Alopecia and Aesthetic Treatments
Alopecia is the abnormal loss of hair, so the term is considered synonymous with baldness (University of Navarra). This problem is not confined to the scalp but can affect other areas of the skin where hair exists, such as eyelashes, armpits, the inguinal region, and beard. Although this explanation might suggest an easily diagnosable disease, the truth is quite the opposite — we are dealing with a group of over 100 types of conditions, for which complete cure, at least in the short and medium term, remains a challenge.
Generically, we can group alopecias as scarring and non-scarring. In the former, the hair follicle is lost, making these irreversible conditions. In the latter, the hair follicle is preserved and therefore potentially reversible.
Androgenetic alopecia or common baldness, responsible for up to 95% of cases, is the most frequent form. This type primarily affects men. Despite technological and pharmaceutical advances, the prevalence of this disease has continued to grow in recent years, with Spain being the second country in the world with the most bald people, behind only the Czech Republic.
Alopecia: Should I Be Worried?
The science that specializes in studying diseases, functions, and anatomy of hair — and therefore alopecias — is trichology. Trichology, by studying the scalp and hair — important cutaneous structures whose alteration can represent the ultimate manifestation of internal diseases — helps us diagnose malnutrition, metabolic problems, psychological or emotional disorders, and stress, thereby assessing the body’s general health status.
Having discussed the importance of hair assessment for recognizing both internal and hair-specific diseases, we should learn the most common symptoms of alopecia, which are losing more than 100 hairs per day and hair weakening.
Upon the presence of any of these symptoms, assessment by dermatology or aesthetic medicine professionals with experience in trichology is essential. These professionals use a series of strategies to assess the type and degree of hair loss and thereby recommend the best treatment for each case.
Do you have alopecia? We can help
Why Do I Have Alopecia?
Since when we speak of alopecia we refer to a heterogeneous group of conditions, each with its own clinical characteristics and pathological findings, we cannot define a single common cause. Even so, the generic division of alopecias into scarring, non-scarring, and structural has implications for both hair loss reversibility and treatment response.
The authors emphasize the irreversibility of scarring alopecias and therefore the need for rigorous medical assessment before undergoing any aesthetic-medical treatment. Generically, scarring alopecias represent various inflammatory conditions of the hair follicle whose origin is linked to alterations in our immune system, genetic problems, or infectious processes.
On the other hand, non-scarring alopecias can be subdivided into focal, patterned alopecias, and diffuse alopecias. Among the first, we find conditions such as alopecia areata, syphilitic alopecia, pressure-induced or postoperative alopecia, among others. As the name suggests, patterned alopecias present a specific hair loss distribution pattern. Here we find the previously mentioned androgenetic alopecia or male pattern hair loss. This alopecia is mediated by the action of male hormones (androgens) on hair follicles sensitive to these hormones in genetically predisposed men. Patterned alopecias also include female pattern hair loss and trichotillomania.
Finally, in diffuse alopecias, there is a more generalized hair loss that can present in varying degrees of severity. In this regard, anagen effluvium and telogen effluvium are the representative alopecias of this category.
A Word on Structural Alopecias
A group of alopecias known as structural alopecias was mentioned earlier. These represent anomalies in hair structure, resulting in fragile, brittle hair that triggers hair breakage or apparent lack of growth. This hair fragility results from abnormal hair formation or external damage that affects its structure.
The two most common alopecias in this group are trichorrhexis nodosa and trichoptilosis or split ends, both being consequences of harmful hair care practices such as the use of chemicals, excessive brushing, straightening, hot combs, permanent treatments, wearing tight hats, excessive heat application or exposure, hairstyles with sustained high tension from elastics or other holding devices, among others. All these factors share damage to the hair shaft.
Thus, we see there are many types of alopecia as well as factors involved in their development; however, this is a good time to emphasize the importance of implementing proper hair care practices as well as following certain dietary guidelines that ensure appropriate intake of trace elements and other nutrients, both strategies aimed at promoting good hair health.
Regarding the importance of proper nutrition and hair care, and without intending to divert your attention from the main content — which is to provide a comprehensive view of alopecias and available aesthetic-medical treatments — we recommend some hair care products and dietary supplements used in the routine practice of professionals at Clínica Skin Esthetic.
These products are not intended as a comprehensive nutritional or treatment solution — for which you should visit a nutritionist and aesthetic medicine professionals — but by their composition, they are useful for optimizing hair health and growth.
Vegan Dietary Supplement with Biotin + Zinc + Selenium
Biotin contributes to the maintenance of skin and hair in normal conditions. Zinc and selenium help protect cells against oxidative stress.
Get itISDIN Lambdapil Anti-Hair Loss Shampoo
Helps reduce hair loss and increase hair density. Contains Serenoa repens and the Trichogen Active Complex.
Platelet-Rich Plasma (PRP) and Alopecia
Platelet-Rich Plasma (PRP) is defined as a platelet concentrate 3 to 5 times above the normal blood platelet value. PRP is a volume of plasma extracted from the patient themselves that contains an exponentially greater amount of platelets than what is found in normal blood. PRP has the potential to deliver a high concentration of growth factors to target tissues by virtue of the content naturally present in platelet granules.
Alopecia, especially androgenetic alopecia, is one of the indications for PRP use with the greatest evidence and clinical relevance. PRP increases proliferation rates of dermal papilla cells, which regulate hair follicle growth.
