There are three subtypes of hair prosthesis: the hairpieces (also known as hair systems or toupees), the wigs (also called caps for male wearers), and weaved hair-extenders.
The hairpieces are partial hair prostheses, while the wigs cover the entire expanse of the scalp including the existing natural hair. Contemporary hair prostheses are constructed with high-quality synthetic or natural hair material and are highly personalized to match the hair color, texture, and density. The transparent base allows almost seamless transition at the hairline. The prosthesis is typically attached to the scalp with tape, glue adhesives, or hair clips. Patients need to be aware that the hair clip-based anchorage system will lead to patches of permanent hair loss where the clips are attached to the hair due to traction-related stress to the hair-bearing scalp.
Hair-extenders, on the other hand, offer more stable and long term solution of anchorage by interweaving the strand of hair piece onto the existing hair. This type of hair prosthesis can be maintained for months at a time before it needs to be re-adjusted by hair aestheticians. Both the camouflaging products and hair prostheses can be used as a stand-alone option or in combination with surgical treatment.
Various camouflaging products are available that can be useful adjunctive treatments for patients who presents with scars at the hair-bearing scalp. Camouflaging products are topical agents that are applied over the hair-bearing scalp to improve on the visual density of the existing hair (ie, Toppik® and DermMatch®). By making the hair appear dense, the underlying scalp tissue with scar will be less visible. The camouflaging products are typically keratin or rayon fibers that will attach to the hair and build a dense matrix over the scalp. Some are in powder-like formulations that require reinforcement with hair spray, while others come in a cream or lotion formulation. While they are simple and non-invasive ways to camouflage the scars, they are temporary solutions and will require daily cleaning and reapplication. Patients may experience shedding of the product with the appearance of pigmented dandruff on their shoulders, or wash-out in rain.
Scalp micro pigmentation
Scalp micro pigmentation (SMP) is another nonsurgical option for patients with depleted donor hair supply. This technique involves creating permanent tattoo microdots of less than 1mm in size at 1mm separation on the scalp to mimic natural shaved hair follicle stumps.
Examples of patients who will benefit from SMP are those with alopecia totalis who are not hair transplantation candidates, those who want to use SMP as a permanent concealer to hide a scar that shows through thinned hair, or those with an alopecic scar who does not wish to undergo surgical treatment.
Patients need to be aware that SMP is a micro-tattoo technique, and as such it will undergo changes over time, including fade or blending, and pigment changes. One must also consider that over time patients’ native hair may change color at which point gray hair and dark SMP pigment may create an unnatural appearance, and because SMP is a permanent tattoo technique, correction will be very difficult.
Low-level laser treatments
Recent reputable independent studies have shown that the low-level laser therapy is another effective treatment for people affected by androgenetic alopecia. During low-level laser light therapy, patients expose their scalp to these special lights devices in a regular interval of treatment sessions. Because of the wavelength spectrum and the energy involved in these laser devices, potential for complications including burn or injury is insignificant. The exact mechanism of how low-level laser therapy works is unknown, but literature suggests that the laser light stimulates hair follicle metabolism leading to a reversal of the miniaturization process.
Several devices have been FDA-cleared for use as hair loss treatment. Some of these devices are portable and can be purchased for personal use although some larger devices require that patients come to the clinic for each treatment session. Most studies published to date reports patients who have undergone 3 or more treatment sessions per week to achieve meaningful improvement. At the time of this writing, several randomized, double-blind clinical trials have shown that low-level laser therapy can increase hair density while a patient is undergoing the treatment. However, it is unclear whether these patients retain the improvement after stopping the therapy.
Double board-certified Facial Plastic Surgeon Dr. Sang W. Kim at Natural Face Clinics specialize in aesthetic enhancement of the face, head, and neck, exclusively. Patients come to see us from the Syracuse metropolitan area and Central New York area including Ithaca, and Rochester. At Natural Face Clinics, we specialize in restoring the youthful neck contour, tired appearance of the brows and eyes, and skin laxity. We offer customized treatment, both surgical and non-surgical, including facelift, eyelid surgery (blepharoplasty), nose surgery (rhinoplasty), brow lift, neck lift, and skin resurfacing. Find out more by scheduling your personal consultation today.