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A Hairy Situation

May 3, 2022   Return

There are a few things in life which can deal a blow to your self-esteem like the way hair loss does. While your friends are busy discussing the latest hairstyle trends (hair strobing, anyone?), you’re panicking over the increasing strands of hair that are clogging your bathroom’s shower drain and the thinning hair on your head. You have tried various ways to remedy the situation, from diligently using serums which claim to boost hair growth to signing up for pricey treatments at hair care centres. However, none of them works. If anything, your hair seems to be thinning out all the more!

If you can relate to the above situation, you aren’t alone. While there are people who gradually accept their hair loss and learn to wear their baldness confidently, many wish for healthy, luscious locks. And who can blame them – hair is perceived to be our crowning glory, after all. If you are one of the latter, read on to discover what Dr Ruban Nathan, a consultant dermatologist has to say about this predicament.

Should you be worried?

“There are various forms of hair loss. But the most common form of hair loss in both men and women is known as androgenic alopecia,” Dr Ruban says. “It begins after puberty and is mainly due to genetic factors. More often than not, androgenic alopecia is inherited from the mother’s side of the family. It is also due to hormonal changes at the hair follicle levels. This is why hair loss occurs in a typical pattern.” When asked how this pattern differs between men and women, he says, “The woman’s hairline remains intact whilst gradually diminishing in density. For men, the hair starts receding at the crown and the top of the scalp.

While there is no factual data about its prevalence in Malaysia, Dr Ruban cites studies from neighbouring countries. “A Singaporean study found that its prevalence increases with age – from 32% among young adults aged 17-26 years old to almost 100% among people in their 80s. Additionally, a Bangkok research reported an incidence of 38.5% from 18-90 years of age.”

Touching on factors which could up someone’s risk of androgenic alopecia, he says, “Smoking, stress, lack of physical activity and sleep problems are risk factors.” But he is quick to assure that ‘while these factors may exacerbate this condition, they aren’t definite causes.’


Are you doomed?

To those who are dealing with androgenic alopecia, Dr Ruban offers hope. “Rest assured, this condition can be treated via various methods. Oral medications like finasteride and minoxidil, for instance can help. Finasteride can retain already-present hair follicles while increasing hair density.”

What about supplements, then? “The effect of supplements on hair loss hasn’t been stringently studied but it’s conventional for us to prescribe supplements like biotin and zinc. In the event that the hair loss is compounded by anaemia, the person will be given haematinics (e.g. folic acid, vitamin B12 and iron) as well.”

Do you need a hair transplant?

“Not everyone needs hair transplantation but it’s necessary for individuals with – for lack of a better word – sufficient baldness and a good donor area (in cases like this, hair is normally harvested from the back of the scalp),” he explains. But what if the donor area is deficient? “Not to worry. Now, the beard and chest areas can be used as donor areas too.”

What can you expect?

Discussing hair transplantation in more detail, Dr Ruban says, “It’s performed under local anaethesia. We start with the donor area first. The harvesting can be as quick as 30 minutes but it can go up to several hours. It depends on the type of hair transplantation – either follicular unit transplantation [FUT] or follicular unit extraction [FUE].”

“If the transplantation is via FUE, the entire scalp is shaved before the surgical procedure begins. If it’s via FUT, only a minimal strip is harvested – hence, allowing the patient to resume their daily routine more quickly i.e. in a couple of days.”

What happens next? “Next, the grafts are prepped and stored in chilled plates. After local anaesthesia has been administered to the scalp’s recipient area, sites or slit are created so the grafts can be inserted. This is done by a team of trained transplant nurses. This in itself will take several hours but it ultimately depends on the team’s expertise and the number of grafts. This is why it’s crucial to choose a good team as you don’t want the grafts to remain too long outside the body,” he emphasises.

Elaborating further, he says, “People may have the misconception that hair transplantation is painful when in fact, it’s very well-tolerated. Also, you needn’t worry about strip scarring. It isn’t bad; all you need is roughly 1cm length of hair to cover the scar.”

If you are wondering whether hair loss can resume after transplantation, he says, “Yes. As a result, those who have undergone transplant surgery require maintenance therapy. This involves consuming finasteride regularly, especially if you are under 40 years old.”

Does it actually work?

Addressing doubts that people may have concerning the efficacy of hair transplants, Dr Ruban says, “Hair transplantation technology has evolved by leaps and bounds over the years. The biggest advancement to date has been identifying how each graft occurs in natural groups of 1-4 hair follicular units or grafts. This allows us to use more single grafts in the hairline area and to create more hair density using the double and quadruple grafts where necessary. In short, near-perfect cosmetic results can now be expected without the old ‘doll’s hair’ appearance.”

“The reason why some people still struggle with hair loss despite having gone to many hair care centres is because those centres are non-medical. Don’t be misguided. Remember, medications like finasteride, supplements and hair transplants are the only therapies which have been proven to be effective in treating androgenic alopecia. Therefore, always go for clinically proven therapies offered by medical hair care centres,” he concludes.

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