Tag Archives: Baldness

Setaria viridis pycnocoma

Botanical Name : Setaria viridis pycnocoma
Family: Poaceae
Genus: Setaria
Species: S. viridis
Kingdom: Plantae
Order: Poales
Synonyms: Panicum pycnocomum, Setaria pycnocoma
Common Names: Ju da gou wei cao, Panicum pycnocomum Steudel.

Habitat : Setaria viridis pycnocoma is native to E. Asia – Japan. It grows on roadsides, forest margins and as a crop weed, especially in S. italica fields, at elevations below 2700 metres.
Description:
Setaria viridis pycnocoma is an annual plant. Culms little branched at base, 60–150 cm tall. Leaf blades 15–40 × 1–2.5 cm, glabrous on both surfaces. Panicle sometimes lobed, 7–24 × 1.5–2.5 cm; bristles green, brownish or purplish, 7–12 mm. Spikelets 2.5–3 mm. This robust form of Setaria viridis may be of hybrid origin, resulting from crossing with S. italica. Unlike Setaria italica, the spikelets are shed whole….CLICK & SEE THE PICTURES

It is hardy to zone (UK) 6. It is in flower from Aug to October, and the seeds ripen from Sep to October. The flowers are hermaphrodite (have both male and female organs) and are pollinated by Wind.

Cultivation :
Succeeds in any well-drained soil in full sun. This robust form of S. viridis may be of hybrid origin, resulting from crossing with S. italica. Unlike S. italica the spikelets are shed whole.

Propagation:
Seed – sow early spring in a greenhouse and only just cover the seed. Germination is usually quick and good. Prick out the seedlings into individual pots as soon as they are large enough to handle and grow them on fast. Plant them out in late spring, after the last expected frosts. Whilst this is fine for small quantities, it would be an extremely labour intensive method if larger amounts were to be grown. The seed can be sown in situ in the middle of spring though it is then later in coming into flower and may not ripen its seed in a cool summer

Edible Uses: Seed – cooked. It can be eaten as a sweet or savoury food in all the ways that rice is used, or ground into a flour and made into porridge, cakes, puddings etc.

Medicinal Uses: Could not find much.
Resources:

Setaria viridis


http://www.efloras.org/florataxon.aspx?flora_id=2&taxon_id=242348807
http://www.naturalmedicinalherbs.net/herbs/s/setaria-viridis-pycnocoma.php
http://www.pfaf.org/user/Plant.aspx?LatinName=Setaria+viridis+pycnocoma

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Hair Loss in Women

Introduction:
One of the commonest forms of hair loss in women (and men) is a condition called telogen effluvium, in which there is a diffuse (or widely spread out) shedding of hairs around the scalp and elsewhere on the body.

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This is usually a reaction to intense stress on the body’s physical or hormonal systems, or as a reaction to medication.

The condition, which can occur at any age, generally begins fairly suddenly and gets better on its own within about six months, although for a few people it can become a chronic problem.

Because telogen effluvium develops a while after its trigger, and causes generalised thinning of hair density rather than a bald patch, women with the condition can easily be diagnosed as overanxious or neurotic.

Fortunately, it often gets better with time. Telogen effluvium is a phenomenon related to the growth cycles of hair.

Hair growth cycles alternate between a growth phase (called anagen, it lasts about three years) and a resting phase (telogen, which lasts about three months). During telogen, the hair remains in the follicle until it is pushed out by the growth of a new hair in the anagen phase.

At any one time, up to about 15 per cent of hairs are in telogen. But a sudden stress on the body can trigger large numbers of hairs to enter the telogen phase at the same time. Then, about three months later, this large number of hairs will be shed. As the new hairs start to grow out, so the density of hair may thicken again.

Many adults have had an episode of telogen effluvium at some point in their lives, reflecting episodes of illness or stress.

Another common type of hair loss in women is androgenetic alopecia, which is related to hormone levels in the body. There’s a large genetic predisposition, which may be inherited from the father or mother.

Androgenetic alopecia affects roughly 50 per cent of men (this is the main cause of the usual pattern of balding seen as men age) and perhaps as many women over the age of 40.

Research shows that up to 13 per cent of women have some degree of this sort of hair loss before the menopause, and afterwards it becomes far more common – one piece of research suggests that over the age of 65 as many as 75 per cent of women are affected.

