COVER STORY: Gone today, hair tomorrow

From head to toe, every part of the human body has its own significance and beauty attached to it, without any of which a person would be incomplete.Historical findings and records show that in every culture and part of the world, among the essentials of human beauty have been beautiful facial features and healthy-looking silky hair. Psychologically speaking, factors like hair, nose, eyes, etc., do play an important role in creating and completing the image of someone in our mind.When we talk about common beauty-related issues in both males and females, we usually find men distressed by the thinning of their hair.

Normally, due to ageing, the balding progress is faster and more intense in men than women.But sometimes, due to some very important hormonal and genetic reasons, this age-related hair loss can occur much before its usual time. When this happens in a more profound manner, it is known as ‘male pattern baldness’.There has been an increase in the cases of men losing a lot of hair well before their middle age, with even some young boys in their late teens and twenties facing the problem of male pattern baldness.Due to my professional responsibilities, I usually come across people from both genders but I have been taken aback by the number of young men I have come across who suffer from severe hair loss and were in the same age group, i.e., between 20 to 30 years of age.

On speaking about his hair loss problem, one of them, a software designer by profession, aged 24, said, “At times I get depressed to see that I am loosing my hair in an uncontrolled manner and it scares me to think where this would lead me to.”Here we explore the causes and the curative procedures available these days for hair loss.

WHY BALDNESS?Normally, hair loss is not an unusual thing to happen to anyone. At an average, a person looses about 100 hairs a day. However, with any variation in the level of the male hormone testosterone, male pattern baldness will most likely aggravate. Testosterone isis chemically-altered inside the body into another very potent hormone called dihydro-testosteron or DHT.When DHT acts on the hair which is already genetically-prone to get weaker from roots, it causes them to go thin and then fall off finally. Due to hormonal effects, the thinned hairs do not grow in the normal manner and find it hard to sustain longer. Inherited DHT genes play an important role in causing male pattern baldness.

The genes, usually called ‘balding genes’, may not necessarily be inherited by all the off-springs. This explains why hair transplantation which transfers non-balding hairs (that is, those that are not genetically sensitive to DHT) to bald areas, is so successful.Even on the new parts of scalp, which were previously bald, these hairs retain their non-balding qualities. Research on hair loss has shown that the genetic outlook contributing to hair fall mostly affects specific parts of the scalp, generally the temples, top and front of the head, then it may spread to the whole head. In some cases of baldness, it affects in the form of bald patches as well, and in those cases the reason for baldness can be any fungal infection, nervous disorders, use of a toxic chemical, certain medicines, severe radiations as used in cancer therapy, any injury or trauma to the affected site or decrease in the level of red blood cells in the body (anaemia).

In conditions of anaemia, the affected areas of the head get deprived of the normal flow and quantity of blood, which diminishes the supply of oxygen and nourishment, thus weakening the hair follicles in the scalp. Besides these factors, researchers are still exploring unexplored biological reasons that may be related to baldness or abnormal hair loss.For those affected by baldness there is still a ray of hope.

The fact that besides the balding sites, fortunately in many cases, there are few parts on the scalp that contain non-balding type hair, which prove to be a great source of help in re-growing hairs on the bald sites. There are horseshoe-shaped fringes of hairs around the bald area on the scalp. These fringes of hair are commonly found at the back of head and are genetically not sensitive to the effects of DHT hormone. That is why these non-balding hairs are currently being successfully used in hair transplantation procedures in various innovative and effective ways.

IN THE BEGINNING...It all started in 1939 when a Japanese dermatologist Dr Okuda introduced a unique method of re-growing hair lost from specific sites of the face -- scalp, eye brows and moustache -- with the use of minor grafts. This method was believed to be the origin of today’s modern practice of hair transplantation which, later in the 1950s, went into experimentation stages by Dr Norman Orentreich, who brought the concept of replacing the hairs on the back and sides of the scalp to the balding areas.His extensive research and experiments revealed that if genetically bald resistant hairs are transplanted into the bald sites, they promote new hair growth at a normal rate.

This idea has helped in formulating the concept of hair transplantation and today it is being successfully and safely performed around the world as a normal outpatient surgical procedure.

HOW IT WORKS Hair transplantation has many forms and techniques, which definitely require skilled and qualified hands for safe results. For instance, selecting the right clinic or hospital is definitely a significant as well as critical thing to do. Among the most frequently used forms of hair transplantation, follicular unit hair transplantation is a widely and effectively used method. The pattern of hair growth is natural, such that they grow from one point area on the scalp in the form of groups of two to three hairs which are irregular in pattern, much like the grass which grows in a fertile field.Scientifically, these growing units are referred as ‘follicular units’. Physicians can use these follicular units from the back and sides of the scalp where the hairs are much bald-resistant in nature. By relocating these carefully taken follicular units in small grafts, the bald areas can re-grow hairs. Since every follicular unit of scalp tissue is surrounded by its small glands (which produce hormones), blood vessels, nerves and regenerating tissue covering, it is very important that the graft follicular unit should be incised carefully without causing any damage to its self-sustained unit.

Since it is a very sensitive and long procedure, it is usually performed in two to four sessions or as per the requirement. This procedure has many advantages over other procedures as it uses small donor graft sizes of minimum scalp tissue and can be taken through minute incisions. This helps in decreasing the extent of trauma given to the donor scalp and increases the number of possible grafts to be transplanted in one session. This hair transplantation procedure also gives more natural looking results even if observed from a close range. Most of the different forms of hair transplantation being practiced today are more or less similar to the follicular unit hair transplantation procedure.

ON THE PAKISTANI FRONTLike in any other part of the world, a good number of people suffering from baldness are also present in our country, and they desperately dream to get their hairs back someday. Regardless of the obvious burdening effects of this cosmetic procedure on one’s pocket, hair transplantation is currently one of the most aspired and approached cosmetic procedures in Pakistan.Interestingly, this treatment option for baldness was first widely accepted by the people in the show business who were then greatly used for marketing purposes to show magical outcomes of hair transplantation.At present, there are numerous clinics have mushroomed that claim to offer the quality hair transplantation procedures. However, it is essential that before embarking on fulfilling the dream of having a head full of healthy-looking hair, one should do proper research and crosscheck the credibility and certifications of the physician who is approached for the procedure. However, for those who are happy and comfortable with whatever hair that is left on their scalp, hair transplantation is nothing but an unwanted luxury.