Platelet Rich Plasma Therapy and Scarring Alopecia
Over the past five years there has been a greater acceptance in the use of Platelet Rich Plasma (PRP) Therapy for hair loss as we have seen many successful studies. However, most of the research and studies focused on patients with androgenic alopecia, which is tied to genetics and is the most common cause of hair loss. As the benefits of PRP Therapy are being more understood, we are seeing its uses expanded, including in the treatment of Alopecia Areata and some Scarring Alopcias. There was an exciting case study shared in the July 2019 journal of Dermatologic Surgery on the successful treatment of two patients with scarring alopecia using PRP Therapy.
While less common than androgenic alopecia, according to the Canadian Medical Association Journal, patients with scarring alopecia make up 7% of patients experiencing hair loss. While the cause of scarring alopecia is not entirely known, scarring alopecia causes inflammation around that hair follicle that eventually leads to the permanent destruction of the follicle. There are various types of scarring alopecias, with the most common being Lichen Planopilaris (LPP), Frontal Fibrosing (Alopecia), and Cicatricial Alopecia (CCCA). For each type of scarring alopecia treatment can vary slightly, with the exception of topical or injected steroids, which are typically the first recommended treatment for all types of scarring alopecia.
So is PRP Therapy a treatment option for scarring alopecia? It is important to remember that the case study in the July 2019 journal of Dermatologic Surgery included only two patients, but below describes the patients and their outcomes:
||African – American
|Hair Loss History
||Decreased density along the scalp vertex since her mid-40s.
||Several years of gradual hair loss diffusely across the scalp. Diminished hair density along frontal hairline and scalp vertex.
||Cicatricial Alopecia (CCCA) with mild component of Androgenic Alopecia
||Lichen Planopilaris (LPP)
||Spironolactone, steroids (topical and injections), topical minoxidil. All were considered ineffective and were stopped prior to PRP Therapy.
||Steroid (topical and injections), hydroxychloroquine 400mg daily. Did not lead to improvement, but continued topical and hydroxychloroquine during PRP Treatment.
||Normal follicular density was noted along temporal hair line and greater than 50% improvement in hair density along scalp vertex.
||Normal density was noted diffusely across scalp and hairline.
This case study shows that there is a place for the use of PRP Therapy in the treatment of some scarring alopecias. At Medi Tresse we have had success in utilizing PRP as a treatment for some patients with scarring alopecia, especially when there is a component of androgenic alopecia as well. While more research needs to continue, this case study is great news for patients with scarring that have not had success with traditional treatments, like steroids, as it gives them another potential option. If you think you could benefit from Platelet Rich Plasma (PRP) Therapy contact our office to schedule a free consultation.
Will I Shed More During the Fall?
With Labor Day fast approaching, summer is unfortunately coming to an end. While we do enjoy the crisp mornings and fall foliage, a lot of our patients have been wondering if and how the change in season can affect their hair.
Patients often tell us they notice more shedding during certain times of the year. Because everyone’s hair cycle is different, we can certainly see a correlation of hair growth or shedding with certain seasons for some patients. During the summer months, the body tends to hold on to hairs to protect the scalp against the harsh midday sun. To compensate, the hair follicles tend to elongate their growth phase in order to provide coverage and shelter for the scalp. As the sun’s threatening rays start to diminish during the changing season, the hairs return to their usual cycle and start to shed as a result.
However, the change is not very noticeable in the majority of people. The truth is, there are other factors such as age, styling, hormones, and genetics that play a more dominant role in our changing hair. If you think you are experiencing a seasonal shed, I suggest wait for the season to change, chances are the shedding will too! However, when in doubt, it is best to consult a hair loss expert.
Posted by Your Medi Tresse Team
How Often Should I See My Hair Loss Specialist?
Your follow up visits provide an opportunity to track your results, update your hair loss specialist on any changes in diet or medications, and to potentially change the treatment plan if necessary. So how often should you see your hair loss specialist? Just like visiting your dentist (although hopefully less painful!), at Medi Tresse we recommend follow up visits every six months.
