THIRUVANANTHAPURAM: At 32, Varun Kumar never thought he would be diving into hair restoration techniques instead of planning his annual school reunion. Yet, here he was, scrolling through online forums, reading reviews, and comparing treatments in search of a quick fix for his receding hairline.
What used to be a simple act – brushing his hair – had turned into a dreaded routine. Each stroke of his comb seemed to snag more strands than he wanted to count, and with each passing day, his confidence felt like it was slipping away along with his hair.
Initially, it had started with minor thinning at the crown, but within a year, that subtle patch had spread. The reflection in the mirror began to look less like the confident man he once recognised and more like someone he hardly knew.
Varun had tried it all – home remedies his mother swore by, over-the-counter shampoos, and trendy oils that promised "thicker, fuller hair in weeks." Nothing worked. Now, he found himself sitting in front of a hair specialist, hoping for a miracle that could restore not just his hair, but his self-esteem.
The growing number of clinics offering hair restoration solutions reflects a rising concern about hair loss. It’s a common issue that nearly everyone experiences, with a typical daily loss of 30-50 hair strands. Hair loss is considered significant when it exceeds 100 strands a day.
While doctors don’t promise miraculous solutions, advancements in the field are leading to better outcomes. Achieving satisfactory results requires patience and time, both from patients and medical professionals. During the first consultation, patients typically aren't immediately offered surgical or non-surgical options; instead, a thorough assessment is conducted.
“There are multiple reasons for hair loss, and sometimes it may even be perceived rather than actual,” explains Dr Binesh VG, professor in the department of dermatology & venereology at Government Medical College, Thrissur. He notes that factors like psychosocial stress, nutritional deficiencies, and genetic predispositions can contribute to hair loss, which is often emotionally distressing and affects quality of life.
Doctors often run a series of tests to identify deficiencies or conditions such as thyroid issues, Lichen Planus, lupus, polycystic ovary syndrome, trichotillomania, alopecia areata, androgenetic alopecia, telogen effluvium etc. The immediate focus is on addressing any deficiencies or controlling underlying diseases.
Dr Asha Zacharia, consultant in dermatology & cosmetology at KIMSHEALTH, Thiruvananthapuram, says that hair loss can begin as early as the teenage years, yet many patients seek help only after years of trying various methods, including home remedies. “Keralites used to take pride in their thick black hair, but lifestyle changes, weather, and increased stress have altered that,” she added, noting that she sees more female patients than males.
The availability of wigs and extensions indicates that hair restoration methods don’t always guarantee full regrowth. Medical management can assist in restoring hair if the underlying causes are identified, but lifestyle management is equally crucial, Dr Zacharia said.
Patients often come to doctors after extensive research, bringing in information gathered from the internet. This requires doctors to spend time guiding them through the process, discussing the time and financial commitments involved, and helping set realistic expectations regarding treatment outcomes. Non-surgical methods, such as platelet-rich plasma (PRP) therapy, often require multiple sessions and ongoing maintenance, while topical treatments like minoxidil need to be used indefinitely.
Surgical hair transplants are generally considered a last resort after non-surgical options have been exhausted. Techniques like follicular unit extraction (FUE) and follicular unit transplantation (FUT) are commonly used, though not every patient is a suitable candidate for these procedures. “We prefer to delay transplants for patients under 20-years-old and typically try PRP and nutritional corrections first,” said Dr Sundeep Vijayaraghavan, head of department of plastic and reconstructive surgery at Amrita Hospital, Kochi. Transplants are pursued when other methods prove ineffective. The goal is for the results to appear completely natural. Achieving optimal hair density involves strategically placing grafts, aiming for around 50 follicles per sq.cm in noticeable areas, says Dr Vijayaraghavan.
Several factors influence the final outcome, including the surgeon’s skill and the quality of equipment used. However, the most critical factor is the quality and density of the donor site, usually located at the back of the scalp. Patients may be prescribed medications to enhance the condition of the donor site prior to transplantation.
FUT, once the gold standard, is still favoured by some patients, particularly those wishing to maintain long hairstyles. However, FUE is increasingly preferred for its improved results with fewer grafts.
The transplant is performed under local anesthesia, with advancements reducing discomfort and the number of injections needed. A procedure involving 2,500 follicles can take around eight hours, while larger transplants of up to 5,000 grafts may require two days. Visible effects can appear within six months, though there’s only an 80% chance of immediate growth. For the remaining 20%, it may take up to nine months to see a reasonable thickness, with hair continuing to increase for up to a year. “As long as the hair in the donor area remains healthy, the transplanted grafts will survive,” Dr Vijayaraghavan adds.
For female patients, there is encouraging news: most respond well to medical treatments, with only about 2% requiring hair transplants.