Hair on your head gives you a complete look, whether it is Man or Woman. In the case of these hair – more the merrier. But when you start losing the very same hair from your head it worries every one, young or old.

Hair Loss affects millions of people. Quite a few try their home remedies and often end up with failure. A lot of people are frustrated because they have spent a lot of money on hair loss clinics that promise guaranteed commercial products and finally got no results. The bitter fact is that, guarantee is a marketing word which is being used by many company to increase sales of their products. No commercial product can be a cure for every types of Hair Fall/Alopecia. Which is the best hair loss product? Unfortunately there is no correct answer to this question because various trigger factors causing different types of hair loss (alopecia). Because of life style, hormonal changes, using certain medications, stress and food habits. Hair Loss has now become a menace to the new world. It could happen to anyone, whether you are a man or woman.

What is hair loss or Alopecia?

Losing 50 to 100 hair per day is natural, of the 1 to 1.5 Lakh hairs on an adult head. And those hairs that have been shed will grow back in normal conditions. However if the hair loss is more than 100 per day, then it’s a cause for concern.

Hair loss often goes untreated, since it is not considered as a disease, besides regular hair fall is also a natural phenomenon. However, this can lead to unfortunate consequences, if the hair fall is more than normal.

Acute hair loss, or a sudden increase in hair loss, could occur due to many reasons such as stress, pregnancy in women, male pattern baldness, female pattern baldness, exposure to strong sunlight, Hypothyroidism, PCOS in Women, anaemia, vitamin B deficiency, Mineral Deficiency etc.

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Hair Loss is by definition is when you notice:

loss of clumps of hair from your scalp
excessive thinning of your hair
unexplained loss of hair from any part of the body
that you are tearing and pulling out your hair (Trichotillomania)
incomplete hair loss on the scalp and/or eyebrows

Alopecia refers to any form of hair loss, hair thinning, or balding anywhere in the body. There are a variety of causes which can lead to hair loss, though the most common and natural one is ageing.

Once you notice the increased hair loss, you need to consult a dermatologist, a trichologist and if necessary an endocrinologist in case the hair loss is related to hormonal imbalance.

Is it normal to lose hair?

Losing 50 to 100 strands of hair per day is normal. It is considered as normal hair loss and no need to worry about it. Most of us take our hair for granted till they suddenly begin to fall more and more due to various reasons and drastic thinning of the hair or appearance of a bald patch.

Which doctor should You consult for hair fall?

As different reasons such as Hypothyroidism, hypopituitarism, and PCOS ( polycystic ovarian syndrome ) can cause hair loss, you may need to see a doctor who is a dermatologist and an endocrinologist where necessary for treatment. A dermatologist can treat hair loss, which is hereditary, and an endocrinologist can diagnose and treat hair loss symptoms associated with various endocrine disorders.

A trichologist too can effectively treat your hair loss symptoms. A trichologist is a doctor who specializes in the study of hair and can treat baldness, hair breakage, itchy/flaking scalp, dandruff and different forms of alopecia.

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How is hair fall and the reasons behind it are diagnosed?

There are various factors that can cause hair loss , the first thing one has to do is to consult the Dermatologist or Trichologist. They will perform a general examination and Trichoscopy of your scalp and assess as to :

How noticeably is your hair thinning? And how many hairs are you losing per day?
Since how long you are losing hair ?
Healthiness of Your Scalp and the Hair Follicles and Hair through Trichoscopy
Any family history of hair loss?
What are your dietary habits?.
What are your hair styling habits? Do you use hot combs or hair straightening?
Have you suffered from any recent illnesses, especially fever, jaundice,skin rashes or allergies?
Do you have any thyroid problems or joint pains?
Do you have any anxiety,stress or depression?
Are you taking any medicines for thyroid problems, arthritis, depression or any heart-related issues?

