• Dr. Henry Ngai

The Hairy Situation That is Hair Loss



Hair loss is a common occurring condition worldwide, regardless of genders. Multiple studies have linked hair loss and balding to lower self-esteem and decreased confidence. Study has shown baldness leads to a loss of quality of life for both men and women alike, with particular effects in the area of self perception and interpersonal relationships.


There are many reasons for hair loss. Alopecia, or hair loss, can occur due to hormonal problems, mechanical follicle damage, or certain immunological conditions. It can also be the result of drug treatments such as chemotherapy. Of course, genetics play a big role in pre-matured hair loss.


The most common cause of hair loss is androgenic alopecia (AGA) or male pattern baldness. In this condition, hairs growing over certain areas like the top of the head and over the temples become more and more sparse. The hairs that do grow are much thinner and more breakable than before. Androgenic alopecia is not a curative condition. It causes a lot of distress for people who have the condition. Multiple treatment modalities have been tried to be combat hair loss. The use of oral medications such as finasteride is used to oppose the hormone dihydrotestosterone or DHT which functions to shorten hair growth cycle length and reduce the size of the hair follicles. Topical medication such as minoxidil is also being employed, but the exact mechanism of how it works is not totally clear. Although these medications have potential side effects, they are still reasonably safe options to treat AGA. These medications require continuous use for as long as the patient desires to maintain the treatment results. If hair growth is successful, abrupt discontinuation will cause regression of the hair growth.


Topical Minoxidil can be obtained over the counter and can be used by both genders. Finasteride is a prescription medication prescribed by a licensed physician. It is mostly prescribed in men, but it can also be used by women, though it requires more caution because it poses risks to the fetus if pregnancy occurs during use.


In recent years, platelet rich plasma or PRP therapy has gained recognition in the area of hair regeneration. PRP involves collection of whole blood of the patient which is taken in an anticoagulant followed by centrifugation to separate the platelets from the red cells and white cells. The platelet can be concentrated 3-5x or more depending on the system used. Platelet rich plasma can prolong the anagen, or active phase, of the hair growth cycle while increasing the levels of different growth factors like PDGF and VEGF. These growth factors induce angiogenesis and cellular activities at injection site. PRP is a safe procedure, and many studies have shown the advocacy of this treatment.


Recently, the use of platelet rich fibrin, or PRF, has also gained more attention in the area of regenerative medicine. PRF, which is also derived by patient’s own whole blood, contains more growth factors as well as anti-inflammatory leukocytes. It can potentially give a better degree of hair regrowth when compared to PRP. The addition of other agents such as exosomes have also increased the efficacy of treating a previously hard to treat medical condition such as this. Topical and oral medications can further add to the treatment efficacy as well.


At Reviva, we also make use of high powered LED lights to further stimulate hair follicles. Independent studies have showed that LED lights in the red and infrared ranges are a useful adjunct to the hair treatments mentioned above.