This document discusses female hair loss and an evidence-based approach to its diagnosis and management. It outlines four key steps: 1) Make an accurate diagnosis using history, exam findings including smartphone microscopy, and targeted labs; 2) Establish baselines using smartphone photos and hair mass measurement; 3) Choose an appropriate treatment; and 4) Manage treatment using measurable feedback like hair mass index. The diagnosis is usually thinning, shedding or breakage, determined by examining hair diameter, density and breakage patterns. Hair mass measurement provides an objective baseline and tool to monitor progress.
As more breakthroughs in the understanding of photomedicine and low level laser therapy occur, it is increasingly important for physicians to understand the role of low level laser therapy in the management of androgenetic alopecia (male and female pattern hair loss). This brief overview from the 19th Annual World Congress of Anti-Aging and Aesthetic medicine (A4M) in Orlando April 2011 followed Harvard/MIT professor, Dr. Michael Hamblin's detailed talk on the mechanisms of low level laser therapy.
Depending on a number of critically important factors, hair transplant surgery can either be one of the best decisions you will ever make or among the worst
Hair transplantation is a surgical technique that removes hair follicles from one part of the body, called the 'donor site', to a bald or balding part of the body known as the 'recipient site'.
As more breakthroughs in the understanding of photomedicine and low level laser therapy occur, it is increasingly important for physicians to understand the role of low level laser therapy in the management of androgenetic alopecia (male and female pattern hair loss). This brief overview from the 19th Annual World Congress of Anti-Aging and Aesthetic medicine (A4M) in Orlando April 2011 followed Harvard/MIT professor, Dr. Michael Hamblin's detailed talk on the mechanisms of low level laser therapy.
Depending on a number of critically important factors, hair transplant surgery can either be one of the best decisions you will ever make or among the worst
Hair transplantation is a surgical technique that removes hair follicles from one part of the body, called the 'donor site', to a bald or balding part of the body known as the 'recipient site'.
Alopecia affects many individuals worldwide. Owing to the large role that hair loss plays in self-image and self-confidence, an increasing number of these men and women seek options for hair restoration.Major considerations and sources of hesitation for strip surgical restoration are the visible linear scar, prolonged downtime, and other expected side effects of invasive procedures. These problems can be circumvented by smaller harvest approaches. However, the traditional punch harvest, which produces no linear scar, does leave patients with an often-unsatisfactory “doll hair” appearance. Follicular Unit Extraction (FUE) is a minimally invasive surgical procedure that utilizes a punch device to harvest occipital follicular units that are later transplanted in areas of loss to restore hair growth. FUE captures the benefit of multiple available restoration techniques and avoids the disadvantages of traditional strip surgery. A number of variations on the procedure are currently in practice and many more exciting advances are underway.
Hair transplant surgery is a popular solution for individuals experiencing hair loss, as it involves the transfer of healthy hair follicles from one part of the scalp to another. In this guide, we will delve into the cost and process of hair transplant surgery, providing a comprehensive overview for those considering this procedure.
Hair Transplant Articles and Documents | Dr Tyng Tan | Hair and Laser ClinicThe Hair and Laser Clinic
Collection of hair transplantation articles and documents shared to you by Dr Tyng Tan of Hair and Laser Clinic (http://www.hairandlaserclinic.com/). A Singapore-based clinic specializing in FUE hair transplant and medical aesthetics.
Laser Hair Removal
Also known as light based hair removal and laser hair reduction
Laser hair removal is a convenient, noninvasive method for permanently reducing or removing unwanted facial or body hair. It leaves the skin looking smoother and silkier than waxing, electrolysis or razors and is a gentle technique that can treat larger areas effectively with minimal discomfort and with no downtime. Today, laser hair removal is one of the most common aesthetic procedures performed in the United States.
by KEN L. WILLIAMS, JR., DO
Hair restoration surgery has evolved into a scientifically based cosmetic surgical discipline over the last half century. A recent hair surgical technique to evolve, Follicular Unit Extraction (FUE), is a donor harvesting technique removing single “follicular units “one unit at a time” with a small round punch.
Hair Transplantation techniques have been evolving and becoming more effective. Among the various cosmetic surgeries, hair restoration has become very innovative. If you undertake this cosmetic surgery then the results would look more natural. It has become a very aesthetic and exciting surgery today. The way it uses hair follicles to restore hair is a unique invention of science. Latest methods like hair cloning are also researched on. This will help in hair multiplication and will also cure baldness with increased hair growth.
Methods and Material:
The two methods included in hair transplant surgery are: Follicular Unit Transplant and Follicular Unit Extraction. Each method has its own unique pros and cons. These methods are based on the doctrine of donor dominance. Some of the tests that are done include: serum chemistries and coagulation studies. Screening technology is also enabled to take follicular measurements.
