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Objectives: 1.The hair restorative Surgeons need to know the fine difference between various types of scarring &Non scarring alopecia.
2.By simple steps of detailed history , clinical scalp examination, trichoscopy, blood chemistry and biopsy for histopath can detect the root cause for hair loss and bring a better outcome for patient.
3.For conditions that are deceptive like diffused Alopecia Areata, chronic Telogen effluvium one may confuse it with Patterned hair loss.
4. for scarring alopecia too , sometimes one has to be sure to offer an appropriate treatment if in remission period.

Introduction: the clinical history should focus on areas where one can ascertain the type of hair loss and any pre existing medical condition leading to hair loss. detailed scalp exam and trichoscopy can pick up exclamation mark hair , sparring of greys , pattern of hair loss, scalp condition , folliculitis, crusts, tufted hair follicular plugging etc Trichoscopy gives detail about follicular ostia, casts ,scales, hair type and ratio, etc. the blood chemistry detects iron/vit D, zinc deficiency, thyroid malfunction or autoimmune diseases. Histopath classifies follicular infiltrate and telogen/anagen ratio.

Materials / method: for scalp examination, hair pull test was done along with detailed exam of scalp for an eczematous condition, depressed patches, pattern of hair loss,any signs of inflammation or infection to rule out syphilis, dissection folliculitis, acne conglobata or fungal cause.Skin, oral mucosa & nails were examined too. for trichoscopy,hair follicles were assessed as having yellow/red/white dots, crusts, keratotic plugs. perifollicular pigment/ halo/pustules were recorded. in some cases histopath was done too. blood chemistry for nutritional def, endocrine /autoimmune causes and VDRL for syphilis sent

Results: most of the cases needed detailed clinical history and examination to come to the diagnosis. blood biochemistry and trichoscopy serve as a great help to detect the coexisting nutrional/metabolic causes of hair loss. some confusing cases with suspicion of scarring were helped out by finding follicular ostia presence.In diffuse hair loss, on close exam & VDRL,syphilis could be detected & successfully traeted medically.For connective tissue disease, SLE/DLE/ wide spread LP biopsy serves as a best tool to finalise your diagnosis. with 2 year remission these patients can opt hair transplant.

Conclusion: before offering the surgical treatment FUT/FUE as a solution , always practice these guidelines to avoid any complication later . In the best interest of patients- these simple steps are of utmost importance and every hair transplant surgeon should be well versed with these conditions to offer the best to their patients.

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Objectives: Doctors should consider FUE Hair transplant as one of the best therapy of choice in early stages of baldness and miniaturisation.

Introduction: FUE Hair Transplants done in early stages specially during miniaturisation increased the chances of achieving great results as the pre- existing hair follicles have increased survival with neighbouring blood supply of transplanted grafts and hence, less possibility of going extinct in the near future.

Materials / method: FUE hair transplant was done in multiple individuals with early hair loss , Grade 2-4 , And those with miniaturization .
Usage of blood vessels of pre existing Grafts for the newly transplanted Hair and vice versa was conceptualised
and VEGF along with other growth factors were used for prevention of immediate telogen phase after transplant.
Grafts were stored in a Peptide rich solution during the procedure.
Followup of Hair Transplant was done with growth factor Serum therapy monthly for four months
to shorten the post telogen phase.

Results: It was observed, FUE Hair transplant, if done in early stages of balding or in miniaturization resulted in better results with thicker long-lasting hair and
also the introduction of growth factors in serum therapy helped maintain the results for a longer duration and also to prevent Further expansion
of the balding area. The per-existing hair fall also got under control with the introduction of Hair transplant at early stages and
usage Combination growth factor therapies.

Conclusion: Transplants done in early stages specially during miniaturization decreased the chances of the existing hair going extinct in the near future.
Hair Transplant can be used as a first line of treatment in early baldness and miniaturization.
It can also prevent further loss and patients can observe dreamy results from the correct timing of transplant in combination with the GFC therapy.

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Objectives: Achieving results in hair transplant with undetectability, natural appearance and maximum density while following the surgical and scientific principles, aligning patient expectations and fulfilling future needs.

Introduction: Hair transplant has been in practice for decades but very less is talked about the role of art for giving the natural appearance.