The cause of hair loss in androgentic alopecia is a chemical called dihydrotestosterone, or DHT, which is made from androgens (male hormones that all men and women produce) by the action of an enzyme called 5-alpha reductase.

People with a lot of this enzyme make more DHT, which in excess can cause the hair follicles to make thinner and thinner hair, until eventually they pack up completely.

Women’s pattern of hair loss is different to the typical receding hairline and crown loss in men. Instead, androgenetic alopecia causes a general thinning of women’s hair, with loss predominantly over the top and sides of the head.

Another important cause of hair loss in women is a condition called alopecia areata, an autoimmune disease that affects more than two per cent of the population. In this, the hair follicles are attacked by white blood cells. The follicles then become very small and hair production slows down dramatically, so there may be no visible hair growth for months and years.

After some time, hair may regrow as before, come back in patchy areas, or not regrow at all. The good news is that in every case the hair follicles remain alive and can be switched on again; the bad news is that we don’t yet know how to do this.

TOP MYTHS ABOUT FEMALE HAIR LOSS:-
•It means you’re not a proper women with two X chromosomes.
•It’s caused by washing your hair too often.
•It’s caused by too much brushing or combing.
•Hair dyes and perms can cause permanent loss.
•It may result from wearing hats and wigs.
•Shaving your hair will make it regrow thicker.
•Standing on your head will help it grow back.
•It’s a sign of an overactive brain.
•There’s a miracle cure out there waiting for you.
•Scan the internet and you’ll see all sorts of miracle cures for baldness on offer, from strange herbal lotions to mechanical devices. Perhaps the most useful first step you can take is to avoid the myths.
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After this there are several options. You can find some way to accept the change and live with it (let’s face it, this is a tall order – most men struggle to come to terms with their baldness and for them at least society equates it with maturity and power).

You can try cosmetic treatments such as wigs or hair thickeners, or you can try medical therapies. The last option is hair-replacement surgery.

The drug minoxidil was first developed for treating high blood pressure, which was found to have the side effect of thickening hair growth in some people. It’s now available as a lotion to apply directly to the scalp.

No one really knows how it works, however, and it’s not effective for everyone. Studies show that only about 20 per cent of women between 18 and 45 have moderate regrowth using the drug, while another 40 per cent experience minimal regrowth.

It works best on younger people with early hair loss. A big disadvantage is that you have to carry on using minoxidil indefinitely or the new hair will fall out.

Another drug, finasteride, which was developed for treating prostate cancer, has also been found to be effective but is only available for men.

Surgical techniques for restoring hair have improved greatly in the past couple of decades, but this is still an option that requires careful consideration.

There are two main options:
•Hair transplantation – tiny punch-holes of skin containing a few follicles of hair are taken from elsewhere in the body (such as the back of the head, if this is still well covered) and implanted into the thinning areas. Some surgeons use a needle to sew in just one or two hairs. However, as women are more likely to have diffuse loss of hair all over the scalp, this technique may not be possible. There has been little success with implanting artificial fibres.
•Scalp reduction – devices are inserted under the skin to stretch areas of scalp that still have hair, then the redundant bald areas are removed. Alternatively, flaps of hairy scalp can be moved around the head.
Key points
•Many causes of female hair loss are temporary – check your general health and be patient.
•Take a look at your family for an idea of your risk of female pattern baldness.
•Don’t be taken in by claims for wonder products – there’s no cure for female pattern hair loss.
•Many women cope well by using cosmetic products, hats and wigs, so persevere until you find your own style.

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose.

Resources :

http://www.bbc.co.uk/health/physical_health/conditions/hair_loss_women.shtml

http://www.prevention.com/health/beauty/unsure/hair-loss-in-women/article/1aebd08f88803110VgnVCM20000012281eac____/

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Hair Loss in Men

Definition:
Each hair grows in cycles?it grows, rests, and then falls out. Usually, this cycle repeats approximately yearly. At any time, about ninety percent of a person’s scalp hair is growing, a phase that lasts between two and six years. Ten percent of the scalp hair is in a resting phase that lasts between two and three months. At the end of its resting stage, the hair goes through a shedding phase.

