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FAQs

This section aims to address common questions that potential clients may have. It serves as a helpful resource that provides quick and easy answers to common inquiries that users may encounter.

Alopecia 

is a medical term used to describe any type of hair loss, whether it is temporary or permanent, localized or generalized, regardless of the underlying cause. It is a broad term used to describe a variety of conditions that affect hair growth, including androgenetic alopecia, alopecia areata, telogen effluvium, and others.

Alopecia areata

is a medical condition characterized by hair loss in circular patches. It can occur in hair-bearing areas, with the first episode occurring in 60% of cases before the age of 20. While the exact cause of alopecia areata is unclear, it is believed to be partly genetic and involve a T-cell mediated immune attack on the hair follicle.

Alopecia areata can present in different patterns, including alopecia areata circumscripta (circular patchy loss), ophiasis (ring of complete hair loss around the back of the head), and sisypho (loss of hair in the frontal, temporal, and parietal regions, mimicking male pattern baldness). In all cases, the follicular ostia (openings of lost follicles on the scalp) are visible, and in the active periphery, exclamation point hairs can be seen, where the broken distal hair is thicker than the proximal hair shaft.

Treatment options for alopecia areata depend on the extent of hair loss. For limited cases, intralesional steroid injections and minoxidil are ideal treatments. For more extensive loss, topical immune modulators may be necessary. Hair transplantation into active areas of alopecia areata is not advisable, as the rate of hair growth in these patches is generally very poor.

In conclusion, alopecia areata is a complex condition that can affect people of all ages. By understanding its patterns and mechanisms, it is possible to identify appropriate treatment options and manage the condition effectively.

Androgenetic Alopecia

Male pattern baldness (MPB), also known as androgenetic alopecia (AGA), is the most typical reason for hair loss. It is untrue to believe that hair loss on one's mother's father is a sign that one is more likely to develop baldness in the future. In actuality, baldness is caused by polygenic genetic traits that can be inherited from either parent.

Thinning of the hair can begin as early as the age of 15 and as late as 55. Hair thinning or hair loss without treatment can affect emotions and self-esteem in a person's life. 

Alopecia reduction (AR)

is a surgical procedure designed to treat hair loss, formerly known as scalp reduction. During the surgery, bald areas on the crown of the head are removed, typically using a vertical incision. In some cases, a horizontal or Y-shaped incision may be used instead. The procedure must be performed sequentially, removing and closing one area of the scalp at a time.

To reduce the number of sessions and the interval between AR procedures, a type of AR called scalp extension has been developed by Patrick Frechet. Scalp extension can be used in conjunction with traditional hair transplant surgery in the frontal or "U-shaped" region of the head.

By combining AR with other hair restoration techniques, it is possible to achieve more comprehensive and long-lasting results. However, as with any surgical procedure, it is important to weigh the potential benefits against the risks and consider all available options before making a decision. 

Alopecia totalis

is a type of hair loss that falls under the category of alopecia areata, which is an autoimmune disorder that causes hair loss on the scalp and other areas of the body. In the case of alopecia totalis, all of the hair on the scalp is lost, often resulting in a completely bald head. While the exact cause of alopecia totalis is unknown, it is believed to be related to a malfunction of the immune system that causes it to attack the hair follicles. 

Unlike other forms of alopecia areata, such as alopecia areata circumscripta or ophiasis, which typically cause hair loss in circular patches or a band-like pattern, alopecia totalis results in complete hair loss across the entire scalp. This condition can be difficult to treat and often requires ongoing management to help promote hair regrowth and prevent further hair loss. Some treatment options for alopecia totalis may include topical immunotherapy, corticosteroid injections, or oral medications, although the effectiveness of these treatments can vary depending on the individual case.

Alopecia universalis

is a type of hair loss that falls under the category of alopecia areata, which is an autoimmune disorder that causes hair loss on the scalp and other areas of the body. In the case of alopecia universalis, all of the hair on the scalp, as well as the eyebrows, eyelashes, and body hair, are lost, resulting in a complete absence of hair on the entire body.

The exact cause of alopecia universalis is not fully understood, but it is believed to be related to a malfunction of the immune system that causes it to attack hair follicles throughout the body. Unlike other forms of alopecia areata, such as alopecia areata circumscripta or ophiasis, which typically cause hair loss in circular patches or a band-like pattern, alopecia universalis results in complete hair loss across the entire body.

Alopecia universalis can be challenging to treat, and there is no cure for the condition. However, there are some treatment options that may help promote hair regrowth and manage symptoms. These may include topical immunotherapy, corticosteroid injections, or oral medications, although the effectiveness of these treatments can vary depending on the individual case. Additionally, individuals with alopecia universalis may benefit from using wigs, hairpieces, or other forms of hair replacement to help manage the physical and emotional effects of the condition.