Results:
Care after Operation:
Just like one should take precaution after any operation, similarly, after undergoing a hair transplant, you must take a number of precautions. Direct exposure to sunlight must be avoided. You must not fiddle with your hair for the first two days; however, shampoo can be done. You must be careful that post operation, scabs must not be formed around the hair shaft. There is also a phase called “shock-loss”. In this phase, newly planted hairs usually fall out. Nevertheless, new hair re-grows within 2 or 3 months. The growth process continues and thickens with time.
Discussions:
A patient takes up hair transplant only when he or she wants to get rid of baldness and hair thinning problems permanently. Nevertheless, it has been reported that hair thinning is also seen post this cosmetic surgery. It is also called “shock-loss”. This is an important side-effect seen after hair transplant surgery. Another common sight is the appearance of bald patches. An estimated amount of 50 hairs are usually lost each day. The temple and the scalp do often get swollen. Itching and Scratching must be refrained from as that can lead to scab formation.
Conclusion:
According to a recent study, papilla cells and stem cells have been found in the hair follicles. It can be used in correcting baldness with the help of hair multiplication. This method is also called hair cloning. Therefore, it can be concluded that the hair surgical technique has a long way to go. Those who want to opt for this surgery can browse through the internet to gain an in-depth knowledge about hair transplantation. Results have proved that pain is negligible and the recovery time also doesn’t protract. You do not need to be hospitalized nor is any bed rest required. Hair Transplant indeed is a viable choice and is rewarding.
Radiation therapy patient treatment planning & post treatment care new/ Labia...Indian dental academy
Indian Dental Academy: will be one of the most relevant and exciting training center with best faculty and flexible training programs for dental professionals who wish to advance in their dental practice,Offers certified courses in Dental implants,Orthodontics,Endodontics,Cosmetic Dentistry, Prosthetic Dentistry, Periodontics and General Dentistry.
icometrix offers imaging biomarkers for anatomical MRI or CT images as well as for functional, diffusion and perfusion MR images.
Medical imaging serves as an endpoint in an increasing number of clinical trials for neurological disorders to evaluate the effectiveness of novel therapeutic options and to better understand the pathophysiology. It is critical to obtain objective imaging measurements.Therefore, the use of
high-quality MRI data and quantitative MRI biomarkers is also recommended in the latest guidelines of the European Medicine Agency on clinical investigation of medicinal products for treatment of dementia, multiple sclerosis and other neurological disorders.
Digital Health: Company presentation by Eyal Gura, Co-Founder & CEO of Zebra Medical Vision at the NOAH Conference London 2019, 30-31 October, Old Billingsgate.
Radiation therapy patient treatment planning & post treatment care newIndian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
MedicalResearch.com: Medical Research Exclusive Interviews December 14 2014Marie Benz MD FAAD
MedicalResearch.com features exclusive interviews with medical researchers from major and specialty medical research and health care journals and meetings.
Low Level Laser Therapy is a non-chemical, side-effect free option for those with hair loss and hair thinning. Does Laser Therapy actually work? What are the mechanisms of low level laser therapy on the scalp and hair follicle. Are there any adverse effects?
Low Level Laser Therapy (LLLT) has been used for wound healing, pain control, lipolysis, anti-inflammatory properties and more. The mitochondrial-based cytochrome-c-oxidase molecule in the electron transport chain accepts the photon which then causes a cascade of events leading to increased ATP production and more.
Over time, when hair follicles that are producing weak, thin, wispy hair are exposed to significant doses of LLLT at regular intervals improvement in hair quality can be seen and measured.
As the delivery of LLLT has become easier for patients (portable) and more powerful over time due to the decreasing cost of laser-diodes, results have improved.
Old-style hand-held devices are relatively weak and many head-worn units contain weak non-laser, non-coherent LED's.
Newer devices like the cordless, rechargeable, 100% hands-free, discreet LaserCap and the hand-held Nutreve personal laser are making it easier for patients to achieve the results they seek.
LaserCap contains 224 diodes at 5mw in a paper-thin circuit board that is sized to fit underneath a standard baseball hat, bandana or scarf. It's rechargeable battery pack makes it the most powerful, portable device available for hair loss patients. 30 min every other day.
Nutreve's Personal Laser, hand-held rechargeable 35 diode unit contains the most diodes of any hand-held on the market today. 20 minutes over one area every other day.
Patients can see thicker, fuller and healthier hair within a few months of use but it does not reverse severe baldness where depletion of hair follicle density has already occurred.
