Full locks lend confidence to us all. Hair loss can shock our self esteem — no matter our age. Do you worry about your own thinning hair or baldness? Hair restoration can revive your look and your confidence level.
With so many options, you may wonder which hair restoration treatment is right for you. Let this guide illuminate the way to healthier hair and restored follicles.
What Is Hair Restoration
Hair restoration — broadly speaking — reduces hair loss while rejuvenating new follicle growth.
There are a plethora of treatment options available: some are FDA approved, others are not. This range includes both surgical and nonsurgical techniques, medications and minimally invasive therapies:
Low level laser light
Platelet-rich plasma (PRP)
Stem cell treatment
Other options include medicated shampoos, non-prescription “camouflage” products, hair pieces and a vast array of natural supplements. A combination of methods is often advised.
Non Surgical Vs Surgical Hair Restoration
First off, there are currently two mainstream surgical restoration techniques:
Follicular Unit Transplantation (FUT)
Follicular Unit Extraction (FUE)
They are remarkably similar. In both cases, follicular units are removed from a donor site on the patient and then grafted onto a recipient site. FUT involves a single strip excision technique, while FUE utilizes a small, round “punch” method to remove follicles from the donor site.
The single strip excision method is the surgical removal of a strip of the patient's scalp. This section of the patient’s scalp is hair-bearing (or bald-resistant), and the follicles are relocated to a balding area. Individual follicular units — natural-formed groupings of hair follicles — are grafted to the recipient site. Meanwhile, the donor site is sutured together, resulting in a thin scar.
FUE, on the other hand, removes follicular units via a small (sometime robotic) “punch” method. With the aid of anesthesia, the micro-removal of 1-4 hairs occurs in tiny patches roughly 0.6 mm - 1.0 mm in diameter. This process is exceptionally labor intensive, yet results in virtually undetectable scars on the scalp — as opposed to the single strip of scarring left by FUT.
For those who prefer buzz-cut hairstyles, FUE offers relief from noticeable scarring. However, even relatively short hair can cover the scar left by single-strip FUT. The lengthy surgical procedure of FUE is difficult for surgeons to learn and increases the cost of hair restoration. FUE may also lead to a lower ratio of successfully transferred follicles.
No matter the route chosen, proper hair follicle extraction is key to transplantation.
Transplanted tissue is removed at an angle equal to the follicles’ natural growth. If this is not accomplished, transection may occur (when the hair shaft is cut from the follicle).
Robotic devices, such as the NeoGraft, are approved by the FDA to assist surgeons during the FUE procedure. Speed settings include a rotational spin to diminish heat, friction and hair follicle damage. While robotic assistance reduces technical limitations, the high cost of the devices and relatively large punch-sizes remain disadvantageous to their use.
The FUE procedure with robotic assistance leads to lower complication rates and an increased number of transferred grafts per session. In comparison to the single-strip method, post-operative care of the FUE technique is faster, easier and less painful for patients.
Non-surgical techniques, however, tackle the problem through less invasive methods.
Two medications — minoxidil and finasteride — are FDA-approved for hair loss. Minoxidil is the topical treatment commonly known as Rogaine. Finasteride (aka Propecia) is a prescribed oral tablet. While neither “cure” baldness, both exert effects that reduce hair loss and stimulate new hair growth. Unfortunately, both medications show inconsistent results and adverse side effects.
Minoxidil extends the follicular growth phase by enhancing circulation to the scalp. It’s typically applied twice daily, and concentrations are available in both 2% and 5%. The 5% minoxidil is so effective that topical application can be reduced to once daily, according to clinical trials.
Finasteride, on the other hand, prevents the conversion of testosterone into dihydrotestosterone (DHT). DHT is a predominant factor in male hair loss. DHT accumulation leads to decreased follicular size and blood circulation, thus thinning healthy hair. Finasteride blocks the enzyme — 5-alpha reductase — responsible for creating DHT. Less DHT = less hair loss + new hair growth
Alternatively, some non-prescription products cover the surface of the scalp with a camouflaging agent. A variety of hues are available to disguise the bald scalp beneath thin hair, or bulk the existing follicles with temporary fibers. A hair piece is also a viable option. They often require maintenance and regular replacement. These products offer short-term relief for patients.
Three non-surgical hair restoration therapies, in particular, receive groundbreaking notoriety:
Low level laser therapy
Platelet-rich plasma therapy
Stem cell hair treatment
Hair Restoration Reviews: Laser Hair Restoration
You may have already heard of low level laser therapy (LLLT). Doctors often advise this treatment in conjunction with other hair restoration therapies. LLLT is clinically proven to provide a significant difference in hair density without negative side effects.
