Heads-up: the many treatments for hair loss

While some men adjust better to hair loss, the reality is that many people struggle with the transition and as hair restoration technology has advanced, so too have the numbers of Irish men having procedures to create a look they are more comfortable with.

Hair loss can occur for a variety of reasons, such as pattern baldness or as a result of stress or illnesses. Hair restoration clinics therefore tend to offer a variety of treatments and have an in-depth consultation with a patient to establish the best course of treatment.

“We see all types of hair loss, from thinning of the hair in the frontal and crown regions to receding hairline and full frontal and crown hair loss. Different ways of treating hair loss include surgical and non-surgical treatments – we offer them all,” says Natasha McDonald, managing director of Tir na n’Óg clinic, which she owns with her husband Dr Kevin McDonald, who previously worked as a cardiothoracic surgeon. As well as managing the business’s two clinics in Dublin, she also operates in the clinic as a hair transplant technician.

“A client usually gets in touch with us by phone or through social media or email, and during those initial communications we want to establish what type of hair loss they have – they can send us video or photos to be reviewed, and we get a lot of information that way,” says McDonald. “We want to see whether they need a transplant, or if a non-surgical intervention would be better at this stage. If they need a transplant, then they come for a free consultation with Dr Kevin to talk through the options and we assess their donor area to get a realistic expectation of what results can be achieved.”

For transplants, clinicians will check the density of hair in a donor area and also check the area of scalp where hair will be implanted. There are two types of hair restoration techniques commonly used – FUE (follicular unit extraction) and FUT (follicular unit transplantation) and choosing which will work best is done on a case-by-case basis.

“FUT is usually the choice for clients looking for a large transplant, who wear their hair a bit longer and don’t mind a scar because it won’t be seen,” says McDonald. “A strip is surgically removed from the donor area at the back of the head by Dr Kevin and this strip is then cut into single lines of grafts by a technician. The size of the strip taken differs depending on the number of grafts required for transplant and the density of the actual donor area. The strip may be between 15 and 25 cm long and usually 1cm wide. If you have a very good donor area, we could take a strip giving you a large number of grafts quickly without the complication of possible bald patches in the back of your head.”

Popular choice

The clinic also offers FUE, which has become a popular choice for people who want to wear their hair shorter. With FUE, donor hairs are extracted using a handheld device and while harvesting the right amount of hair may take several sessions, it avoids the thin linear scar caused by FUT.

“For most hair loss issues, we can use a treatment called AHI [aesthetic hair integration],” says Lorraine Lambert, chief executive of Ailesbury Hair Loss Clinics, which operates in Dublin and Cork. “This is a variation of standard follicular unit extraction that we have developed over the past 15 years. Follicles are extracted using a motorised follicle extractor, which is wonderful as it leaves close to no scarring at all in the donor site following extraction and heals within three to four days.

“We then place the follicles using an AHI hair implantation pen,” says Lambert, “which enables us to angle the hairs correctly, place at the correct depth and not cause incision scarring in the placement zones. The procedure will usually take three to four hours approximately and then at the end, the doctor will go through all of the post-procedure instructions as it’s important that the client washes the hair correctly the week following the session.”

Clinics will typically follow up in the weeks after the transplant to check the progress, and additional treatments, such as scalp micropigmentation, may be used to blend areas or help cover up scarring. With certain clients, scalp micropigmentation can be used as a treatment in and of itself, without the need for any transplants.

"Many of the people I meet in my clinic are clients who suffer from hair loss and decided to wear shaved look, or men who want to add a finishing touch to areas they had treated with FUE or FUT," says Malwina Wojewoda, owner of His & Hers Micropigmentation Clinic in Malahide,Dublin.

Micropigmentation is a permanent make-up technique, similar to tattooing, in which tiny amounts of pigment matched to your hair colour are dotted onto your scalp with a needle. This can either be used all over the head to create a shaved head effect, or used to blend or extend areas that are patchy. “After a transplant, micropigmentation can be used on the scar tissue and blended with the rest of existing hair. The end result camouflages the parts previously affected with implants,” says Wojewoda.

‘Freshly shaved aesthetic’

“Our male clients tend to be between 30 and 50, often they have an active lifestyle and they embrace the freshly shaved aesthetic. We meet with potential clients to talk them through the entire process – it can take a couple of sessions and it does need to be redone – we guarantee the work for two years and I have clients where the original treatment is still looking great after four or five years. Then it will start to gradually fade and need to be reapplied,” says Wojewoda. “It is a great treatment as it is non-invasive and gives immediate results, however, it is not for everyone – if a person wants to wear a longer hairstyle we will often recommend other treatments for them.”

The uptake in men looking for hair restoration treatments is mirrored in the UK market.

“There has also been a shift in male attitudes towards beauty and grooming in recent years. Men invest much more into their personal appearance than they used to and take better care of themselves generally,” says Dr Thomy Kouremada-Zioga, a sought-after hair restoration specialist, who operates from a busy clinic in London.

“This is definitely due to the fact that celebrities and footballers are being more open about the hair transplant procedures. Media coverage helps drastically and makes people feel more comfortable regarding the actual procedure,” says Kouremada-Zioga.

While the range of treatments is growing, and treatments are becoming more accessible, caveat emptor applies. “Hair transplant patients are being lured to black-market pirate clinics across the world, at an alarming rate. They are promised low prices and guaranteed results. Unfortunately, these ‘clinics’, where surgeries are performed by non-doctors with little or no training, are causing irreparable harm,” says Kouremada-Zioga. “ISHRS [International Society Of Hair Restoration Surgery] members warn consumers to do all necessary research prior to surgery and to find a doctor who can verify their credentials. Your safety and wellbeing are at risk if you don’t do your homework.”