Tracking your results is extremely important, and any hair loss specialist should be taking photos and doing trichoscopy (which is highly magnified photos where you measure the hair) to track your progress. As you see your hair every day, it is often difficult to notice changes, but in your follow ups you will easily be able to track your progress throughout treatment.
The follow up is an important time to update your hair loss specialist of any major changes in your diet or medications. A major diet change, like becoming a vegetarian, could affect your hair loss if you are not receiving enough vitamins and nutrients. Some medications have been found to induce hair loss, and your hair loss specialist can help guide you through if the medication could be problematic to your hair.
For most patients, hair loss is progressive, which means that it will continue to get worse if not treated correctly. By seeing your hair loss specialist every six months, you can ensure that if you need to make changes to your treatment plan, it is done in timely fashion. The earlier hair loss is treated, the better chance there is for re-thickening and re-growth during treatment.
Treatments During the Summer
With the summer coming up, patients often tell us they are concerned about starting a new treatment as they plan on being more active and out in the sun, and they are not sure how our treatments may affect their ability to do so. What is great about the treatments offered at Medi Tresse is that they will not stop you from having a fun filled summer! However, please remember whenever you plan to spend time in the sun it is important to always ensure proper sun protection. Let’s look at some of our most common treatments and if potential side effects could affect your summer plans.
Platelet Rich Plasma (PRP) Therapy – There is limited down time from PRP Therapy, however, in terms of summer activities, we do recommend that you refrain from swimming and direct sun light on your scalp for 48 hours. The good news is that means you can have your treatment on a Wednesday and be on the beach on Saturday!
Low Level Laser Therapy (LLLT) – Whether you are using a laser band or a laser cap, there are no known side effects from LLLT. Using your LLLT device will not stop you in any way from enjoying the nice weather!
Formula 82M – Formula 82M is a specially formulated minoxidil solution. Formula 82M is great for patients that have tried over the counter minoxidil products and found them to be irritating or greasy, as it is specially compounded to be non-irritating and less greasy. With limited side effects, Formula 82M will not get in your way of enjoying your summer activities.
The good news is you do not have to choose between one of these great treatments and having a fun filled summer. You will be able to enjoy the summer more knowing that you have taken the first steps in treating your thinning hair. Do not hesitate to contact our office if you have any specific questions about these treatments.
Posted by Your Medi Tresse Team
How to Identify and Treat Hair Loss After Menopause
Approximately 40% of women experience visible hair loss by age 40, but for many that event doesn't come up until after menopause has ended or it's in a later stage. And even then, it can be difficult to spot hair loss and start treatment therapy before it's too late.
Fortunately, there are distinctive signs that you should be looking for and there are treatment methods that may yield even better results if you catch the symptoms early on. Here's how to identify and treat hair loss after menopause.
Why does it happen?
This is an issue that countless women struggle with. It mostly has to do with a reduction in estrogen and progesterone production in your system, which then leaves the androgens unopposed. Androgens can decrease the functionality of your follicles and lead to early hair loss or thinning. This condition is commonly referred to as female pattern hair loss.
How can I spot it?
The key here is to spot the symptoms before your follicles cease functioning altogether. The earlier you spot the telltale signs, the better off you'll be receiving hair rejuvenation treatments. Here are a few signs to keep a sharp eye out for:
Widening of your part: While men typically see losses right at the forehead, women more typically see them in their part. If you notice any widening, that's a sign that loss is happening.
Excessive Shedding: While it is normal to shed between 50-100 hairs a day, if you are noticing an increase in shedding, it is possible that that your experience female pattern hair loss or telogen effluvium.
Bald Patches: Small patches of baldness is a sign that more may appear shortly. This type of loss is most likely alopecia areata.
How can I treat it?
Fortunately, there are a variety of treatments available to you if you're experiencing menopause-related female pattern hair loss. Here are some of the most effective options available to you:
Platelet Rich Plasma Therapy: PRP stimulates follicle activity by injecting platelets, stem cells and growth factors taken from your own blood into affected areas of your scalp.
