Indian men are losing their hair earlier than they thought they would, and doctors are using their heads to develop new methods in surgery, and innovative marketing to service them. Yolande D'mello brings you the how, why and what of hair loss among men, offering a few solutions across budgets along the way
Indian men are losing their hair earlier than they thought they would, and doctors are using their heads to develop new methods in surgery, and innovative marketing to service them. Yolande D'mello brings you the how, why and what of hair loss among men, offering a few solutions across budgets along the way
The voice at the other end of the phone, terribly polite and call centre-trained, asked us to drop by for an appointment with Dr Vivek Nigam the following day at 2.30 pm. Easy-peasy. Done in 60 seconds. 
The wait the next afternoon at the lobby of his three-storeyed four Bungalows, Andheri clinic was not as short. Sixty minutes, and counting.
Dr Nigam is a busy cosmetic surgeon flying through 27 hair transplants every month; that's one surgery a day. And the bustle at the Dr Nigam Hair Transplant Clinic, which he co-runs with wife Dr Divya, is proof that business is good.
Thirteen years ago, he had seen this coming. "It was obvious that the hair transplant industry would be big soon, with foreign patients flying in for affordable procedures, and Western firms looking to tie up with Indian counterparts. The domestic market has been growing steadily too," he says, looking less like a doctor and more a businessman in a black velvet jacket.u00a0
It's hard to focus on what he is saying with phones ringing incessantly, and a team of five tele consultants, ironically, some on the heavier side themselves, dishing out 'Slim-on-Phone' advice to concerned callers excited at the 'lose 8 kg in 30 days' offer at this lose-weight-gain-hair clinic. "Fifteen kg in three months, 30 kg in six months," says one, following it up with the facility to buy low-cal bread and slimming atta, all prepared in a kitchen housed on the first floor.
For young Indian men troubled by hair loss, the surgeon dishes out a plate of services. Plasma Cell Therapy involves extracting a client's blood, zeroing in on special plasma cells and later injecting them into the scalp in a bid to help nourish the roots. Three sessions over three months will make your hair denser by 20 per cent, promises the doctor. For those who fancy a slice of Western treatment, Mesotherapy requires you to take an injection every week for a month, followed by one a month for 11 months. "It's packed with anti-oxidants and is imported from Singapore. Each shot costs Rs 2,500."
Dr Nigam and his fraternity are likely to be busy for a while, if Chandigarh-based plastic surgeon Dr Tejinder Bhatti, Director of Darling Buds Hair Transplant Center, is to be believed. In a survey he conducted among 50,000 Indian male patients randomly selected through e-mail contact groups across diverse socio-economic segments from all over India, 63.2% of the group aged 21 to 61 years admitted to suffering from Male Pattern Baldness (MPB).
The survey compared the results of an American study dated 2009, where 56.6% of the study group (total 35,000) suffered from one form of MPB or another. "Our numbers were way higher. Indians are more prone to hair loss. It's probably on account of our diet which includes spicy food, and tropical weather conditions," says Dr Bhatti over the phone from Chandigarh.
What's perhaps a bigger cause for concern is that compared to the US group, the Indian respondents suffering from MPB were far younger. Almost 46% of them belonged to the 21-31 age bracket (compare that with just 10% from the 42-51 year bracket).
Typically, hair loss among men begins at 18 to 20 years and continues for 15 years before it stabilises. "The process could go on till age 40. But we've had patients as young as 14 consulting us," says London-based surgeon Dr Bessam Farjo who's been heading the Farjo Medical Centre (www.farjo.net) for specialised hair loss treatments since 1992.
"I don't recommend transplants for patients younger than 25 because the pattern in which their hair loss will unfold is not yet established," says Dr Farjo.
Ultra-Refined Follicular Unit Transplantation (FUT) is one of the most popular treatments at the Centre and costs anywhere between ufffd3,000 and ufffd9,500 depending on the number of grafts needed (a graft refers to a few strands of hair attached to the epidermis and dermis of the skin).
A transplant involves moving individual hair follicles from one part of the body (the donor site) to bald or balding parts (the recipient site). FUT typically involves the extraction of hair follicles from the back of the head that's pre-programmed not to lose hair (the area lacks receptors to receive DHT or Dihydrotestosterone, a hormone that triggers hair loss) and transplanting it on areas that are sparse.
