ENRICH is a dermatology clinic, so hair loss assessment is geared towards working out the root cause of hair loss so a strategy can be tailored and individualised. Through proper assessment, we are able to offer a range of options to stimulate hair growth and reduce ongoing hair loss.
Depending on the cause of hair loss, procedures may include topical and oral therapies. One of our treatments activates stem cells for hair growth on the scalp. Whilst transplantation is the most heavily marketed way of addressing lost locks, regrowth is not a one-size-fits-all scenario. There are other options that can prove effective.
To activate stem cells, we inject a special substance into follicles that acts as a growth stimulant. Growth factors and stem cells are used to trigger the follicle, activating the stem cells and causing underdeveloped or underactive follicles to grow.
Our treatments don’t work for all types of hair loss, but can work for a few different forms of hair loss in men and women.
This treatment works in certain circumstances, but results depend very heavily on the state of the scalp to begin with. It also depends on the cause of follicle impairment or loss. You may expect just some regrowth after a procedure, not a full head necessarily – but, everybody is different, so results really do vary considerably.
Catching hair loss early means greater support for your underactive follicles. Follicles can be stimulated into producing hair, supporting healthy, functional follicles.
Expectations need to be managed when it comes to hair loss. Sometimes regrowth is an impossibility or results are very limited. Sometimes, the treatment itself is worse than the hair loss, ( yes it can be painful) and needs to be abandoned.
One study (Swapna et al 2014) offered us this: ‘…injection for androgenic alopecia is a simple, cost-effective and feasible treatment option for hair loss and can be regarded as a valuable adjuvant treatment modality…’
The research team recruited participants who had previously tried other (unsuccessful) hair loss treatments. The schedule included four injections across the scalp. Over the study period, hair counts increased from an average of 71 follicular units to 93 follicular units. That means just over 22 more hairs per square centimetre on the scalp.
Researchers also conducted what’s known as ‘hair pull tests’ before and after the study, finding that a mean of 10 hairs came out of each man’s head prior to treatment when pulled, but after the PRP injections, the pull tests were mostly negative. That means no hairs came out when pulled in nine out of the 11 study participants. This indicates that not only did the treatment work to increase hair count but also strengthened follicles.
The study group was small; however, these results in men who had undergone previously unsuccessful procedures were impressive and encouraging. The men in the study reported an average satisfaction rating with the injections of seven out of 10.
The actual treatment is reasonably straightforward. The doctor removes about 120ml of your own blood from your arm. The blood is then put into a special centrifuge (ours results in a denser mixture at the end – we use the Angel centrifuge), which separates out the red and white blood cells from the plasma and platelets.
This process takes about 10 minutes.
Then, using a special injector with multiple prongs (to reduce the time it takes to cover your whole scalp) is used to inject the treatment into your scalp. Anaesthetic is used to avoid any discomfort. The process is then complete for one of your sessions. You need multiple sessions to get results. Sessions in total can take approximately an hour.
We have a range of treatments including medication, lasers and PRP.
Some loss can be halted or reversed, but it will depend on the cause. Patchy loss sometimes resolves itself with no treatment over a period of months.
The idea behind treatments is ideally hair regrowth, but also to slow or hide loss. Medication-based male treatments include Minoxidil (Rogaine) or another prescription-only drug in pill form.
Minoxidil is available over the counter, and is used as a scalp rub twice daily. It can be used by men or women. Minoxidil has been shown – in some people – to reduce loss or increase growth rates. The effects are most apparent after 16 weeks, but you must keep applying the product to see the effects. Side effects include irritation, unwanted growth on nearby areas (face or hands), and rapid heartbeat.
This prescription is only available to men and is taken as a pill. The drug in the pill can slow loss and some new growth may appear. The effects only continue so long as you are taking the pill. Side effects include the possibility of reduced libido and sexual function, and an increased risk of prostate cancer. Pregnant women should not touch crushed or broken tablets.
Some medicines can cause hair loss, with the most well-known of these being chemotherapy drugs. Other drugs can cause hair loss too, however, such as anti-inflammatory drugs or immunosuppressants. Drugs include those used for cancer, arthritis, depression, heart and circulatory issues, and birth control.
Surgery revolves around hair transplants. A surgeon removes the hair with a tiny bit of follicle still attached from another part of your body and implants it on the scalp. Medication may be required at the same time. Hair transplants can become quite costly and uncomfortable, with risks including infection and scarring.
