Previous month:
April 2011
Next month:
June 2011

Stem Cells from Hair Follicles May Hold Key to Vitiligo Treatment

image from www.nature.com Vitiligo is a disorder characterized by patchy loss of skin pigmentation due to immune attacks on melanocytes.  In cases where the vitiligo resolves spontaneously or with anti-inflammatory treatments, pigmentation returns to the skin starting at the areas where hair follicles reside.

A recent article in Journal of Investigative Dermatology described Repigmentation during recovery from vitiligo. "During the active phase of vitiligo, cutaneous melanocytes are destroyed. During recovery, as seen in this clinical image of a patient's leg (a), the destroyed melanocytic cells can be replaced. These new melanocytes appear to be derived from a protected population of cells within the hair follicle as shown in these dermoscopic images (b and c) from two patients recovering from vitiligo."

The question is then asked, "could hair transplantation be used to restore pigmentation to those areas depigmented by permanent vitiligo?"

If you have permanent vitligo, we would like to hear from you.  Please email doctorb@baumanmedical.com for information on clinical trials to address permanent vitiligo using hair follicle / stem cell transplantation. 


Tonight on NYU Doctor Radio, Hair Loss, Hair Growth Meds, Hair Transplants

image from farm3.static.flickr.com Tonight on NYU Doctor Radio-SiriusXM-81, Hair Loss Expert Dr. Alan J. Bauman will discuss the medical management of hair loss. Prevention, treatments, transplants, myths and misconceptions... and more!

Live on the air tonight: Thursday, May 26th at 6:30pmET/3:30pmPT

Tweet your hair loss questions @DrAlanBauman in advance and he'll answer them live on the show.


Is "Shedding" your top hair loss complaint?

Hair shedding, also called "hair fall" or "effluvium" in medical circles, can be troublesome.  More hair in your brush, in your shower drain, in your sink, on your pillow, etc. is NOT something that most people look forward to noticing... especially if you're seeing less hair on your head!  Decreasing coverage in men or shrinking ponytail volume in women are top complaints of those experiencing hair loss.  But, what are the causes of shedding? Is shedding temporary? Normal, natural? How much shedding is "too much?" 

Some hair loss patients that we see at Bauman Medical Group often complain of seeing hair literally falling out of their scalp. Many patients will actually bring in hair that they have collected over time and others will physically show us that hair is literally falling out of their head when they comb through it. If you are a 'hair collector' we can discuss whether that's a good idea or not! Patients often also complain of hair shedding when they start a new hair regrowth regimen.

Some patient complain that excessive shedding occurs at regular intervals or specific times of the year.  To know whether a shedding phase is significant or not sometimes requires a little bit of investigation on the part of Hair Restoration Physician. Sometimes the amount of noticeable hair shedding is a function of the color, quality, curl and length of the hair. Other factors may include the frequency of shampooing, styling or other haircare habits.

The normal and natural Hair Growth Cycles that each follicle goes through gives us some insight.  Every normal follicle on your body will spend a certain amount of time producing hair (Growth or Anagen Phase) and some time 'resting' (Catagen/Telogen Phases), eventually switching back into a growth phase.  Unlike other parts of your body--think: fingernails--which will grow cotinually and uninterrupted, hair production in the follicles has a specific "on" and "off" routine. The length of time that healthy follicles would normally spend in a growth phase is determined genetically--some people can grow long hair to their hips and others to only their shoulders.

Somewhere between the time when the hair follicle switches off and then begins to produce hair once again, the resting hairshaft is shed.  In the animal kingdom, there may be a synchronized shed of hair (like in the Springtime, for example) to ready the animal for the summer months by shedding the protective 'winter coat.'  In humans, hair cycling is considered to be mostly randomized and actually not that well understood. However, we do know that hair follicles can 'cycle off' due to a variety of reasons, including but not limited to hereditary hair loss, certain medications, crash diets, stress, illness, high fever, etc.

Of the approximately 100,000 hair follicles on a normal scalp, it is estimated that on any given day 10% (approximately 10,000) are in a resting phase and not producing hair.   Each day, some of the resting follicles are 'switching on' and others are 'switching off' theoretically each producing a shed of a single hair. According to medical textbooks, 100-200 hairs shed per day is considered "within normal limits." In patients without a hair loss problem, the numbers of hairs shed are theoretically replaced by the new growth.  But the problem is that for some patients with some types of hair loss, the shed hairs may not replaced by good quality hairs or by any hair at all!

There are many factors that could determine whether 100-200 hairs shed is a problem or not for different patients. Progressive hereditary hair loss (male pattern or female pattern baldness) is characterized by a shortening of growth cycles as well as a miniaturization of the hair follicles in the affected area.  This means that in these patients, hair follicles in the hairline and crown/vertex area in men and the frontal, temporal or top area in women, will continue to will produce thinner, shorter and wispier hair over time. These patients may or may not complain of shedding.

...

"Hair Complaints..." to be continued!

If you are seeing excessive hair shedding as well as a decrease in coverage of your scalp or a recession of the hairline or decrease in hair volume, this could be a sign of a medically-treatable hair loss condition.  For more information, contact Dr. Alan Bauman at doctorb@baumanmedical.com or visit http://www.baumanmedical.com

 

 

 


Allergan due to start Phase2 Latisse trials for hair growth

http://www.clinicaltrials.gov/ct2/show/NCT01325337?term=Safety+and+Efficacy+Study+of+Bimatoprost+in+the+Treatment+of+Men+With+Androgenic+Alopecia&rank=1

 

image from farm3.static.flickr.com

 

The table above, found on fda.gov, shows that Allergan will be comparing the safety and efficacy of three different solutions of bimatoprost applied once a day to the 'vehicle' solution (no active ingredient) as well as a 5% minoxidil solution (2/day).  300 patients will participate.

