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Medical Management of Hair Loss - Webinar - DrAlanBauman 2015

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For many, hair loss can be a devastating psychological condition. Unfortunately, dermatologists and primary doctors often fall short when it comes to the state-of-the-art diagnosis and treatment. It's up to hair restoration physicians and integrative practices to take the lead in the medical management of hair loss. Helping patients maintain, enhance and restore their own living and growing hair is a rewarding field to be in. Mismanaging patients expectations or therapies will certainly lead to disappointment. In this webinar, learn an overview of how we diagnose, measure, treat and track hair loss patients on various effective medical regimens. We often prescribe finasteride and FinPlus compounded finasteride, Formula82M minoxidil, LaserCap and in-office laser therapy, PRP with ECM BioD ACell, nutraceuticals and FUE NeoGraft hair transplantation. See some before and afters from various monotherapy patients. HairCheck cross sectional hair bundle trichometry is the key to keeping patients compliant. Thank you to LaserCap

Additional training is available from Dr. Alan J Bauman so visit http://www.haircoach.net for upcoming hands-on PRP and HairCheck classes.

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Medical Management of Hair Loss - Webinar - DrAlanBauman 2015

  1. 1. MEDICAL MANAGEMENT OF HAIR LOSS 
 FOR THE INTEGRATIVE MEDICINE PRACTICE Alan J. Bauman, M.D. Diplomate, American and International Board of Hair Restoration Surgery Fellow, International Society of Hair Restoration Surgery February 27, 2015 OVERVIEW
  2. 2. DISCLOSURES The following conflicts of interest are pertinent to this author’s presentation: NONE Please note: This presentation discusses FDA-approved and non FDA-approved / off-label use of medications. This presentation discusses FDA-cleared and non FDA-cleared / investigational medical devices.
  3. 3. WHY HAIR LOSS MANAGEMENT TREATMENTS? • Simple to integrate into existing age-management practice • Elective treatments are performed on a cash basis and are not dependent on insurance reimbursements. • Treatments are generally low-risk, patients are generally healthy. • Effective hair loss treatments are in high demand for the aging population. • High patient satisfaction associated with treatments that help patients look good and feel good.
  4. 4. ALAN J. BAUMAN, M.D. • M.D. w/ Cor et Manus Award – New York Medical College • General Surgery – Beth Israel Medical Center, NY • General Surgery – Mt. Sinai Medical Center, NY • Hair Transplant Fellowship – Eastwood, NY • Bauman Medical Group – Boca Raton (est. 1997) • Diplomate, American Board of Hair Restoration Surgery • American Academy of Anti-Aging Medicine • American Hair Loss Association • American Hair Loss Council • Fellow, International Society of Hair Restoration Surgery • International Alliance of Hair Restoration Surgery Alan J. Bauman, M.D.
  5. 5. • Exclusively treat men and women with hair loss. • >1000 patients/year, >250 hair transplant procedures • 12 staff members • 11,000 sqft 5 ORs, Classroom, HairCheck Zones 50:50 male:female patients Pro Bono hair transplants via “Operation Restore”
  6. 6. OBJECTIVES • Prevalence & psychological impact of hair loss in men & women • Etiology of common forms of hair loss • Evaluation and Diagnosis of hair loss • Effective multi-therapy regimens, Treatments & Tracking • Keys to Successful Medical Management of Hereditary Hair Loss • Additional Educational Opportunities
  7. 7. THANK YOU! 7 Transdermal Cap, Inc. Dr. Michael Rabin, MD - LaserCap Inventor & CEO Prerna Khemka - Director Visit LaserCap.com
  8. 8. HAIR LOSS
  9. 9. • Affects roughly 35 million men in the US • 40% of men will have noticeable hair loss by age 35 MALE HAIR LOSS PREVALENCE
  10. 10. • Hair loss affects roughly 21 million women in the US • 65% of women will have noticeable hair loss by age 60 FEMALE HAIR LOSS PREVALENCE
  11. 11. HAIR & AGE “Aged? But he does not appear aged, just look, his hair has remained young!” --Marcel Proust In Search of Lost Time (1913-1927)
  12. 12. IS HAIR IMPORTANT?
