clinical standards of competence for those who are aligned with statutory regulators that appears to have caused concern for doctors, dentists and nurses in aesthetic practice. Lay groups have much to offer us in a patient setting—they have contributed to positive improvements in the NHS with regard to whistleblowing, ethics, leadership and transparency. But clinical standard-setting appears to be one step too far, and this has alarmed a large group of clinicians who took to their social media pages to voice their opinions. The majority are deeply disappointed at never being given a chance to vote on this in their own professional membership organisations, namely the British College of Aesthetic Medicine and the British Association of Cosmetic Nurses. They quickly organised themselves into a campaigning group, the British Association of Aesthetic Nurses Doctors and Dentists, and took to the air on BBC Radio 4 to call for a mandatory register with underpinning legislation. On 12 March 2018, they featured on the ‘Botox Bother’ feature on current affairs programme You and Yours to discuss the launch of the JCCP register, and were again invited to speak on the programme on 13 March.If we are serious about safety, we can no longer accept that voluntary is OK. This is fundamentally flawed by the mere use of one single word—voluntary. Nurses are mandated to protect the public, and the Nursing and Midwifery Council exists to ensure they fulfil this duty. No voluntary register will ever be able to exact the same gravitas without relevant underpinning legislation. References Roberts M. Women missing from breast implant register. 2018. https://tinyurl.com/y9cc6g8o (accessed 27 March 2018) Google Scholar FiguresReferencesRelatedDetails 2 April 2018Volume 7Issue 3ISSN (print): 2050-3717ISSN (online): 2052-2878 Metrics History Published online 4 April 2018 Published in print 2 April 2018 Information© MA Healthcare LimitedPDF download

Superficial temporal artery flap for reconstruction of complex facial defects: A new algorithm.

BackgroundA variety of island flaps can be based on the superficial temporal artery with variable tissue composition. They can be used for defect reconstruction, cavity resurfacing, facial hair restoration, or contracture release.MethodsSeventy-two patients underwent facial reconstruction using a superficial temporal artery island flap from October 2010 to October 2014. The defects had various etiologies, including trauma, burns, tumors, exposed hardware, and congenital causes. We classified the patients by indication into 5 groups: cavity resurfacing, contracture release, facial hair restoration, skin coverage, and combined. The demographic data of the patients, defect characteristics, operative procedures, postoperative results, and complications were retrospectively documented. The follow-up period ranged from 24 to 54 months.ResultsA total of 24 females and 48 males were included in this study. The mean age of the patients was 33.7±15.6 years. The flaps were used for contracture release in 13 cases, cavity resurfacing in 10 cases, skin coverage in 17 cases, facial hair restoration in 19 cases, and combined defects in 13 cases. No major complications were reported. Conclusion: Based on our experiences with the use of superficial temporal artery island flaps, we have developed a detailed approach for the optimal management of patients with composite facial defects. The aim of this article is to provide the reader with a systematic algorithm to use for such patients.

Message from the ISHRS 2018 World Congress Program Chair

1. Parsa Mohebi, MD, FISHRS (info{at}parsamohebi.com) 1. Encino, California, USA ![][1] The field of hair restoration will never be the same! I was recently a featured guest on a talk show on one of the local radio stations in Los Angeles. One of the questions the host asked

Calendar of Hair Restoration Surgery Events

Calendar of Hair Restoration Surgery Events

Graft Quality Index: A Morphologic Classification of Follicular Unit Excision (FUE) Grafts

1. Robert H. True, MD, MPH, FISHRS (drtrue{at}hairlossdoctors.com) 1. New York, New York, USA Graft quality is a significant component of all hair restoration surgery, especially Follicular Unit Excision (FUE). There is much discussion in our professional community about the impact of graft

Safe and easy hair transplantation utilizing KD spreader

Aim: An atraumatic insertion of graft is key to successful outcomes in this procedure but there is a definite learning curve in available techniques. Many physicians do not continue hair restoration practice because of the repeated initial failures. The goal of any technique or instrument in follicular unit extraction (FUE) is to extract an individual follicular unit without transaction and implanting it in recipient area without producing physical trauma to the follicular unit. This article describes a novel technique in which an innovative instrument, the KD spreader, that addresses all the problems faced by novice physicians during FUE hair transplantation. More importantly unique design of the instrument also solves the problem of fatigue of the operator’s hands while performing the hair transplantation procedure.