Low-Level Laser Therapy: Low level lasers have helped improve follicle activity by using laser stimulation to increase the energy portion of the cells.
Follicular Transplant: Follicular transplants are typically a last-resort option for those women who are in later stages of female pattern hair loss, and requires a hefty amount of recovery time.
Whether pre- or post-menopause, female pattern hair loss can seriously affect your confidence and self-image. Spotting these symptoms early on could be the key to a highly effective treatment.
At Medi Tresse we have seen women with all different types of hair loss and varying causes of hair loss. With any patient we see, the first step is to diagnose the cause of the hair loss. For many patients, their hair loss is truly genetic, but for others it could be due to a hormone imbalance, stress related, or even a change in medication. One patient population that we often see is patients with polycystic ovary syndrome, more commonly known as PCOS.
While the cause of PCOS is still unknown, PCOS is an endocrine system disorder, which means the hormones are directly affected. Common symptoms of patients with PCOS are irregular periods, excess androgen, and polycystic ovaries, which means the ovaries have become enlarged and contain many small cysts.
Women with PCOS can often see thinning hair due to excess androgen levels, which are commonly known as male hormones like testosterone. Before starting any sort of hair loss treatment, a patient with PCOS would want to make sure that their hormone levels have been checked and are in proper balance. If a woman has elevated androgens, this can potentially be managed with very specific birth control pills which can block the negative effects on hair. Once the hormone levels are in proper balance, then the patient could be a candidate for hair loss treatments.
Posted by Your Medi Tresse Team
Are all Low Level Laser Therapy (LLLT) Devices the same?
Low Level Laser Therapy (LLLT) has become one of the most popular treatments for female hair loss, and with the increase in popularity we have also seen an increase in at home options. However, many patients tell us it can be confusing when they try to research and compare all of the LLLT devices. Before we get into the devices, it is important to understand what exactly is LLLT.
LLLT stimulates the hair follicle cells to grow in the scalp and increases cellular activity around the follicle. This also decreases inflammation so existing hairs can grow thicker and stronger. While LLLT has been proven to be effective for many years, the 2014 double-blind study published in the American Journal of Clinical Dermatology, truly showed the power of LLLT in treating hair loss.
With a simple internet search, you will find a number of at home LLLT devices, such as the LCPro by LaserCap, the Capillus, the LaserBand 82 by HairMax, the Theradome, or the iGrow, and this can be very overwhelming to the patient. However, there are a few key differences that you need to look out for when comparing devices. First, the laser wavelength should be between 650nm-655nm. Secondly, the laser output per diode should be 5mw. Thirdly, the diodes should be true lasers and not just red lights. Lastly, the number of diodes is extremely important. Many of the full caps are sold with varying numbers of diodes, often varying between 80 and 272, but you truly need at least 220 diodes in the cap to ensure you are receiving the proper coverage to the entire scalp. While some products like the HairMax LaserBand 82 only have 82 diodes, since they only cover a third of the head, they have the sufficient number of diodes in the treatment area, you just have to move the device to treat the entire scalp.
If you think you are interested in LLLT, it is important to speak with a hair loss specialist that can not only determine if a LLLT device is right for you, but guide you through the decision making process to purchase the best device.
Posted by Your Medi Tresse Team
What Is Female Pattern Hair Loss
Female pattern hair loss (FPHL), clinically known as Androgenic or Androgenetic Alopecia, is the most common cause of hair thinning and loss in women. Up to 50 % of women have some degree of female pattern hair loss in their lifetime. It certainly is more common as women age, particularly after menopause, but it can start as early as the teenage years. Female pattern hair loss tends to run in families, and inheritance can be from either the mother or father, but sometimes there is no family history. We know that hormones play a role in this type of hair loss, especially the “androgenic” hormones such as testosterone.
