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Aesthetics Journal
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Treating Alopecia with Mesotherapy and Botulinum Toxin Dr Philippe Hamida-Pisal presents a pilot study on a new protocol for treating alopecia, created with Pam Cushing, Dr Michelle Westcott and Dr Jan Nel Hair possesses a symbolic connotation of strength and seduction that dates back to Egyptian times and to which we still attach great importance. The appearance of hair can be interpreted in very different ways, in concepts that rank from sexuality to religion. As a result, hair loss can have a significant psychological impact that varies depending on culture, age and sex.
Numbers to remember In an adult, these are the average numbers for:1 • Hair density: 200 follicles / cm2 • Number of hairs: 100-150,000 • Diameter: 0.1mm • Growth per month: 1-1.5cm • Hair life: 2-7 years • Number of cycles: 15-20 • Hair resistance: 100gr
Alopecia and the hair cycle There are different types of hair loss that can appear as defined patches or as more widespread and diffuse areas. We know that the incidence of alopecia increases dramatically with age and androgenic alopecia is the most common type of hair loss in both men and women. In the Caucasian population, 70 to 80% of men and 42% of women between 50 and 70 years old show signs of hair loss.1,2 The hair cycle is divided into three phases:1,2 1. First, we have the active growth phase of hair follicles known as anagen. A hair is formed by a bulb with a vessel in its centre that brings nutrients to it. This phase lasts between two to four years and, if a hair is torn during this phase, it will never grow back. 2. Then we have the resting phase, called catagen, when a hair stops growing. It gradually detaches from the bulb and rises to the surface of the skin. The dermal papilla begins to separate itself from the hair follicle and the vessels it contains disappear gradually. 3. Finally, we have the falling phase, called telogen, during which the hair is detached from the follicle. The residual bulb disappears and another is formed to give birth to a new hair. The dermal papilla, which contains vessels, migrates to the new bulb to provide it with the nutrients it needs for a new growth phase.
hair loss by speeding up the hair renewal process. After 25 cycles, the follicle becomes exhausted and the hair becomes finer, until it dies and disappears. Treatment is directed towards this hormonal transformation in order to prevent the conversion of testosterone into DHT.1,2,3
Therapeutic approach
Dr Michelle Westcott, Dr Jan Nel (from the Society of Mesotherapy [SoMZA] South Africa), Pam Cushing and I (from SoMUK), who are all key members of the Societies of Mesotherapy, have devised a treatment protocol for androgen alopecia using a combination of mesotherapy and botulinum toxin. The purpose of the treatment is to prevent the catagen phase and extend the anagen phase through the use of antioxidant and cytoprotective molecules, which will aim to induce the stimulation of cellular metabolism and hydration. These molecules are present in cocktails such as NCTF 135 HA from Filorga Laboratory, NCTC 109 from mesoestetic or Cytocare 516 from Revitacare. We already understand the role of polyrevitalising solutions and their effect in terms of regrowth, quality, moisture, thickness and hair shine.4 By combining different types of vitamins in one solution, practitioners are able to offer patients tailored treatments for their individual concerns. Similarly, we also know the action of botulinum toxin on the sebaceous glands, keratin and therefore its effect on the quality and stiffness of hair.5 Injecting botulinum toxin into the peripheral muscle increases the decompression of vessels through muscle relaxation, thus causing an augmentation in oxygen to the frontal and coronal scalp.6 The metabolism of Before
After
The role of hormones Baldness depends on certain hormones, called androgens, hence the scientific name of androgenic alopecia. Androgens are converted into dihydrotestosterone (DHT) by the 5-alpha reductase enzyme, which makes them active and encourages
Reproduced from Aesthetics | Volume 3/Issue 7 - June 2016
Figure 1: Before and after six weeks of treatment with botulinum toxin and mesotherapy