This sector needs laser protection supervisors

Journal of Aesthetic NursingVol. 7, No. 1 Guest EditorialFree AccessThis sector needs laser protection supervisorsMike MurphyMike MurphySearch for more papers by this authorMike MurphyPublished Online:5 Feb 2018https://doi.org/10.12968/joan.2018.7.1.6AboutSectionsPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareShare onFacebookTwitterLinked InEmail Laser safety is critical. Many of the Class 4 lasers used routinely in today's clinical centres are very powerful machines, and their use can inflict serious damage to the eyes and the skin. Laser practitioners therefore need to ensure safety is a high priority at all times, to prevent injury to staff and patients.I recently spoke with several insurance companies and they all had the same observation to share: the number of laser-related claims is going through the roof. The main reason for this is simply a lack of proper training and understanding—many laser operators are not following safety protocols and/or are not using the correct safety equipment. Without a significant change in attitude and approach to treatment, the number of incidents, accidents and insurance claims will inevitably increase.All Class 4 lasers are potentially hazardous to the human eye. Many emit invisible light, so you will not know your eyes have been exposed until you feel or hear a ‘pop’! The best way to protect yourself is using the proper safety glasses, yet many suppliers do not routinely supply them with their lasers.Following the Keogh review in 2013, Health Education England (HEE) published a report in November 2015 which described a new framework of qualifications for the aesthetics sector (HEE, 2015). This applies to all aesthetic practitioners and therapists involved in delivering laser, intense pulsed light (IPL) and light-emitting diode (LED) treatments in the skincare field, and should help to improve safety standards.Most insurance companies now require all Class 3B/4 laser and IPL providers to have taken the Core of Knowledge course. The syllabus for this course is set down by the Medicines and Healthcare Products Regulatory Agency (MHRA), and is defined in its guidance on safe use in medical, surgical, dental and aesthetic practices (MHRA, 2015). Some London borough authorities require treatment providers to undergo training in the Core of Knowledge before issuing them a licence to practice.Many lasers used for the removal of hair, blood vessels, pigmentation, tattoos and skin rejuvenation are Class 4 systems. Without proper training in the Core of Knowledge (delivered by a qualified laser protection advisor (LPA), as recommended by HEE), it is difficult to see how anyone can truly understand what they are doing with their laser, or the associated hazards. When I spoke with the insurance companies, I asked if they would be interested in encouraging their clients to appoint properly trained laser protection supervisors (LPS). They responded positively to this suggestion, for obvious reasons. In most parts of the UK, there is no legal requirement for LPS to work within the private sector; however, not only is it good practice to employ LPS, but also some insurance companies have indicated that such clients might receive preferential premiums as a result of doing so.Without a good understanding of lasers and their hazards, safety will always be compromised—that is when accidents happen. A good risk assessment of your laser room, coupled with having a properly trained LPS, will help to minimise unwanted incidents. But laser safety must be a constant priority, not merely an annual safety check, and it must involve everyone. References Health Education England. Part one: qualification requirements for delivery of cosmetic procedures: Non-surgical cosmetic interventions and hair restoration surgery. 2015. https://tinyurl.com/z43cs8s (accessed 19 January 2018) Google ScholarMedicines and Healthcare Products Regulatory Agency. Lasers, intense light source systems and LEDs—guidance for safe use in medical, surgical, dental and aesthetic practices. 2015. https://tinyurl.com/y8nsycn8 (accessed 19 January 2018) Google Scholar FiguresReferencesRelatedDetails 2 February 2018Volume 7Issue 1ISSN (print): 2050-3717ISSN (online): 2052-2878 Metrics History Published online 5 February 2018 Published in print 2 February 2018 Information© MA Healthcare LimitedPDF download

Establishing and prioritizing research questions for the prevention, diagnosis and treatment of hair loss (excluding alopecia areata): the Hair Loss Priority Setting Partnership

Hair and scalp problems are common. Various conditions can result in hair loss and may present as increased hair shedding, hair thinning or patchy to complete hair loss. In some conditions the hair may regrow, in others the alopecia (hair loss) is permanent. Frequently overlooked is the psychological impact of hair loss on an individual. The visible nature of hair loss and fear of progression may lead to low self‐esteem, anxiety and depression. Unfortunately, there is a lot of uncertainty around the most effective treatments for these disorders. This study, funded by the charity Alopecia UK, aimed to identify uncertainties in hair loss management, prevention, diagnosis and treatment that are important both to people with hair loss and to healthcare professionals. This was done by creating a hair loss ‘priority setting partnership’ (PSP) between patients, their carers and relatives, and healthcare professionals, to identify the most important uncertainties in hair loss. This study presents the top 10 research priorities for hair loss (excluding alopecia areata) to guide researchers and funding bodies to support studies important both to patients and clinicians.

