How to regrow lost hair or make thinning hair more dense?

Many a times we see online that if you have lost all of your hair, you need a hair transplant.

But what if someone told you that we can regenerate lost hair through a wide range of regenerative treatments?

Lets understand the process of hairloss, what actually happens.

Normally, 85% of our hair is in growing phase or anagen phase where our root produces hair continuously, which lasts about 3 years. 2% are in catagen phase where our hair root is regressing so that the growth phase comes to an end, which lasts about 3 weeks.

13% are in Telogen or stagnant phase, where the root is not making hair. Its just lying vacant. This lasts about 3 months. The non-growing hair are just stuck inside the root. Next comes the exogen phase where the hair sheds.

The hair cycle is typically anagen  catagen telogen exogen.

The roots retains its thickness through various hair cycles, hence the hair growing out remains same thickness in consecutive hair cycles.

Now, for people undergoing hair thinning or baldness, what changes happen?

• The root keeps shrinking in diameter from one cycle to the next hence the hair growing out keeps getting thinner in next cycles. This is called miniaturization which is the hallmark sign of androgenetic alopecia.
• Telogen phase lasts longer than 3 months so root is not making hair for a long time. The root is alive, but just not making hair because its weak.
• Anagen phase gets shorter so hair length does not increase much.
• This results in an anagen to telogen ratio which was previously 85:13 is now 60:40. Less hair in anagen phase means less hair on the scalp and more empty roots.

So if we want to restore volume and density, we need to reverse all of that.

We want to

• Reverse miniaturization
• Lengthen anagen phase.

Now lets see how we can do that.

1. One of the primary factors that damage the hair follicle and cause miniaturization is DHT ie the active form of testosterone called Di hydrotestosterone. Anything that can control or counter DHT will have a beneficial effect on hair thickness. Finasteride is a medicine that is USFDA approved to prevent androgenetic alopecia or hair thinning. Finasteride can be used as a tablet or lotion. However the tablet works way better than the lotion. This medicine since its blocking the active from of testosterone can have certain sexual side effects hence we can adjust or lower the dose of the medicine to reduce the chances of side effects.
2. Second extremely crucial step to more hair is using minoxidil. This is a drug that will lengthen the anagen ie growing phase of the hair follicle so that you have more hair on your head at any given time thus increasing density. Minoxidil comes in a lotion or tablet form. Lotion is USFDA approved for androgenetic alopecia. Tablet is equally effective and way easier to take as compared to the lotion.
3. Prp ( platelet rich plasma)  or GFC ( growth factor concentrate). These are therapies that are done at monthly intervals. In these therapies typically a sample of blood is taken and centrifuged to extract platelets that are injected into the area of hairloss ( prp). From the platelets growth factors are extracted and injected into the area of hair loss (gfc). These growth factors or growth protein are naturally present in our platelets that stimulate the hair follicle and promote growth.
4. LLLT low level laser therapy. This is a treatment wherein low level laser in the wavelength of 650 to 900 nm is used to stimulate the hair follicles. These wavelengths at low energy cause photobiomodulation causing increase in ATP production, increased ROS signalling, and decrease in inflammatory cytokines. This results in increased cell proliferation, increased oxygenation and production of growth factors. All of this will eventually lead to more hair growth. LLLt therapy can be taken in the form of laser helmet which is a home use device or laser domb which is an in-clinic device.
5. Exosome therapy: Exosomes are molecules that are released by cells to give signals to the surrounding cells. These signals are key in executing teamwork between cells as a mode of communication, to achieve a common goal. So if the goal is to make new hair, there have to be signals between the hair bulge stem cells and surrounding dermal sheath so that they proliferate and move down the hair root to start making new hair calls. There also have to be signals between dermal papilla cells ( the master computer of hair formation) and matrix amplifying cells ( the core cell that multiplies to make hair) . these signals might become weak with age, hence role of injecting external exosomes is to provide these signals from outside. Exosome therapy is done once a month.
6. Dermaroller : Dermaroller is a time tested device to induce growth factors by creating microinjuries, hence body produces its own healing factors that help in hair growth. There are certain issues with using a dermaroller such as how to use on hairy scalp. Its always better to have a dermatologist do it for you rather than at home.
7. Nutraceuticals: Nutrient deficiencies are extremely common now and without restoring the normal nutrient levels in the body, expecting hair growth is out of the question. So adding nutraceuticals is a good way to cover up for deficiencies.

So like we can see that there are multiple ways to regenerate lost hair. A good trichologist will always suggest a combination so that you get best results.