Introduction
A 37 year old man presented to the clinic with advanced hair loss to his forehead, and moderate loss to his crown. His hair loss had been slowly progressing over the last 10 years, but had accelerated over the last 3 years. His employment as a salesman in an upmarket industry required he consult and liaise with a large customer base. He felt that his first impressions were impacting on his ability to service potential clients.
He reported no excessive hairloss (shedding), but was aware he had lost a lot of his hair at the forehead.
He consulted Ashley and Martin to assess options to improve his hair growth and thereby improving his general appearance.
Patient background
This client reported good health with no ongoing health concerns.
He was on no current medications, either long or short term.
Family History
He reported a family history of hair loss in his father and brother.
Examination
On examination hair density was weak at the forehead. There was a strong possibility of irreversible hair loss in this area. When you have an area of hair loss where no hair growth is apparent you will not know for approximately 8 months if any hair will grow back in this area. You cannot tell if the follicles are in telogen phase (sleep phase) or the follicle has died (no possibility of hair growth again).
Occipital and parietal sections of the scalp showed no signs of hair loss.
Diagnosis and Treatment Options
Male Androgenic Alopecia – Norwood IVa
• Prescription Based Medicinal Program
• Lasercap
• Surgery
• Hair System
Other Medical Issues
This client reported a history of skin eruptions, primarily of an allergic nature.
No other health problems.
Treatment
Doctor recommended prescription topical medication, herbal medication and in house laser treatment fortnightly.
Prescription anti dihydrotestosterone medication was not recommended due to his wife wishing to fall pregnant (dangers of this medication being used by males whilst their partner is pregnant have now been established not to be a factor in men using this medication).
Several weeks later the treatment protocol changed to our Lasercap as his key treatment tool due to allergic reaction to the topical solution.
Discussion
Sadly, this client had a skin irritation from using the prescription topical medication within the first few weeks (1 in 1000 people are allergic to our topical medication).
The Dr prescribed an alternate prescription topical medication but again he reacted to this solution.
Given he was now not able to use 2 of our most important medications to treat his hair loss he only had 2 viable options of treatment left to him – surgery and/or Lasercap.
You have approximately 100,000 hairs on your scalp. With Male Androgenic Alopecia the hair loss only occurs at the crown and forehead. In time the hair follicles on these parts of your scalp die. When this occurs you will not get hair regrowth. A hair system and/or surgery are the only options available to you as effective treatment when this occurs.
However, you can only take 7000 hairs from the back and side of your scalp for surgery into the top of your scalp. This is because the harvested hair from the side of your scalp will not regrow after removal. So, you have a limited potential number of hairs that can be taken from the side of your scalp. If you took all of your hair you would be bald at the sides and back of your head!
Given we can only harvest a maximum of 7000 hair follicles from the side of the scalp it is important to keep the follicles on the top of your head alive for as long as possible. This is s why it is important to use non-surgical treatments even if you have surgery.
This client could not use our medical program due to side effects. His only other option was a Lasercap.
Surgery was the final option to him.
He purchased a Lasercap.
Outcome
He found the Lasercap easy and straight forward to use – 30 minutes every second day.
He gained good results over the first 8 months of treatment, but his forehead failed to respond to his satisfaction. He decided to undertake surgery to strongly restore his hair growth throughout his scalp.
Conclusion
This client was happy with the results by combing Lasercap and surgery.