Establishing and prioritizing research questions for the prevention, diagnosis and treatment of hair loss (excluding alopecia areata): the Hair Loss Priority Setting Partnership.

Hair and scalp problems are common. Unfortunately, many uncertainties exist around the most effective management and treatment strategies for these disorders. To identify uncertainties in hair-loss management, prevention, diagnosis and treatment that are important to both people with hair loss and healthcare professionals. A Hair Loss Priority Setting Partnership was established between patients, their carers and relatives, and healthcare professionals to identify the most important uncertainties in hair loss. The methodology of the James Lind Alliance was followed to ensure a balanced, inclusive and transparent process. In total, 2747 treatment uncertainties were submitted by 912 participants; following exclusions 884 uncertainties relating to hair loss (excluding alopecia areata) were analysed. Questions were combined into 'indicative uncertainties' following a structured format. A series of ranking exercises further reduced this list to a top 25 that was taken to a final prioritization workshop where the top 10 priorities were agreed. We present the top 10 research priorities for hair loss (excluding alopecia areata) to guide researchers and funding bodies to support studies important to both patients and clinicians.

Therapeutic efficacy and safety of a 1927-nm fractionated thulium laser on pattern hair loss: an evaluator-blinded, split-scalp study.

Laser- or light-assisted therapies have been used to improve the perifollicular environment by upregulating the expression of growth factors and signaling molecules for hair restoration. The aim of our study was to preclinically and clinically evaluate the therapeutic efficacy and safety of a 1927-nm fractionated thulium laser on pattern hair loss (PHL). An in vivo hairless mouse study and an in vivo human skin environmental scanning electron microscopy (ESEM) study were performed with different power and energy settings. Thereafter, an evaluator-blinded, split-scalp study was conducted to evaluate hair thickness and density in 10 PHL patients treated with 12 sessions of fractionated thulium laser treatment with or without post-laser treatment application of a growth factor-containing (GF) solution. In in vivo hairless mouse skin, inverted cone-shaped zones of thulium laser-induced tissue coagulation (LITC) were noted immediately after treatment in the epidermis and upper to mid-dermis without remarkable ablative tissue injury. The ESEM study revealed round to oval-shaped zones of non-ablative LITC on the surface of the stratum corneum of a human subject immediately after laser irradiation. In PHL patients, 12 sessions of thulium laser monotherapy at 1-week intervals resulted in significantly increased hair density and thickness. Post-laser treatment application of GF solution offered additional therapeutic efficacy by improving hair density and thickness on the split scalp. The use of a fractionated thulium laser with or without post-laser therapy application of GF solution to treat PHL elicited remarkable improvements in hair thickness and hair counts.

Controversy on the role of iron and a clinical trial with intermittent iron and nutritional supplements in hair loss management

Background: Reports dating 1932, (86 years prior) emphasise the role of iron deficiency in hair loss. However, blood tests sometimes show normal iron levels in these patients. Should we still include iron in our treatment or conclude that iron has no role in hair loss management? In an attempt to review the dilemma we have come across studies recommending intermittent iron therapy, which as a low dose supplement, can be utilized even in the absence of overt deficiencies. A clinical comparison of hair loss patients having normal haemoglobin is presented with standard 2% minoxidil treatment versus intermittent iron therapy once in three days and comprehensive iron therapy along with intermittent once in three days, inclusion of other hair nutrients, antioxidants, vitamins, calcium, aminoacids and omega 3. Objective: Review the role of iron in hair loss management. Understand why hair loss patients sometimes present with normal iron reports. Evaluate if intermittent iron therapy can help in hair loss management. Evaluate if by the same analogy, inclusion of other intermittent hair nutrients along with iron therapy can deliver better hair growth in addition to controlling hair loss. Method: Sixty women volunteers having hair loss despite normal haemoglobin, were enlisted for this prospective study. Three groups of twenty women each were created. Treatment group I, received standard hair loss treatment with 2% minoxidil. Iron therapy group II, received intermittent iron therapy and the nutrition group III, received intermittent iron with intermittent inclusion of antioxidants, vitamins, calcium, aminoacids and omega 3 which are known to benefit hair loss management. Results were evaluated with global photography, trichoscopy counts for hair density and hair calibre. Observations: Minoxidil 2% group I had reduction in hair fall after 10 weeks. This group at the end of 6 months had 9% improvement in density, with 17% non responders and 3% worsening of the condition. The intermittent iron therapy group II, had reduction of hair fall after 8 weeks and 16% improvement in density over 6 months. The group III, with Intermittent iron plus intermittent antioxidants, vitamins, calcium, aminoacids and omega 3 had the best benefit showing reduction in hair fall after 4 weeks and 21% improvement in density over 6 months. This group also showed 12% improvement in hair calibre over 6 months. There were no non responders or worsening of condition in group II & III. Conclusion: Iron is an integral part of hair loss management program. Compensation of low iron levels by autophagy or arrest of hair growth make iron available to maintain normal levels in circulation which may mislead to us believe that there is no iron deficiency. Other nutrients antioxidants, vitamins, calcium, aminoacids and omega 3 are required to ensure complete utilization of iron and also support active hair growth. We present clinical evidence that intermittent iron therapy once in three days along with comprehensive inclusion of other nutrients once in three days consistently results in control of hair loss along with new hair growth. The comprehensive intermittent therapy, can be a considered for management of hair loss without waiting for the evidence of detecting low nutrient levels through laboratory tests.