CLICK & SEE THE PICTURES

Shedding 50 to 100 hairs a day is considered normal. When a hair is shed, it is replaced by a new hair from the same follicle located just beneath the skin surface. Scalp hair grows about one-half inch a month.

Hair is made up of a form of protein, the same material that is found in fingernails and toenails. Everyone, regardless of age, should eat an adequate amount of protein to maintain normal hair production. Protein is found in meat, chicken, fish, eggs, some cheese, dried beans, tofu, grains, and nuts.

Male pattern baldness occurs in a distinct way (and sometimes can affect women too). Hair may start Hair may start to disappear from the temples and the crown of the head at any time. For a few men this process starts as early as the later teenage years, but for most it happens in their late 20s and early 30s. A little thinning of the hair may be noticeable first, followed by wider hair loss allowing more of the scalp to become visible.

Some men aren’t troubled by this process at all. Others, however, suffer great emotional distress associated with a lack of self-confidence and sometimes depression.

Abnormal hair loss can be due to many different causes, but about 50 percent of the population experience normal hair loss by the time they reach 50. People who notice their hair shedding in large amounts after combing or brushing, or whose hair becomes thinner or falls out should consult a dermatologist.

Causes:
By far the most common cause of hair loss in men is androgenetic alopecia, also referred to as “male pattern” or “common” baldness. It is caused by the effects of the male hormone dihydrotestosterone (DHT) on genetically susceptible scalp hair follicles. This sensitivity to DHT is present mainly in hair follicles that reside in the front, top, and crown of the scalp (rather than the back and sides) producing a characteristic and easily identifiable pattern described by Norwood (see Norwood Classification).

It is frequently stated that “hair loss comes from the mother’s side of the family.” The truth is that baldness can be inherited from either parent. However, recent research suggests that the reasons for hair loss and balding may be a bit more complex than originally thought. Factors on the x-chromosome have been shown to influence hair loss, making the inheritance from the maternal side of the family slightly more important than the paternal one (Markus Nothen, 2005).

The identification of an androgen receptor gene (AR) on the x-chromosome helps to explain why the hair loss pattern of a man resembles his maternal grandfather more often than his father. However, this is clearly not the whole story since a direct inheritance of baldness from the father is observed as well. An autosomal (non-sex) linked gene would explain this type of transmission – but this gene has not yet been found.

DHT is formed by the action of the enzyme 5-alpha reductase on testosterone, the hormone that causes sex characteristics in men. DHT causes male hair loss by shortening the growth, or anagen, phase of the hair cycle, causing miniaturization (decreased size) of the follicles, and producing progressively shorter, finer hairs. Eventually these hairs totally disappear.

In the patient below, we see a close-up of the side of his scalp where the hair is not affected by DHT. We see mostly groups of full thickness hairs (called terminal hairs) and a few scattered fine, vellus hairs. This is normal.
In the area of thinning (see circle below), we see that most of the hair has been miniaturized, although all of the hair is still present.

In the region that is balding (second circle in the center), there is extensive miniaturization and some, but not all of the hair has disappeared.

What this shows is that the initial appearance of balding is due to the progressive decrease in hair shaft size, rather than the actual loss of hair – in early hair loss, all the hair is still present. This is the reason why hair loss medications, such as finasteride (Propecia) work in early hair loss (since they are able to partly reverse the miniaturization process) but don’t work in areas that are totally bald. It is also the reason why men’s hair restoration surgery, if not planned properly, can result in hair loss due to the shedding of surrounding miniaturized hair.
Androgenetic hair loss is caused by three interdependent factors: genes, hormones, and age:

Other causes of hair loss, which may not follow this pattern, include:

•Iron-deficiency anaemia
•Under active thyroid
•Fungal scalp infection
•Some prescribed medicines
•Stress

Other medical conditions that can produce diffuse hair loss in men include thyroid disease . Certain medications, including some drugs used for high blood pressure and depression, and the use of anabolic steroids, can also cause male hair loss.

How the problem can be solved:
If there’s a reversible cause, it’s normally possible to stop hair loss. For instance, if it’s caused by iron deficiency you can stop hair loss by replenishing the body’s iron stores.