Dr. Alan J. Bauman, M.D.
doctorb@baumanmedical.com
ABHRS Certified
Alopecia affects many individuals worldwide. Owing to the large role that hair loss plays in self-image and self-confidence, an increasing number of these men and women seek options for hair restoration.Major considerations and sources of hesitation for strip surgical restoration are the visible linear scar, prolonged downtime, and other expected side effects of invasive procedures. These problems can be circumvented by smaller harvest approaches. However, the traditional punch harvest, which produces no linear scar, does leave patients with an often-unsatisfactory “doll hair” appearance. Follicular Unit Extraction (FUE) is a minimally invasive surgical procedure that utilizes a punch device to harvest occipital follicular units that are later transplanted in areas of loss to restore hair growth. FUE captures the benefit of multiple available restoration techniques and avoids the disadvantages of traditional strip surgery. A number of variations on the procedure are currently in practice and many more exciting advances are underway.
Hair transplant surgery is a popular solution for individuals experiencing hair loss, as it involves the transfer of healthy hair follicles from one part of the scalp to another. In this guide, we will delve into the cost and process of hair transplant surgery, providing a comprehensive overview for those considering this procedure.
Hair Transplant Articles and Documents | Dr Tyng Tan | Hair and Laser ClinicThe Hair and Laser Clinic
Collection of hair transplantation articles and documents shared to you by Dr Tyng Tan of Hair and Laser Clinic (http://www.hairandlaserclinic.com/). A Singapore-based clinic specializing in FUE hair transplant and medical aesthetics.
Laser Hair Removal
Also known as light based hair removal and laser hair reduction
Laser hair removal is a convenient, noninvasive method for permanently reducing or removing unwanted facial or body hair. It leaves the skin looking smoother and silkier than waxing, electrolysis or razors and is a gentle technique that can treat larger areas effectively with minimal discomfort and with no downtime. Today, laser hair removal is one of the most common aesthetic procedures performed in the United States.
by KEN L. WILLIAMS, JR., DO
Hair restoration surgery has evolved into a scientifically based cosmetic surgical discipline over the last half century. A recent hair surgical technique to evolve, Follicular Unit Extraction (FUE), is a donor harvesting technique removing single “follicular units “one unit at a time” with a small round punch.
Hair Transplantation techniques have been evolving and becoming more effective. Among the various cosmetic surgeries, hair restoration has become very innovative. If you undertake this cosmetic surgery then the results would look more natural. It has become a very aesthetic and exciting surgery today. The way it uses hair follicles to restore hair is a unique invention of science. Latest methods like hair cloning are also researched on. This will help in hair multiplication and will also cure baldness with increased hair growth.
Methods and Material:
The two methods included in hair transplant surgery are: Follicular Unit Transplant and Follicular Unit Extraction. Each method has its own unique pros and cons. These methods are based on the doctrine of donor dominance. Some of the tests that are done include: serum chemistries and coagulation studies. Screening technology is also enabled to take follicular measurements.
Results:
Care after Operation:
Just like one should take precaution after any operation, similarly, after undergoing a hair transplant, you must take a number of precautions. Direct exposure to sunlight must be avoided. You must not fiddle with your hair for the first two days; however, shampoo can be done. You must be careful that post operation, scabs must not be formed around the hair shaft. There is also a phase called “shock-loss”. In this phase, newly planted hairs usually fall out. Nevertheless, new hair re-grows within 2 or 3 months. The growth process continues and thickens with time.
Discussions:
A patient takes up hair transplant only when he or she wants to get rid of baldness and hair thinning problems permanently. Nevertheless, it has been reported that hair thinning is also seen post this cosmetic surgery. It is also called “shock-loss”. This is an important side-effect seen after hair transplant surgery. Another common sight is the appearance of bald patches. An estimated amount of 50 hairs are usually lost each day. The temple and the scalp do often get swollen. Itching and Scratching must be refrained from as that can lead to scab formation.
Conclusion:
According to a recent study, papilla cells and stem cells have been found in the hair follicles. It can be used in correcting baldness with the help of hair multiplication. This method is also called hair cloning. Therefore, it can be concluded that the hair surgical technique has a long way to go. Those who want to opt for this surgery can browse through the internet to gain an in-depth knowledge about hair transplantation. Results have proved that pain is negligible and the recovery time also doesn’t protract. You do not need to be hospitalized nor is any bed rest required. Hair Transplant indeed is a viable choice and is rewarding.
Radiation therapy patient treatment planning & post treatment care new/ Labia...Indian dental academy
Indian Dental Academy: will be one of the most relevant and exciting training center with best faculty and flexible training programs for dental professionals who wish to advance in their dental practice,Offers certified courses in Dental implants,Orthodontics,Endodontics,Cosmetic Dentistry, Prosthetic Dentistry, Periodontics and General Dentistry.
icometrix offers imaging biomarkers for anatomical MRI or CT images as well as for functional, diffusion and perfusion MR images.
