There are many reasons people lose their hair. Heredity is the most common cause of alopecia, the medical term for baldness. The trait can be inherited from either the mother's or father's side of the family. Women with this inherited tendency have thinning hair but usually do not become totally bald. Hair loss usually starts in the late teens, twenties or thirties.
Hair loss also can result from many medical conditions, including high fever, severe infection and thyroid disease. Women commonly lose hair after childbirth. Major surgery, certain medications and chemotherapy may cause hair loss.
There are proven medical treatments for hair loss. Results vary greatly because the response to treatment depends on the initial cause of the baldness. Frequent washing is effective at halting or decreasing baldness for some patients, while others require treatments which may include the use of systemic steroids or hormones, or the application of ointments, tar preparations and antibiotics directly to the scalp.
Hair transplantation
Surgery may correct some types of baldness. The most common surgical form of hair replacement is hair transplantation. During this procedure, surgeons transfer grafts of skin and hair from the back of the scalp, where hair growth is full, to bald areas.
Traditional hair transplantation moves round grafts of skin and hair about the size of a pencil eraser from the back and sides of the scalp. These grafts are then placed in the bald areas. Several transplant sessions are always required, and the procedures are usually done at six-week intervals. The number of procedures done depends on the amount of hair replacement desired.
Hair transplantation is performed on an outpatient basis. Hospitalization is not necessary. Patients are given intravenous sedative for relaxation. A local anesthetic is then injected into the scalp.
Micrografts and minigrafts are a new modification to hair transplantation. As few as one or two hairs are transplanted with each graft (several hundred or more per session). This technique provides a more natural hairline but requires a greater number of grafts.
During micrographic transplantation, strips of skin and hair are excised, and the donor site is sutured. These strips are cut into small grafts with varying numbers of hairs per graft. The smallest grafts are called micrografts and minigrafts. While more tedious and time consuming, the results from this procedure are the most cosmetically acceptable and avoid the appearance of having "doll's hair" or "corn rows."
Transplanted hair usually goes into a resting stage after hair transplantation. The short hairs that were transplanted will fall out within a few weeks. You will see no growth for up to three or four months. The second transplant procedure may be performed despite lack of hair growth. Six to eight months will pass before the quality of your new hair can be properly evaluated.
Scalp reduction
Some patients with extensive hair loss may not have enough hair to transplant satisfactorily. In those cases, scalp reduction is considered.
Scalp reduction is another surgical technique. It involves removing areas of bald scalp and stitching the scalp together to bring existing areas of hair growth closer together. Sometimes the skin of the scalp is too tight for this. In that case, tissue expansion is necessary.
Tissue expansion involves placing a silicone balloon under the scalp and then inflating the balloon gradually to expand the scalp. After the scalp has stretched, there is enough skin to work with for the scalp reduction technique.
Postoperative Care
The most common problem following scalp surgery is bleeding. Some bleeding is expected because the scalp contains many blood vessels. Bruising of the skin around your eyes frequently occurs, but it usually goes away within two weeks. Swelling is normal and may occur three to four days after surgery. This subsides within 10 days. Infection is not a common complication.
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