The trial is scheduled to start in June 2011 and complete sometime in September 2012.


First Video: Robotic FUE Hair Transplant ARTAS, thanks baldtruthtalk.com

 

Thanks to baldtruthtalk.com for giving us this first look at Robotic FUE hair transplantation using the ARTAS device from Restoration Robotics. As we have previously mentioned in a separate post on the FDA-approved FUE hair transplant Robot, eventually the ARTAS robot may help the surgeon harvest the hair follicles for transplantaton. What we noticed most on this video is that the punch that the robot uses (1.0mm) is much larger than the smallest punch used for NeoGraft FUE (0.8mm). It is important to note that a wound from a 1.0mm punch is 160% more traumatic than a wound from a 0.8mm punch. 

For more information on what automated, less invasive, no-scalpel, no-stitch FUE NeoGraft hair transplant technology is available today, visit http://www.baumanmedical.com or http://www.neograft.info


Latisse for Scalp Hair Growth on ABC Good Morning America

   

Could the FDA-approved eyelash growth medication Latisse be the next topical hair growth drug for men and women with hair loss?   Allergan thinks it might have some promise since they've started clinical trials to seek FDA-approval.   In this week's New York Times, experts weighed in on their perspective in the use of Latisse on the scalp to encourage hair growth. 

At Bauman Medical Group, we use fda-approved medications, laser therapy, nutritional modification in addition to off-label treatments in some cases to help our patients enhance, protect and restore their own living and growing hair.

Generally, for women with thinning hair and hair loss, alternatives to the FDA-approved topical treatment Rogaine (minoxidil) or 82M (strong, prescription-strength minoxidil) are used when side effects like skin irritation occur. 

Latisse/bimatoprost is a topical treatment that MAY be able to be used just once a day, as opposed to minoxdil topicals which MUST be used twice a day for maximum effectiveness.

Research is underway which will determine how effective Latisse will be and which patients are likely to get the best response.

Tracking with HairCheck and other standardized devices make the medical management of hair loss an accurate and scientific processs.

For more information on the medical management of hair loss and the latest hair growth treatments, visit http://www.baumanmedical.com

 


Hair Loss / Hair Transplant Robot and NeoGraft FUE on FOX NEWS

As a full-time hair transplant surgeon, personally, I'm excited about the ARTAS robot and it's possibilities. Hopefully, those of us who already routinely perform no-scalpel/no-stitch FUE hair transplant procedures using automated devices like NeoGraft will be amongst the first to take ARTAS for a "test-drive" and see what the device is capable of. Now that the device is FDA-approved, the testing can begin.

Just a reminder, harvesting the hair for transplantation plays NO role in the final naturalness of the restoration in the transplanted area--this is determined exclusively by the artistry of the surgeon. For what's available today for treating hair loss safely and effectively, visit http://www.baumanmedical.com


Latisse for Scalp Hair Growth - NY Times Article

Nytlogo152x23

 

Our patient, Richard Paduda, was featured today in a NY Times article on new strategies for hair growth and the prevention of hair loss. 

Excerpt from the New York Times article by Douglas Quenqua, May 4 2011:

Z-SKIN-B-articleInline While the F.D.A. has not approved Latisse as a hair-loss treatment — only two drugs have that designation: minoxidil (Rogaine, also a topical medication) and finasteride (Propecia, which is administered in pill form) — there are no laws preventing doctors from prescribing it for that purpose. Dr. Bauman said he has been prescribing a generic form of bimatoprost, the active ingredient in Latisse, to combat hair loss since 2007, and that it has worked for about 70 percent of his patients.

“What we found is that where patients were applying Latisse, especially in areas where the hair was thinner and wispier and less pigmented, the hair grew thicker, stronger and healthier,” he said.

Though some users of Latisse have experienced skin discoloration, Dr. Bauman said he had never seen any such reaction on the scalp of his patients.

Certainly, Mr. Paduda, who used Latisse daily from November through February, is a happy customer. By the third week, he said, both he and friends he asked for reactions were seeing results. “I even busted out the old ‘before’ and ‘after’ pictures,” he said. “It was a noticeable difference.”

 

Regardless of what treatment you choose (topical minoxidil, bimatoprost, lasercap laser therapy, in-office laser hood treatments, NeoGraft FUE transplants, etc.) you should have baseline measurements and photos taken by a Diplomate of the American Board of Hair Restoration Surgery. Tracking should be performed every 90 days using HairCheck, scalp microscopy and standardized photos.

Sincerely,

Dr. Alan J. Bauman - Hair Restoration Physician

Boca Raton FL  http://www.baumanmedical.com


Mega FUE hair transplant easier with NeoGraft, which is not a robot

NeoGraft is not really a robot, but it is a medical device which makes harvesting individual hair follicles and follicular units for transplantation (FUE) more accurate and more efficient. Just a few years ago, hair transplant surgeons could not imagine harvesting over 2,000 FUE type grafts in a single day. Today, this is a common hair transplant reality! New methods also allow for two-day procedures, so more hair follicles and follicular units can be harvested and implanted in a single visit to the clinic. This set contains examples of patients who have had two-day sessions of FUE / NeoGraft transplantation, commonly known as a "Mega FUE" hair transplant. For more information on Dr. Alan Bauman's no-scalpel, no-stitch, no-staple harvesting technique using FUE NeoGraft, visit www.baumanmedical.com or www.neograft.info