We do not perform hair transplants at ENRICH Clinic.
Wigs or hairpieces are sometimes the best option for those of you who can’t regrow your hair, no matter what you have tried. There are some beautiful hairpieces available, so there is no need for this to be obvious to anyone except yourself.
A diagnosis must be made to make sure underlying disease can be ruled out or identified and managed accordingly.
You will be required to undergo blood tests to rule out diseases, in particular, thyroid issues.
Hereditary hair loss, also known as male-pattern baldness or female-pattern baldness, is hair loss that follows a classic pattern. This may be a receding hairline or a bald patch in men, but usually appears as thinning in women. The age at which this occurs will also be imprinted into your DNA – you can thank your parents for that.
The rate of thinning is also predetermined in hereditary hair loss, as is how much overall will be lost. Some men will start balding as early as adolescence, while others may only start balding very much later on in life. Hair may also just become thin and soft, as opposed to falling out entirely.
Compulsive pulling may cause hair loss, and over time, if the same hair is pulled out over and over, the follicles can stop functioning.
This is a specific test to see how many hairs come out when your hair is pulled. This test helps establish the rate of loss.
The roots need to be examined to see if there is any underlying infection causing your hair loss.
Light microscopy is used to check the hair shaft for irregularities that may offer clues to the loss.
Hair loss is normal – we all lose up to 100 hairs per day off our body and scalp. The replacement rate is usually sufficient that the cycle remains stable: just as many new hairs grow as old ones fall out. Hair loss occurs when the growth cycle is no longer balanced.
We don’t always know what causes hair loss, but we do understand what elements contribute more often than others.
Hormone imbalances can contribute to hair loss, at least temporarily. Many women lose hair at a great rate (scarily and unexpectedly fast!) due to pregnancy and childbirth, though this resolves. Menopause may also cause an increase in thinning.
The thyroid is in control of many hormones, so if function is interrupted, hair loss can be the result.
Alopecia areata occurs when for some reason, the immune system attacks your follicles. This leaves bald patches.
Ringworm or other infections can infect follicles, causing them to malfunction. Infections can be treated and hair usually regrows, unless the infection was severe and scarring remains.
Lichenoid conditions can cause irreparable scarring to follicles, causing bald patches that cannot be repaired.
In some cases, such as when the cause of hair loss is medication or a temporary, unmanaged medical condition, hair loss may resolve by itself. Pattern hair loss (androgenic alopecia), unfortunately, does not resolve on its own, and if it bothers you, you may benefit from treatments.
While androgenic alopecia is not a medical condition, we can treat the issue with varying levels of success with drug or non-drug treatments. Everyone is a little bit different in their response. It is unusual for androgenic alopecia to reverse.
Causes of resolvable hair loss include thyroid disorders and in biological females, pregnancy or post- birth due to hormonal fluctuations. These are often reversible forms of hair loss may be distressing since hair loss can be patchy and unexpected, but fortunately, it is unusual for it to stay this way.
An unmanaged thyroid condition may result in ongoing hair loss. We can help treat thyroid conditions and help to halt the hair loss.
All drug treatments come with risks, since drugs, by their very nature, are designed to block certain biological processes. In the case of hair loss, the drugs block androgens like testosterone from affecting hair follicles. This interruption can cause a subsequent hormonal disturbance that may affect other functions, such as sexual function and libido. We must weigh the risks with how determined you are to regrow hair. Other treatments may be more appropriate.
Side-effects of drug treatments can include an increased risk of prostate cancer in men. Pregnant women should not touch crushed or broken tablets, as it can be absorbed via the skin and affect the developing foetus with the incorrect hormonal messages. The incorrect hormonal messages can interfere with sexual organ development, resulting in anatomical abnormalities.
Scalp injections have proved to have some success in clinical trials, though no hair-loss treatment comes with a guarantee of success. Each person is different, and individual results vary. The scalp injections typically result in some regrowth of hair, but it may not be as much as you might like.
Research has shown positive outcomes for hair regrowth, though repeat treatments are necessary.
Hair loss can share a common source in any sex. Androgenic alopecia is the result of androgens negatively affecting a follicle’s ability to produce hair. When women enter menopause, their hormonal profile looks about the same as a man of equivalent age if there are no reasons why this might be untrue, for example, hormone therapy. Androgens are the predominant hormone in menopause, replacing the dominance of oestrogen and progesterone.