FUT requires a strip of hair carrying multiple strands to be grafted while Follicular Unit Extraction (FUE) involves extracting and transplanting single strands.
Surat-based naturopath Dr Rohit Shah, an alumnus of the Gujarat Ayurvedic University set up the Alopeciacure Treatment Center with wife Ragini after encountering a 16 year-old patient who lost body hair thanks to a wrong prescription of steroids. The Center now receives patients from across the world at its seven global centres.
While genetics is key, modern living has contributed a range of trigger factors. "An imbalanced diet, high stress, irregular sleeping patterns, frequent perming, straightening, colouring, rebonding, all of which involve the use of chemicals, are major factors," says Dr Shah.
Dr Nigam puts it to Darwanian theory, though. Having spent eleven years in the transplant industry, he has seen his clients get younger. "It's evolution. According to the Darwanian theory, man must evolve. He is now indoors a lot more, and doesn't need as much body hair to protect him from the environment. The human brain is increasing in size. Blood is being diverted there as opposed to feeding hair follicles."
High awareness and plenty of options make sure 21 year-olds walk into Dr Nigam's, inquiring about transplants.
And while Dr Farjo refrains from recommending the procedure to younger men "because their expectations are too high", age hardly matters for Dr Nigam who says post-surgery dizziness and soreness that could last for two weeks is the only risk you take. No wonder then that the 40 year-old is readying himself for a Bio Fibre Artificial Hair Transplant surgery later this year for his thinning crown.u00a0
Popular with celebrities, the surgical procedure uses synthetic hair that will be implanted into the skin. Five per cent of patients' bodies reject this treatment, making a one-month trial the first step. "Since it's synthetic, the hair doesn't grow or grey. It's the latest fad," says Dr Nigam of the treatment that costs Rs 100 per graft.
But at Nigam's, there's a treatment for every budget. It's a competitive market, and his Rs 35-per graft offer has ready takers. "Each graft must be attached by hand by trained medics. We transplant an average of 3,000 grafts per client over a period of seven hours. To cut down on time, we decided to employ one right-handed and one left-handed doctor to speed the process," he shares with a satisfied grin.u00a0
Seven hours of surgery later you are still not promised a full head of hair. "With FUT or FUE, we use the client's hair from the back and sides of the head. Your hair will grow and grey naturally but you will not enjoy the density of a full head of hair. It is useful to cover bald spots."
u00a0u00a0
Dr Shah is skeptical of the claim of a permanent cure and resorts to topical herbs and oils that help nourish hair follicles. Lifestyle changes are mandatory, he says. An extensive website lists therapy sessions of varying duration priced between Rs 3,000 and Rs 6,000.
Dr Shah's 27 year-old client, a Bengaluru-based engineer tried steroid shots that he says didn't quite work. Ayurvedic herbs and the daily use of oils for a year yielded better results, claims Lokesh Pattnayak. If hair loss is on account of an iron deficiency or thyroid imbalance, oral medication may help. Using cortisone (steroids) creates complications," warns Dr Shah.
The arrival of foreign entrants like US-based Nu Hart Hair Clinics that set up its first India centre at Kemps Corner last month, and mushrooming neighbourhood transplant centres like five year-old Your World located off a bustling street leading to Dadar (E) station, signals a buzzing trade.u00a0
u00a0
Co-partner Kajal Bathija has a solution for every troubled head in the middle-class suburb. Standing next to a local Bharatiya Janata Party office, you see more than a few politicos walk by -- but probably to visit the political party center next door. Not that we'd know if they were there for a consultation; the salon promises strict privacy.
The 1,200 square feet salon offers services ranging from Rs 5,000 to Rs 25,000, and a range of Indian and imported hair pieces that are fixed onto the client's existing hair using clips, FDA approved glue, or weaving.
More heads than hands led Bathija to hire a third technician to work with men aged 19 to 60, among whom are a majority of young guys "of marriageable age looking for a mate". A hair piece can be attached to your scalp using simple steel clips in a process called Micro Wefting, while permanent solutions require experienced hands like Tashi Ghesingh and Swapan Dalai to tightly plait existing hair around the bald patch using surgical thread, and stitch the hair piece to the plait.