  13. 13. IMPACT OF HAIR LOSS Premature Aging Embarrassment Emotional Distress ↓ Body-image satisfaction ↓ Self-esteem ↓ Self-confidence Socially & Professionally The psychosocial consequences of androgenetic alopecia Authors: Cash T.F.1; F.cash T.*Source: British Journal of Dermatology, Volume 141, Number 3, September 1999, pp. 398-405(8) Publisher: Blackwell Publishing
  14. 14. CELEBRITY HAIR LOSS
  15. 15. CELEBRITY HAIR LOSS Naomi Campbell Serena Williams Britney Spears
  16. 16. HAIR FOLLICLE – BASIC SCIENCE
  17. 17. HAIR FOLLICLE ANATOMY
  18. 18. HAIR FOLLICLE CYCLING • Anagen • Catagen • Telogen
  19. 19. ETIOLOGY: WHAT CAUSES HAIR LOSS?
  20. 20. TYPES OF HAIR LOSS • Alopecia Areata • Androgenetic Alopecia • Trichotillomania • Telogen Effluvium • Anagen Efffluvium
  21. 21. MALE ANDROGENETIC ALOPECIA
  22. 22. ♂ANDROGENETIC ALOPECIA
 (HEREDITARY MALE PATTERN HAIR LOSS) Men: DHT-mediated miniaturization of hair follicles Testosterone Dihydrotestosterone (DHT) 5-αR • Shorter growth cycles • Less pigmentation • Decreased Caliber
  23. 23. DHT-MEDIATED
 HAIR FOLLICLE MINIATURIZATION HairCam Dermoscopy 60X (c) Alan J. Bauman M.D. (c) Alan J. Bauman M.D.
  24. 24. DHT-MEDIATED
 HAIR FOLLICLE MINIATURIZATION NORMAL MINIATURIZED HairCam Dermoscopy 30X (c) Alan J. Bauman M.D. (c) Alan J. Bauman M.D.
  25. 25. ♀ ANDROGENETIC ALOPECIA
(HEREDITARY FEMALE PATTERN HAIR LOSS) Women: ‘highly-sensitive’ hair • Hormone ‘Imbalance’ • PCO • Childbirth • Menopause / TAH • Androgen Sensitivity • Medications • Illness • Stress • Nutrition • Environmental/Social Ludwig-Savin Scale
  26. 26. TREATMENT MODALITIES
 FOR HAIR LOSS • Risk Reduction • Pharmaceutical • Nutraceutical • Laser Therapy • Cell Therapy • Hair Transplantation
  27. 27. 
 
 PHARMACEUTICAL TREATMENT FOR HAIR LOSS
  28. 28. PHARMACEUTICAL TREATMENTS • Topical Medication – stimulate / enhance hair growth • OTC Minoxidil (2%, 5%, Rogaine, Generic, Foam) • Compounded Rx Minoxidil (Formula 82M) • 10-14 drops / Twice a day, every day • Oral Medication (for Men) – reduce DHT • Propecia (finasteride 1mg) – daily prescription pill • 9 of 10 keep the hair they have or improve • 2% have side effects • Compounded Finasteride (FinPlus) Note: Formula 82M and FinPlus are available from Masterpharm NY
  29. 29. MEDICAL THERAPY: RESULTS
  30. 30. FINASTERIDE
 RESULTS Finasteride 1mg ONLY: baseline, 10 months (c) Alan J. Bauman M.D. (c) Alan J. Bauman M.D. (c) Alan J. Bauman M.D. (c) Alan J. Bauman M.D. (c) Alan J. Bauman M.D.
  31. 31. FINASTERIDE RESULTS 30 y/o NW5, Finasteride x 5 months, no Surgery 49 y/o start finasteride at time of surgery, 10 months Courtesy: Alan J. Bauman, M.D. (c) Alan J. Bauman M.D. (c) Alan J. Bauman M.D. (c) Alan J. Bauman M.D.
