Practical Hair Density possible in Hair Transplantation

On an average, an adult human scalp contains 100,000 follicular units in total.  In baldness, there is already 50% loss of follicular units in the bald looking area. On an average the density of a non bald scalp is 80-100 follicular units per square cm. This density varies from person to person.

Hair transplantation can hide the baldness in single sitting, but it cannot provide the natural density in one session. In hair transplantation, doctors can plant 25-35 follicular units (FU) per square cm, which is much less than the normal density, though this much density can hide the baldness with artistic planning of the grafting. For normal density, a second sitting of 25-35 follicular units (FU) per square cm is required. Sometimes, a third sitting may be required for natural density.

In the front hairline, usually single FUs are grafted for natural look. In this area, 35-45 FUs can be planted in 1 square cm. In the crown and vertex area, the double and triple FUs are planted.

With over enthusiasm if more than 40-50 FUs are planted in 1 square cm then the chances of growth will be less because there will be competition between the grafts for blood supply.  This competition among FUs will result in death of a lot of hair follicles as well as necrosis of skin. That means permanent loss of follicle and permanent scar on head. This can be better understood with an example: In plantation in our garden, we are always advised to keep a minimum distance in between the plants for optimum growth; else most of the plants die.

For doctors, dense packing is an ongoing learning process; the goal is to achieve density while staying within the scalp’s safe limit of vascular damage. 

Alopecia Totalis

Introduction

Alopecia totalis is the loss of all scalp hair. It is believed to be an autoimmune disease, the immune system attack hair follicles causing hair loss.  Stress is another contributor of Alopecia totalis.  Excessive hair loss occurs at once in the case of illness or cancer treatment, autoimmune disorders, stress or hormonal changes. Environment can also contribute to the cause of this disease. It can affect both male and female under the age of forty.

Symptoms

Alopecia totalis may start as a receding hair line growing gradually or sudden. In the beginning patches of hair loss can be seen on the scalp along with tingly feeling or pain. In some cases hair loss seems to be affecting one side of the scalp. This further can lead to a total baldness. Another indication of Alopecia is to be able to pull out ones hair easily.

Diagnosis of Alopecia totalis 

Although one knows that Alopecia totalis means hair fall in large amount, still doctor will examine your medical history, physical examination and a family history as there is an unknown genetic cause that makes your immune system to attack hair follicles and causes Alopecia totalis. Examination of scalp for hair fall patterns is done and the doctor also looks at the individual hairs. Blood samples are taken to know the causes of the diseases. If you have just begun to lose hair vitamins or medications helps to slow down the hair loss. But in cases of total hair loss hair can regrow only after hair transplant surgery.


Treatments

Methotrexate and corticosteroids are most popular treatments for Alopecia totalis . These medications usually come in the form of creams or injections and are applied to an affected area. These are effective where the patches of hair loss are small. Elocon ointmet and minoxidil can also be used.

Dr Pradeep Sethi, MD(AIIMS),         Dr Arika Sethi, MD(AIIMS)
Direct Hair Transplantation Center
Dehradun/Rishikesh/Gurgaon
Ph:   +91-8057541540
dhtclinic@gmail.com

www.directhairtransplantation.com