Based on the above factors and overall general health, the doctor may then advise you to undergo :

Blood Test: to determine if you suffer from any health problems such as anaemia, hypo protenemia and thyroid. etc;
Pull Test: in which the doctor will pull your hair to see how many hairs come out on an average.
Scalp Biopsy: in which the doctor will scrape some skin and a few hairs from your scalp to check if you suffer from any kind of scalp infection.
Light Microscopy / Trichoscopy in detail: which will help diagnose any disorders of the hair shaft you may suffer from.

Hair loss can occur due to a poor diet, stress, vitamin deficiency, thyroid problems, pregnancy, treatments like chemotherapy, or due to ageing. These conditions are not very serious and can be addressed easily by taking medicines, or stopping certain medicines, and changing your lifestyle. Very often the hair grows back.

If your hair loss is due to genetic reasons or medical conditions, your hair may not grow back naturally. This can be distressing for you as hair loss can affect your overall appearance. Under such circumstances, based on your general physical health and the pattern and severity of hair loss, and your doctor’s suggestions, you may consider a couple of medical procedures, which can help to overcome your hair loss problem.

The Hair Growth Cycle:

Just like the human being has different stages of life such as Child hood, Youth, Adulthood and Old age, even hair has different stages of growth.

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Hair is made up of keratin, which is protein produced within the hair follicles on the uppermost layer of the skin or the Dermis. The follicles keep producing new hair cells and push out the old dead cells. The hair that you see on your head are compact strands made of dead keratinized cells.

At any given time, 90% or more of the hair on your scalp are in growing phase or Anagen Phase. No two hairs have the same growth pace. In fact, each hair follicle goes through an entire growth cycle of its own, which is influenced by factors such as age, nutrition, illness, and also ethnicity.

It is because each hair follicle goes through a different growth cycle, that you shed only a certain number of hairs per day. If all the hairs on your head went through the same growth cycle, all your hair would fall off at once.

Starting from growing stage to falling off stage, each hair strandgoes through three stages:

Anagen (Growing Phase) – is the hair growing phase, which can last between two to seven years. At any time, about 80% – 90% of the hairs on your head are in the anagen phase. The hairs in this phase grow from 1 cm to 1/2 inch every 28 days. Your genetics determine the amount of time your hair follicle stays in the anagen phase.
Catagen (Resting Phase) – signals the end of the active growing phase and approximately 1% of the hair is in this phase at any given time. This phase of the hair lasts for around 10 to 14 days.
Telogen ( Hair Falling Phase) – this is a resting phase, at the end of which your hair is released and it falls out, i.e., the resting hair stays in the follicle till it is pushed out by the growth of a new anagen hair. At any given time, 10% – 15 % of all hairs are in the telogen phase. The follicle then remains dormant for 3 months and the whole process recurs again.

What are the causes of alopecia/hair loss?

Some of the most common causes of alopecia/hair loss include:

physical stress due to overwork illness, accident, injuries, childbirth, emotional disorders, or surgery which can cause telogen effluvium
usage of birth control pills by women
pregnancy in women which can result in hormonal imbalances
scalp infections such as ringworm or fungal infections or the commonest Dandruff
poor diet, especially less protein intake, which can cause hair loss as hair strands are essentially made of the protein, keratin
excessive hair styling , hot combing/ hair straightening and colouring
smoking
genetic hair loss
autoimmune disorders such as Alopecia areata, or lupus, where the immune system of the body attacks its own healthy cells, including hair follicles
chemotherapy which can result in spot baldness or complete baldness
taking excessive amounts of Vitamin A supplements
Vitamin D deficiency
male pattern baldness caused by a combination of family genes and male hormones
female pattern baldness caused by family genes
medical conditions such as, anaemia( Lack of Blood ), iron deficiency, polycystic ovary syndrome (PCOS) in women, eating disorders, and thyroid disease
vitamin B deficiency in the body
sudden weight loss due to physical trauma
burns and X-rays too can cause sudden temporary hair loss
taking medicines such as blood thinners and anti-depressants
trichotillomania which is an impulse control disorder causing people to compulsively pull out their own hair
natural ageing, especially when people enter their 50s or 60s.
Women who attained menopause

The above are the commonest reasons for hair loss

What are the types of alopecia/hair loss?