  32. 32. MINOXIDIL RESULTS (BEFORE & AFTER 6MOS)
 COMPOUNDED MINOXIDIL FORMULA 82M (c) Alan J. Bauman M.D. (c) Alan J. Bauman M.D. (c) Alan J. Bauman M.D. (c) Alan J. Bauman M.D. (c) Alan J. Bauman M.D. (c) Alan J. Bauman M.D.
  33. 33. NUTRACEUTICAL OPTIONS
  34. 34. VITAMINS & PHYTONUTRIENTS • Bioactive ingredients derived from plants • Beneficial for • Hair conditioning • Hair growth stimulation • Scalp dermatitis • Anti-microbial agents
  35. 35. PHYTONUTRIENTS 
 FOR IMPROVED HAIR GROWTH • Promote hair growth secondary to: • Increased blood flow • Activation of dermal papilla • DHT inhibition • Anti-inflammatory effects • Increased nutrition
  36. 36. • Asiasari • Proanthocyanidins • Saw Palmetto / Serenoa Repens • Ginkgo biloba • Aloe • Caffeine • Bergamot • Ginseng • Henna • Hibiscus • Ilicium • Biotin • Astragalus Root • Poria Cocos • Rehmannnia • Nettle Leaf • Horsetail PHYTONUTRIENTS PROMOTING HAIR GROWTH
  37. 37. • Saw palmetto • Azelaic acid • Zinc • Vitamin B6 • Linoleic acid • Oleanolic acid NUTRIENTS THAT MAY INHIBIT DHT Sereona Repens / Saw Palmetto
  38. 38. LOW LEVEL LASER THERAPY
  39. 39. LOW LEVEL LASER THERAPY • Cytochrome-C-Oxidase • ATP production • non-ionizing • non-thermal • non-mutagenic • no side-effects growth factor production extracellular matrix deposition cell proliferation & motility anti-apoptosis and pro-survival Gene Transcription
  40. 40. LOW LEVEL LASER THERAPY ~5 months of LLLT in-office (c) Alan J. Bauman M.D. (c) Alan J. Bauman M.D. (c) Alan J. Bauman M.D.
  41. 41. LLLT - RESULTS Courtesy: Alan J. Bauman, M.D. (c) Alan J. Bauman M.D.
  42. 42. LLLT - RESULTS Courtesy: Alan J. Bauman, M.D. (c) Alan J. Bauman M.D.
  43. 43. 6 MOS. OF LOW LEVEL LASER THERAPY Courtesy: Alan J. Bauman, M.D. (c) Alan J. Bauman M.D. (c) Alan J. Bauman M.D. (c) Alan J. Bauman M.D. (c) Alan J. Bauman M.D.
  44. 44. LASER THERAPY - LASERCAP LaserCap Regimen: 30min. every other day (c) Alan J. Bauman M.D. (c) Alan J. Bauman M.D. (c) Alan J. Bauman M.D.
  45. 45. • Effective • Non-Chemical / Non-Invasive • No side-effects • Powerful - 224 laser diodes • Portable - Battery Powered (no cord) • Hands-free / Hassle-free (no combing) • Discreet - Not “Clunky” or obvious • Physician Only • One Time Cost - least $ tx over time WHY LASERCAP? 45 Celebrity Radio DJ & Bauman Hair Transplant Patient, Kevin Rolston of KVJ Show, using LaserCap!
  46. 46. SURGICAL OPTIONS
  47. 47. SURGICAL THERAPY:
 HAIR TRANSPLANTATION • Redistribution of ‘permanent’ follicles into thinning/balding areas • Donor Dominance • Follicular Unit Extraction “FUE” • Large sessions / tiny grafts •Artistic • Hairline location / shape • Hair Follicle angle, orientation, position • Pain-free computerized local anesthesia • Natural results Donor Area Naturally-occurring follicular units at 60x magnification
  48. 48. FOLLICULAR UNIT EXTRACTION (c) Alan J. Bauman M.D. (c) Alan J. Bauman M.D. (c) Alan J. Bauman M.D.