Tighter plaiting and quicker results are a week away, with an excited Bathija waiting to inaugurate a mint-new weaving machine.
The comments book seems to say clients have found what they were looking for. 'I walked in feeling like Anupam Kher and walked out as Salman Khan,' reads an anonymous scribble.
And for those who haven't crossed the hair loss hill, grooming brands are offering fancy goo to hold on to what they are left with. French luxury hair care brand Kerastaseu00a0 offers hair treatment rituals at select salons. "The importance of the male grooming market in India is clear -- it's worth Rs 1,000 crore, and growing at the rate of 11 per cent," says Shweta Sodhi, Education Manager, Kerastase.
Kerastase Homme is a just-launched line specially for the Indian male, and includes a densifying scalp and hair boosting spray that costs Rs 1,500 for 125 ml. But it's the Kerastase Aminexil that Sodhi calls their "wonder product". It reduces hardening of hair follicles that causes baldness. Aminexil saves the hair you have, and costs a cool Rs 8,970.
But if it's genes you are fighting, there's little you can do. Most cases of MPB are put down to genetics. Dr Shamma Shetye, Head of Microbiology at the Worli branch of diagnostic chain Metropolis Healthcare Limited, is approached by doctors to conduct the Genetic Hair Loss Test. Shetye was one of seven medicos who invented the Genetic Analyser, that with a DNA sequencing reaction coupled with specially developed software, allows parishioners to detect the MPB gene and the type of balding patterns it will create. "The test offers 70 per cent surety, and costs Rs 9,000," says Dr Shetye of the test that's effective only in the nascent stages of balding.
But the man you should be watching is Dr Farjo who is in the middle of breakthrough research on Hair Cells Regeneration, a procedure that aims to clone hair cells. "It's a bit like gardening. Unlike with a hair transplant where hair is moved from a dense area to a sparse area of the head, regeneration is not limited."
In a simple 30-minute surgery under local anesthesia, hair tissue is extracted and sent to a lab at Intercytex Ltd., a medicine-manufacturing facility that dissociates the hair-inductive dermal papilla cells through tissue culture.
"One hundred cells can be made into 1 million outside the body and injected into the patient in the form of a solution. This will help hair grow naturally and results will be visible in a few months," he claims.
The bummer: it could cost around ufffd50,000. "Although clinical trials are on, and it isn't available commercially yet, I already have patients waiting to try it out," says Dr Farjo over the phone from Manchester.u00a0
If you were to ask Rikin Sampat, a 20 year-old, a trained pilot who suffered hair loss after an acute bout of jaundice at 18, he'd say, "live with it". Sampat tried homeopathy that managed to halt the hair loss but left him with little to work with. He then decided to work it to his advantage, and shaved off the rest too.
"Looks are important but it's about feeling good. I've always been into fitness and I work out to stay healthy. I am frequently asked the same question: 'Why so young?' but, I don't have control over that. Instead of a full head of hair, attitude could work better towards leaving you looking good."
Looking ahead
Okay, so you are balding. Now what?
Don't let it pull you down. You are more than Cousin It from The Addams Family. Focus on other physical strengths.
Let fashion rescue you. Wear a hat, and have a different one for every mood. If the queen can carry it off at 85, it means that it has been in fashion for just that long.
Go bald stylishly. Bruce Willis, Billy Zane, Patrick Stewart, Andre Agassi all made bald the new beautiful.
Use it to your advantage. Everyone has that one physical aspect they are insecure about. What important is to be confident in your skin.
If someone is being a jerk and giving you a hard time, grab a razor and wait for them to fall asleep.
2010 survey
63.2% Indian males suffer from Male Pattern Baldness (MPB)
Dr Tejinder Bhatti's, a Chandigarh-based hair transplant surgeon conducted a pilot study on hair loss among Indian men last year. Of the 50,000 male patients randomly selected through e-mail contact groups 63.2% in the age group 21-61 years suffered from MPB.
Age distribution
21-31 years - 46%
32-41 years - 35%
42-51 years -10%
52- 61 years - 9%
65% had tried medication. 22% had used creams and pastes. Only 1.03% responded positively to the measures.
235 had resorted to hair transplantation of which 66% were satisfied with the results. Of the dissatisfied group, 88% had received outdated punch grafting at clinics which had not updated their techniques.