A huge number of treatments have been tried to slow down and even reverse the process of male pattern hair loss – some are successful, others aren’t. But many men find their hair loss slows down or stops for no apparent reason at a certain age anyway.

It’s a good idea to ensure an illness isn’t responsible, particularly if the hair loss is patchy rather than being in the typical male pattern distribution. Moreover, if the hair loss is accompanied by other symptoms (such as tiredness) then blood tests may be necessary.

Treatments
•Wigs, weaves and hair transplants are, obviously, the most direct form of treatment, while some advocate shaving or close cutting which simply makes the hair loss less obvious. Different hairstyles can create the appearance of a fuller head of hair, or a close shave cut can make baldness less apparent.
•Herbal preparations that contain zinc, magnesium, iron, vitamin E and other substances in various combinations can help.
•Minoxidil is a lotion available from the pharmacist that you rub on to the scalp. It slows down the process of hair loss and can cause new hair growth but you have to keep on using it or it will stop being effective.
•Finasteride (Propecia) is the latest drug treatment. It comes in tablet form and works by slowing down hair loss; it’s also reported to cause new hair growth. In the UK it’s only available on private prescription from your GP and is only effective while you take it.

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose.

Resources:
http://www.bbc.co.uk/health/physical_health/conditions/hair_loss_male.shtml

Causes


http://beatpsoriasis.com/baldness-definition.htm

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Calculator Tells the Bald Future

A pioneering new computer programme that predicts if and when men will go bald is being offered to British men.

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The “baldness calculator” — said to be the world’s first reliable tool for predicting hair loss — has been a huge hit with men.

The programme calculates the exact age at which someone will go bald or have lost most of their hair or provides reassurance by predicting that they will still have a full head of hair in old age.

More than half a million German men used it within ten days of it being unveiled there and three million men have tried it out globally so far.

Sixty per cent of users of the calculator to date have been young men aged between 15 and 30. Two thirds of all British men will eventually suffer hair loss, according to recent research.

The programme asks users about their age, marital status, occupation, where they live, what their current hairline is, hair loss in their family and their stress levels.

German scientists devised the programme because half of men in their country suffer from hereditary hair loss.

Adolf Klenk, head of research and development at hair care firm Dr Kurt Wolff, said: “More and more men value full hair but especially younger men.

“They are looking for a partner and are at the peak of their social lives. They are very conscious about their looks and being accepted within their social groups. They get concerned that if they lose their hair, they will cease to be attractive to others whereas older men don’t care so much.”

Klenk said that men with a history of hair loss on either their mother or father’s side of the family are most at risk of going bald.

Source:The Daily Telegraph

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Hair Transplantation

 

Definition:
Hair transplantation is a surgical technique that involves moving skin containing hair follicles from one part of the body (the donor site) to bald or balding parts (the recipient site). It is primarily used to treat male pattern baldness, whereby grafts containing hair follicles that are genetically resistant to balding are transplanted to bald scalp. However, it is also used to restore eye lashes, eye brows, beard hair, and to fill in scars caused by accidents and surgery such as face lifts and previous hair transplants. Hair transplantation differs from skin grafting in that grafts contain almost all of the epidermis and dermis surrounding the hair follicle, and many tiny grafts are transplanted rather than a single strip of skin.

Since hair naturally grows in follicles that contain groupings of 1 to 4 hairs, today’s most advanced techniques transplant these naturally occurring 1 – 4 hair “follicular units” in their natural groupings. Thus modern hair transplantation can achieve a natural appearance by mimicking nature hair for hair. This recent hair transplant procedure is called “Follicular Unit Transplantation.”..

 

History:
The use of both scalp flaps, in which a band of tissue with its original blood supply is shifted to the bald area, and free grafts dates back to the 19th century. Modern transplant techniques began in Japan in the 1930s, where surgeons used small grafts, and even “follicular unit grafts” to replace damaged areas of eyebrows or lashes. They did not attempt to treat baldness per se. Their efforts did not receive worldwide attention at the time, and the traumas of World War II kept their advances isolated for another two decades.

The modern era of hair transplantation in the western world was ushered in the late 1950s, when New York dermatologist Norman Orentreich began to experiment with free donor grafts to balding areas in patients with male pattern baldness. Previously it had been thought that transplanted hair would thrive no more than the original hair at the “recipient” site. Dr. Orentreich demonstrated that such grafts were “donor dominant,” as the new hairs grew and lasted just as they would have at their original home. Today Dr. Orentreich’s practice still performs hair transplants.