Medical imaging serves as an endpoint in an increasing number of clinical trials for neurological disorders to evaluate the effectiveness of novel therapeutic options and to better understand the pathophysiology. It is critical to obtain objective imaging measurements.Therefore, the use of
high-quality MRI data and quantitative MRI biomarkers is also recommended in the latest guidelines of the European Medicine Agency on clinical investigation of medicinal products for treatment of dementia, multiple sclerosis and other neurological disorders.
Digital Health: Company presentation by Eyal Gura, Co-Founder & CEO of Zebra Medical Vision at the NOAH Conference London 2019, 30-31 October, Old Billingsgate.
Radiation therapy patient treatment planning & post treatment care newIndian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
MedicalResearch.com: Medical Research Exclusive Interviews December 14 2014Marie Benz MD FAAD
MedicalResearch.com features exclusive interviews with medical researchers from major and specialty medical research and health care journals and meetings.
Low Level Laser Therapy is a non-chemical, side-effect free option for those with hair loss and hair thinning. Does Laser Therapy actually work? What are the mechanisms of low level laser therapy on the scalp and hair follicle. Are there any adverse effects?
Low Level Laser Therapy (LLLT) has been used for wound healing, pain control, lipolysis, anti-inflammatory properties and more. The mitochondrial-based cytochrome-c-oxidase molecule in the electron transport chain accepts the photon which then causes a cascade of events leading to increased ATP production and more.
Over time, when hair follicles that are producing weak, thin, wispy hair are exposed to significant doses of LLLT at regular intervals improvement in hair quality can be seen and measured.
As the delivery of LLLT has become easier for patients (portable) and more powerful over time due to the decreasing cost of laser-diodes, results have improved.
Old-style hand-held devices are relatively weak and many head-worn units contain weak non-laser, non-coherent LED's.
Newer devices like the cordless, rechargeable, 100% hands-free, discreet LaserCap and the hand-held Nutreve personal laser are making it easier for patients to achieve the results they seek.
LaserCap contains 224 diodes at 5mw in a paper-thin circuit board that is sized to fit underneath a standard baseball hat, bandana or scarf. It's rechargeable battery pack makes it the most powerful, portable device available for hair loss patients. 30 min every other day.
Nutreve's Personal Laser, hand-held rechargeable 35 diode unit contains the most diodes of any hand-held on the market today. 20 minutes over one area every other day.
Patients can see thicker, fuller and healthier hair within a few months of use but it does not reverse severe baldness where depletion of hair follicle density has already occurred.
Dr. Alan J. Bauman, M.D.
doctorb@baumanmedical.com
ABHRS Certified
Muktapishti is a traditional Ayurvedic preparation made from Shoditha Mukta (Purified Pearl), is believed to help regulate thyroid function and reduce symptoms of hyperthyroidism due to its cooling and balancing properties. Clinical evidence on its efficacy remains limited, necessitating further research to validate its therapeutic benefits.
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
ABDOMINAL TRAUMA in pediatrics part one.drhasanrajab
Abdominal trauma in pediatrics refers to injuries or damage to the abdominal organs in children. It can occur due to various causes such as falls, motor vehicle accidents, sports-related injuries, and physical abuse. Children are more vulnerable to abdominal trauma due to their unique anatomical and physiological characteristics. Signs and symptoms include abdominal pain, tenderness, distension, vomiting, and signs of shock. Diagnosis involves physical examination, imaging studies, and laboratory tests. Management depends on the severity and may involve conservative treatment or surgical intervention. Prevention is crucial in reducing the incidence of abdominal trauma in children.
Basavarajeeyam is a Sreshta Sangraha grantha (Compiled book ), written by Neelkanta kotturu Basavaraja Virachita. It contains 25 Prakaranas, First 24 Chapters related to Rogas& 25th to Rasadravyas.
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
Integrating Ayurveda into Parkinson’s Management: A Holistic ApproachAyurveda ForAll
Explore the benefits of combining Ayurveda with conventional Parkinson's treatments. Learn how a holistic approach can manage symptoms, enhance well-being, and balance body energies. Discover the steps to safely integrate Ayurvedic practices into your Parkinson’s care plan, including expert guidance on diet, herbal remedies, and lifestyle modifications.
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1. FEMALE HAIR LOSSFEMALE HAIR LOSS
The diagnosis & managementThe diagnosis & management
is easier than you think!is easier than you think!
Bernard Cohen, MDBernard Cohen, MD
VOLUNTARY CLINICAL PROFESSORVOLUNTARY CLINICAL PROFESSOR
UNIVERSITY OF MIAMI SCHOOL OF MEDICINEUNIVERSITY OF MIAMI SCHOOL OF MEDICINE
JANUARY 16, 2016JANUARY 16, 2016
MIAMI BEACH, FLMIAMI BEACH, FL
2. DISCLOSUREDISCLOSURE
Dr. Cohen owns the patents, and receives royaltiesDr. Cohen owns the patents, and receives royalties
on hair mass measuring technologies.on hair mass measuring technologies.