When your hair growth cycle is disturbed, problems such as hair loss, and hair thinning begins. If for instance, your hair enters the resting phase too early, excessive shedding and thinning of the hair occurs.

There can be a number of reasons which lead to the disruption of the hair growth cycle, and result in different types of alopecia such as:

Alopecia areata – starts suddenly and causes hair loss in patches anywhere in the body in children and young adults. This condition is also known as ‘spot baldness’. This condition is observed to run in families and experts believe this condition could be the result of autoimmune disease, where the immune system of the body mistakenly attacks the hair follicles.
A person suffering from this condition may lose all the hair. This though can be a temporary condition and the hair may grow back after a few years. Though there is no guarantee.

Involutional alopecia – is a natural process, wherein, hair thinning occurs with age. With ageing, most of the hair follicles go into the dormant or resting phase, while the length of the rest of the hairs gradually become shorter and as a result, the hair quantity becomes thinner.
Androgenic alopecia – is a genetic condition. Men with this condition suffer from what is commonly known as male pattern balding, which can start during late teens or their early 20s. Women with this condition suffer from what is known as female pattern balding and begin to notice the thinning of their hair after around 40 years of age.
Alopecia totalis – is an autoimmune disorder and occurs when a person experiences total loss of hair on the head, and face, including eyebrows and eyelashes. This can be a sudden process or a gradual progression of alopecia areata. This condition can affect children as well as adults.
Alopecia universalis – is also an autoimmune disorder in which there is total hair loss all over the body, including eyebrows, eyelashes, and pubic hair. It is considered to be the most severe form of alopecia areata.
Scarring alopecia – can be caused by various disorders such as:
- frontal fibrosing alopecia (occurs in women during menopause),
- scleroderma (an autoimmune rheumatic disease)
- lichen planus (an itchy rash),
- discoid lupus (a mild form of lupus)
- folliculitis decalvans( occurs in men causing patchy baldness and scarring)

Scarring alopecia occurs mostly in adults and is a condition where the hair follicles get destroyed. The hair can never grow back.

Telogen effluvium – occurs mainly due to the body’s reaction to stress, brought about by, illnesses such as cancer, mental and emotional disturbances, medications such as blood thinners, hormonal imbalances, stress during childbirth and so on. In this condition hair thinning occurs on the scalp. The hair usually regrows after the stress period is over.
Alopecia barbae – is loss of hair in the beard area and affects men, and it causes hairless patches in beards.

Traction alopecia – is a condition of hair loss which is common in women. It occurs due to tension in the hair shafts caused by very tight ponytails, braids, or pigtails. If the hair is tied regularly for too long, it can lead to prolonged traction alopecia, and the hair on the affected areas may never grow back.
Anagen effluvium – is widespread hair loss all over the body due to chemotherapy, immunotherapy, or radiotherapy. The hair loss is usually temporary and grows back after a certain period of time.

What are the symptoms of alopecia/hairloss? How is alopecia/hair loss diagnosed?

The symptoms of alopecia or hair loss include:

excessive hair loss ( more than 150 hairs a day) from the scalp
hair loss from other parts of the body, apart from your head
thinning of hair on the head, especially scalp
a receding hairline
patches of broken hairs
an M shaped pattern in front of your head, just above your forehead, leaving the crown of the head exposed
clumps of hair on your pillow
complete loss of all hair from the head
complete loss of all hair on the entire body
excessive hair loss while shampooing

What are the complications of alopecia/hair loss?

The complications of hair loss or alopecia are mainly psychological in nature. Hair loss can affect you emotionally, and cause you to feel that your identity is being threatened since it has to do with your self-image that you want to portray to others.

If you are suffering from excessive hair loss, it is not only advisable to undergo treatment immediately for it, which will not only help you manage your symptoms, but also boost up your self image, self confidence and help you to wholeheartedly accept yourself as you are.

