Hair Restoration Research Articles

A Persuasive in the Management of Indralupta (Alopecia areata) with Ayurvedic approach

The aim of the case study is to evaluate the efficacy of Leech therapy along with ayurvedic treatment in Alopecia areata (INDRALUPTA). It is prospective interventional case report on alopecia areata treated with leech therapy and ayurvedic formulations. Using a subjective evaluation, an improvement in growth of hair on bald patches over scalp region was observed. An 18-year-old female patient, resident of Delhi, presented with complaints of two bald patches (right parietal & vertex) over the scalp without any secondary changes. With these complaints, the patient visited Shalya Tantra, Outpatient department (OPD No 16) at Chaudhary Brahm Prakash Ayurved Charak Sansthan, New Delhi. She took treatment for six weeks and got complete remission in her symptoms. Line of treatment adopted was tridosha shamaka, rakta-shodhaka and raktamokashana (Leech application). Leech therapy supplemented with ayurvedic formulations have definite role in Alopecia Areata (Indralupta) especially of recent origin. A case series or pilot study may further strengthen above case report and open new treatment arena for such cases. This case report can also be used to formulate hypothesis for management of baldness from an ayurvedic perspective.

Manifesto for change: governance and regulation within the aesthetics industry

Journal of Aesthetic NursingVol. 9, No. 8 Joint Council for Cosmetic PractitionersManifesto for change: governance and regulation within the aesthetics industryDavid SinesDavid SinesE: E-mail Address: [email protected]Executive Chair, Joint Council for Cosmetic PractitionersSearch for more papers by this authorDavid SinesPublished Online:7 Oct 2020https://doi.org/10.12968/joan.2020.9.8.350AboutSectionsView articleView Full TextPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareShare onFacebookTwitterLinked InEmail View article References Cosmetic Practice Standards Authority. CPSA clinical and practice standards. 2018. http://www.cosmeticstandards.org.uk/uploads/1/0/6/2/106271141/cpsa_overarching_principles_for_consultation_final.pdf (accessed 21 September 2020) Google ScholarHealth Education England. Report on implementation of qualification requirements for cosmetic procedures: non-surgical cosmetic interventions and hair restoration surgery. 2015. https://www.hee.nhs.uk/sites/default/files/documents/HEE%20Cosmetic%20publication%20part%20two.pdf (accessed 21 September 2020) Google ScholarJoint Council for Cosmetic Practitioners. Competency framework for cosmetic practice. 2018. https://www.jccp.org.uk/ckfinder/userfiles/files/JCCP%20Competency%20Framework%20final%20V8%20September%202018.pdf (accessed 21 September 2020) Google Scholar FiguresReferencesRelatedDetails 2 October 2020Volume 9Issue 8ISSN (print): 2050-3717ISSN (online): 2052-2878 Metrics History Published online 7 October 2020 Published in print 2 October 2020 Information© MA Healthcare LimitedPDF download

Types and Treatment of Hair Loss in Men and Women.

In this article, the author focuses on 4 common hair loss disorders that occur in both men and women. The author discusses research related to androgenetic alopecia, telogen effluvium, alopecia areata, and scarring alopecia and provides details on how to approach and manage these diseases according to patient gender. There are a range of tools and tests that can assist with the diagnostic process and help ensure that relevant and high standards of patient care are maintained. In some cases, no medical intervention is always a treatment option. However, appropriate medical treatments, although still relatively limited in some cases, are safe and have proven efficacy. Hair loss has immense emotional and psychological impact in both genders, and it is always important to consider this when planning hair loss management pathways.

Analysis of YouTube hair loss treatment information: What makes for engaging content?

Patients are increasingly seeking effective hair loss treatments. The internet and social media are popular sources of health information, but the quality and reliability of the content available to patients is highly variable. More than two thirds of American adults reported using YouTube in 2019. We investigated public interest in hair loss treatment information on YouTube and evaluated the quality of health information in videos with high viewer engagement. In July 2020, we used Google Trends, limited to YouTube searches, to analyze relative interest in hair loss treatments worldwide. We searched YouTube using nonsurgical and surgical hair loss treatment terms and we analyzed the retrieved video content. The DISCERN tool was used to evaluate the quality of health information in the hair loss treatment videos with highest viewer engagement. There is increasing public interest in YouTube searches for hair loss treatments. A large number of hair loss treatment videos are available on YouTube, but potential patients are likely to access mostly new content created by well-subscribed channels. Videos with high viewer engagement contain information that can be useful in guiding treatment decisions, but tend to be biased because they are intended to promote dermatology and hair restoration clinics. Patients are using YouTube as a source of hair loss treatment information. Videos created by hair restoration experts contain reliable information, but their quality can be improved by providing links to other sources.

