Hair is the ornament of the body. Hair thinning and baldness cause psychological stress due to their effect on appearance.
Hair loss or baldness (technically known as alopecia) is a loss of hair from the head or body. Baldness can refer to general hair loss or androgenic alopecia (male pattern baldness). Some types of baldness can be caused by alopecia areata, an autoimmune disorder. The extreme forms of alopecia areata are alopecia totalis, which involves the loss of all head hair, and alopecia universalis, which involves the loss of all hair from the head and the body.
• Hair loss is a common reason for male and female patients to consult with a Dermatologist.
•Recent measurements indicate that the average rate of natural hair loss is closer to 35 to 40 hairs per day.

• In India over 63 million people suffer from abnormal hair loss.
• In USA Androgenic alopecia affects 40 million male and 20 million female per year.


Physical Stress: Surgery, acute or chronic illness, Anaemia, lack of sleep.
Emotional stress: Job loss, death of a family member, marrital difficulty.
Diet Consideration: Rapid weight loss, unusual dieting habits, vegetarian, prolonged fasting, protein intake failure.
Hormonal cause: Postpartum, OCP, Menopause, HRT by Testosterone.
Endocrinopathy:Hypothyroidism,hyperthyroidism.

Oral Medication causes Alopecia:
Blood thinning agents: Heparin , Coumarin. Retinoid: Isotretinoin, Etretinate. Antihypertensive agents: Propranolol, Captropril.
Miscellaneous: Quinacrine, Allopurinol, lithium, thiouracil.

Most common types of Hair loss
– Androgenic alopecia – Alopecia areata
– Postpartum alopecia – Diffuse Alopecia.

Newer approach:

Treatment options
1. PRP ( Platelet Rich Plasma) therapy.
2. Derma Roller therapy.
3.Laser Hair therapy by laser comb or laser helmet
Combination of above measures give excellent outcome.
Platelet Rich Plasma ( PRP ) Therapy
Platelet-rich plasma (PRP) has become a newer method for the treatment of various types of alopecia. The role of  PRP  for hair growth of those patients who are not candidates for surgery or those patients wanting a more aggressive nonsurgical approach to treatment. It is obtained from the patient’s own blood after processing in an automated centrifuge and it is injected subcutaneously into the area of alopecia.Many growth factors play a fundamental role in the life-long cyclic transformation of the hair follicle functioning as biologic switches that are turned on and off during the different phases, controlling the active phase and promoting apoptosis to induce catagen and telogen.The main growth factors involved in the establishment of hair follicle are vascular endothelial growth factor (VEGF), epidermal growth factor (EGF), insulin 1-like growth factor, and fibroblast growth factor (FGF). Platelets release large amounts of platelet-derived growth factor (PDGFaa, PDGFbb, and PDGFab), transforming growth factor beta (TGFβ1 and β2), EGF, and VEGF.

How long do the treatments take?
• Each treatment takes approximately 45 minutes to complete and normally recommend 2-3 treatments spaced at 4-6 week intervals.
• Patient begins to notice effects after 2-3 weeks.
• However, collagen takes 3 months to mature so improvements will continue over time.

How long does it last ?
o Typically the improvements last for 1 to 2 years, mostly 18 months .Biannual touch-up treatments will maintain the results .
o However , is the case for maintaining health generally, this depends on a healthy lifestyle that includes drinking lots of water, minimizing sun exposure and keeping up the vitamins intake.

Advantages of PRP therapy
IT is an autologous process so less chance of autoimmune diseases like allergy and hypersensitivity .
It is easy to perform & cost effective.
No chance of transmission of diseases like HIV ,hepatitis B & C etc . Unlike surgery it is free from the associated risks: general anesthesia, sedation, post operative infections and other complications of surgery .

Side effects:
• Pain and headache, for first 12-24 hours are mild.
• Swelling and redness 1-3 days .
• Bruising (2 weeks, masked by make-up)
Contraindication :
NSAIDS drugs taking 1 to 2 week before History of recent stroke
Cigarette smoking(heavy),
alcohol consumption
Active infection at the inject site

What is Microneedle Derma Roller?
• Derma Roller, is a innovational micro-wound method for curing skin problems, like Hair loss, typical acne scars, hyper pigmentation, aged skin, stretch marks and so on.
• To stimulate collagen production by injuring the skin through hundreds of punctures.
• Used in Europe for years, it is quickly gaining popularity in the U.S. because of the amazing results it provides.
• It have been successfully applied to the indication of hair restoration in cases of alopecia.

How does Derma Roller work?
• Derma Roller uses extremely fine micro-needles, which penetrate the skin just enough to stimulate collagen and elastin production leads to smoothing of wrinkles and scars.
• It enhance nutrients supply to hair follicle by increases blood supply.
• The resulting micro-channels help in increasing the absorption of serums and topical creams and increased overall efficacy of skin care products.
• The Roller leaves the epidermal barrier fully intact.
• The micro-channels created by the needles fully close within just a few hours after initial application.
• To ensure the patient can quickly resume normal schedules.