3. In a general dermatology practice...In a general dermatology practice...
90% of women presenting with hair loss have:90% of women presenting with hair loss have:
ThinningThinning REDUCTION IN DIAMETERREDUCTION IN DIAMETER
SheddingShedding REDUCTION IN DENSITYREDUCTION IN DENSITY
BreakageBreakage RARELY A COMPLAINTRARELY A COMPLAINT
AND A SCALP BIOPSY IS NOT REQUIREDAND A SCALP BIOPSY IS NOT REQUIRED
TO MAKE THE DIAGNOSISTO MAKE THE DIAGNOSIS
4. FOUR STEPSFOUR STEPS
1. Make the diagnosis1. Make the diagnosis
Combinations frequently existCombinations frequently exist
2. Establish baselines2. Establish baselines
““How much hair” is present before treatmentHow much hair” is present before treatment
3. Choose a treatment3. Choose a treatment
4. Manage with measureable feedback4. Manage with measureable feedback
““MEASUREABLEMEASUREABLE”” FEEDBACK =FEEDBACK = ““EVIDENCE-BASEDEVIDENCE-BASED””
10. PHYSICAL EXAMPHYSICAL EXAM RULE OUT THE “UNCOMMON 10%”RULE OUT THE “UNCOMMON 10%”
Frontal fibrosing alopeciaFrontal fibrosing alopecia
Diffuse and patchy AADiffuse and patchy AA
SLE, infection, inflammationSLE, infection, inflammation
Scarring alopecias, etc.Scarring alopecias, etc.
BIOPSY MIGHT BE REQUIREDBIOPSY MIGHT BE REQUIRED
11. PHYSICAL EXAM– ThinningPHYSICAL EXAM– Thinning
PART - Xmas treePART - Xmas tree
DISTRIBUTION - Horseshoe retentionDISTRIBUTION - Horseshoe retention
12. PHYSICAL EXAM– SheddingPHYSICAL EXAM– Shedding
PART -- Widened but no Xmas treePART -- Widened but no Xmas tree
DISTRIBUTION -- Generalized, no horseshoeDISTRIBUTION -- Generalized, no horseshoe
PULL TEST -- PositivePULL TEST -- Positive
13. PHYSICAL EXAM– BreakagePHYSICAL EXAM– Breakage
SLIDE DISTALLY ALONG PONYTAIL GRASP 6-10 HAIRSSLIDE DISTALLY ALONG PONYTAIL GRASP 6-10 HAIRS
Look for drop outs Try to break the bundleLook for drop outs Try to break the bundle
19. THINNING
WIDE RANGE OF DIAMETERSWIDE RANGE OF DIAMETERS
FOLLICULAR UNITS ARE PREDOMINATELY SINGLE HAIRFOLLICULAR UNITS ARE PREDOMINATELY SINGLE HAIR
21. Picture of ourPicture of our
Lab slip
STANDARDIZED “HAIR-RELATED” REQUISITION FORMSTANDARDIZED “HAIR-RELATED” REQUISITION FORM
Thinning will be diagnosed by micro-imaging.Thinning will be diagnosed by micro-imaging.
Blood tests are needed to screen for shedding, which frequently co-exists.Blood tests are needed to screen for shedding, which frequently co-exists.
27. ABSTRACT
Background: Hair loss affects millions worldwide. At
present, most dermatologists use simple, non-
quantitative methods to monitor hair loss progression
and response to treatment, with an emphasis on density
alone. However, the diameter of the hair fibers also
contributes greatly to the appearance of hair.
Objective: Evaluate the accuracy and sensitivity of a
cross-section trichometer (the HairCheck® device), a
simple, hand-held device that measures hair mass
influenced by both density and diameter.
Materials and Methods: Using surgical silk and cut
human hair, we analyzed the correlations between the
HairCheck® readings, the number and diameter of
strands, and the bundle dry weight.
Results: Direct correlations were observed between a
bundle’s cross-sectional area, displayed as the Hair
Mass Index (HMI), the number of strands, fiber diameter,
and bundle dry weight.
Conclusion: Cross-Section Trichometry (CST), the
HairCheck® System and its methodology to determine
the HMI, may provide a quick and accurate tool to
assess progressive alopecia and treatment response in
the clinic.
CONCLUSIONS
• Direct correlations were observed between the
bundle’s cross-sectional area, displayed as the Hair
Mass Index (HMI), the number of strands, the silk/hair
diameter, and the bundle dry weight. Therefore, HMI is a
meaningful measure of the hair mass.
• We have given the name Cross-Section Trichometry
(CST) to the trichometer system and its methodology.
CST is a simple modality that can quickly and accurately
measure the cross-sectional area of a bundle of hair, and
converts it to HMI for display.
