Alopecia

subVisual

Alopecia Treatment

Drugs

1. Oral medication

Finasteride

The history beginner of medical alopecia treatment first defining scientific mechanism of alopecia.
Finasteride for alopecia (original drug Propecia™) is 1/5 dose of the same finasteride for prostatism (Prosca™)
Finasteride can stop losing hair in 1-year medication among 99% patient and increase 10% hair in average in 2-year medication among 66% patient.
No significant side effect and disappear just after stop taking drugs mostly, even though there notes 1~2% of side effects such as impotent, decreasing sexual desire, etc.

Dutasteride

Another powerful weapon for alopecia treatment.
FDA approved dutasteride (Avodart™) as a drug for alopecia in 2009. It is too late compared to Propecia™ of 1997.
Because its stronger effectiveness of blocking 5αR ability. Dutasteride inhibits not only type 1 5αR but also type 2 5αR, contrastively finasteride can inhibit type 1 5αR.
Dutasteride looks more careful to prescribe but we can believe doctor’s experience because we know FDA approved it after 10-year verification.

2. Topical medication

Minoxidil

Minoxidil, an essential drug for alopecia now was an unpopular antihypertensive drug.
The mechanism of topical minoxidil is estimated to improve blood circulation.
Minoxidil shows enhancement of hair thickness by regulation of hair cycle.
The method and types have been developed to use to improve its inconvenience of sticking and smells.

3. Others

Triamcinolone

A steroid injection mainly used for alopecia areata and sometimes can be used for androgenetic alopecia.

Alphatradiol

Alphatradiol is not approved for alopecia but can be applied for alopecia treatment on its mechanism of 5αR inhibition.

Spironolactone

Rarely used for alopecia on its mechanism of regulation to androgen.

Home scalp care

1. Cosmetics

Scalp advantage

In the case of facial skin, the gap between the stratum corneum is too narrow and oily, making it difficult for cosmetic ingredients to be delivered to cell tissues. Even if it is absorbed into the pores, other work waits to move to the target cell.
In that respect, scalp has advantages. The pores on the scalp are bigger, the scalp skin texture is softer and younger than that of facial skin. Gravity helps delivery down to the pores whereas solution on the facial skin slip down or dried out before absorption.
Also noteworthy, pores are the target point itself for the hair care solutions.
But cosmetics have an inevitable limitation. Cosmetics could act at the superficial skin. Mechanism of hair loss works at inside mid to deep dermis area.
Cosmetic such as hair tonic, essence, shampoo, mask etc. cannot prevent hair loss. So, cosmetic could be used as an assistant solution for medical treatment.
The most important thing is that cosmetic for clinics should be bio compatible, eco-friendly, and no sensitive for skin. For example, chemical sulfates (SLS, SLES, ALS, ALES), parabens, silicones, benzophenones, synthetic perfumes, artificial colors are common materials of cosmetics but should not be contained for the products for alopecia patients. Harmful materials on cosmetic could disturb medical treatment for alopecia. That is a big cost for a piece.

Active ingredients

There were many cosmetic products for hair loss care even before Propecia™. Most of them were senseless, but some of them showed some changes (not significantly) by some unexplainable reason.
Around 2006, the reason why the plant ingredients in some hair care products are effective was revealed. Most plant under the strong sun light have their own defensive measures. Plants cannot move to shelter sunlight which induce oxidation. Polyphenols are the defensive measure of the plants to be accurate procyanidin a kind of catechin materials. It was getting known that TGF-β2 & TGF-β1 is one of main factor of hair loss around early 2000’s. Procyanidin in plants showed significant inhibition to TGF-β2 & TGF-β1.
Dermal papilla is the core organ of hair follicle and is mostly composed of collagen Ⅳ and laminin 5. When follicle is degrading, collagen Ⅳ and laminin 5 are decreased by MMP9 which is simulated by MIF (macrophage inhibition factor).
TricoClin™ shampoo and tonic contains the ingredients from polyphenol procyanidin abundant plant extracts such as apple bark, grape seed, acrtium lappa root, ecklonia cava etc. Spirulina and lonicera flower extracts have the function to regulate MMP9, MIF.

