Hair Loss/Lasercomb

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QUESTION: Hello, Dr Peter what are your views on lasercomb regarding male pattern baldness. Is it beneficial?

Sir I have gone through your numerous questions and answers and have realized that in your opinion the best way to treat male pattern baldness is combination of finisteride and dutasteride in order to lower the dht as much as possible and to use minoxidil for stimulating hair growth. Additionally you also recommend zinc and ketaconazole shampoo in order to block dht even more. Sir apart from these thing do u recommend anything else for genetic hairloss?

ANSWER: Yes I think Low Level Laser Light Treatment = LLLT does work to prolong hair growth. My choice for the method of delivering the red light at about 650 nm wavelenght is to use either the LaserCap or the Capillus cap both of which deliver over 1200mw of power with the diodes only a few millimeters away from the skin. The original Lasercomb only had 9 diodes with only 45 mw of power which would mean you would have to hold it to your head all day and still not get the results you would get with LaserCap or Capillus for 30 minutes every other day.
You can read more about this on my website at this url
http://www.hairdoc.com/non-surgical-treatments/

“Low level laser therapy (LLLT) has been shown in thousands of peer-reviewed publications to increase cellular survival, proliferation and function. The light is absorbed by mitochondria and increases cellular respiration, and induces activation of transcription factors via reactive oxygen species. Controlled clinical trials have shown efficacy in treating stroke, stimulating wound healing, orthopedic conditions and relief of chronic inflammation. Preclinical studies have shown effectiveness in spinal cord injuries, peripheral nerve regeneration, heart attacks, degenerative brain diseases and traumatic brain injury.

Not surprisingly LLLT is able to stimulate and preserve hair follicles in patients with androgenetic alopecia and other hair loss disorders.  A peer-reviewed study published in 2009 led to FDA clearance of a laser comb device for hair re-growth. The hair follicles cannot be “brought back from the dead” but significant improvement in hair density and quality can be achieved if treatment is started before hair loss has progressed too much. Preclinical studies using LLLT to stimulate ex vivo human follicles in culture and accelerate mouse hair re-growth have also been reported.”

http://lasercap.com/

http://www.capillus.com/lllt-hair-loss

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QUESTION: 1)Sir I know that i have genetic hair loss, what I do not know is that along with genetic hairloss whether I have telogen effluvium or not.So sir is there any way to find out that whether i have teogen effluvium because of ibd or i simply do not have telogen effluvium. Any signs which can show that along with genetic hairloss i have or do not have telogen effluvium?

2) Can increased sex/masterbation causes telogen effluvium?

3) There are certain topicals which contains growth factors such as IGF 1, VEGF, BFGF, etc and dht inhibitor like copper tripeptide - 1 . Does these agents have any beneficial effect in androgenic alopecia treatment?

ANSWER: 1.-Low Level Laser Light units such as LaserCap and Capillus do help prolong the advent of androgenetic alopecia- They are beneficial in the treatment of these conditions
2, Masturbation does not cause hair loss or increase telogen effluvium
3. Topical DHT inhibitors do help prevent male pattern baldnesss. The other ingredients mentioned do not have enough proven studies in double blind experiments for me to comment.

---------- FOLLOW-UP ----------

QUESTION: 1)Sir I know that i have genetic hair loss, what I do not know is that along with genetic hairloss whether I have telogen effluvium or not.So sir is there any way to find out that whether i have teogen effluvium because of ibd or i simply do not have telogen effluvium. Any signs which can show that along with genetic hairloss i have or do not have telogen effluvium?  Sir i mean to ask that what would be the signs which shows that i also have telogen effluvium apart from male pattern baldness

Answer
A Telogen Effluvium is a shedding of a large number of hairs due to something which stressed the hairs during their ANAGEN phase one month earlier.. Four weeks after the stress the hairs fall out in much greater number than the normal 50 to 100 hairs lost per day.
If you can not make that determination by yourself then see your dermatologist who can pull on your hair to see if it comes out easily and if all the hairs are in the telogen phase.
 Bout of IBD can cause enough stress to push many actively growing hairs into their next life cycle. So you could start keeping tract of how many hairs are lost per day and then tell your dermatologist. Another option is for you to have a scalp biopsy and the dermatopathologist will be able to tell your doctor if you are going through a telogen eflluvium.
If you can not determine if you are losing 200 hairs per day and the hairs are coming out easily then see your dermatologist so that you can have an expert look at your hair to tell you if it is normal loss of 50 to 100 per day with gradual loss  leading to male pattern baldness or if you have TE from IBD , or if you have BOTH chronic TE form IBD plus male pattern baldness. IF you have both then you need to treat yourself for both.