Follicular Unit Excision

(FUE) is a modern hair transplant technique that differs from conventional strip harvesting, which involves surgically removing a strip of scalp from the back of the head. Instead, FUE involves individually harvesting follicular units, which are groups of hair follicles that naturally grow together. This is done using a small, specialized tool that extracts individual follicles from the donor area of the scalp, usually at the back of the head or sides. The extracted follicles are then transplanted into the recipient area, where hair loss has occurred.

FUE has several advantages over strip harvesting, including less scarring and a quicker recovery time. With FUE, there is no linear scar in the donor area, which can be a concern for patients who prefer to wear their hair short. Additionally, FUE allows for more precise harvesting, which can result in a higher percentage of viable grafts and a more natural-looking hairline.

It's important to note that FUE is not suitable for all patients or all types of hair loss. Dr. Flores can evaluate your individual case and recommend the most appropriate technique for your specific needs.

Central Centrifugal Cicatricial Alopecia

(CCCA) is a type of scarring alopecia that affects the crown or vertex of the scalp, and typically occurs in African American women, although it can affect individuals of any race or gender. CCCA is characterized by progressive hair loss and scarring in the affected area, which can lead to permanent hair loss.

CCCA is thought to be caused by a combination of genetic and environmental factors, such as tight hairstyles, chemical hair treatments, and scalp inflammation. The condition may also be associated with other medical conditions, such as autoimmune disorders.

CCCA encompasses a range of related conditions that affect the central scalp, including folliculitis decalvans, follicular degeneration syndrome, and pseudopelade of Brocq. Folliculitis decalvans is a chronic bacterial infection of the hair follicles that can lead to scarring and hair loss. Follicular degeneration syndrome is a condition in which hair follicles become damaged and scarred, leading to progressive hair loss. Pseudopelade of Brocq is a rare form of cicatricial alopecia that is characterized by patchy hair loss and a smooth, white, scarred appearance of the scalp.

If you are experiencing hair loss or scalp inflammation, it's important to consult a dermatologist for an accurate diagnosis and appropriate treatment. While there is no cure for CCCA, early diagnosis and treatment can help slow or stop the progression of the condition and preserve remaining hair. 

Cicatricial alopecia

is a type of hair loss that involves scarring and requires prompt treatment. This condition can be divided into two major types: inflammatory and non-inflammatory. Inflammatory cicatricial alopecias include discoid lupus, lichen planopilaris, and folliculitis decalvans, while non-inflammatory types include pseudopelade of Brocq and follicular degeneration syndrome. It is important to seek medical attention promptly for cicatricial alopecia as early diagnosis and treatment can help prevent further hair loss and scarring.

Chronic telogen effluvium

is a condition that primarily affects women between the ages of 30 and 60 years. It is characterized by periodic shedding of hair without an obvious and definable cause, through a process known as telogen effluvium. While the exact cause of chronic telogen effluvium is not well understood, it is believed to be linked to factors such as hormonal changes, nutritional deficiencies, and stress.

Women's Hair Loss

The specific cause of female hair loss is unknown, but genetic and hormonal factors are almost certainly involved. Due to an excess of androgen hormones, some women are prone to hair loss at a young age. When estrogen levels decline and androgen hormones become proportionately stronger, hair loss only becomes more noticeable during menopause.

When assessing a woman for hair loss, it is important to keep in mind that women are more prone to various forms of hair loss illnesses. Pregnancy may cause hair to continue in the anagen phase up to delivery, at which point it sheds. 

The top of the head typically has the most pronounced loss. Hair grading is the Ludwig scale for female thinning. Women can also exhibit a different form of hair loss that mimics androgenetic alopecia or male pattern baldness. Inherent genetic factors in women continue to be the leading cause of hair loss in the general population, despite the possibility of many external variables having an impact. Hair loss typically starts to become apparent in the late 20s and picks up speed following menopause, possibly due to an imbalance between male and female hormone levels. Hair restoration in women is challenging to produce the required density for a satisfactory outcome. Hair density may be achieved by combining different-sized grafts, our FUE technique is specially adapted to female hair loss. Surgical hair restoration candidacy may be one option.

De-emphasis grafting

is a technique used to improve the appearance of a previous hair transplant that did not produce the desired results. This method involves strategically placing new, healthy hair grafts in front of and around poorly executed grafts from the previous procedure. By doing so, the emphasis is shifted away from the old grafts, while adding overall density to the hairline. The new grafts are carefully selected for size, angle, fit, and gentle insertion to ensure a natural-looking outcome.

Diffuse Patterned Alopecia (DPA)

is a type of hair loss that is characterized by a diffused pattern of hair thinning, which is similar to male pattern baldness but without actual bald spots. Unlike other forms of hair loss, hair loss in DPA does not affect the occipital donor area at the back of the head. This means that hair can still be harvested from this area for hair transplantation procedures.