The shifting preferences of patients and physicians in nonsurgical hair loss treatment.

There are multiple etiologies for hair thinning and loss, including genetic, hormonal, immune, scaring, and infectious. Hair loss treatment involves both surgical intervention and nonsurgical therapies such as pharmaceuticals, haircare products, vitamins, and low-level laser therapy (LLLT). While pharmaceuticals have been extensively researched, the efficacy of other therapies remains inconclusive. With so many available treatments, consumers often research their options using search engines such as Google and/or seek help from hair restoration physicians. To identify and analyze changing trends in international consumer and physician interest in nonsurgical hair loss therapies. Worldwide trends in Google searches of hair loss products (2004-2020) were compared with product prescription frequency surveys from members of the International Society of Hair Restoration Surgery (2004-2019, ~29% response rate). Minoxidil and finasteride were the most prescribed hair loss treatments, while "minoxidil" was the most "Googled" term. Generic products were searched more often than their brand counterparts. Nutritionals and haircare prescriptions increased over time. LLLT was also increasingly prescribed, with Internet searches increasing following government regulation announcements. The COVID-19 pandemic initially negatively affected hair loss treatment searches, which have since returned to, and surpassed, pre-pandemic levels. Regulations and social media have influence on consumer interest in hair loss products. A weak economy and coronavirus fears may persuade consumers to turn to cheaper hair loss treatment alternatives. Hair restoration specialists need to keep abreast of online trends to communicate effectively with their patients. Patients should be cognizant of the safety and efficacy of hair restoration treatments.

The Life and Legacy of O'Tar T. Norwood: A Founding Father of the Norwood-Hamilton Classification System for Male Pattern Baldness, the Forum, and the ISHRS

![Figure][1]</img> O'Tar T. Norwood Feb. 1, 1931 – Jul. 28, 2020 Dr. O'Tar T. Norwood, a globally prominent physician who was founder of our journal, Hair Transplant Forum International , and co-founder of the International Society of Hair Restoration Surgery, has left a legacy that will

Co-Editors' Messages

</br>![][1]</img> Dr. O'Tar Norwood has been an inspiration to us all. He will forever be remembered by the hair restoration community, and his memory will live on in the Forum . We have dedicated much of this issue to tributes from his closest colleagues and friends to commemorate his legacy.

Reducing Surgical Time: An Innovative and Versatile Instrument for Creating Multiple Brick-Pattern Sagittal Recipient Sites in a Single Stroke

<b><i>Introduction:</i></b> Recipient-site creation is a very important step in the hair transplant procedure as it ultimately decides the density, direction, and exit angle of the implanted hair and the final result of the procedure. It can be done with knives or needles. The slits can be <i>sagittal</i> (parallel to hair direction) or <i>coronal</i> (perpendicular to hair direction). For better visual density and coverage, the majority of hair restoration surgeons use sagittal slits. <b><i>Methods:</i></b> Recipient-site creation takes up a significant amount of the surgeon9s time. A considerable reduction in surgical time for coronal slit creation has been described using a multi-slit knife.¹ A multi-slit knife for sagittal slits has not been described until this paper. Our technique reduces surgical time by the use of an innovative and versatile new instrument that enables the creation of single rows of equidistant “brick-pattern” sagittal slits of the same direction, angle, and depth in a single stroke. <b><i>Results:</i></b> The device that we have designed enables the surgeon to reduce the time needed for recipient-site creation while increasing precision. It is a versatile instrument that can be used with appropriate configurations in bald, thinning, and vertex regions. <b><i>Discussion:</i></b> The vast majority of hair restoration surgeons typically use cut-to-size knife blades to create recipient sites, which is repetitive and time-consuming. Brick-pattern slits are preferred to minimize the “see-through effect,” which adds time and challenges.³ Our instrument is easy to assemble and use, and can create slits at desired density, depth, and angle.

Prevention of impending scalp necrosis by topical nitroglycerine in hair transplant surgery.

Recipient site necrosis is a rare but potentially devastating complication of hair restoration surgery. Appropriate case selection and procedure performed by expert surgical team are although mandatory but not enough to prevent such event, particularly in megasessions. Timely recognition of impending necrosis is very important to consider preventive measures. We aim to evaluate the use of topical nitroglycerine in preventing the incidence of impending necrosis in hair restoration surgery. A retrospective observational study was designed to determine the efficacy of nitroglycerine spray in consecutive cases of hair transplant troubled with dusky skin vulnerable to necrosis. 1580 cases that underwent hair transplant were enrolled and topical nitroglycerine was used in 88 patients vulnerable to necrosis. A management algorithm was also proposed from clinical observations and literature review to avoid vascular injury that may lead to necrosis. 83 cases (94.32%) were rescued by topical nitroglycerine and five developed necrosis eventually. Five cases who had considerable black hue and treated successfully with above treatment were reported in detail. Our experience with the use of nitroglycerine spray on the cyanotic area aided in the prevention of impending necrosis due to its vasodilatory effects on arterioles.

