surgical hair restoration
August 12th, 2009Link: http://www.gohair.com
Plast Reconstr Surg. 1999 Jul;104(1):222-32; discussion 233-6. surgical hair restoration: repair of undesirable results.
Epstein JS.
Surgical hair restoration has been performed as a treatment for male pattern hair loss for more than 40 years. Although techniques have changed dramatically over the past several years, making it possible to achieve natural-appearing results, there are still many patients with unacceptable outcomes. These patients may have had procedures performed in the past with antiquated techniques or performed recently with substandard techniques. The causes of unfavorable results can be classified into one of three categories: technical errors, poor planning, or complications. The results in these patients can be dramatically improved through a number of different reparative surgical techniques. The majority of these techniques can be performed in an office outpatient setting. More than 40 patients unsatisfied with previous surgical hair restoration have been treated with the different techniques reviewed in this article. All patients had successful outcomes with significant improvement in appearance. Despite the increased challenges when performing reparative surgery, outcomes were favorable in all patients, with small to significant improvements in appearance achieved. Some of these challenges include the limited supply of donor hairs, reduced scalp laxity, and theoretically reduced vascularity due to scarring and transected blood vessels, and patient skepticism. Furthermore, the few complications that occurred were minor and correctable, including one case each of poor hair growth associated with extensive small graft (consisting of one to four hairs) transplanting, and of scalp scarring associated with the removal and primary closure of a large number of "plug" grafts (typically grafts 3 to 4 mm in size consisting of seven or more hairs) in a single procedure.
Treatment of trichotillomania:
July 30th, 2009Arch Gen Psychiatry. 2009 Jul;66(7):756-63.
N-acetylcysteine, a glutamate modulator, in the treatment of trichotillomania: a
double-blind, placebo-controlled study.
Grant JE, Odlaug BL, Kim SW.
Department of Psychiatry, University of Minnesota School of Medicine,
Minneapolis
Trichotillomania is characterized by repetitive hair pulling that causes
noticeable hair loss. Data on the pharmacologic treatment of trichotillomania are
limited to conflicting studies of serotonergic medications. N-acetylcysteine, an
amino acid, seems to restore the extracellular glutamate concentration in the
nucleus accumbens and, therefore, offers promise in the reduction of compulsive
behavior. OBJECTIVE: To determine the efficacy and tolerability of
N-acetylcysteine in adults with trichotillomania. DESIGN: Twelve-week,
double-blind, placebo-controlled trial. SETTING: Ambulatory care center.
PATIENTS: Fifty individuals with trichotillomania (45 women and 5 men; mean [SD]
age, 34.3 [12.1] years). INTERVENTIONS: N-acetylcysteine (dosing range, 1200-2400
mg/d) or placebo was administered for 12 weeks. MAIN OUTCOME MEASURES: Patients
were assessed using the Massachusetts General Hospital Hair Pulling Scale, the
Clinical Global Impression scale, the Psychiatric Institute Trichotillomania
Scale, and measures of depression, anxiety, and psychosocial functioning.
Outcomes were examined using analysis of variance modeling analyses and linear
regression in an intention-to-treat population. RESULTS: Patients assigned to
receive N-acetylcysteine had significantly greater reductions in hair-pulling
symptoms as measured using the Massachusetts General Hospital Hair Pulling Scale
(P less than .001) and the Psychiatric Institute Trichotillomania Scale (P = .001).
Fifty-six percent of patients "much or very much improved" with N-acetylcysteine
use compared with 16% taking placebo (P = .003). Significant improvement was
initially noted after 9 weeks of treatment. CONCLUSIONS: This study, the first to
our knowledge that examines the efficacy of a glutamatergic agent in the
treatment of trichotillomania, found that N-acetylcysteine demonstrated
statistically significant reductions in trichotillomania symptoms. No adverse
events occurred in the N-acetylcysteine group, and N-acetylcysteine was well
tolerated. Pharmacologic modulation of the glutamate system may prove to be
useful in the control of a range of compulsive behaviors.
Hair loss treatment
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Hair loss treatment
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Hair loss, balding Click above link for our hair
loss treatment homepage
Peter H. Proctor, PhD, MD
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