Holistic treatment of the hair follicle
In view of the countless questions we receive at the Thalassa clinic in relation to hair care and hair loss treatments, we have sought to provide a medical, scientific, adapted and global response to all these problems.
In order to correctly explain our therapeutic principles and the protocols that structure them, it is worth recalling some notions of capillary anatomy and physiology. Human hair represents a group of 100,000 to 150,000 hairs. Each individual loses an average of 40 to 100 hairs a day. With peaks of up to 175 per day during seasonal peaks (spring and fall).
This drop is normal and is integrated into the process of the different phases of the capillary cycle.
A follicle is capable of producing 20 to 25 successive hairs during its lifetime.
The cycle of each hair comprises a phase of continuous growth (3 to 5 years) that ends after 3 weeks (telogen phase). The bulb, which has been inactive, returns to the surface. The hair, even if it is dead, remains adherent for 3 months (anagen phase).
In the face of hair loss, it is advisable to eliminate certain pathologies (anemia, hypothyroidism …) certain side effects of medications, certain intoxications first. We may also be dealing with an autoimmune process: naked, alopecia areata. One can never ignore the role of acute or chronic stress in a hair loss.
When these various pathologies have been eliminated, we can divide ours and our patients into two groups:
- Hair loss due to androgen action.
- Hair loss unrelated to the action of androgens.
This division, as will be seen, will be important from a therapeutic point of view.
At the pathophysiological level, the installation of androgenetic alopecia corresponds to a shortening of the capillary cycle, triggered and maintained by androgens.
Each cycle is shorter than the previous one. The total number of cycles is achieved much more quickly.
The follicle has exhausted its potential. It will disappear many years in advance.
It is thus clear that, if we want to effectively delay the development of this type of baldness, it will be necessary to act early, in order to maintain an appreciable amount of follicular cycles.
For androgenetic alopecia to develop, there must be a continuous impregnation of the scalp with male hormones. Alopecia begins at puberty and continues to progressively drag hair loss. It becomes irreversible if nothing is done in time. It affects only areas of the scalp with specific receptors for androgens.
The hair at first becomes thinner, shorter, less pigmented. It is then replaced, over the years, by a fine down. Then, it disappears, giving rise to real baldness, which is definitive.
The study of phenomena that come into play during androgenetic alopecia clearly shows that, for it to be effective, it is imperative to prevent the local action of androgens. The main male hormone is testosterone, which is active in certain tissues and organs when it is converted to dihydrotestosterone.
This activation occurs thanks to an enzyme called 5-alpha reductase, of which there are two types: 5-alpha-reductase 1 and 5-alpha-reductase 2.
In the scalp, type 1 is markedly predominant.
The substances that will oppose the action of this enzyme will prevent the transformation of testosterone into dihydrotestosterone. It will not be able to exert its action of shortening follicular cycles. The mechanism of androgenetic alopecia will be stopped.
For several years, finasteride tablets have been successfully used, in a dose of 1 mg per day, in the treatment of androgenic alopecia. It is a type 2 5-alpha-reductase inhibitor, therefore not very specific to the scalp. But its ability to lower the overall level of dihydrotestosterone gives it a proven efficiency.
We recently started using a 5-alpha reductase type 1 and 2 inhibitor: dutasteride. Its action is significantly more potent than that of finasteride, and it acts on the type 1 enzyme, which is present in the scalp. It is an effective treatment. The problem is that it is taken in tablets and that, therefore, it is the production of dihydrotestosterone of the whole body that is affected. This explains the possible side effects, but which are not constant: decreased libido, decreased fertility, etc.
It was therefore tempting to apply this treatment topically, directly to the scalp, in order to drastically reduce the production of dihydrotestosterone to this level and not to modify the rest of the body. This is what we do thanks to scalp mesotherapy using injectable dutasteride.
Thus, we can distinguish several types of patients:
- Young man with significant androgenic hair loss with a family history of alopecia (cases of alopecia on the side of the paternal family are the most determining).
It is necessary, first of all, to fight the hormonal risk. The use of dutasteride in the treatment is essential. The addition of autologous platelet growth factors (scalp biostimulation) will allow us to oppose the phenomenon of apoptosis that reduces the hair follicle cycle. Vitamins, minerals and vaso-stimulants are welcome to complete the treatment.
- Woman in the perimenopause phase, with signs of androgenic hair loss, or younger woman with the same clinical picture. The same protocols will be applied as in 1), because the mechanisms are similar, although they act with a more moderate intensity.
- Young or less young woman, suffering from a seasonal hair loss without an androgenic characteristic or who complain simply because the hair is dull or less full. The addition of dutasteride is not necessary. Platelet growth factors, minerals, vitamins and vaso-stimulants can be used.
From a therapeutic point of view, it seemed wise to group, in a single treatment, the administration of all substances relevant to hair growth and the fight against alopecia.
Thus was born the holistic treatment of the hair follicle. Combines, in the same session, injections of the following substances:
1º) Platelet growth factors
Biostimulation with autologous plasma is an excellent way to fight hair loss as it opposes this phenomenon in 2 different ways. It stimulates the development of hair follicles thanks to the various growth factors contained in platelet-rich plasma. It is also opposed to the phenomenon of degeneration and programmed death of the hair (phenomenon of apoptosis) that occurs in androgenetic alopecia. It is quickly recalled here that plasma, rich in platelets, is obtained by collecting blood followed by centrifugation to separate the different components of the blood.
2nd) 5 alpha-reductase inhibitor
This is mainly dutasteride. We explained at the beginning of the article the interest of this product because it opposes the negative effects of androgens on the hair follicle.
3rd) Vitamins, minerals and amino acids
Vitamin B6 or Pyridoxine: it is a water-soluble vitamin that intervenes in the growth of hair and nails. Stimulates the secretion of keratin and potentiates the action of zinc. Vitamin B5 or pantothenic acid: improves hair hydration and elasticity. Vitamin B8 or Biotin: its deficiency is associated with hair loss. Zinc: essential mineral for the formation of keratin (the protein in the hair structure). It also has some 5 alpha-reductase inhibitory effect. Methionine and Cysteine: important amino acids used in the composition of keratin.
Minoxidil, Rutin, Ginkgo Biloba: improve nutrition, hydration and oxygenation of the scalp. The holistic treatment of the hair follicle allows you to inject all of this in the same session. Platelet-rich plasma is an excellent solvent for the other components. It allows, in addition to its effect itself, to dilute dutasteride whose lipid solubility makes penetration into the skin painful. We advise the holistic treatment of the hair follicle for any type of hair loss, knowing in advance that the addition of blocking products will be particularly indicated when the or the patient has criteria of androgenic type.
In androgenetic alopecia, it seems to us that it will be interesting to start with a monthly treatment rhythm, until stabilization and, subsequently, improvement of the phenomenon can be verified. We will then be able to expand the spacing of the sessions, knowing, at the outset, that a maintenance therapy will be necessary to protect the hair from the harmful effects of androgens.
When it comes to simple seasonal hair loss, two or three sessions in the middle of the seasons are often sufficient.