Anxiety and Hair Restoration Surgery

The objective of this study is to compare the anxiety scores before and after hair transplant surgery in bald patients. This prospective, comparative study was conducted in a private setup after obtaining the informed consent. The Hamilton Anxiety Rating Scale (HAM-A) was used. Only those patients who filled the pro forma before surgery and underwent first hair transplant were included. All the details of the patients such as age, time elapsed since surgery, score before and after the surgery and so on were noted. All the data were analyzed using analysis of variance test. A total of 50 patients were included, with mean age of 30.9 years. The average HAM-A anxiety score was 33.16 before the surgery and 19.62 after the surgery. The average time interval (before and after surgery) was 12.7 months. The average anxiety score in patients less than 30 years of age was 33.46 before surgery and 18.5 after the surgery. Similarly, the average score in patients above 30 years of age was found to be 32.89 before surgery and 20.65 after the surgery ( P &lt; .01). The results indicated a significant improvement on the anxiety score after the surgery ( P &lt; .01). The hair transplant definitely improves the anxiety in the balding patients.

Follicular Unit Excision Punches and Devices.

Follicular unit excision (FUE) is used to harvest follicular units for hair transplantation using trephine punches. The characteristics of FUE punches can impact the success of this technique; thus, many innovative punch designs and devices have been developed. With many options available, it can be difficult for the hair restoration surgeon to know which punch best suits the needs of their patients. To provide a comprehensive review of punch shapes and devices available. Search of PubMed, reference mining of relevant publications, and hand searching trade publications. We examined FUE punches and devices and consolidated descriptive information for each to create textual and visual guides. No single punch shape or device may suit all cases; thus, it is important to know the best uses and limitations of each. The surgeon should have a comprehensive knowledge base of available punch shapes and devices and understand the advantages and disadvantages of each. It is also beneficial to have an in-depth knowledge of skin properties and follicular unit structure. Ultimately, understanding the dynamics behind punch excision will enhance the FUE technique.

Comparison of mitochondrial transplantation by using a stamp-type multineedle injector and platelet-rich plasma therapy for hair aging in naturally aging mice

The mechanism of hair loss caused by aging is related to mitochondrial dysfunction. Pep-1-mediated mitochondrial transplantation is a potential therapeutic application for mitochondrial disorders, but its efficacy against hair aging remains unknown. This study compared platelet-rich plasma (PRP) therapy with mitochondrial transplantation for hair restoration and examined the related regulation in naturally aging mice. After dorsal hair removal, 100‐week‐old mice received weekly unilateral injections of 200 μg of allogeneic mitochondria-labeled 5-bromo-2′-deoxyuridine with (P-Mito) or without Pep-1 conjugation (Mito) or human PRP with a stamp-type electric injector for 1 month. The contralateral sides were used as corresponding sham controls. Compared with the control and corresponding sham groups, all treatments stimulated hair regrowth, and the effectiveness of P-Mito was equal to that of PRP. However, histology revealed that only P-Mito maintained hair length until day 28 and yielded more anagen follicles with abundant dermal collagen equivalent to that of the PRP group. Mitochondrial transplantation increased the thickness of subcutaneous fat compared with the control and PRP groups, and only P-Mito consistently increased mitochondria in the subcutaneous muscle and mitochondrial DNA copies in the skin layer. Therefore, P-Mito had a higher penetrating capacity than Mito did. Moreover, P-Mito treatment was as effective as PRP treatment in comprehensively reducing the expression of aging-associated gene markers, such as IGF1R and MRPS5, and increasing antiaging Klotho gene expression. This study validated the efficacy of mitochondrial therapy in the restoration of aging-related hair loss and demonstrated the distinct effects of PRP treatment.

Oral Nitroglycerin and Hair Transplant Surgery

Hair restoration surgery is performed under local anesthesia. The use of epinephrine reduces blood loss during the procedure. However, a few cases of scalp necrosis related to the use of local anesthetics with epinephrine have been reported, especially in smokers. We present a case report in which the area of early necrosis was prevented from advancing by using nitroglycerin (sublingual).

