Difficult Cases Panel ISHRS Dr Alan Bauman - non-surgical hair regrowth

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Sometimes, "difficult cases" present as patients who are for whatever reason not great candidates for hair transplant surgery. In these instances, we bring to bear our 'toolbox' of medical treatment regimens that can help improve hair growth. These treatments may include Formula 82M minoxidil, LaserCap low level laser therapy, nutritional modification, platelet rich plasma, etc. Tracking compliance and results over time requires routine cross-sectional hair bundle measurements using the HairCheck device on a regular basis. Here are some of our 'difficult cases' successfully treated without hair transplantation using the most state-of-the-art medical therapies at Bauman Medical Group clinic in Boca Raton FL http://www.baumanmedical.com

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Difficult Cases Panel ISHRS Dr Alan Bauman - non-surgical hair regrowth

  1. 1. DIFFICULT CASES Alan J. Bauman, M.D. Bauman Medical Group – Boca Raton, FL ISHRS Annual Scientific Meeting 2013 ALAN J. BAUMAN M.D., A.B.H.R.S.
  2. 2. DISCLOSURES • Shareholder – HairScience LLC • Consultant – P&G, MasterPharm Please note: This presentation may contain information regarding the off-label use of medications, devices and other products that have not been evaluated by the FDA. ALAN J. BAUMAN M.D., A.B.H.R.S.
  3. 3. CASE1: 70 Y/O FEMALE “LAURA M.” • Chief Complaint: work.” “I‟m losing hair all over for many years… My dermatologist‟s treatments did not • Hair Loss Genetic Hx: + father, + mother, + paternal grandfather • Allergies: bacitracin, neo/polysporin, • • Medical Hx: Surgical Hx: skin cancer, breast cancer, HPV, chronic eczema, anemia appendectomy „62, R forearm hemangioma „72/‟86, bilateral mastectomy „79, breast reconstruction ‟01, bladder suspension „10 • Hair Loss Tx Hx: Used OTC minox2% solution for 2-3wks, d/c‟d due to dermatitis had >3 kenalog injections(.5mg/ml x 1cc) scalp oral prednisone taper x 4 wks. Referred by local derm, tx‟d for alopecia areata • Nutritionals: ALAN J. BAUMAN M.D., A.B.H.R.S. MVI, D, Omega3, Calcium
  4. 4. “LAURA M.” – 70F ALAN J. BAUMAN M.D., A.B.H.R.S.
  5. 5. LABS / DIAGNOSTICS • CBC & Chem20: wnl • Ferritin: 84 • Thyroid panel: wnl • CAG repeat: 25 (Low Androgen Sensitivity) • HairCheck 10/2/12 Frontal 60x Occiptial (tab#34): 50 HMI Vertex (tab#20): 40 HMI Frontal (tab#11): 30 HMI L-temple (tab #10.5x6L): 19 HMI ALAN J. BAUMAN M.D., A.B.H.R.S. Vertex 60x
  6. 6. ASSESSMENT / PLAN • Diffuse Hair Loss w/ Weak HMI & Poor Coverage in frontal, temples and vertex • Weak occipital HMI – poor donor quality • ? Misdiagnosis / failed treatment with intradermal steroids and OTC minox • Plan: • Begin pulsed LLLT 2.8J/cm2 over 575 cm2 of scalp (frontal to vertex) every other day • Start compounded Minoxidil Formula 82M; 30 drops (frontal to vertex) q12h ALAN J. BAUMAN M.D., A.B.H.R.S.
  7. 7. LAURA M. – 60X DERMOSCOPY Vertex Frontal T = 0 days (baseline) ALAN J. BAUMAN M.D., A.B.H.R.S. T = 90 days
  8. 8. MINOXIDIL “FORMULA 82M” • Minoxidil 5% • Retinoic Acid 0.01% • Fluocinolone 0.001% • Oleanolic Acid (olive leaf extract) • Algae extract • Phytantriol • Vitamin E • Propylene Glycol-free • DOSAGE: apply 1ml (~30 drops) to scalp q12hr ALAN J. BAUMAN M.D., A.B.H.R.S.
  9. 9. LOW LEVEL LASER THERAPY • 224 divergent / non-collimated / wide-angle laser diodes • 5mW / diode, 650 nm, 80% duty cycle • 30 min, every other day over 575cm 2 • Dosage 224 * 0.005 W * 1800 sec * .80 / 575cm 2 = 2.8 J/cm 2 • 575cm2 = ½ area of a sphere with circumference of 60cm ALAN J. BAUMAN M.D., A.B.H.R.S. LASERCAP
  10. 10. HMI TRACKING Bauman Medical Group - Hair Mass Index (HMI) Tracking Sheet Patient Name: Mardyks, Linda Date of Birth: 8/22/53 Hair Mass Index 110 Occipital Tab #34 85 Vertex Tab #17 60 Frontal Tab #8 Temple Tab #10.5x6L 35 10 Hair Mass Index Log Exam Date ALAN J. BAUMAN M.D., A.B.H.R.S. Occipital Tab #34 Vertex Tab #17 Frontal Tab #8 Temple Tab #10.5x6L Notes Techs
  11. 11. 0 DAYS 90 DAYS 180 DAYS 0 DAYS 90 DAYS 180 DAYS OCT 2012 JAN 2013 APR 2013 OCT 2012 JAN 2013 APR 2013 ALAN J. BAUMAN M.D., A.B.H.R.S.
  12. 12. 270 DAYS JULY 2013 ALAN J. BAUMAN M.D., A.B.H.R.S.
  13. 13. 270 DAYS OCT 2012 – JULY 2013 ALAN J. BAUMAN M.D., A.B.H.R.S.
  14. 14. OTHER EXAMPLES ALAN J. BAUMAN M.D., A.B.H.R.S.
  15. 15. ANA B. (68YO) LaserCap qod, Formula 82M Minoxidil bid x 6mos ALAN J. BAUMAN M.D., A.B.H.R.S.
  16. 16. ARLENE T. (68F) LaserCap qod, Formula 82M Minoxidil bid, Biotin 2500mcg po bid ALAN J. BAUMAN M.D., A.B.H.R.S.
  17. 17. ZACH (28M) LaserCap qod, Formula 82M Minoxidil bid x 90 days ALAN J. BAUMAN M.D., A.B.H.R.S.
  18. 18. MICHAEL K. (39M) Formula 82M Minoxidil bid x 6mos ALAN J. BAUMAN M.D., A.B.H.R.S.
  19. 19. VANSANTA S. (61F) LaserCap qod, Formula 82M Minoxidil bid x 6mos ALAN J. BAUMAN M.D., A.B.H.R.S.
  20. 20. CYNTHIA B. (65F) LaserCap qod, Formula 82M Minoxidil bid, Biotin 2500mcg po bid x 6mos ALAN J. BAUMAN M.D., A.B.H.R.S.
  21. 21. TAKE-HOME TEACHING POINT Non-Surgical Treatment Options • Medical Management Works • Formula 82M Minoxidil • Diagnosis • Finasteride/Dutasteride Follow-up • LaserCap • Tracking • Platelet Rich Plasma • Compliance • Nutritionals • Thank You!! ALAN J. BAUMAN M.D., A.B.H.R.S. Follow @DrAlanBauman on Twitter doctorb@baumanmedical.com
  22. 22. THANK YOU! ALAN J. BAUMAN M.D., A.B.H.R.S.

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