Diffuse Unpatterned Alopecia (DUPA)

is a condition characterized by widespread thinning of hair across the scalp, which can be particularly severe in the frontal and vertex areas. Unfortunately, this type of hair loss can also affect the occipital region, which presents a challenge for hair transplant procedures as the transplanted hair may not survive. Therefore, other hair restoration methods may need to be considered for individuals with DUPA.

5-alpha reductase inhibitor

is a medication that blocks the enzyme 5-alpha reductase, which is responsible for converting testosterone to dihydrotestosterone (DHT). DHT is known to contribute to hair loss in androgenetic alopecia (AGA), also known as male pattern hair loss. Finasteride is a selective type II 5-alpha reductase inhibitor that is commonly used in the treatment of AGA because it targets the enzyme in hair follicles and the prostate. Dutasteride is a type I and type II 5-alpha reductase inhibitor that blocks the enzyme more broadly throughout the body, but it is not currently FDA-approved for the treatment of AGA.

Lichen Planopilaris

is a prevalent type of scarring or cicatricial alopecia, accounting for around 30 to 40% of all scarring alopecias. It is characterized by inflammatory lesions with follicular hyperkeratosis at the periphery, as opposed to central hyperkeratosis observed in discoid lupus. Treatment options include intralesional steroid injections, systemic steroids, and possibly hydroxychloroquine. However, hair transplant is not recommended until the disease is under control.

Ludwig Scale

is a diagnostic tool used to describe female pattern hair loss, which is also known as androgenetic alopecia in women. This type of hair loss is characterized by centralized diffused loss of hair, unlike male pattern hair loss, which follows a distinct pattern. The Ludwig Scale is a three-point grading system that helps physicians classify the degree of hair loss in women.

A Ludwig I indicates mild hair thinning throughout the central scalp, while a Ludwig II indicates moderate thinning with notable hair loss in the central scalp. A Ludwig III indicates severe hair loss and thinning in the central scalp, which can be distressing for women.

Women who are diagnosed with Ludwig III hair loss require a thorough medical evaluation, including a metabolic workup and possible scalp biopsy, to determine any underlying causes of hair loss that may be reversible. This evaluation can help identify any hormonal imbalances, nutrient deficiencies, or other medical conditions that may be contributing to hair loss.

By using the Ludwig Scale, physicians can accurately classify the degree of hair loss in women and develop a treatment plan that is tailored to their specific needs. This may include a combination of topical treatments, oral medications, and lifestyle modifications to improve overall hair health.

Norwood classification

also known as the Norwood-Hamilton scale, is a widely used system for categorizing male pattern baldness. It was first proposed in 1975 by Dr. O'Tar Norwood, and has since been modified and expanded by Dr. James Hamilton. The classification system consists of seven stages, each representing a different degree of hair loss and balding pattern.

Class I represents a juvenile or adolescent hairline without any evidence of balding.

Class II shows some limited fronto-temporal recession and mild elevation of about a finger's breadth above the upper brow crease, which is a normal progression for an adult.

Class III is the earliest stage of androgenetic alopecia, with a deeper fronto-temporal recession. Class III vertex is a variation in which there is early signs of hair loss in the vertex, or crown of the head.

Class IV of the Norwood classification for male pattern baldness, there is a further recession of the hairline in the fronto-temporal region, along with hair loss in the vertex. However, there is still a well-defined and strong band of hair that separates the front and back of the scalp.

Class V, the area of hair loss becomes more extensive, and the band of hair separating the front and vertex regions begins to break down. This results in a more diffuse and less defined pattern of hair loss across the scalp.

Class VI, there is a complete loss of the band of hair connecting the front and vertex regions, resulting in a more advanced and diffuse pattern of hair loss. However, there is still a high fringe of hair maintained at the back and sides of the scalp.

Class VII, there is a low fringe of hair remaining, along with a horseshoe-shaped pattern of hair loss around the back and sides of the scalp. This represents the most advanced stage of male pattern baldness in the Norwood classification.

It is important to note that the Norwood classification is not a definitive diagnosis, but rather a tool to help doctors and patients understand the degree and pattern of hair loss. Additionally, hair loss can manifest differently in different individuals, and not all cases of male pattern baldness will fit neatly into one of the seven Norwood stages.

Traction Alopecia

is a form of hair loss that occurs as a result of constant or repetitive tension on the hair follicles, usually due to tight hairstyles such as braids, weaves, and ponytails. This type of hair loss is particularly prevalent in the African-American community, but it can occur in any ethnic group. The constant tension on the hair follicles can cause inflammation and damage to the hair follicle, leading to hair loss that is often irreversible. Traction alopecia can also be caused by certain hair care practices such as excessive brushing, heat styling, and chemical treatments. Early intervention can help prevent further hair loss and promote regrowth, but if left untreated for an extended period of time, the damage to the hair follicle may become permanent.

If you have any questions or concerns regarding your hair loss, please don't hesitate to contact our office. Our team is always happy to assist you with your needs.

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