2020 World Congress Program At-a-Glance

</br>![][1]</img> Focused Sessions allow Congress attendees to join sessions specific to their interest and experience level in the field of hair restoration surgery. The program has been designed so attendees can attend all 9 focused sessions if they would like. Each session will be followed by

President's Message

</br>![][1]</img> Dear Colleagues, I hope you have all had a safe re-entry in the opening of your practices. We recently analyzed the results of the 2019 Practice Census, which revealed that the hair restoration industry is growing, with an estimated worldwide market for surgical hair

The first hair transplant assessment scale: parameters for good hair transplantation

There have been significant advances in the field of hair restoration over the last two decades. A good hair transplant is not only about the quantity...

Extensive Scarring Alopecia Treated Through a Single Dense-Packing Follicular Unit Extraction Megasession.

Follicular unit extraction (FUE) is becoming more popular in hair restoration. However, its potential for treating extensive scarring alopecia is unknown. Patients with scarring alopecia larger than 100 cm2 were enrolled from 2015 to 2018. After assessing scar quality regarding vascularity, pliability, and thickness, dense-packing megasession (DPM)-FUE was performed on high-quality recipient sites. Patients were followed up at 1 week and 12 months postoperatively to evaluate complications, survival rates of grafts, and patient satisfactions. Cases of nonscarring alopecia were reviewed as controls. Fifty-two scarring alopecia and 55 nonscarring alopecia patients were enrolled. The mean scar area was 120 cm2, and the procedure required an average of 8 operative hours, with no difference between groups (p > .05). Graft amount and postoperative complications were similar as well (p > .05). The survival rate in scarring alopecia was lower than that in the control but was still 85% (p < .05). Follow-up photographs showed effective scar camouflage after DPM-FUE. Most patients were very satisfied with the final results (p > .05). DPM-FUE is a safe and effective treatment for extensive scarring alopecia.

The edge out punch: An advancement that reduces transections in follicular unit excision hair transplantation.

The follicular unit excision (FUE) technique has become the preferred method for hair transplants over the traditional strip harvest technique due to low scar visibility and shorter recovery time for the patient. However, a limitation of the FUE technique is the potential for graft trauma due to the small diameter, sharp punches used to harvest individual follicular units. Here, we introduce the novel edge out FUE punch that is designed with a thicker wall and has an internal bevel. We describe how the dynamics of this punch reduces the risk of follicle transection. A review of the available literature and information on the edge out punch in comparison with other punch shapes, as well as the authors' experience in this area, is provided. The edge out punch is designed with thick walls and an internal bevel, placing the sharp cutting edge on the outer diameter. The dynamics of this punch aid in directing the graft into the center of the punch lumen and keeps the sharp cutting edge away from the hair follicles deeper in the dermis, reducing the risk of follicle transection. The dynamics of the forces generated by the edge out punch aid in minimizing follicular transections during graft harvesting. By understanding the dynamics behind this novel punch, hair restoration surgeons (HRSs) can optimize their surgical technique to obtain consistently high-quality grafts during FUE.

Innovations hair restoration surgeons have made to adapt to the challenges of follicular unit excision.

Early use of follicular unit excision (FUE) as a method of hair transplantation was limited by high rates of hair follicle transection. This hurdle has been overcome by innovative methods, punch shapes, and devices. With the vast array of tools available, it can be difficult for hair transplant surgeons to choose the best option for their practices. To provide an in-depth review and comparison of currently available FUE methods, punch designs, and motorized devices, and discuss how these tools fit the unique skin and hair characteristics of patients. A review of the literature and available information on FUE methods, punches, and devices, as well as the authors' experience in this area, is provided. Innovative FUE methods, punch shapes, and motorized devices have successfully minimized the rate of hair follicle transection. Methods include the use of sharp punches with depth control, and blunt rotating punches. Punch shapes such as flared, hybrid, and edge out have successfully reduced transections by keeping the cutting edge away from the follicles under the skin. The development of motorized devices using features including rotation, roto-oscillation, oscillation, vibration, suction, and hydration has also aided in achieving more successful graft excision. Follicular unit excision is a widely used technique by hair restoration surgeons. Therefore, it is important for physicians to be aware of the array of punches and devices available and understand how these tools can be used to adapt to the unique skin and hair characteristics of individual patients to optimize successful graft harvesting.

2020 ISHRS Practice Census Offers Key Insights on Hair Restoration Practices and Procedures

As the leading organization specializing in surgical and non-surgical treatment of hair loss and an international symbol of excellence, the ISHRS stands on the three pillars of research, education, and collegiality. That's why when members were invited to participate in the society's 2020 Practice