Through the binding of platelet-derived growth factors and interactions between dermal papilla cells and primitive stem cells, activation of the proliferative (anagen) phase of the follicular cycle begins, leading to the formation and maintenance of the hair follicle. The anagen phase of the hair cycle is maintained, alongside a delay in the progression of the catagen phase, which over time leads to an overall increase in hair density.
It is important to mention that platelet-rich plasma can be used alone or in combination with other treatment strategies, even with conventional pharmacological therapy (oral finasteride + topical minoxidil), with high efficacy of this combined intervention described.
This procedure is based on the administration of intradermal microinjections distributed throughout the scalp (approximately 3 mL) at intervals of 2-3 weeks per application. As with any aesthetic-medical procedure, aesthetic medicine practitioners will determine if this is the best treatment for your case and ensure appropriate follow-up.
Mesotherapy / Intradermotherapy for Hair
Hair mesotherapy consists of the infiltration of a medical product or medication into the dermis of the scalp through the application of microinjections in which small amounts of the specific product are administered. Among the compounds most frequently used for hair mesotherapy are: drugs such as dutasteride, finasteride, and minoxidil; complexes of vitamins, minerals, and amino acids such as vitamin B6 (biotin), vitamin B5 (panthenol), zinc, arginine, glutamine, glycine, and cysteine; hyaluronic acid, among others.
Other compounds used for hair mesotherapy are biopeptides, which act on the follicular life cycle by activating cellular signaling cascades with the expression of genes responsible for hair bulb revitalization, activation of the follicular growth cycle, and inhibition of hair loss. Some of these peptides available on the market include acetyl-3 decapeptide, decapeptide-4, oligopeptide-41, copper-1 tripeptide, octapeptides, decapeptides, and other specific oligopeptides.
The market offers different combinations of the aforementioned products. It is the aesthetic medicine professionals who will define the best combination for your case; however, regardless of the combination administered, the practitioner must ensure that these preparations carry the corresponding CE marking as an injectable product.
Based on the authors’ experience, hair mesotherapy sessions are suggested every 2-3 weeks for periods between 6 months and 1 year to achieve appropriate results. Like PRP, hair mesotherapy can be performed in combination with other aesthetic-medical approaches based on potential improvement in results.
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Physical Therapies for Alopecia
Carboxytherapy, microneedling, and low-level lasers are some of the physical methods used in trichology.
Microneedling
Microneedling is based on a mechanical, repetitive system using fine needles to create microperforations in the superficial layer of the skin, specifically in the stratum corneum. This process increases skin permeability, thereby facilitating the transport of activating agents to areas affected by hair loss. Additionally, the physical action of cutaneous perforation induced by microneedling stimulates the release of platelets and their associated factors, which play a crucial role in hair growth. These effects have been discussed in detail in the section dedicated to platelet-rich plasma (PRP) therapy.
Carboxytherapy
Carboxytherapy consists of the dermal or subcutaneous administration of high-purity medicinal carbon dioxide. This technique has multiple effects on the target tissue, which we can summarize as: increased oxygen availability at the application site, activation of fibroblasts with increased production and remodeling of collagen and elastin, formation of new blood vessels, and a vasodilatory effect on the vascular bed with the consequent overall increase in blood flow to hair follicles and adjacent tissues. All of this achieves a significant anti-aging and hair induction effect.
According to the authors’ experience, carboxytherapy application at intervals of 1 to 2 weeks for periods longer than 3 months, with a minimum of 5 sessions, is effective for promoting hair growth and density. However, the interval between sessions and the number of sessions required will always be individualized for each case. Again, the authors and the literature describe better results when this procedure is combined with other aesthetic-medical approaches.
Low-Level Lasers
Finally, but no less relevant, the use of low-level lasers represents another physical modality, specifically based on the emission of light photons with low irradiance (less than 50 nW). This approach achieves various biological effects related to photodermolysis. Although the exact mechanism of action on the hair follicle is not completely clear, a direct mitochondrial activation in target cells is proposed.
Skin Esthetic Pearls on Hair Treatment
In this post, we provide a comprehensive overview of alopecia, a condition characterized by abnormal hair loss. Alopecia is not an easily diagnosable disease, as it can result from more than 10 types of conditions, and complete cure is a challenge. Alopecias are classified as scarring and non-scarring, with the former being irreversible and the latter potentially reversible. Androgenetic alopecia, also known as common baldness, is the most frequent form and primarily affects men.
A comprehensive medical evaluation is essential to determine the type and degree of hair loss and select the appropriate treatment.
In summary, alopecia is a complex condition that can be caused by a variety of factors and requires careful diagnosis and treatment. Treatments may include medical therapies such as PRP and hair mesotherapy, as well as physical methods such as carboxytherapy, microneedling, and low-level lasers.
Clínica Skin Esthetic
Aesthetic medicine performed in unauthorized centers by personnel lacking proper training and qualification poses a serious risk to patient health. At Skin Esthetic, we are an Advanced Aesthetic Medicine Clinic. We perform aesthetic-medical procedures with high scientific rigor, by a duly qualified team, always focused on preserving the natural look that only you can have. Remember, at Skin Esthetic we work so that your only concern is thinking:
Why didn’t I do this sooner…?