For the next twenty years, surgeons worked on transplanting smaller grafts, but results were only minimally successful, with 2-4 mm “plugs” leading to a doll’s head-like appearance. In the 1980s, Uebel in Brazil popularized using large numbers of small grafts, while in the United States Rassman began using thousands of “micrografts” in a single session.

In the late 1980s, Limmer introduced the use of the stereo-microscope to dissect a single donor strip into small micrografts. In 1995, Bernstein and Rassman published the first paper on “Follicular Unit Transplantation,” where hair is transplanted exclusively in naturally occurring groups of 1-4 hairs. With microscopic dissection of donor pieces from an excised portion of scalp, individual follicular units containing but 1-4 hairs could be prepared and individually relocated into needle punctures in the recipient areas. Since the transplanted hair mimics the way hair grows in nature, close to natural results were attainable.

The follicular unit hair transplant procedure has continued to evolve, becoming more refined and minimally invasive as the size of the graft incisions have become smaller. These smaller and less invasive incisions enable surgeons to place a larger number of follicular unit grafts into a given area. With the new “gold standard” of ultra refined follicular unit hair transplantation, over 50 grafts can be placed per square centimeter, when appropriate for the patient.

Surgeons have also devoted more attention to the angle and orientation of the transplanted grafts. The adoption of the “lateral slit” technique in the early 2000s, enabled hair transplant surgeons to orient 2 to 4 hair follicular unit grafts so that they splay out across the scalp’s surface. This enabled the transplanted hair to lie better on the scalp and provide better coverage to the bald areas. One disadvantage however, is that lateral incisions also tend to disrupt the scalp’s vascularity more than sagitals. Thus sagital incisions transect less hairs and blood vessels assuming the cutting instruments are of the same size. One of the big advantages of sagitals is that they do a much better job of sliding in and around existing hairs to avoid follicle transection. This certainly makes a strong case for physicians who do not require shaving of the recipient area. The lateral incisions bisect existing hairs perpendicular (horizontal) like a T while sagital incisions run parallel (vertical) along side and in between existing hairs. The use of perpendicular (lateral/coronal) slits verses parallel (sagital) slits however, has been heavily debated on patient based hair transplant communities. Many elite hair transplant surgeons typically adopt a combination of both methods depending on what is best for the patient.

The procedure:
At an initial consultation, the surgeon analyzes the patient’s scalp, discusses his preferences and expectations, and advises him/her on the best approach (e.g.,single vs. multiple sessions) and what results might reasonably be expected.

Click to see on pictures : CORRECTIVE HAIR TRANSPLANT PROCEDURE

For several days prior to surgery the patient refrains from using any medicines, or alcohol, which might result in intraoperative bleeding and resultant poor “take” of the grafts. Pre-operative antibiotics are commonly prescribed to prevent wound or graft infections.

Hair transplantation is a surgical technique in which a physician redistributes hairs from an area of thick growth to bald areas.

This Procedure is Performed because:
In patients who are concerned about their balding, hair transplantation can significantly improve their appearance and self confidence. Realistic expectations are important, however. It is important to remember that hair still cannot be created; it can only be redistributed from the back of the scalp to the front.

Most patients undergoing hair transplantation have traditional male or female pattern baldness, with hair loss on the front or top of the scalp. Patients must still have thick hair on the back or sides of the scalp, or there may not be enough hair follicles to move. In some cases, patients with hair loss from lupus, injuries, or other medical problems may be treated with hair transplantation.

Patients undergoing hair transplantation should be otherwise relatively healthy, or surgery is less likely to be safe and successful. Always discuss your risks and options with your physician before undergoing any elective surgery.

Surgery:
Transplant operations are performed on an outpatient basis, with mild sedation (optional) and injected topical anesthesia, and typically last about four hours. The scalp is shampooed and then treated with an antibacterial chemical prior to the donor scalp being harvested.