Female pattern hair loss is typically more pronounced in the frontal areas of the scalp. Over time the hair shaft gets thinner in a process known as “miniaturization”. Your hair goes through a constant life cycle, as we naturally shed and grow new hairs. However, miniaturization occurs, because the anagen phase, or growth phase, of the hair cycle gets shorter, which means the hair is not able to grow as long or thick as it has in the past. Eventually if not treated, the affected hair will continue to get smaller and disappear completely.
The good news is there are great treatment options for female pattern hair loss, but it is very important to start as early as possible. If a hair has been lost for a long time there is no way to get it back, unless you surgically transplant a different follicle in that area. However, with Platelet Rich Plasma (PRP) Therapy or Low Level Laser Therapy (LLLT) you can reverse the miniaturization and thicken and grow existing hairs. If your loss is recent, we may be able to re-activate dormant follicles so that they start producing a hair again. If you think you may be experiencing signs of female pattern hair loss it is important to see a hair loss specialist as soon as possible so that they can diagnose your type of hair loss and come up with a treatment plan tailored to your specific needs.
Formula 82M vs OTC Minoxidil
When many patients start to see signs of hair loss, their first thought is often to try one of the many over the counter minoxidil treatments. Minoxidil is a topical treatment, and the most commonly known brand is Rogaine. Minoxidil can be a great first step for hair loss, and was FDA approved in 1988. Patients experiencing Androgenic Alopecia (Female Pattern Hair Loss), Telogen Effluvium, and early Traction Alopecia are good candidates for minoxidil.
While minoxidil can be a good first step for patients with early signs of hair loss, many patients feel that over the counter minoxidil treatments can be irritating or make their hair greasy. At Medi Tresse we offer a specially compounded minoxidil solution called Formula 82M, which combats these issues. Formula 82M is specially formulated to be less irritating and less greasy, while also having a higher absorption rate, which means your scalp and follicles will receive a greater percentage of the minoxidil in Formula 82M than with an over the counter option.
Most patients will start to see a benefit from Formula 82M in three to six months, but for some patients it could take six to twelve months. At Medi Tresse we have seen the best results for patients when they combine the Formula 82M with Platelet Rich Plasma (PRP) Therapy or a Low Level Laser Therapy (LLLT) device like a laser cap. If you think you may be experiencing signs of hair loss the first step should always be to see a hair loss specialist who can not only diagnose your type of hair loss, but provide you with a treatment plan tailored to your needs.
New Year's Resolutions For Your Hair Health
If you are anything like the team here at Medi Tresse, you have probably spent the last month coming up with a list of New Year's Resolutions for 2017. Since our main focus at Medi Tresse is the well-being of your hair, we just want to make sure you do not forget about the health of your locks this upcoming year! Here are a few resolutions that will help improve hair health and decrease breakage in 2017!
- Take a daily multivitamin to help assure your follicles are provided with the adequate nutrition they need to grow strong. The following vitamins and minerals are essential for not only hair, but healthy skin and nails as well:
- Copper, Iron, Zinc, Biotin, Vitamins B6, B12, A, C, D, E, and Omega-3’s
- While taking a daily multi-vitamin is great, nothing beats the natural vitamins and nutrients we get from our diet. Try to make foods that are naturally high in vitamins and nutrients essential to hair health a staple in your diet, such as dark leafy greens, which are high in Iron, Copper, Vitamin A, and Vitamin E or avocados, which are high in Biotin and Copper. You can find a full list of foods in our Avoid the Crash Diet This New Year blog post.
- Try to use the same shampoo for at least 6 months before changing it. Hair can respond to the changing chemicals in the shampoos and become too dry.
- Trim your hair every 6-8 weeks, which promotes strong, healthy locks that are free of brittle split-ends.
- Try not to over style your hair. While you can find a blow dryer and flat iron straightener in all of our bathrooms, just remember that excessive heat can damage the hair, and we want to be careful not to dry out the follicle. Moderation is the key when it comes to using your blow dryer and flat iron.
If you have any hair health questions in 2017, please remember you can always reach out to the Medi Tresse teams in Boston and Chattanooga. Most importantly, we hope that you and your family have a safe and healthy 2017.
Posted by Your Medi Tresse Team