2. Food & habits

Food for health is for the hair

Proteins and vitamins, especially vitamin B complex, minerals are essential for hair growth. Good balanced food contributes good cell energy metabolism around hair follicle. Eggs, nuts, vegetables, and seaweeds are not only good foods but also good drugs for patients.

Good habit for body is good for hair.

Stress is one of the causes of hair loss along with time, androgen, and genes.
Nobody knows how to manage, prevent, avoid, or get along with stress. But everybody knows what stress is, why stress comes, where stress comes. And people know the way to relax in some degree. That can be foods, exercise, leisure, talking etc.
We especially recommend sleeping. Sleeping from 10 p.m. to 2 a.m. is also a medicine for patients. Sleeping costs no money, no labor, and no trouble.
One more recommendation, you do not hesitate to meet your doctor. Some symptoms of hair loss slip away just by meeting a doctor.

Healthy hair, healthy body!
Healthy hair, healthy life!

Medical procedure

1. Scalp care

① Massage

Performed for relaxation scalp tension and helps blood and microcirculation from trapezius muscle to scalp muscles. Hand massage and medical device with natural oils.

② Steamer

Scalp steamer helps opening pore to excrete bodily waste and softening skin dead cells. Can be skipped when the scalp is too dryed and sensitive.

③ Scaling

Soft scaling helps to remove bodily waste and exfoliation then soothes scalp skin without any harmfulness.

④ Shampoo

Gently rub and massage the scalp with fingertip skin. Then, gently press acupressure points before washing. Shampoo is not recommended to spend long time.

⑤ Hair pack & scalp mask

Performed to soothe, give nutrition, oil-water balance to the scalp skin, and repair damaged hair shaft.

⑥ Electroporation

Performed for delivering various solutions into the scalp skin on the theory that the short-splited electro frequency makes micro delivery hole in the skin barrier. EP has a good merit of pain control. To perform EP process electric precautions are needed such as carrying metal items, sudden control of device.

⑦ LED

LED as a photo dynamic actor, have cell use the solution just delivered by mesotherapy. IR, Red, Yellow wavelengths are usually used. IR is for wound healing, Red is for cell regeneration, Yellow is for blood vessel. Red is main for hair care, but IR + Red is more used after mesotherapy.

⑧ Hair balance

Application of hair tonic to the scalp and hair nourishing oil to the hair cuticle

2. Mesotherapy

The main clinic hair care procedure is mesotherapy.
Mesotherapy is a procedure for delivering active ingredients into the hair follicle tissue.
Refer to Mesotherapy for Alopecia page.

Hair transplantation

Hair transplantation is the surest remedy for alopecia treatment and an ultimate solution.
Transplanted hair can survive its own life on the principle of doner dominance.
Patient should not stop caring their hair after the surgery. Transplantation does not mean increasing hair. The survival rate of transplanted hair is not 100%. Neighbor hairs around the transplanted hairs are still influenced by testosterone.

1. FUT (Follicular unit transplantation)

Harvest a thin, long piece of tissue from donor scalp using stereo-microscopic dissector. Then divided to follicular units for surgery. This technique is more recommendable for its stable, speedy operation and lower cost than FUE.

2. FUE (Follicular unit extraction)

Harvest each individual follicle unit with microscopic circular incisions. This technique is recommendable for small amount of follicle unit and patient who concern big scar line and pain.

3. Slit/DHI (Direct hair implantation)

DHI is the most widely performing hair transplantation method. This technique makes the operation easy and fast with pen type DHI tool.
Slit technique is more detailed transplantation technique. Slit method can make better condition for implanted follicle survival by shaping a slit hole for each implant using special blades.

Hair prosthesis

Hair prosthesis is a different concept from wig.
Wig is for decorate one’s expression or figure. Fashion looks, actors looks or professional looks. That means temporary hair or hair of not real.
Prosthesis has the concept of alternative hair. Alternative hair is necessities of life for the people who are suffering from hair loss. It is not decoration or fashion and daily belongings.
So, the ideal hair prosthesis needs to be made of real human hair, airy and durable.