Commonest complications of Hair Fall include:

low self-esteem
Anxiety and Depression
dandruff, if hair loss is as a result of poor nutrition
sunburn on the scalp and exposure to the harmful ultraviolet rays of the sun, which can be prevented by wearing a hat or applying a sunscreen lotion on the scalp
Hypothyroidism or Diabetes, and vitiligo if a person suffers from alopecia areata since these conditions are also linked to problems with the immune system

What are the treatmentModalities for alopecia/hair loss?

Medical treatments

Depending on your age, gender, the type of hair loss or alopecia, and your overall health condition We will prescribe intake of certain medications, creams, Lotions and ointments for application for mild to moderate cases of hair fall. This approach helps in lot of cases without requiring any other methods of treatment. In few cases that may require further line of treatment we will advise them Laser Photo Therapy or Platelet Rich Plasma ( PRP ) Treatment or Hair Transplantation.

PRP Therapy:

Some of the cases that are resistant to Medical Treatment require PRP Treatment.

Our blood is made up of red blood cells, white blood cells, platelets, and plasma. Plasma, is the fluid part of the blood which suspends and carries blood cells and nutrients throughout the body. Platelets are tiny cells in the blood which rush to any site of injury, when bleeding occurs, to plug and form a clot and repair the damage. Platelets are also known to be a reservoir of growth factors that stimulate tissue recovery by increasing blood flow and cytokines. They are known to be responsible for stimulating and enhancing hair follicle function.

Platelet-Rich Plasma (PRP) is processed blood plasma, a concentration of plasma with platelets from which red blood cells and white blood cells are removed. This concentration of PRP taken from the patient’s own blood is injected into the scalp to promote hair growth. The scalp is that the skin that covers the top part of your head.

Who is eligible for Platelet-Rich Plasma (PRP) therapy?

You are eligible for PRP therapy if:

you are not completely bald and have low-density hair
you do not smoke heavily or drink alcohol frequently
you do not indulge in drugs usage
you do not take blood thinners
you do not suffer from medical conditions such as chronic skin or liver disease, cancer, metabolic disorders, blood disorders such as platelet dysfunction syndrome, Less number of Platelets in your body, hypofibrinogenemia, hemodynamic instability

The PRP Treatment for Hair thickening and Re Growth:

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At the outset, the doctor will discuss at length with you about your medical history, including your family history, your nutrition, medications you take (including vitamins), your hair care regimen, recent surgeries and a detailed history of your hair loss situation. The doctor will also perform a general physical examination. Depending on your medical condition, you may have to undergo certain medical tests, such as blood tests, or a scalp biopsy to determine your eligibility for PRP hair therapy.

Once you are okayed for PRP hair therapy, you will be given certain guidelines to follow, before the actual procedure.

Prior to each session of the therapy, approximately 30 ml or 60 ml of blood will be drawn from you depending on the size of the area to be treated.

Extraction of Platelet-Rich Plasma (PRP) from the blood

Our blood contains:

White Blood Corpuscles (WBCs) – involved in protecting the body against infectious diseases and foreign invaders
Red Blood Cells (RBCs) – which carry oxygen to different parts of the body
Platelets – involved in clotting and repairing injuries
Plasma – fluid which carries nutrients and vitamins throughout the body.

The blood drawn from your system, before each session, is spun in a centrifuge, a machine used by scientists to isolate the solids from the liquids in any solution. Due to the centrifugal force, the blood spins very rapidly in the centrifuge causing the heaviest particles in the blood, i.e., the red blood cells to fall to the bottom of the vial. Sitting just above the layer of red blood cells are the white blood cells and platelets with plasma. Atop this layer, rests a clear solution of blood plasma.

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The PRP Procedure

The doctor marks out the area on your scalp where hair needs to be restored.
The marked area on your head is anesthetized using a local anesthesia.
A disinfectant is applied on the area which is to be treated.
The PRP is injected into the deeper layers of your scalp.
The site is then cleaned thoroughly.

In the First Step 12 to 20 mi of your blood is drawn through a Syringe.

This blood is centrifuged and the red blood and white blood cells are separated from the platelet-rich plasma (PRP).

The platelet-rich plasma (PRP) is what is used for the PRP treatment.

Typically, 8 ml – 12 ml of injectable PRP is considered as the optimum volume for injecting into the scalp.