Materials / method: Following the correct:
Angle
Direction
Density
Distribution
Coronal/saggital slitting
Micrografts
Slit slack method

Results: Will be shown in pre -post photographs in considering each and every aspect separately.

Conclusion: Hairline desinging and surgical restoration is definately an art before science following the principles through the surgical scientific principles.

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Objectives: Use of Progenitor Cell Micrografts give a satisfactory result in Male Pattern or Androgenetic Alopecia as confirmed by Pre and Post Trichogram . It can be used in Conjunction with Hair Transplant and can prolong need for addditional Hair Transplant .
It’s a viable Modality option in the arnamentarium for non surgical Hair Restoration .

Introduction: Hair Restoration using Micrografts with specific progenitor cells is a FDA approved exciting new technique .
It’s a Short and relatively painless procedure with minimum Downtime . It involves harvesting autologous Tissue from Donor and reinjecting the filtered specific cells .

Materials / method: Trichogram
Skin Biopsy Punches
Rigenera mechanical Disruptor

Preprocedure Trichogram is done 7 days prior to procedure . Signed Consent and photographs are taken .
3 dermal Punches 2.5 mm are used to retrieve biopsies from the hairy part of mastoid area after shaving , under sterile precautions and using local anaesthesia.
Biopsies are placed in a ready positioned Rigeneracons device. 1.2 ml physiological saline is injected by a specific connector and then placed inside the Rigenera machine main body . Extracted solution is injected into the patients scalp perpendicularly at 4 mm depth.

Results: Hair counts and hair density measurements are shown to almost double after treatment on repeat Trichogram .

Conclusion: Balancing the cosmetic result achieved and Patient Satisfaction regarding almost all aspects of this procedure including downtime it’s an exciting new addition in our armamentarium with Platelet Rich Plasma and Follicular unit Hair Transplant .

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这项工作的完成感谢以下机构的支持： Minal Medical Centre Team

Objectives: Minoxidil is not a new invention, but arguable one of the most efficient hair growth stimulating treatments. The hair stimulation part is unfortunately often not addressed when treating hair loss, focusing only on hormonal or immunosuppressive options.
Lack of knowledge about minoxidil when it comes to females, and fear of side effects, are common reasons to why physicians hesitate in using it in their female patients.
This presentation shows the journey of nine female patients on either oral or topical minoxidil, to provide a better understanding of the treatment and recommended follow-ups.

Introduction: Hair loss is often perceived as cosmetic rather than medical, and a common complaint among dermatologists is that patients often turn to cosmetic clinics first for treatment. But even with a correct diagnosis at a dermatology clinic, many physicians are reluctant in treating female hair loss patients with minoxidil. Common reasons to this hesitancy might be fear of side effects and lack of knowledge about dosing and follow ups. This presentation demonstrates the use of topical and oral minoxidil in different hair loss diseases, and what to look for if patients are not experiencing results.

Materials / method: Nine female patiens with different hair loss conditions, diagnosed by the author clinically or by histology, received either topical or oral minoxidil as the only treatment or part of a combination therapy. Follow-up time was up to 18 months. The hair loss conditions were female pattern hair loss, alopecia areata, chronic telogen effluvium and frontal fibrosing alopecia. Evaluation of the results were based on the patients´ own and author´s examination, and pictures taken before and during the treatment. Blood tests and blood pressure were monitored in patients using oral minoxodil.

Results: Visible improvent in hair density and reduction in hair shedding was accomplished. The dosage of oral minoxidil was 0.625 mg daily, and in those receiving topical treatment, the solution was 5% once daily.
Two of the patients on oral minoxidil experienced mild hypertrichosis, in spite of that, they both continued with the treatment. Because of the use of low grade topical steroids, none of the patients receiving topical minoxidil experienced irritative dermatitis.
No serious adverse reactions were reported.

Conclusion: Minoxidil, whether it is oral or topical, is a safe and effective medication to stimulate hair growth, even in female patients. The hair stimulation part is unfortunately often not addressed when treating hair loss diseases, focusing only on hormonal or immunosuppressive options. An integrative part of succeeding with hair loss treatments, is combination therapy, where the reason to hair loss is addressed, as well as a stimulation to increased hair growth.

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