  49. 49. 
 FOLLICULAR-UNIT EXTRACTION • NeoGraft FUE using 0.8mm punch (c) Alan J. Bauman M.D. (c) Alan J. Bauman M.D.
  50. 50. DONOR HEALING FROM “FUE” (c) Alan J. Bauman M.D.(c) Alan J. Bauman M.D.
  51. 51. FUE / NEOGRAFT
 [DONOR HEALING] Courtesy: Alan J. Bauman, M.D. (c) Alan J. Bauman M.D.(c) Alan J. Bauman M.D. (c) Alan J. Bauman M.D. (c) Alan J. Bauman M.D.
  52. 52. FUE BENEFITS • No Stitches, No Staples, No Linear Scar • Less Trauma, More Rapid, More Comfortable Healing • Less Activity Restriction Postoperatively • Useful for BHT (Body Hair Transplantation), Scar Cover (c) Alan J. Bauman M.D.
  53. 53. (c) Alan J. Bauman M.D. (c) Alan J. Bauman M.D. (c) Alan J. Bauman M.D. (c) Alan J. Bauman M.D. (c) Alan J. Bauman M.D.
  54. 54. HAIRLINE + TEMPORAL POINT (c) Alan J. Bauman M.D. (c) Alan J. Bauman M.D. (c) Alan J. Bauman M.D. (c) Alan J. Bauman M.D.
  55. 55. HAIRLINE + TEMPORAL POINT (c) Alan J. Bauman M.D. (c) Alan J. Bauman M.D. (c) Alan J. Bauman M.D.
  56. 56. CELL THERAPY & PRP 
 IN HAIR RESTORATION
  57. 57. PRP FOR TISSUE REGENERATION • Platelets are storehouses for regulatory, signaling, and growth factor molecules that contribute to the recovery and healing of tissue. Dr. Joseph Purita uses PRP/Stem Cell Therapy to revive pitching career of Yankee Bartolo Colon.
  58. 58. PRP IN HAIR RESTORATION • Platelets are storehouses for regulatory, signaling, and growth factor molecules that enhance hair growth (stand-alone therapy) as well as healing after hair transplantation (Rinaldi, Bouhanna, Amgar, Cole, Cooley, Uebel) PRP preparation at Bauman Medical Group using “YesPRP” kits and centrifuges.
  59. 59. GROWTH FACTORS • platelet-derived growth factor - PDGF • transforming growth factor beta - TGF-B • fibroblast growth factor • insulin-like growth factor 1 - IGF1 • insulin-like growth factor 2 - IGF2 • vascular endothelial growth factor - VEGF • epidermal growth factor - EGF • nerve growth factor - NGF • interleukin-1 – IL1-B • Interleukin-8 – IL8 • keratinocyte growth factor • connective tissue growth factor
  60. 60. PRP FOR ALOPECIAAREATA (c) Alan J. Bauman M.D.(c) Alan J. Bauman M.D.(c) Alan J. Bauman M.D.
  61. 61. PRP FOR ANDROGENETIC ALOPECIA 61 Before & 12 months After PRP & ECM treatment ONLY (c) Alan J. Bauman M.D. (c) Alan J. Bauman M.D.
