Hair transplants get a leg up

This week, two studies in The Archives of Dermatology described a new procedure to cover thinning hairlines by using hair follicles from the legs and grafting them to the forehead. Sanchita Sharma writes.

Getting a new head of hair got cricketer Shane Warne an instant upgrade from retired cricketer status to becoming Britain’s favourite celebrity Elizabeth Hurley’s fiancé. It also got him thousands in advertisement dollars for proving ‘bald men can get hair back without looking absurd’.

But more than that, what makes Warne truly worthy of the pin-up status among men-who-once-had-hair is his making hair transplantation almost acceptable by taking away the association of hair loss with loss of virility and vitality. Warne’s hair graft got him a model girlfriend without much fuss and made many men with thinning pates to reject dodgy combovers and windblown toupees in favour of a more permanent second crop of head fuzz.

Dozens of cricketers and television commentators chose to follow his footsteps and got hair transplants to boost confidence at work and at play (and by play I don’t mean cricket). Virender Sehwag went a step ahead and became the brand ambassador for a hair transplantation clinic, which, he said, got him his hair grafting done for free.

Transplant surgery involves removing hair from the back of a man’s head to the thinning site. I say men because 25% of men in their 20s and 60% in their 40s suffer from hair loss because of a condition called androgenic alopecia — male pattern baldness — that typically begins with hairloss at hairline above the forehead and eventually creates a horseshoe-shaped pattern of hair around the ears. The problem stems from sensitivity — largely inherited — to the effects of hormones on hair follicles.

Two techniques are generally used, the more common one being follicular unit extraction (Fue) that extracts one follicular unit — a basic grouping that may have one, two or three hairs — at a time and transplants it under local anaesthesia. The other is the strip technique that involves removing a block of skin with hair, breaking them down into follicular units and implanting each back.

Traditionally, follicles are taken from the area that runs an inch or two above the ears and temples to the back of the head. Follicles from this area — called the safe donor zone because follicles that spout there are impervious to the hormones that cause hair loss — can be transplanted to the front of the head without fear that they may fall off. But since hair that grows at the back of the head is typically thicker than the fine hair that grows in front, the hairline begins to look harsh and coarse.

This week, two studies in The Archives of Dermatology described a new procedure to cover thinning hairlines by using hair follicles from the legs and grafting them to the forehead. Leg hair had been transplanted before to the back of the head, but had never been used to restore the hairline. Leg hair is finer than those salvaged from the back of the head, so the final effect is more natural.

Of course, it’s best to start using treatment to get hair loss under control when it starts. Over the past couple of years, drug treatments using minoxidil (brand names Mintop, Multigain, Tugain, Morr, Mintop, Gromane, Alopec) ) and finasteride (Contiflo, Finalo, finara, Finast, Finax, Fincar, Fintride, Growvita, Fistide) have effectively lowered hairloss. These prescription drugs work as well to treat women’s falling hair.

Given that now the thinning-hair club is spoilt for choice, you could consider trashing crude products — spray-ons designed to camouflage shining pate with artificial hair; or weaves, which involves glueing other people's hair to your scalp — in favour of permanent grafts that help you look your best.