REFERENCES
ACKNOWLEDGMENTS
• Arnold J. Hair mass index. 4th Annual Congress European
Society of Hair Restoration Surgery Barcelona 2001.
• Cohen B. The cross-section trichometer: a new device for
measuring hair quantity, hair loss, and hair growth. Dermatol
Surg 2008;34:900-10; discussion 10-1.
• Hendriks MA, Geerts PA, Dercksen MW, van den Hurk CJ ,
Breed WP. Evaluation of Cohen's Cross-Section Trichometer
for Measuring Hair Quantity. Dermatol Surg 2012. [Epub]
Cross-Section Trichometry, A Clinical Tool
for Assessing the Progression and Treatment Response of Alopecia
Joaquin J. Jimenez, Tongyu Cao Wikramanayake, Lucia M. Mauro, Irene A. Tabas,
Anne L. Chen, Isabel C. Llanes, Lawrence A. Schachner
Department of Dermatology & Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, FL
EXPERIMENTAL PROCEDURES
TCW is the recipient
of a Career
Development Award
from NIH/NIAMS
(AR050487).
RESULTS
RESULTS
INTRODUCTION
Figure 3. Cross-Section Trichometry (CST) of surgical
silk. (a) Correlation between the number of 5-0 strands
and Hair Mass Index (HMI). (b) CST of mixed silk
strands of different types/diameters. (c) Correlation
between HMI, the number of strands, and bundle weight.
c
87
79
72
64
57
50
49
35
30
25
21
16
11
0
10
20
30
40
50
60
70
80
90
100
HMI
ba
2
11
21
29
38
51
55
63
0
10
20
30
40
50
60
70
0 20 40 60 80 100120140 160180
HMI
Number of Silk Strands
r=0.9969
31 34
40 43
50
55 58
65.3
80.282.8
88.6
97.499.4
105.3
0
20
40
60
80
100
120
80 90 100 110 120 130 140 150 160
HMI
Number of Silk Strands
Weight(0.01g)
r=0.9953
r=0.9656
Type
Number of Surgical Silk Strands
3-0 80 60 40 20
4-0 20 40 60 80 60 40 20
5-0 20 40 60 80 60 40 20
6-0 20 40 60 80
Figure 4. Cross-
Section Trichometry
of bundles of cut
human hair using the
HairCheck® device.
Shown is correlation
between the HMI, the
number of hair
strands, and bundle
weight.
23 24 25 27 28 29 30 31 32
48.2
50.9 52.3
55.2 55.8 57.4
59.1
62.0
64.7
0
10
20
30
40
50
60
70
310 320 330 340 350 360 370 380 390 400 410
HMI
Number of Hair Strands
Weight(0.01g)
r=0.9959
r=0.9874
Applications of Cross Section Trichometry:
• Early detection of non-visible hair loss.
• Progression of hair loss.
• Evaluation of response to hair loss treatments (drugs,
devices and over-the-counter products).
• For hair transplantation, CST in the donor area during
initial consultation will help develop realistic
expectations.
• Assess hair breakage.
a b
c
d
e
mm
0 1 2 3 4 5
Figure 1. For assays of hair
density, any hair with a diameter
of greater than 30µm is counted
as one hair without consideration
of the variation in hair diameter.
But for conditions such as
androgenetic alopecia, the hair
diameter varies greatly (left).
• Currently, most dermatologists use simple, non-
quantitative methods to evaluate alopecia, with an
emphasis on hair density alone.
• Small decreases in hair density are not easily detected
by the naked eye, e.g., in global photographs.
• In addition to density, the diameter of hair fibers also
contributes greatly to the appearance of hair mass.
Figure 2. The HairCheck® System consists of a locating
strip (a,b) attached to a pair of eyeglasses (a) and the
measuring device (c,d). A four-legged template is
placed on a numbered tab of the locating strip (b) to
mark the sample site, and the tab number is recorded to
allow return to the same site for future measurements.
The measuring device is hand-held and transmits a pre-
determined load to a bundle of hair (at least 2.5 cm [1
inch] in length) captured by a J-slot (c, d, e). The hair
can be of any type, from super fine to very coarse.
Obtaining the Hair Mass Index (HMI): Bundles of
surgical silk or cut human hair were placed in the J-slot
of the measuring device (c). When the lever arm is
squeezed (d), the cross sectional area of the bundle is
instantaneously displayed as the HMI on the device’s
LED screen and expressed as: mm2 of hair per cm2 of
scalp x 100, rounded up to the closest integer.
All details & published data @All details & published data @ www.howtomeasurehair.comwww.howtomeasurehair.com
SIMULTANEOUSLY MEASURE DENSITY & DIAMETERSIMULTANEOUSLY MEASURE DENSITY & DIAMETER
28. •
b
EXPERIMENTAL PROCEDURES
a b
c
d
e
Figure 2. The HairCheck® System consists of a locating
strip (a,b) attached to a pair of eyeglasses (a) and the
measuring device (c,d). A four-legged template is
HAIR MASS MEASUREMENT
29.