  62. 62. PRP FOR ANDROGENETIC ALOPECIA Dr. Alan J. Bauman using PRP plus Extracellular Matrix for hair regrowth as seen on NBC/WPTV and ABC/WPLG
  63. 63. WHAT IS THE KEY TO A SUCCESSFUL HAIR LOSS PRACTICE? SATISFIED PATIENTS! PATIENT COMPLIANCE TRACKING & FOLLOW-UP
  64. 64. ©Copyright2014BaumanMedicalGroup,P.A.AllRightsReserved. HAIRCHECK™: CROSS SECTION HAIR BUNDLE TRICHOMETRY Hair Mass Index (HMI) HMI is a sensitive, scientific measurement of hair growth HMI is a combination of quantity of hair fibers and thickness of hair fibers Repeatable through stereotactic scalp geography Measurements can be performed non-invasively, within minutes, without hair trimming Comparison of occipital (control) zones to other less permanent areas of scalp can assist in diagnosis and can also measure percentage of hair loss. Comparison of measurements in the same areas of scalp over time can assess hair loss/hair growth changes, response to treatments and ensure compliance
  65. 65. MEDICAL MANAGEMENT OF HAIR LOSS
 FOR THE ANTI-AGING PRACTICE = “HAIRCOACH” • Hands-on Workshops: “HairCoach” • HairCoachMD & HairCoachRN • Hair Loss Risks • Hair Loss Diagnosis • Hair Restoration Treatments • Hair Growth Tracking & Compliance Protocols Upcoming Class… Registration Open! www.HairCoach.net
  66. 66. SPACE IS LIMITED – RESERVE YOUR SEAT Upcoming Classes are Open for Registration 1450 S Dixie Hwy, Boca Raton, Florida 33432 Become a Certified HairCoachMD™ Learn more and register online at www.HairCoach.net • Receive  Protocols,  Hands-­‐on  Training  &  Business  Plan   • Receive  Certificate  &  Starter  Kit  (a  $1,500  value)   • Check  HairCoach.net  for  current  pricing  info   • Questions?  Call  Andres  at  561.213.2638 • Help  men  and  women  suffering  from  Androgenic  Alopecia   and  hereditary  male  &  female  pattern  hair  loss   • Provide  HairCheck®  Consultations  to  track  and  measure  hair   growth  results   • Incorporate  Dr.  Bauman’s  proven  treatment  &  compliance   protocols  including  how  to  apply  PRP  for  hair  regrowth
  67. 67. “This hair restoration class was complete; academics and hands-on training. A full program to implement into my practice” Dr. Kenneth Orbeck, Bioidentical Hormone Doctor BodyLogicMD, Greenville, South Carolina “Concise and thorough introduction to medical evaluation, prevention and treatment of hair loss in both men and women” “Program was well-organized but casual, very informative with good information, but not overwhelming” “This class provided me an opportunity to utilize proven therapies to improve outcomes in care that I already provide” “One of the best classes so far I that I’ve attended; comprehensive and hands-on”   “I found the class useful in giving me a basis to add hair rejuvenation to my practice” Dr. Jan Karlin, Biodentical Hormones Specialist Nova Cosmetic Center, Orlando, Florida Dr. Jeffrey Thackrey, Bioidentical Hormone Doctor BodyLogicMD, Fort Lauderdale, Florida Dr. Karen Brainard, Board Certified, Family Practice Bradenton East Integrative Med, Bradenton, Florida Dr. Elena Dolskaya, OBGYN   Tru-Well, St. Petersburg, Florida   Dr. Michael Chesner, Cardiologist   Weitzman & Chesner MD, Long Beach, New York TESTIMONIALS FROM HairCoachMD CLASS ALUMNI Learn more and register online HairCoach.net • Class  space  is  limited   to  18  people   Questions?     Call  Andres  at   561.465.7655     or  email   HairCoach@BaumanM edical.com
  68. 68. Contact for more info: 
 Prerna Khemka, 
 LaserCap Director: 
 sales@lasercap.com 
 (216) 672-0614 www.LaserCap.com ……………………………………………… ……….… ASK PRERNA! LaserCap Promo Codes for HairCoach! Become a LaserCap Distributor!
  69. 69. THANK YOU! FIND OUT MORE & REGISTER AT www.HairCoach.net Ask about Promo Codes 
 www.baumanmedical.com
 www.linkedin.com/in/alanjbauman
 www.twitter.com/dralanjbauman
 www.facebook.com/baumanmedical Alan J. Bauman, M.D.

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