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Sunday, February 18, 2001

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For a head full of hair

Balding and thinning hair has long been the bane of many. But now transplanting hair provides the solution to this problem, says Dr. H. KRISHNA HANDE.

MALE pattern baldness (MPB) or androgenic alopecia is due to the presence of a group of male sex hormones collectively referred to as androgens. Although the androgen level of bald men is no higher than that of men with a full head of hair, the fact remains that a certain minimum amount of androgens must be present before male pattern baldness can occur. The average man has enough androgens circulating in his body to develop MPB.

Male pattern baldness is a genetic condition which affects millions of men in India. Whether or not a man will lose hair is determined before he is born. Male pattern baldness is not due to using a particular shampoo or wearing a helmet or hat, or brushing or rubbing one's hair often. On an average a man loses 100-150 hairs a day, but most of this re-grows because the follicle remains healthy and intact. A typical adult head consists of about 150,000 hair follicles.

Hair transplantation is a surgery in which grafts of hair with the follicle are removed from the horseshoe shaped donor area around the back and sides of the head and placed in areas where baldness or thinning of hair is seen. The transplanted hairs are genetically programmed not to fall out. The scalp is elastic and so once the donor strip is removed, it is sutured together. The only evidence of surgery is a thin line hidden under the hair that grows on the back of the head.

The fact that hair has been transplanted from one area of the scalp to another has no effect on its genetic predisposition to grow hair. Hair transplants have been performed for over 35 years. The new technique, however, has enabled surgeons to create more aesthetic and more natural looking results than before. Old "plug style" techniques, where large circular punches of skin that contained 15-20 hairs each, created "dolls hair" or "corn- rows", but the recent use of tiny micro and mini grafts, called follicular micro-grafting, has dramatically improved the results of hair restoration surgery.

The surgery requires only local anaesthesia and is virtually pain free. Patients are usually between 20 and 70 years. During the initial visit, the doctor decides if transplantation is suitable. The patient is completely alert during the surgery. The procedure takes about two to four hours. After the operation, the patient is asked to wear a disposable surgical cap as dressing which is removed after three days. The patient is then asked to shampoo the head.

After surgery, initially, the transplanted hairs are only a few millimeters in length. Once transplanted, they may appear to be growing but actually are being thrust out. In three or four weeks, nearly all the newly transplanted hairs will be shed. Following this, new growth begins. One can expect to see normal hair growth around three or four months after the procedure.

In some cases, hair growth may be slower. This is due to individual variation. However growth occurs at the normal rate of 1/4 to 1/2 inch per month. At times, one may require more than one sitting to get a satisfactory result.

The author is a Consultant Plastic and Cosmetic Surgeon, Hande Hospital, 44, Lakshmi Talkies Road, Shennoy Nagar, Chennai. Ph: 6442517, 6449422, 6447538.

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