30. THETHE DEVICEDEVICE MEASURES THE CROSS SECTIONALMEASURES THE CROSS SECTIONAL
AREA ON THE HAIR.AREA ON THE HAIR.
THETHE TEMPLATETEMPLATE MEASURES THE CROSS SECTIONALMEASURES THE CROSS SECTIONAL
AREA ON THE SCALPAREA ON THE SCALP
A single numeric value = mmA single numeric value = mm22
of hair per cmof hair per cm22
of scalpof scalp
31. So... In the treatment period... If
THE DIAMETERS GET BIGGER OR SMALLER
OR
THE DENSITY GETS HIGHER OR LOWER
The value displayed on the LED screen
will reflect those changes.
SENSITIVITY
Device can detect a change of 3 hairs in a bundle of 600 hairs.
33. TREATMENTTREATMENT
SHEDDINGSHEDDING
Review blood test resultsReview blood test results
Correct deficiencies and abnormalitiesCorrect deficiencies and abnormalities
Refer patient to appropriate specialistRefer patient to appropriate specialist
If physiologic, re-assure patient ofIf physiologic, re-assure patient of
expected return to normalexpected return to normal
36. MANAGEMENTMANAGEMENT
Same for shedding & thinningSame for shedding & thinning
Use Hair Mass MeasurementUse Hair Mass Measurement
(CROSS SECTION TRICHOMETRY)(CROSS SECTION TRICHOMETRY)
to guide your management decisions.to guide your management decisions.
Casual photography is of value, but is not evidence-based.Casual photography is of value, but is not evidence-based.
It is too imprecise and does not generate measureable data.It is too imprecise and does not generate measureable data.
If less than 50% of the hair has been lost -If less than 50% of the hair has been lost -
the underlying skin will not be visible to the eye (or camera).the underlying skin will not be visible to the eye (or camera).
38. DOCTOR, I THINK I’M LOSING MY HAIRDOCTOR, I THINK I’M LOSING MY HAIR
92-72/92 = 22%92-72/92 = 22%
SHE HAS A 22% LOSS (THINNING) WHICH CANNOTSHE HAS A 22% LOSS (THINNING) WHICH CANNOT
BE SEEN VISUALLY, OR ON CAMERABE SEEN VISUALLY, OR ON CAMERA
7272
9292
39. BASELINEBASELINE
She chooses toShe chooses to
postpone treatmentpostpone treatment
49497272 6767
12 MONTHS LATER12 MONTHS LATER
She is 7% worseShe is 7% worse
40. BASELINEBASELINE
She chooses to startShe chooses to start
laser therapylaser therapy
49496767 7575
12 MONTHS LATER12 MONTHS LATER
She’s only 10% improvedShe’s only 10% improved
41. BASELINEBASELINE
She’s dissatisfied and agreesShe’s dissatisfied and agrees
to add MNX to her laser therapyto add MNX to her laser therapy
49497575 8181
12 MONTHS LATER12 MONTHS LATER
She has a 7% improvementShe has a 7% improvement
with combination therapywith combination therapy
42. BASELINEBASELINE
But the MNX is too difficult to applyBut the MNX is too difficult to apply
bid, she wants to apply qd.bid, she wants to apply qd.
49498383 8282
6 MONTHS LATER6 MONTHS LATER
Surprisingly she isSurprisingly she is
no worseno worse
43. 5 MONTHS AFTER5 MONTHS AFTER
CHILDBIRTHCHILDBIRTH
Patient is actively shedding and frantic.Patient is actively shedding and frantic.
She is re-assured and not treated.She is re-assured and not treated.
49495555 7777
12 MONTHS AFTER12 MONTHS AFTER
CHILDBIRTHCHILDBIRTH
She is 30% improvedShe is 30% improved
And almost back to normalAnd almost back to normal
44. BASELINEBASELINE
A low ferritin and Vitamin DA low ferritin and Vitamin D
are picked up on blood screening.are picked up on blood screening.
Treatment is commenced.Treatment is commenced.
49497979 8686
12 MONTHS LATER12 MONTHS LATER
She is 9% improved afterShe is 9% improved after
one year.one year.
45. IS IT DIFFUSEIS IT DIFFUSE OROR PATTERN HAIR LOSS?PATTERN HAIR LOSS?
(occiput & mid scalp essentially equal)(occiput & mid scalp essentially equal)
CONCLUSION = Hair Loss is DIFFUSE not PATTERNCONCLUSION = Hair Loss is DIFFUSE not PATTERN
6262
6464
46. BASELINEBASELINE
Patient reluctantly startsPatient reluctantly starts
minoxidil for thinning.minoxidil for thinning.
