Changing trends in hair restoration surgery

Androgenetic alopecia is an important and common cause for baldness. Despite recent advances, the drug therapy remains unsatisfactory. Surgical hair restoration is the only permanent method of treating this condition. This article discusses the latest trends in hair restoration surgery.

Author: Venkataram Mysore
Venkat Charmalaya - Centre for Advanced Dermatology, Bangalore, Karnataka, India

Hair serves an important cosmetic function in humans and either the lack or excess of hair causes significant emotional stress. Pattern hair loss (androgenetic alopecia, PHL) represents the most common cause for baldness in men. The past decade has seen significant developments in the management of androgenetic hair loss. While medical therapy with both minoxidil and finasteride has a definite place in the management of male pattern hair loss (MPHL), its effect is temporary and the results are not satisfactory in advanced pattern hair loss. Surgical management remains the only permanent method of restoring hair in PHL. Introduction of recent techniques such as follicular unit transplantation have improved the cosmetic results and patient satisfaction. This article reviews the recent trends in the surgical management of male PHL.

The term androgenetic alopecia (pattern baldness) has evolved from its dependence on the twin factors of androgens and genetic background. Pattern hair loss is probably multifactorial and may be inherited as an autosomal dominant trait with variable penetrance. The responsible genes have not yet been identified.

Although the term is used for both males and females, there are considerable differences between the sexes. Male pattern alopecia often presents in the first decade after puberty and is characterized by deep bitemporal recession and balding of the vertex, whereas female pattern alopecia, which commonly presents in 4th to 5th decades, is more diffuse, without bitemporal recession.

It is doubtful whether the hair loss seen in women is primarily androgen dependent and it is possible that several other factors may be responsible; hence the term 'female pattern hair loss (FPHL)' is preferred to the term androgenetic alopecia when referring to women with this type of alopecia.[2],[3] One noteworthy feature in both female and male pattern hair loss is that occipital scalp is spared of this process and the hairs in this region persist for life.

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How to cite this article:
Venkataram M. Changing trends in hair restoration surgery. Indian J Dermatol Venereol Leprol 2006;72:103-111

How to cite the URL:
Venkataram M. Changing trends in hair restoration surgery. Indian J Dermatol Venereol Leprol [serial online] 2006 [cited 2006 May 16];72:103-111. Available from:;year=2006;volume=72;issu...

Published: 16 May 2006


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Indian Journal of Dermatology, Venereology and Leprology