Summary
In this episode of The Peter Atia Drive, Peter Atia interviews Dr. Alan Bauman, a board-certified hair transplant surgeon who has treated over 20,000 patients. They discuss the prevalence of hair loss, which affects almost 100 million Americans, with 80 million being men and 46 million being women. Hair loss and premature graying are both genetically predetermined. Male pattern hair loss can start after puberty and affects 20% of men in their 20s, 30% in their 30s, and 40% in their 40s. Hair loss is 98-99% genetically determined and can vary in speed and pattern. Women's hair loss is multifactorial and can be affected by hormones. Shedding is a normal process, but a change in follicle percentages can result in a thinner head of hair. Dihydrotestosterone (DHT) is the primary trigger for male pattern hair loss, and finasteride is a common treatment that blocks the enzyme that turns testosterone into DHT. However, it is not without side effects and does not completely block DHT. The literature on prostate cancer and finasteride is still confusing.
The hosts discuss the history and science behind hair restoration surgery and hair loss treatments. They explain that one of the main causes of hair loss is DHT, a hormone that can shrink hair follicles. They also discuss the use of finasteride, a drug that can inhibit DHT production, and its potential side effects on the prostate. They mention that Rogaine was the first FDA-approved medication for hair loss and that it is available over-the-counter, but can be difficult to use. They also discuss the challenges of treating hair loss in women, particularly those with PCOS, and the limitations of current treatments. The speaker recommends early evaluation and measurement for those with a family history of hair loss to assess the risk and potential preventative measures.
The context is about Platelet-Rich Plasma (PRP) therapy for hair growth. The speaker explains how they started using PRP in 2006-2007 and noticed improvements in hair growth. PRP stands for platelet-rich plasma and is derived from the patient's own blood. Platelets contain growth factors and cytokines that help with tissue regeneration and repair, which has a positive effect on hair growth. PRP was initially used as a wound healing treatment, but physicians noticed an improvement in hair growth when applied. PRP has a role in preventing the loss of follicle function and enhancing weak follicles. Combination therapy is used to prevent the loss of follicle function, enhance follicles, and restore density to areas that are too far gone.
The context discusses hair transplant procedures and the different techniques used by doctors. The traditional linear harvesting technique is still used by many national clinics and some doctors prefer it over the newer single follicular extraction (FUE) method. However, FUE is considered a better approach for aesthetics. The number of grafts that can be harvested and implanted in a day depends on the patient, but large cases are usually done over two consecutive days. Alternative sources of donor hair, such as beard or body hair, may be used if the patient has scar tissue or has had less efficient harvesting techniques in the past. Women's hair transplant procedures are different from men's due to less volume and greater ability to cover up donor sites. The biggest risks of the procedure are bleeding and infection, but these are rare. The main concern is that the patient may not be happy with the results, so clear communication between the doctor and patient is essential. The doctor must be clear about what is possible and what is not in terms of achieving the desired outcome.
