There are two methods of harvesting hair grafts during hair transplant surgery, which are Follicular Unit Excision formerly known as Follicular Unit Extraction (FUE) and Follicular Unit Strip Surgery (FUSS).
FUE harvests one hair graft at a time with a tiny punch that ranges from .7mm to 1mm in size. These punches leave circular scars in the donor area. On the other hand FUSS harvests the hair grafts by cutting a strip of donor tissue which is dissected in to 1, 2, 3 and 4 hair “follicular unit groupings”. This method results in a linear scar in the donor site. Which technique is best for you? How do you decide which method to pick? It is difficult choice for many prospective patients. However, after going over the pros and cons of both methods in depth, you will be in a better position to make a well informed decision for yourself. There are many pros and cons for both FUE and FUSS harvesting methods.
The Pros for FUE:
The Cons for FUE:
Since the beginning of time, whenever there have been vital facts, there have also been great myths. Does stress cause hair fall? What is male pattern baldness? What is DHT? Are there any home solutions for baldness?
According to the NHS, 8 million women in the UK experience hair loss, which is medically known as alopecia. It can lead to a number of psychological problems including poor self-esteem and heightened self-consciousness.
Male pattern baldness generally results in a receding hairline, followed by thinning of the hair on the crown and temples. In some cases, it progresses to complete baldness. According to the International Society of Hair Restoration Surgery, 40% of men will experience noticeable hair loss by the age of thirty-five.
Let’s bust some of the most popular Hair Loss myths:
Fact: This is completely untrue as hair density is a polygenic trait, in a lay man’s language it means it is determined by more than one ancestor’s gene.
Fact: Most of the leading health expert say that masturbation is a healthy way to release stress and experience pleasure. In this case masturbation, could actually be a solution for it.
Fact: It is normal to lose some hair while washing, it is part of the natural growth cycle.
Fact: Unless you are wearing a really tight hat or a cap that cuts off the blood circulation you can wear it as much as you want to.
Fact: Testosterone is the main hormone considered for hair loss.
Fact: For men, hair loss can begin in teenage years. In such cases, it is necessary to consult a hair restoration specialist.
What is Lichen Planopilaris?
Lichen planopilaris is a rare inflammatory condition that results in patchy progressive permanent hair loss mainly on the scalp.
Three forms are recognised:
Who gets Lichen Planopilaris and why?
Clinical features of Lichen Planopilaris
Symptoms may include:
Lichen planopilaris is usually slowly progressive.
How is Lichen Planopilaris diagnosed?
Lichen planopilaris is suspected on the clinical presentation and careful examination of the mouth, nails and skin for evidence of lichen planus elsewhere.
Trichoscopy reveals absent follicles, white dots, tubular perifollicular scale and perifollicular erythema.
The diagnosis may be confirmed on a scalp biopsy that includes hairs with surrounding redness and scale at the edge of an area of hair loss. Lichen planopilaris is an example of a primary lymphocytic folliculitis.
However, it is not always possible to make a diagnosis on biopsy. Biopsy from an already scarred area of hair loss is unhelpful. Where there is only patchy scarring hair loss and no evidence of inflammation the diagnosis may not be able to be confirmed.
(Dr Delwyn Dyall-Smith FACD, Dermatologist)
Treatment of Lichen Planopilaris
Treatment should be sought and provided early as no treatment recovers hairs that have been lost and replaced by scarring. The aim of treatment is to slow progression of the disease and relieve symptoms. Hair loss may continue, although at a slower rate.
Response to treatment is variable and some published studies contradict others as to the efficacy. The best patients can expect is to stop progression of hair loss and to minimize scalp discomfort.
Lichen planopilaris (LPP) tends to be progressive, and the most effective treatments have response rates of only 10%.
Recently Low laser light therapy (LLLT) has shown potential effectiveness in scarring alopecia.
Platelet-Rich Plasma (PRP) is a promising new therapeutic treatment for people who have lichen planopilaris and may improve hair thickening in affected areas. Additional studies are warranted to elucidate the clinical benefit and optimal dosing strategies.
In conclusion, apart from LLLT, PRP is also effective in at least improving hair thickening which is a real cosmetic concern for patients.
(Jeffrey F. Scott)