Hair Transplantation into the Nape of the Neck

Background: Hair loss at the nape of the neck causes embarrassment and psychological stress in a number of patients due to a variety of causes including acne keloidalis nuchae and traction alopecia. Objectives: To report a case of hair transplantation into the nape of the neck as a treatment option for scarring resulting from acne keloidalis nuchae. Methods: 700 grafts where transplanted from the occipital donor area and transplanted by follicular unit extraction (FUE) into the nape area of a male patient with recurrent scarring folliculitis in that area. Results: Hair Restoration was successful with natural looking results. More tumescence than usual and skin traction was necessary to stabilize the skin during graft insertion due to soft skin in the nape area. Conclusions: Hair Restoration Surgery into the nape of the neck is an option for patients with hair loss in that area. FUE is the best method of hair transplantation allowing the selection of 1 and 2 hair FUE grafts in order to achieve a natural looking result in the nape area.

Moustache restoration using follicular unit extraction technique for esthetic repair of prolabial alopecia in adult male patients with repaired bilateral cleft lip: An initial report in eight patients

Prolabial alopecia is an inherent feature of bilateral cleft lip cases, occurring in varying degrees which is worsened following cleft lip repair. In the Southeast Asian population, a strong healthy moustache is considered a symbol of pride and hence many patients seek treatment of their alopetic prolabium due to the cleft lip. The alopetic prolabium also adds to the patients dented confidence by adding to the typical cleft lip look. Among the two techniques mentioned in the literature for hair restoration, namely, follicular unit extraction (FUE) and follicular unit transplantation techniques, the FUE technique offers a minimally invasive and virtually scar less option and is often preferred by most of the patients as well as the surgeons. A very few studies have focused on moustache restoration in adult male patients presenting with prolabial alopecia following bilateral cleft lip repair. This article presents the initial report in 8 adult male patients presenting with prolabial alopecia after repaired bilateral cleft lip that underwent moustache restoration using the FUE technique of hair restoration.

Automatic Biofibre® Hair Implant an Innovative Hair Restoration Technique for the Improvement of Quality Life

Background: The problem of alopecia affects both sexes at all ages with sometimes significant psychological sequelae. Along with androgenetic alopecia, there are forms of alopecia of various origin as traumatic, surgical, pharmacological and others. In 1993 the first biocompatible fibers (Biofibre®) were developed in Italy by Medicap company. Aim: Automatic Biofibre® hair implant is a soft surgery technique which is performed under local anesthesia, that enables an immediate aesthetic result without pain, scars or hospitalization. Methods: Biofibre® hair are similar to natural hair and they are available in 13 colors, that can be washed and dried with moderate heat, but cannot be bleached. The fibers are 15 cm long, until 45 cm. Besides straight fibers, there are also tight curl, soft curl and wave. Since the last years it is also available the MHD® hair variant that allows to use 3 hairs with the same graft. Automatic Biofibre® hair implant device allows to implant until 800 Biofibre® hair per hour reducing scalp trauma. Results: This modern technique of hair restoration is indicated to treat diffuse hair loss or hair thinning, both for men and for women. Conditions for success are: suitable patient with healthy scalp, qualified physician, respect of implant protocol and after care application, correct identification and therapy of possible skin reactions. Conclusions: Nowadays automatic Biofibre® hair implant is a valid surgical technique and can be also used alone or in combination with FUE to provide good final results.

Advances in Hair Restoration.

Hair loss affects millions of people worldwide and can have devastating effects on an individual's psychological and emotional well-being. Hair restoration technologies have advanced with the use of robotics and manual and motorized follicular unit extraction to provide patients excellent clinical results. Adjuvant modalities such as platelet-rich plasma injections, lasers and stem cells can further enhance the survivability and appearance of hair transplants.

Calendar of Hair Restoration Surgery Events

Calendar of Hair Restoration Surgery Events