Thank you for your question. You’re 28-years-old and you submitted a photo of the top of the scalp showing your hair part.
And you say you were starting to lose hair a year ago. And you’ve been on minoxidil for about 10 months or so and you’re looking into Acell and PRP and you’ve learned that it doesn’t work for everybody.
And so you want to learn more about other options. Well, I can certainly share with you how I approach patients like yourself in my practice who have similar concerns and issues. A little bit of background, I’m a Board-certified cosmetic surgeon and Fellowship-trained oculofacial plastic and reconstructive surgeon.
I have been in practice in Manhattan and Long Island for over 20 years. Hair transplant and hair loss have been a very big part of my practice. In fact, I am the founder of TrichoStem™ Hair Regeneration Centers.
This is a system we developed that evolved from hair transplant surgery using the acellular matrix and PRP. And we’ve been treating patients from all over the world, men, and women of a very wide range of ages.
So I think I can help you to just understand the landscape of what you are dealing with. So to begin with, it is certainly a little bit less common for a woman your age to have hair loss, and therefore, it’s actually very important to have a proper medical evaluation before you undergo any treatment.
So what does that mean? Well, for a young woman, you want to make sure that hormonal levels are appropriate. So, whether it’s seeing an endocrinologist or your gynecologist, you want to check hormones such as testosterone, estrogen. You want to check vitamin D3.
You want to check thyroid levels. There’s essentially a hair loss workup panel, a combination of the hormone levels as well as complete blood count, making sure you’re not anemic. In fact, you can even look at certain inflammatory markers. So once you have a proper medical workup, in addition, we also look at family history.
When we have treated younger women, we often see a certain consistency with family history. Not every time but for example, one of our youngest patients was 16-years-old.
When I was being told about her in the hall by my nurse before I went into the room, I was ready to do biopsies and other things to try to figure what’s going on. And then I learned because her mother had exactly the same condition with the same onset, it became clear that this was a familial trait.
Nonetheless, it doesn’t mean that you still don’t get medical work-up but it means that at least you may fall in what is usually the 95% likelihood of something called androgenetic alopecia or genetic pattern hair loss.
Now doing Hair Regeneration treatment now for more than 7 years in our practice, we have had a wide range of patients of all ages. And in women, we are seeing large groups of women in their 20s and early to mid-30s who previously were not really being paid attention to because there weren’t really that many options.
There’s essential, the only FDA approved drug is minoxidil and most patients, most women who come to us will feel basically indifferent about the benefits of minoxidil. So as far as the question of the acellular matrix and PRP, it is something that I am very happy to see that more people are validating the benefits of these treatments.
The challenge is, what we had to overcome over many years being in the front of the parade and being the first to really or first of a handful of doctors to be pursuing this for more than 7 years ago, essentially what the challenge is the formulation, the method of placement and the strategy for the individual patient.
And what we developed was an algorithm for patients based on gender, age of onset, degree of hair loss, and rate of progression. And from that, I developed formulations and systems based on my clinical experience.
So the question is about whether or not ACelland PRP always works, well I can tell you, as of recently, for the past several years of treating women, we almost basically haven’t had any treatment failures for women with androgenetic alopecia which means genetic pattern loss.
Now, as I often tell my patients is your scalp didn’t read a textbook. So you don’t always get to have just one diagnosis. You can have androgenetic alopecia with telogen effluvium, you can have it with alopecia areata, and you can have it with lichen planopilaris. You can have a lot of things happening concurrently.
So there are times when I would take a patient like yourself and I would even do biopsies in three separate areas just to confirm the diagnosis. Our strategy is to develop a treatment plan based on those particular characteristics as I mentioned and do treatments based on that strategy.
So we’re actually managing hair loss. We’re not just doing injections and just hoping for the best. We actually have strategies based on our clinical experience. So I think it’s reasonable for you to still pursue this injection type of treatment but be confident about who is doing it for you so you feel like they have the experience needed to do the best job they can for you.
Understanding hair loss is a progressive condition and there is nothing that will work forever. But essentially, if you can reactivate hair growth and improve coverage then you are better off at any given point of time after the injection.
Let’s say in our practice, we tell our patients, expect improvement generally for women at around 9 months. And we follow our patients every 3-6 months. And a lot of times, we see growth earlier but in terms of getting density and coverage, it takes about 9 months for most women.
So I think it’s important to learn more and do some more research. Get your medical work-up done and decide if you want to go ahead and try something other than minoxidil. So I hope that was helpful, I wish you the best of luck and thank you for your question.