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Hair loss treatments According to the NHS, male-pattern baldness (androgenic or androgenetic alopecia) affects half of all men by the time they turn 50, whilst femalepattern baldness affects an estimated eight million women in the UK. David Jacobs asks practitioners how to best treat these patients. Dr Sherif Wakil, a cosmetic doctor and hair transplant surgeon at the Royale Skin Clinic, says the number of patients attending his clinic for hair loss therapies is increasing. “Over the past 10 years, hair loss treatment has grown dramatically. The recession meant a lot of redundancies, and men in their late 40s or 50s or even 30s [with hair loss] look much older than their age. These people have found themselves competing with a younger generation who have hair on top of their head and skin that looks better. At a disadvantage, these guys started having Botox and fillers, and Platelet Rich Plasma (PRP) injections for hair loss.” Dr Wakil suggests that there may be another reason for the increase in demand. “In the past, people depended on shampoos or moisturisers. But numbers have increased because patients understand that other treatments are now available, both surgical and non-surgical.” A similar explanation is offered by Dr Britta Knoll, president of the German Society of Mesotherapy, “There’s growing interest because of more information regarding the possibility of treating these forms of hair loss with mesotherapy,” she says. According to Mr Michael May, a specialist
surgeon at the Wimpole Clinic, as awareness of new procedures has grown, so too has public confidence. This, he believes, has not only encouraged more patients to visit clinics, but has also prompted more clinics to open. The initial consultation Dr Wakil, whose treatment of choice is PRP and AQ growth factor, explains his approach: “I undertake a hair analysis and a full history. I examine the patient’s hair under a microscope and a special camera. This gives an indication of how many hairs a patient has per square centimetre, and their hair loss. Then I test the hair at the back of the head and check the health of the scalp to see if there’s dandruff or other problems, such as psoriasis. “The history is very important, it gives an indication about the type of alopecia the
Clinical Practice Special Feature
person has. There’s an obvious relationship between general health and hair loss, so I look to see if there are any underlying problems. If so, I advise that these are addressed before treatment starts. I also ask about any family history. Then I examine the patient and ask about any earlier treatments and whether these made any difference.” Dr Knoll, who sees around 20 patients a week, explains the protocol of mesotherapy treatment to her patients and details the ingredients. She checks for severe autoimmune disease and whether patients have allergies to the ingredients or signs of infection on the scalp. She also takes photographs for comparative purposes. She explains, “First we do an examination and take a medical history – we need to know what kind of treatment has been carried out before. We also need to know if there has been a laboratory check and everything is okay with the blood and hormones. We clean the skin and give a mixture of specific bio revitalisers that are composed for mesotherapy.” CEO of Dermagenica Dr Gabriela Mercik, who typically uses the Dermaheal HL hair growth programme containing nano-peptides before hair transplants, to improve hair condition, establishes the pattern and type of hair loss, the level of vitamin D and the patient’s genome to diagnose the problem. Mesotherapy treatment First described by the physician Michael Pistor, mesotherapy is an injection treatment that nourishes layers of the skin where there is cell repair and growth. Treatment is primarily carried out on the top of the head and only works if the hair bulbs are still alive. Compared to other techniques, Dr Knoll finds that the main advantage of mesotherapy is that it is a gentle treatment, involving little pain. “We very rarely see any side-effects. Patients may have some bruising or itching, and if there are only a few hairs left they must take care not to go out in the sun – micro-injection points create hyper-pigmentation when in contact with the sun. Patients have to cover their heads and wash their hair before they come for treatment but then avoid washing or
Treating hair loss with mesotherapy. Images courtesy of Dr Britta Knoll
Aesthetics | September 2014
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