89.35% recovered well, 10.65% had complications. Of the latter group, 65% of the dissatisfied lot had infections within 7-10 days of the transplant, and 35% had to live with bad scars.
The study compared the results of a USA study dated 2009 where 56% of the US study group (total 35,000) had one form of MPB or the other. MPB was more prevalent among Indian men as compared to the US study group.
Do you see yourself here?
Norwood Classification chart
Originally developed by Dr James Hamilton in the 1950s, the pattern baldness classification system was modified to its current form by Dr O'Tar Norwood in 1975 and is thus known as the Norwood Classification.
Type I: Indicates minimal hair loss and results in simple receding hairline.
Type II: There are usually limited areas of recession of the hair line, especially at the temples.
Type III: This is the first level on the scale that a dermatologist would regard as real pattern baldness and something that needs treatment. Most type three scalps have deeper symmetrical recession at the temples. The affected areas are bare or only sparsely covered by hair.
Type III vertex: Vertex refers to the back of the head; the hair loss is significant at the crown of the head in a circular pattern.
Type IV: This will include sparse or no hair on the vertex. The hairline recession and hair loss from the vertex are separated by a band of moderately dense hair that extends across the top. This band connects with the full hair that fringe the sides of the scalp.
Type V: A progression of type IV, the vertex hair loss region is still separated from the front temporal region but it is less distinct.
Type VI: In type six, the bridge of hair that crossed the crown is now gone with only some sparse hair remaining.
Type VII: Type seven is the most severe form of hair loss. Only a narrow band of hair in a horseshoe shape survives on the sides and back of the scalp.
The handbook
Your guide to Follicular Unit Transplant
1. The hair transplant specialist locates hair follicles that are genetically resistant to going bald. The hair at the back of the head is suitable for the same. A strip is removed from this area after putting the patient under local anaesthesia.
2. Donor tissue is removed and the area is sutured. A good doctor will leave little or no scarring. Gradually the scar is covered by existing hair. Sutures are removed seven to ten days after the hair transplant.
3. The donor tissue is trimmed and made into micrografts (single hair grafts), follicular unit grafts (grafts containing 2-4 hairs) and multiple follicular unit grafts (grafts that contain more than one multiple follicular unit - up to 8 hairs) by surgical technicians.
4. The bald area is prepared by administering local anaesthesia, and an outline is drawn to mark the area that needs to be covered.
5. Grafts are inserted after making paper cut-sized slits in the skin. These slits are created in irregular patterns, which is what makes the hair transplant effective and the results, natural.
After 14 days of recovery, the patient heals and the hair starts to grow naturally. After four months the hair should have grown to an average length.
Save the day
5 natural ways to hold onto the hair you have
1. Wash your hair with shampoo at least twice a week. Don't change the brand of shampoo frequently; stick to one brand that suits your hair.
2. Don't apply shampoo directly on your hair. Dilute it or foam it in your palm before you use it. This will minimise the impact of chemicals. It is advisable to use a little oil at least half an hour before shampooing.
3. Don't use a conditioner after every wash. It can weaken the roots.
4. Avoid exposure to air pollution and excessive exposure to sunlight. Both can act on the chemical bonds of hair follicles and increase the rate of weathering.
5. Keep your comb and hair brush clean. Wash them in hot water with a cap of antiseptic solution added, once a week.
-- advises Dr Rohit Shah, Surat-based naturopath
5 top reasons why men lose their hair
1.u00a0 Stress disrupts several systems in the body. It can cause disorders and addictions.u00a0
2. Irregular sleeping habits and an imbalanced diet are a product of fast-paced urban lives and demanding deadlines.
3. Medications for other illnesses can lead to hair loss. Check the content chart on protein shakes to make sure they don't contain steroids.
4. Hair Treatments like perming, straightening, rebonding, dyeing involve the use of strong chemicals. Any chemical action on hair shafts can break down the chemical bonds of the hair cuticle and cortex.
5. Hereditary-pattern baldness is a natural condition caused by a combination of genetics, hormone levels and the aeging process. If you have a history of hair loss in your family, start taking extra care of your hair.
ADVERTISEMENT
Subscribe today by clicking the link and stay updated with the latest news!" Click here!