Here is an article you can read on diagnosis and treatment of Telogen Eflluvium
http://emedicine.medscape.com/article/1071566-treatment
Because acute telogen effluvium is a reactive process, which resolves spontaneously, treatment usually is limited to reassurance. Any reversible cause of hair shedding, such as poor diet, iron deficiency, hypothyroidism, or medication use, should be corrected.

While chronic telogen effluvium is less likely to resolve rapidly, reassurance is appropriate for these patients. Often, the knowledge that the hair loss will not progress to baldness is comforting to the patient. The patient should be encouraged to style the hair in a way that masks any perceived defects in hair density.

While topical minoxidil is not proven to promote recovery of hair in telogen effluvium, this medication has a theoretical benefit and is well tolerated. Patients who are eager to play an active role in their treatment may choose to use minoxidil.
The symptom of both acute and chronic telogen effluvium is increased hair shedding. Patients usually only complain that their hair is falling out at an increased rate. Occasionally, they note that the remaining hair feels less dense. In both forms of telogen effluvium, hair is lost diffusely from the entire scalp. Complete alopecia is not seen.

Acute telogen effluvium is defined as hair shedding lasting less than 6 months. Patients with acute telogen effluvium usually complain of relatively sudden onset of hair loss. Careful questioning usually reveals a metabolic or physiologic stress 1-6 months before the start of the hair shedding. Physiologic stresses that can induce telogen effluvium include febrile illness, major injury, change in diet, pregnancy and delivery, and starting a new medication. Immunizations also have been reported to cause acute hair shedding. Papulosquamous diseases of the scalp, such as psoriasis and seborrheic dermatitis, can produce telogen effluvium.

Chronic telogen effluvium is hair shedding lasting longer than 6 months. The onset is often insidious, and it can be difficult to identify an inciting event. Because of the duration of the hair shedding, patients are more likely to complain of decreased scalp hair density, or they may note that their hair appears thin and lifeless.
Laboratory studies are of little use in the diagnosis of telogen effluvium if there is clear history of an inciting event. Scalp biopsy is the most useful test to confirm the diagnosis, although this is seldom necessary if the history is characteristic and a gentle hair pull produces numerous telogen hairs. Telogen hairs are identified by a white bulb and the lack of a gelatinous hair sheath.

If a biopsy is performed, some authors advocate taking three 4-mm punch biopsy specimens, all imbedded horizontally. This method provides a generous sample for determining anagen-to-telogen and terminal-to-vellus ratios and leads to greater diagnostic accuracy.[20]

Chronic telogen effluvium may have a metabolic cause. Testing should be directed toward causes that are common and correctable. If any sign or symptom of hypothyroidism is present, a thyrotropin test is warranted. Iron deficiency is common in premenopausal women. Evaluation of CBC count, serum iron, iron saturation, and ferritin may be warranted. Note that CBC count results may be completely normal in women with mild iron deficiency and hair loss, particularly in women older than 40 years. Blood is more essential than hair, and the body will shed hair before red cell indices become microcytic. Also, note that ferritin behaves as an acute phase reactant. Inflammation can produce normal ferritin levels in an individual who is iron deficient. Although a low ferritin is proof of iron deficiency, a normal ferritin level does not exclude iron deficiency.

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Peter J. Panagotacos, <B>M.D.</B>

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I have 30 years experience in the field of medical and surgical Hair Restoration and am Board Certified in Dermatology and Hair Restoration Surgery.

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I have 30 years experience in the field of medical and surgical Hair Restoration and am Board Certified in Dermatology and Hair Restoration Surgery. More information can be found at my website www.hairdoc.com

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