What types of hair loss treated by derma roller?
• Alopecia areata.
• Male pattern baldness .
• Any type of non scaring alopecia where the hair follicles are not damaged.

How to act on hair loss ?
• Derma roller can help restore the hair by
stimulating the flow of blood.
• Using a micro needle length as small as 0.2 mm is said to be able to effectively create an environment that is conducive to hair re-growth.

Hair growth products with derma roller therapy ?
    •    It is highly recommended to incorporate certain hair growth products with derma roller therapy for better result.
    •    Minoxidil (Trugain 5%) can be applied to the scalp during use a derma roller to allow the topical product to penetrate deeper.
    •    Hair growth shampoos, such as Biotin H 24, can also be used for better hair growth.
    •    Hair will grow naturally in course of time.
    •    Results vary patients to patients. Sometimes get quick result and sometimes may be delayed but every patient get result if he/she follow the instruction.

How often Dermaroller and PRP used ?
• PRP is applied once in a month for 3  months. But maintenance is required two times in a year give amazing result.
• Derma roller usually used once in a week for 10 to 15 times is enough to achieved satisfactory result.

Laser Hair Therapy

• The only medical device that has been clinically proven to promote hair growth .
• Laser hair therapy is a safe, effective, and FDA- cleared way to treat hair loss by stimulating growth in hair follicles.
• General improvements in the look of your hair will be noticeable in approximately 8-16 weeks .
• It stimulating growth and halting hair loss in 90% of users .
• For best results, use the Laser Comb three times a week for 10-15 minutes.

FDA approved laser hair treatment has a proven triple action
1. Grows new and healthy hair.
2.Double the follicle size of existing hair. 3.Slows down and stops hair loss.

How it works?
The low-energy laser diodes ( 660 nm) in the Laser promote hair growth in two ways:
The laser energy increases blood flow in the scalp, stimulating the health of hair follicles by providing additional nutrients and carrying away harmful waste products like dihydrotestosterone (DHT).
2. The laser light also encourages the production of a naturally-occuring molecule known as adenosine triphosphate (ATP), increasing cellular metabolism and activity to promote thicker, more natural- looking hair growth.

Conclusion
• Although for the treatment of hair loss is challenging for the dermatologist, newer treatment options can be tried for better result to satisfy our patients.
• Combination of PRP therapy, Derma roller therapy and Laser hair therapy may be the future hope for effective treatment outcome in many patients.
Frequently Asked Questions:

Q. Causes of Premature greying of Hairs?

Mostly genetic. But nutritional deficiency and stress also play role for Premature greying of hairs. The person who takes less vegetables and more fatty diet are frequently suffer of this problems.
Zinc, folic acid,Vit-B12,, Biotin essential for prevention.

Q. How can I care of my hairs?
Clean the hairs with suitable shampoo 2-3 times in a week
Use hair oils when the scalp is dry
Use conditioner once in a week
Do not use soap,curd,vinegar,lemon over scalp
Do not wrap or comb hair when remain wet.

Q. How can I prevent Hair fall?
Avoid crude shapoo
Avoid : Stress and anxiety
Ensure proper sleep and early going to bed at night
Avoid using curde, lemon, vinegar over scalp
Avoid crush dieting
Do not wrap head after bathing
Do not comb your wet hairs
Take plenty of fruits and vegetables and High Protien Diet

Q. What are the most common causes of hair fall?
Stress/anxiety- lack of sleep or delayed sleep at night
Dieting
Use of unhealthy materials over scalp

Q. What kind of foods should I take for hair?
Lots of Fruits and vegetables and proteins

Q. Causes of localised hair loss?
Due to Dermatological diseases
Causes of excessive hair growth?
Hormonal,genetic,drugs and Idiopathic

Q. How can treat for excess hair growth in my face?
Diode 808 Laser / Long Pulse Nd Yag /IPL and Medical treatment if necessary

Q. Is laser treatment is safe for permanent hair removal?
Mostly safe but should be done by qualified Dermatologists.

Q. How many times laser need to do ?
6-12 sessions

Q. In case of balding-is there any new effective treatment other than hair transplantation?
PRP therapy and Dermaroller therapy

Q. Who can do hair transplantation? Side effect?
Those where medical treatment is failed and there are some hairs in the back of scalp.
Side effects are not significant

Q. Is there is any role of Hair oil for hair growth?

No
Q. Is there any benefits from frequent shaving of hairs?
No

Q. Is hair rebounding is safe?

Mostly not safe because of using low quality medicines for it in many parlours. But may be safe if done in a good centre with good medicines.

Q. Does hair threading cause more hair growth?
No

Q. What is the benefit of using curd, vinegar, lemon juice over scalp hair ?
Harmful

Q. Is there is any role of Mehadi use for hair fall?

No