49496565 7979
8 MONTHS LATER8 MONTHS LATER
““Doc, I don’t think theDoc, I don’t think the
minoxidil is working.”minoxidil is working.”
48. IS IT DIFFUSEIS IT DIFFUSE OROR PATTERN HAIRPATTERN HAIR
LOSS?LOSS?
(occiput & mid scalp essentially equal)(occiput & mid scalp essentially equal)
6868 6767
Editor's Notes
In a general dermatology practice – 90% of women with hair loss have one of three diagnoses
Or a combination of 2 or 3
A scalp biopsy is not required
I will attempt to show you how to makethe diagnosis – remembering that (combinations do exist)
Then establish your treatment starting point or baselines
And then–how to manage the treatment– using modalities that give you evidence-based feedback
So… make thte diagnosis – establish the baselines – then treat and manage
You’ll want to ask these questions in your medical history. They all point to thinning
Hit these items in your medical history. They point to shedding
Hit these items in your medical history. They point to thinning
So… make thte diagnosis – establish the baselines – then treat and manage
On physical exam, try to identify the less common 10%
In these cases a biopsy might be required
Part the hair down the midline. A Xmas tree distribution is highly suggestive sign of thinning
Retention of hair in the horseshoe fringe is a sign of thinning as well
When the hair is parted – look for general widening with no Xmas tree – that suggests shedding
The distribution of loss is diffuse . Then Grasp 20 or 30 hairs and give them a tug. If more than 3 come out it’s a positive pull test.
Because theres a high proportion of telogen hairs in states of effluvium
To check for breakage put together a pony tail and examine with a contrasting background.
The short broken hairs fall out of the bundle.
The take 5 or six hair, wrap around your fingers and try to break them. Brittle hair with break easily.
So… make thte diagnosis – establish the baselines – then treat and manage
It’s a dermatoscope
The phone slips into a shell that contains a lens and light source.
The device comes with a good archival software for keeping track of the photos
The image on the left is what you see.
On the right is the same image zoomed in for close examination
In cases of shedding expect to see hairs of essentially all the same diameter
In cases of thinning, the hairs become progressively miniaturized
So on the left -- a micro-image of cut hair. Note the wide variation of diameters and the single hair follicular units.
On the right is what you see using the PhotoFinder– Take a look at how easily the variation can be seem – there is no need to cut hair
So… make thte diagnosis – establish the baselines – then treat and manage
We use a form that contains the hair-related lab test and diagnoses.
Tip –Don’t use a hair diagnosis - use Unspecified endocrine disorder 259.9 and the tests are rarely denied
the the insurance company.
90% of women with thinning but a small percentage have an adrenal hormone imbalance identified with DHEAS and testosterone
So… make thte diagnosis – establish the baselines – then treat and manage
So… make thte diagnosis – establish the baselines – then treat and manage
This technology – called cross section trichometry – has been published by me as well as Drs. Jimenez and Cao.
It is in multiple published articles and textbook chapters Used by Loreal, Proctor and Gamble, and Unilever
IT CONSISTS OF -- READ THE SLIDE
So… make thte diagnosis – establish the baselines – then treat and manage
So… make thte diagnosis – establish the baselines – then treat and manage
I would also add breakage
I would also add breakage
A female with hair loss can be measured in two areas
If the occiput and mid scalp are about equal, the hair loss is diffuse
If the mid scalp is less than the occiput then she would have androgenetic alopecia
We can track the progress of propecia, minoxidil, laser, biotin, transplants
Or evaluate low level laser therapy
This patient is 21% improved after one year
We can track the progress of propecia, minoxidil, laser, biotin, transplants
Or evaluate low level laser therapy
This patient is 21% improved after one year
We can track the progress of propecia, minoxidil, laser, biotin, transplants
Or evaluate low level laser therapy
This patient is 21% improved after one year
We can track the progress of propecia, minoxidil, laser, biotin, transplants
Or evaluate low level laser therapy
This patient is 21% improved after one year
We can track the progress of propecia, minoxidil, laser, biotin, transplants
Or evaluate low level laser therapy
This patient is 21% improved after one year
We can track the progress of propecia, minoxidil, laser, biotin, transplants
Or evaluate low level laser therapy
This patient is 21% improved after one year
A female with hair loss can be measured in two areas
If the occiput and mid scalp are about equal, the hair loss is diffuse
If the mid scalp is less than the occiput then she would have androgenetic alopecia
We can track the progress of propecia, minoxidil, laser, biotin, transplants
Or evaluate low level laser therapy
This patient is 21% improved after one year
As heres an example I gave earlier
3 measurement
Pt has a 50% loss on the vertex and a 12% loss in the midscalp