Q. Why We Became Bald?

The most common type of hair loss in both men and women is referred to as Androgenic Alopecia or Male Pattern Baldness (MPB).

Research has shown that it is hereditary / genetically programmed process, which responds to external stimuli, essentially male hormones. Testosterone is converted to dihydrotestosterone (DHT) by an enzyme 5α reductase. It is DHT that acts on in the regions which are susceptible to androgenic alopecia. It appears that androgenic alopecia is under the control of a single dominant sex linked autosomal gene.

DHT


Nowadays the onset of baldness occurs at much early age than in father. This probably suggests role of many other factors in addition to genetics. The stressful competitive life style and altered dietary habits (leading to metabolic deficiencies like iron / vitamin deficiencies) have been blamed for this.

The follicles in the affected areas gradually shrink, resulting in fine and lighter growth, ultimately this leads to complete cessation of growth of hair.

DHT-2

 

Hamilton Norwood classification is the most widely used classification. This divides the Male Pattern Baldness into 7 groups as shown in figure:

Norwood-Scales

 

Ludwig devised a classification system for the types of androgenic alopecia in women (three types) as shown in figure:

Female-pattern-baldness

Although there is considerable variation among ethnic groups as far as the average number of hairs is concerned, it is typical that the average individual with a relatively full head has approximately 100000 to 150000 or more hairs growing from the scalp. The density of adult hairs can vary between 100 and 400 per square centimeter i.e. (100 follicular units / sq cm).

The density of about 60 grafts per square cm gives excellent results. To calculate the required number of grafts, measure the area with a measuring tape in square cms.
Number of grafts required = Bald area in sq cms x 60 grafts
e.g. if bald area is 50 sq cms then number of grafts required is 50 x 60 = 3000 grafts

The number of required grafts varies according to many factors-

  • How much hair loss you have
  • Possibility of loss of hair in future as predicted by your genetic pattern
  • Your own expectation about density
  • Quality as well as quantity of both donor and bald areas

This can be planned only after you are seen by us. As per your age, the pattern will be planned out so that results are naturally fitting to your chronological age.

Hair transplant is carried out under local anesthesia and you will remain quite comfortable both during and after the procedure. The ambience remains cool and calm. The procedure may also be carried out under general anesthesia as per your preference.
After the procedure you will be prescribed antibiotic or pain killers for few days (usually 5 days). You will be able to go home on the same day or you may choose to stay overnight.

You will develop a layer of scab (that protects the hairs from shearing). The scab falls off in 1-2 weeks period. The shafts of transplanted hairs also fall off (in technical term this is called effluvium), but the roots remain inside. New hairs (normal, natural hairs) start growing about 3 months after procedure. During this period you may notice small red itchy points over the transplanted site which indicates that hairs are growing out of your skin. The density of transplanted hairs may be thinner initially in totally bald areas, which gradually increases over the time. It usually takes 6 to 9 months to appreciate the results of a hair transplant. You can comb the hairs in desired style. You will need to get them regularly cut / shaven. They will grow back.
If a second / subsequent session is planned, it must be at least 3 to 6 months after the first session.

This depends on

  • Size of bald area (extensive bald area may need more than one session)
  • As per genetic program – the loss of existing hairs in future, will need hair transplant
  • Personal desire about density and number of follicles

Some patients prefer to get it done in stages at their own wish, getting the lost hair replaced at intervals to maintain natural look (and in this way they don’t get chance to develop a bald image and never develop bad psychological impact of baldness).

Transplanted hairs are permanent. It is already described that donor hairs are genetically programmed to stay lifelong (they are said to be immune to balding effects of male hormones). They grow like normal hair. They will grey according to genetic pattern.

Hair Transplant is a safe procedure. Like any other cosmetic procedure hair transplant is done to benefit you practically without any side effects.

  • In patients with advanced degree of hair loss (Norwood V, VI, VII), hairs can be harvested from other parts of body ( by FUE). This is usually done in combination with FUT megasession / gigasession to get highest possible number of grafts and achieving maximum area coverage.
  • The possible donor areas over body are:

Chest, armpits / axilla, abdomen, back, beard, forearm, thighs / calves / legs & pubic area

In African scalp the shafts and roots of hairs are curly (banana shaped roots). Number of hair follicles is less per square cm, even then the density looks great owing to curliness. So requirement of hair follicles is usually less to get good results. The utmost care is mandatory during separation of hairs in this population. FUE technique leads to more damage to hair grafts (owing to curliness of hair, straight punches are more likely to cut the roots). Still the recommended technique is FUT in African hairs, though FUE may be useful for body hairs. Meticulous harvesting and meticulous root separation is required to save their curly roots.

Olmec team has wide experience in Negroid / Ebony and Curly Hair Transplant.