Few doctors also perform a procedure called micro needling along with PRP Hair Therapy.

A derma roller, or mesogun, or an insulin syringe is used to create micro holes on the scalp.
These controlled micro-injuries to the scalp skin triggers the skin’s repair process by making it naturally produce collagen and elastin, thereby creating an ideal environment for your own natural hair to regrow. The microchannels created by the injuries aid the quick absorption of the injected Platelet Rich Plasma (PRP) and other topical products used on the scalp. The injuries induce the platelets to release growth factors at the injury site, and “awaken” dormant hair follicles to begin the production of new hair.

Any Side effects of Platelet Rich Plasma (PRP) therapy for hair?

You may experience tenderness and soreness, minimal pain, and pinpoint bleeding in the areas where injections were delivered. You may also experience a feeling of ‘tightness’ on your scalp for a day after the procedure. A few patients also complain of a headache for a day post the procedure.

What are the advantages of Platelet Rich Plasma (PRP) therapy for hair?

The advantages of PRP therapy for hair include:

Very minimal side-effects limited to soreness and redness of skin for a day or two.
Very less recovery time. The patient can continue with his/her daily tasks right after the procedure.
Minimally invasive procedure requiring only the injections.
The treatment process is quick and is usually over within 60 mins to 90 mins.

How many sessions of Platelet Rich Plasma (PRP) therapy for hair are required to produce desired results?

Usually one requires 6 to 8 sessions of PRP with monthly once interval.The effects of a full round of PRP treatment (which may consist of one to eight sessions) may last up to a year or more than that, in quite few cases they can last for few years. Therefore, the procedure can be repeated if required before that time without any side effects.

How long will it take to recover from Platelet Rich Plasma (PRP) therapy for hair?

There is hardly any downtime after a PRP hair procedure. The patient can get back to his/her regular routine right after the procedure.

Are there any pre and post-treatment guidelines for Platelet Rich Plasma (PRP) therapy for hair?

Pre-Procedure Guidelines

The doctor may advise you to stop taking vitamins, (or multivitamins), blood thinners and other contraindicated medicines (if you take any) for this procedure at least a week prior to the procedure.
You need to avoid smoking and drinking alcohol and also stop using hair products at least three days before the procedure.
Wash your hair the morning of the PRP session or the day before the PRP session.
The doctor may also recommend you to increase the intake of water a day before the procedure

Post-Procedure Guidelines

Post the procedure (a day or two after) you may be advised to shampoo your hair.
You need to avoid certain medications, especially anti-inflammatory medications, for at least 3 – 7 days after the procedure as anti-inflammatory medications prevent inflammation, which is essentially required for the platelets to perform their function of stimulating hair growth.
Avoid smoking and drinking alcohol, as these habits can interfere with the healing process.
Avoid venturing out in direct sunlight. Wear a hat to protect your scalp from direct sun rays.
If you wish to color your hair, you can do so after 3 days of the procedure.

PRP hair therapy is not suitable for heavy smokers, drinkers, and those who take drugs.

What is the cost of Platelet Rich Plasma (PRP) therapy for hair in India?

Depending on the lab equipment being used to obtain PRP, the cost per session (only therapy) in India can vary between Rs. 5,000 to 12,000 per session.

Are the results of Platelet Rich Plasma (PRP) therapy for hair permanent?

A full round of PRP hair therapy (which can consist of 6 to 8 sessions) can make your hair thick, increase hair growth, and arrest hair loss for sometime. However, the treatment needs to be repeated yearly for maintaining good results.

All the cases are not suitable for PRP Treatment and every body may not respond to the Medical Treatment, in such cases Hair Transplantation is the best mode of treatment.

Hair Transplantation Procedures – An Overview

Hair transplantation is a surgical method, which is used to treat acute irreparable hair loss or varying levels of alopecia in men and women. The doctor removes hair follicles from a part of your body, which is called the “donor site” and inserts the follicles in the bald patches on your head, which are known as the “recipient sites.”

There are two primary techniques of hair transplantation: