Hair transplantation

Each hair follicle can produce a hair approximately 20 times per lifetime, after which it dies. Because each hair remains in the hair follicle for three to five years, a person would only experience baldness after 60 to 90 years. Baldness at a young age with a hereditary cause is caused by the degree of sensitivity of certain hair follicles to the hormone dihydrotestosterone (DHT). This DHT is formed from the hormone testosterone under the influence of an enzyme (5-alpha-reductase, types I and II). The DHT binds to the androgen receptor (a 'biological magnet') of the hair follicle, which therefore has less blood flow. The growth phase of the hair is therefore shortened from three to five years to just a few months. The affected hairs become finer and shorter with each hair cycle and the hair follicle eventually dies at an accelerated rate. If this process occurs in many hair follicles, the hair becomes thinner. The number of androgen receptors a person has is genetically determined and that explains why some people go bald and others do not.

There are quite a few products and treatments that claim to have an effect on stopping hair loss due to androgenetic alopecia (hereditary baldness). Every two months a new shampoo, lotion or nutritional supplement comes onto the market with claimed effectiveness. Unfortunately, these claims are usually empty promises and the effect cannot be scientifically proven. However, there are also plenty of options whose effectiveness has been proven in scientific studies. Below is an overview of the treatment options used at Intermedica. The effectiveness of the products can be expressed as a percentage of full effectiveness, where hair loss is completely normalized. The effectiveness of the products for which scientific evidence is available is as follows (estimates): Minoxidil lotion: 25% Diane pill, Yasmin pill or Yaz pill: 25% Trix Basic Alpha + Trix Basic Beta: 25% Aminexil: 20% Androcur: 20% Other nutritional supplements: 0-10% Shampoos with Aminexil: 5% Other shampoos and lotions: 0-2% The effectiveness of the various products should not be added together. However, the effectiveness of one product can be improved slightly if another product is used. In addition, treatments are offered for which there is also only weak evidence that they inhibit the process of hair loss due to androgenetic alopecia. Examples of such treatments are light and laser treatments and the injection of vitamins and minerals into the scalp (PRP, mesotherapy). These are not carried out at Intermedica.

The drugs finasteride and dutasteride have been prescribed for a long time and with good clinical results to women with hair loss due to androgenetic alopecia by the dermatologists of the Intermedica Clinic. These medicines are prescribed off-label. Off-label use of medicines means that they are prescribed for a purpose or in a different way than that for which they were approved. This is done based on a doctor's professional assessment. This is legally permitted. Finasteride and dutasteride were originally approved and prescribed for the treatment of prostate problems, but in low doses they also appear to be effective in preventing hair loss due to androgenetic alopecia, a so-called positive side effect. Finasteride and dutasteride affect the amount of dihydrotestosterone (DHT) in your blood. DHT is an important substance in the development of the male genitalia. This development starts in the womb and continues in men until the end of puberty. To prevent any risk (however small it may be!) of a genital abnormality in a male fetus, the prescription of finasteride and dutasteride is subject to strict rules.* The Intermedica clinic can prescribe finasteride or dutasteride to women under certain conditions. These conditions are: there is infertility (post-menopausal, sterilization) or finasteride or dutasteride is the only possible treatment in your situation (other treatments have proven to be ineffective or insufficiently effective) and you have been fully informed about the advantages and disadvantages of finasteride/dutasteride and you sign a statement about this (“informed consent”) and consultation has taken place with the pharmacy that supplies the medicine. It is solely the dermatologist who assesses and decides on each patient and circumstance. By the dermatologists of the Intermedica Clinic in 2013 in collaboration with internationally renowned trichologists conducted a retrospective study on the effectiveness of finasteride and dutasteride when used by women with androgenetic alopecia. You can read the results of this research here or download it in PDF format below. PDF scientific publication: “The effectiveness of finasteride and dutasteride used for 3 years in women with androgenetic alopecia”. Ids H. Boersma, Arnold P. Oranje, Ramon Grimalt, Matilde Iorizzo, Bianca M. Piraccini, Emiel H. Verdonschot *The Lareb side effects center received ten reports of possible side effects of finasteride/dutasteride in women in the period between 2005 and 2014. Two of these reports concerned the use of finasteride during pregnancy. On this basis, pharmacies are advised not to supply finasteride and dutasteride to fertile women. You can find Lareb's full message here.