The most common cause of hair loss in men is male pattern hair loss, in other words androgenetic alopecia. Androgenic alopecia; It is a disease that occurs with the effect of hormones in people with genetic predisposition, can be seen in both sexes and progresses with hair loss. In genetic predisposition; The distribution of the 5-alpha reductase enzyme in the scalp is an important determinant. Hair loss occurs due to hormones activated by this enzyme. Thick, black hairs are replaced by light-colored and fine-type hairs. Its incidence increases with advancing age, but the age of onset and rate of progression are variable. 80% of Caucasian men have hair loss by the age of 70. Although this situation is perceived as a very common physiological event with age, it negatively affects the quality of life and pushes people to seek a medical remedy. Today, there is a search for different methods for hair loss and its treatment.
The aim of the treatment of androgenic hair loss is to stop the miniaturization of the hair follicle and to increase the regrowth of the hair and the thickness of the hair shaft. Current treatments stop the progression of the disease and provide a small amount of new hair growth. With the increase in the level of knowledge of the patients about hair loss, the chance of early diagnosis and treatment increases, and the psychosocial effects of the disease are reduced. Although this condition of people with hair loss is perceived as a benign condition and treatment is not needed, it is a cause of psychological stress that causes significant deterioration in quality of life in some patients. When deciding on treatment, the person should first be informed about the natural progression of the condition.
MEDICAL TREATMENTS; There are 2 FDA-approved agents for the treatment of hair loss in men; Topical minoxidil and oral finasteride treatments. Both treatments have a stimulating effect on hair growth and prevent hair loss. The hair loss-stopping effect of medical treatments appears 3-6 months after the start of the treatment, and the visible new hair growth effect occurs 6-12 months later. Continuous treatment is required to achieve maximum effectiveness. People should be informed that the hair density before hair loss can never be reached with treatment and that the main purpose of the treatment is to prevent the progression of hair loss.
SURGICAL TREATMENTS; Hair Transplantation is the transplantation of hair from the occipital (neck) region to the balding vertex (hill) or frontal (front) area. With modern techniques, graft survival rates exceeding 90% are provided. Modern hair transplantation started in Japan in the 1930s, and grafts taken in the form of punch were used for eyebrow and eyelash shedding. Over time, it was realized that the androgen-resistant occipital area was a better donor. In 1995, Bernstein and Rassman discovered follicular unit transplantation and hair follicles began to be transplanted as units containing 1-4 hairs. In follicular unit transplantation, donor hairs can be removed in 2 ways;
1) Follicular Unit Transplantation (FUT) Hair follicles taken in the form of strips from the nape area, where there are genetically resistant hair follicles, are divided into clusters of 1-4 to accommodate hair and hair follicles, using appropriate techniques under microscopic instruments, without disturbing their natural structure. or it is planted in the area that has been completely spilled. The area where the hair is taken from the nape is stitched in accordance with aesthetic surgery methods. The disadvantage of this method is the scar in the form of lines in the nape area.
2) Follicular Unit Extraction (FUE) The method of follicular unit extraction is to take the hair follicles one by one from the nape area in the form of a 1 mm punch with special fine-tipped needles and transfer them to the thinned or completely spilled area. Since there are no stitches, there is no scar formation. It provides recovery in a shorter time than the FUT method.
PRP; Platelet Rich Plasma Platelet rich plasma (PRP) contains over 20 growth factors. PRP has long been used in bone grafts, dental implants and wound healing. Studies have shown that implanting hair follicles with PRP during hair transplantation increases the success rate of hair transplantation. In a scientific study, 13 of 26 patients with fine hair were injected with PRP 5 times at 2-3 week intervals, and saline injection was applied to 13 patients. At the end of the treatment, significant thickness was observed in the hair sections of the patients who underwent PRP, but there was no difference in the number of hairs. This study suggests that PRP can be used to improve hair quality.