Autoimmune-related loss of hair can affect anyone, as can temporary hair loss related to an underlying health condition. Autoimmune-related hair loss tends to be an ongoing loss, while health conditions tend to get treated effectively and the issue resolves.
Typically we’d try a single treatment at a time so we can measure results. It depends on the person and the nature of hair loss. Everyone is assessed individually, with tests run to determine the root cause and a treatment plan designed accordingly.
Doubling up on treatments isn’t always smart, especially with hair loss. It’s important to be able to see what is working and what isn’t, and adjust treatment accordingly.
We use an anaesthetic cream on the scalp before applying the injections to minimise any discomfort. Needles by their very nature can sting a little, so we make sure you are comfortable during your treatments. If you require regular pain medicine during treatments, you’ll have it. We will advise you of what to expect at your appointment. No surprises!
After treatment, your scalp may be a little tender, but this is an expected response to injections. Inflammation will reduce quickly as your scalp heals.
The minoxidil scalp rub mode of action isn’t understood, but it may dilate blood vessels on the scalp to improve follicle health. Because it affects blood vessels, it can have some unwanted impacts on the rest of the body, since it is absorbed. Do not use minoxidil on broken skin, as it can increase absorption into the blood.
There are some known possible side-effects from minoxidil, including severe scalp irritation, unwanted facial hair growth, fast heartbeat, chest pains, swollen hands and feet, rapid weight gain, feeling light-headed, headaches, dizziness, confusion, and flushing. You may also experience changes to the colour or texture of hair.
Some treatments come with side-effects, particularly drug treatments. Injections do not come with side effects.
Side-effects vary by drug treatment, with hormone-blocking drugs causing hormonal disturbances, as per the mode of action of the treatment. Creams can cause issues in some people, including headaches and swollen hands and feet, especially if the product absorbs into the bloodstream.
Every treatment comes with a unique risk profile, so research each treatment you are considering or talk to your dermatologist about what could go wrong.
Hair growth is slow, so it takes a while to see results. After a successful round of PRP injection treatments, you can expect to see hair starting to grow after a few months. With drug treatments, the same applies, it can take at least six months. Hair loss treatments are a long game, so prepare yourself for a wait.
After six months to a year, you’ll know if your treatments are working because you’ll see hair growth. You can also get a check-up to do the hair-pull test and check your follicle health.
Depending on what treatment you’re having, you can expect to be in the clinic for about an hour. Each treatment will be different in terms of whether you are prescribed medication or have scalp injections. Naturally, a prescription is quicker than injections, but there are also blood tests and other examinations to be completed.
Scalp injections require multiple applications, usually about four spaced a month apart. Whether you’ll need to get further treatments depends on results. We’ll track your results over time to see if additional treatments are required.
You take/use drug treatments and scalp creams daily. Their effect is lost once you stop taking/using these treatments.
You can expect to be on treatments for at least six months before you start to see results. Hair is slow to grow even on a good day, but we are kickstarting a damaged follicle, often over multiple treatments. Results take time and being patient is important.
We do not perform hair transplants at ENRICH Clinic. Hair transplants are a specialised treatment that take a time. We cannot comment on whether they are worth it or not .
You should be able to care for your hair normally, however taking care to use irritant-free hair-care products is important. Any product that contains sodium laurel sulphate, for example, should be avoided, since SLS is a substance researchers use to irritate the skin deliberately. It has no place in our skin and hair care products. Irritating your freshly revived follicles may result in the loss of hairs, which is counterproductive.
Your doctor may provide you with recommendations for hair-care products that won’t irritate your scalp.
*With all surgeries or procedures, there are risks. Consult your physician (GP) before undertaking any surgical or cosmetic procedure. Please read the consent forms carefully and be informed about every aspect of your treatment. Surgeries such as liposuction have a mandatory seven-day cooling-off period to give patients adequate time to be sure of their surgery choice. Results may also vary from person to person due to many factors, including the individual’s genetics, diet and exercise. Before and after photos are only relevant to the patient in the photo and do not necessarily reflect the results other patients may experience. Ask questions. Our team of dermatologists, doctors and nurses are here to help you with any of your queries. This page is not advice and is intended to be informational only. We endeavour to keep all our information up to date; however, this site is intended as a guide and not a definitive information portal or in any way constitutes medical advice.