“Low-level laser treatments (LLLT) are popular non-invasive and non-chemical options for hair loss that work by activating energy production in the hair follicle and modulating DHT.”
— Dr. Cheri Ong, Dermatologist for American Dermatology Associates, Inc.
Unfortunately, laser therapy is heartbreakingly slow and expensive. It is also not considered as effective as hair loss medications, such as minoxidil and finasteride. Results may take up to 18 months, and, depending on the severity of each case, treatments may take place quarterly, monthly, fortnightly or even weekly. Treatments can take place at home or in a clinician’s office.
During each treatment, low level laser light (also called soft laser, cold laser, red light therapy or bio-stimulation) is directly applied to the scalp. Hair cells absorb the light, and weak follicles reactivate to produce healthy regrowth. The laser light accomplishes this by promoting microcirculation of the blood and protein synthesis. Weak follicles revive; dead follicles do not.
“Among various mechanisms, the main mechanism is hypothesized to be stimulation of epidermal stem cells in the hair follicle bulge and shifting the follicles into anagen phase… LLLT for hair growth in both men and women appears to be both safe and effective.”
Home-use LLLT devices are designed in multiple FDA-cleared methods. A laser comb, for example, is a hand-held device that emits low-level laser light while combing the hair. Safe and hands-free LLRT helmets and baseball caps are also available for purchase and home use.
Hair Restoration Reviews: PRP Hair Restoration
For those with recent hair loss, platelet-rich plasma (PRP) therapy can restore previous hair growth. It also works as an adjunctive treatment alongside other therapies for thinning hair and hair loss. Unlike laser therapy, improvements are visible in as little as three months. (Whew!)
Neil Sadick, a NYC-based dermatologist and director of Sadick Research Group, explains:
“[Platelet-Rich Plasma] is a great treatment option for hair loss because it has a number of scientifically based articles showing its efficacy increasing hair count, hair thickness, and the growth phase of the hair cycle.”
Platelet-rich plasma is naturally derived from the patient via blood samples. The blood is placed in a centrifuge, separating the patient’s platelets and plasma from the red and white blood cells. The high concentration of platelets in the remaining plasma contain growth factors that assist in hair regeneration. This platelet-rich plasma is reintroduced into the patient’s balding areas.
"The first result that patients usually note is decreased hair shedding, followed by early regrowth and increased length of hair... The general consensus is that receiving treatments every three to six months on a long-term basis are optimal for continuing to stimulate the growth factors and stem cells that are associated with regrowth and stopping hair fall out."
According to some physicians, patients see roughly 30-40% of regrowth from previous hair loss in the first three months.
However, the longer follicles lay dormant, the harder it is for them to revive and produce new growth. If you’ve experienced hair loss for many (10+) years, PRP therapy might not be the restoration route for you.
Hair Restoration Reviews: Stem Cell Hair Restoration
Stem cell hair restoration is similar to PRP therapy in several respects:
Minimally-invasive injections are naturally-derived from the patient
Growth factors slow hair loss and stimulate regrowth in weakened follicles
Improvements in hair growth begin to show in just a few months
Unlike platelet-rich plasma, the growth factors in stem cell hair restoration are obtained from adipose (fat) tissue rather than blood samples. Once the fat tissue is extracted from the patient, the tissue is placed in a centrifuge to separate the fat cells from stem cells. The procured stem cells are chock full of rejuvenating mesenchymal cells and growth factors to restore hair growth.
These adipose-derived stem cells are called stromal vascular cells (or ADSVC). When injected into the patient’s affected areas, these adult stem cells regenerate damaged and dormant hair follicles. They also protect patients from the hair-thinning effects of DHT. Stem cells are undifferentiated — thus, they’re able to transform into multiple cellular subtypes, as needed.
In conclusion, treatment using ADSVCs appears highly effective for alopecia areata and may represent a new avenue of therapy for hair regeneration. ADSVC injection promotes good stability of the hair by increasing the hair density, the hair diameter, and decreasing the pull test to almost zero. Furthermore, patients must be very well selected depending on their lifestyle, the cause of hair fall and baldness grade to obtain a good result with this procedure.
Stem cell hair treatments are particularly useful for those too young for surgical hair treatments. (When done at early ages, hair transplantation can result in eventual follicular miniaturization and hair loss in donor sites.) Stem cell treatments can also be administered in conjunction with PRP therapy for accelerated results.
You’ll feel your best — from head to toe — with restored confidence in the looks of your locks.
Your medical history, age, gender and stage of hair loss all factor into choosing the right hair restoration treatment. You’ll want to go over your options with an experienced clinician to determine the appropriate avenue. Treatment costs will likely play a role in your decision, as will treatment length and potential side effects. Think it through and find the right treatment for you.