In the usual follicular unit procedure, the surgeon harvests a strip of skin from the posterior scalp, in an area of good hair growth. The excised strip is about 1-1.5 x 15-30 cm in size. While closing the resulting wound, assistants begin to dissect individual follicular unit grafts from the strip. Working with binocular microscopes, they carefully remove excess fibrous and fatty tissue while trying to avoid damage to the follicular cells that will be used for grafting.

The surgeon then uses a fine needle to puncture the sites for receiving the grafts, placing them in a predetermined density and pattern, and angling the wounds in a consistent fashion to promote a realistic hair pattern. The assistants generally do the final part of the procedure, inserting the individual grafts in place.

Risk Factor:As with any surgical procedure, risks exist. The most common complications of hair transplantation are bleeding, infection, and scarring.

Though less dangerous, it is also possible that the transplanted hair won’t look as good as you had desired. Older techniques often resulted in unnatural appearing tufts of new hair growth. With modern techniques, this complication is infrequent.

Post-operative care:
Advances in wound care allow for semi-permeable dressings, which allow seepage of blood and tissue fluid, to be applied and changed at least daily. The vulnerable recipient area must be shielded from the sun, and shampooing is started two days after the surgery. Some surgeons will have you shampoo the day after surgery. Shampooing is important to prevent scabs from occurring around the hair shaft. Scabs adhere to the hair shaft and increase the risk of losing newly transplanted hair follicles during the first 7 to 10 days post-op.

During the first ten days, virtually all of the transplanted hairs, inevitably traumatized by their relocation, will fall out (“shock loss”). After two to three months new hair will begin to grow from the moved follicles. The patient’s hair will grow normally, and continue to thicken through the next six to nine months. Any subsequent hair loss is likely to be only from untreated areas. Some patients elect to use medications to retard such loss, while others plan a subsequent transplant procedure to deal with this eventuality.

Modern techniques:
There are two main ways in which donor grafts are extracted today. These are the Strip Harvesting Technique and the Follicular Unit Extraction (FUE) Technique.

The Strip Harvesting Technique involves removing a strip containing a large group of follicular units from the donor area – almost always from the back and sides of the scalp. The strip is then divided into grafts (or follicular units) containing 1 to 4 follicles.

The Follicular Unit Extraction (FUE) Technique involves removing one follicular unit at a time directly from the donor area – usually the back and sides, but also sometimes from the chest, legs or face (beard hair) – using a small punch usually of between 0.5mm and 1mm in diameter.

Side effects:
Hair thinning, known as “shock loss”, is a common side effect that is usually temporary. Bald patches are also common, as fifty to a hundred hairs can be lost each day.

Other side effects include swelling of areas such as the scalp and forehead. If this becomes uncomfortable, medication may ease the swelling. Additionally, the patient must be careful if his scalp starts itching, as scratching will make it worse and cause scabs to form. A moisturizer or massage shampoo may be used in order to relieve the itching.

Relevant Anatomy
The scalp is divided into 5 layers, which are easily remembered by the mnemonic SCALP, which represents, in order from outermost to innermost layer, the skin, connective subcutaneous tissue, galea aponeurosis, loose connective tissue, and periosteum over the cranium.
The skin contains all the epidermal appendages, including hair follicles, which extend into the connective subcutaneous layer. In areas that have undergone hair loss, thinning of the outer 2 layers usually occurs. This situation can be appreciated when one compares the thickness of the scalp in recipient areas to that in donor areas.

The subcutaneous layer is well vascularized and contains the main penetrating branches of the named main arteries that travel primarily along the external surface of the galea. The importance of staying superficial along the connective subcutaneous tissue layer (when one makes slit recipient sites to avoid compromising circulation) has only recently become apparent. The scalp has an excellent blood supply. The supraorbital, supratrochlear, superficial temporal, postauricular, and occipital arteries are the primary vessels, and they typically travel with the veins.

The galea aponeurotica is a nonelastic layer that connects the frontalis muscles anteriorly with the occipitalis muscle at its posterior aspect. The temporoparietal fascia, in which the superficial temporal artery travels, is also connected to the galea. The galea sliding over the loose connective tissue layer allows for most scalp mobility. This loose connective tissue layer and the periosteum below have minimal sensory innervation.

The sensory innervation of the scalp closely follows the vascular supply. At the anterior aspect, the supraorbital and supratrochlear nerves provide sensation to the anterior half of the scalp. On occasion, sensation to the frontal scalp can diminish for several weeks when a large number of graft recipient sites are made along the hairline. The occipital nerve serves the posterior half of the scalp, whereas the supraauricular and superficial temporal nerves contribute innervation from the sides.

Perhaps no anatomic feature of the scalp is more important with regard to hair transplantation than the microscopic distribution of hair. Scalp hairs usually do not grow individually; they most often grow in tiny follicular-unit bundles, which usually contain 2-3 hairs and occasionally 1 or 4 hairs. A follicular-unit contains these 1-4 terminal hairs, a sebaceous gland element, and insertions of the arrector pili muscles, all wrapped in an adventitial tissue sheath. These follicular units are dispersed throughout the scalp, where non–hair-bearing skin constitutes up to 50% of the total tissue. By transplanting only these follicular units and dissecting away the 50% of unnecessary non–hair-bearing tissue, the most natural-appearing results can be attained.
Prognosis
Most modern hair transplants result in excellent hair growth within several months after the procedure. Often, however, more than one treatment session is needed to create the best-looking results. The replaced hairs are usually permanent, and no long-term care is necessary.

Recovery
During the recovery period after surgery, the scalp is often very tender. Strong pain medications taken by mouth may be necessary for several days. A bulky surgical dressing, or sometimes a smaller dressing protected by a baseball cap, must be worn for at least a day or two. Some surgeons may also recommend several days of antibiotics or anti-inflammatory drugs following surgery. After this very brief recovery period, no special treatment is needed.

Cost
In recent years hair transplants have become less expensive. Prices typically range from $3.00 to $7.00 per graft, with $4 to $5 per graft being about average. Normally the price per graft also drops as the size of the surgical session increases. Depending on the needs of the patient a typical surgical session can range from 1,500 to over 4,000 grafts, resulting in a total cost of approximately $6000 to $15,000. A few clinics offer larger sessions of up to 6000 grafts in one sitting.

Contraindications:
Perhaps the most difficult part of being a surgeon is knowing when not to operate. In elective cosmetic surgery, sound judgment must certainly be exercised.

Individuals must be motivated to undergo hair transplantation. Although the author does not conduct a formal psychological evaluation by means of lengthy questionnaires and examinations, some surgeons use this method. During the consultation, the present author generally reads to the individual to ensure that he or she is mature enough to decide to undergo the planned procedure. A prospective patient who has realistic motivations and expectations before the procedure is likely to be happy after the procedure. Honest and thorough preprocedural consultation is perhaps the most important part of the process.

Poor medical health is a potential contraindication for elective surgery of any kind. Individuals cannot be taking anticoagulants (eg, Coumadin, aspirin) before the procedure. Good surgical judgment must be exercised when one considers surgery in individuals with potentially complicating medical conditions. Age is not a medical contraindication. The author has performed procedures on men in their late 70s. Ensure that such patients provide medical clearance from their internist.

Perhaps no single hair-loss condition calls for more conservatism in judgment than premature MPB. Teenagers and men in their early 20s are particularly self-conscious about hair loss because most of their peers still have full heads of hair. These young men often hold unrealistic expectations, desiring a youthful hairline that will not be appropriate as they age. Worse, early surgical correction uses a large number of donor hairs, which will be sparse in the future, potentially resulting in an unnatural look and a disappointed patient.

In general, attempt to delay the procedure in individuals in their 20s or younger, though the author has performed procedures in select individuals as young as 20 years. When counseling young men about hair loss, the author advises a conservative approach to give patients time to consider hair transplantation. If the patient and surgeon agree on transplantation, restore a relatively high hairline and instruct the patient to use minoxidil for the crown region. Perhaps in the future, as effective medical therapies that end or substantially slow MPB progression become available, a less conservative approach can be taken.

For a number of medical conditions that are associated with or that can cause hair loss, treatment with hair transplantation is not appropriate. Examples are the active phases of alopecia areata, lupus, and infections. Scalp conditions, such as vitiligo and psoriasis, must be evaluated because hair transplantation can aggravate them.

Resources:
http://en.wikipedia.org/wiki/Hair_transplantation
http://www.nlm.nih.gov/medlineplus/ency/article/007205.htm

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