Hair is a filament-like biomaterial that grows from follicles located in the dermis (inner layer of the skin). In humans, hair is absent only on the palms, soles, and vermilion (red part) of the lips. While most of the body is covered with fine, vellus hair—especially in females—thicker, terminal hair grows on the scalp, underarms, and pubic region. Hair color is determined by melanin: eumelanin produces black and brown shades, while pheomelanin is responsible for red tones. As melanin production declines with age, hair turns gray.
Hair serves several protective functions in humans, such as shielding the skin from UV rays, heat, cold, and insect bites. Eyebrows and eyelashes protect the eyes and also assist in non-verbal communication by expressing emotions like surprise or sadness.
Beyond biology, hair plays a significant role in social and cultural identity. Thick, healthy hair is often associated with youth, vitality, and social status. Hair loss can dramatically affect a person’s self-esteem, leading to social withdrawal and emotional distress. As such, restoring hair becomes a priority for many individuals.
Each hair comprises a shaft (non-living keratin) and a follicle (living tissue with stem cells). Hair growth occurs in three phases:
Anagen (growth phase) – lasts 2–6 years
Catagen (transition phase) – 2–3 weeks
Telogen (resting/shedding phase) – about 3 months
At any time, about 85–90% of scalp hair is in anagen. Only anagen-phase hair grows long and strong. In areas like the eyebrows, the anagen phase is shorter, which limits their length. In AGA, high levels of DHT force follicles prematurely into telogen, causing thinning and eventual hair loss. In women, weak androgens like DHEA can follow a similar pathway.
Surgical Hair Restoration and Medical Treatments Procedures
Hair loss varies in onset, extent, and progression among individuals. While early-stage hair thinning may respond well to medical treatments, more advanced cases often require a combination of medical, injectable, or surgical interventions. Advancements in both medication and hair restoration surgery continue to evolve, offering effective options for patients.
- Minoxidil (Topical)Originally developed for high blood pressure, minoxidil boosts hair density and thickness by shortening the hair’s resting phase (telogen) and extending the growth phase (anagen). Available in 2%, 5%, and 10% strengths, it must be applied regularly to maintain results.
- Finasteride & Dutasteride (Oral)Finasteride blocks the Type I 5-alpha-reductase enzyme, reducing DHT levels that trigger follicle miniaturization. Dutasteride inhibits both Type I and II enzymes and is considered more effective. Both are prescription-only and safe for long-term use under medical supervision.
- Bimatoprost (Topical)Initially used for glaucoma, this medication was found to promote eyelash growth and is under research for scalp hair regrowth. It acts via prostamide receptors to stimulate follicle activity.
- Biotin (Vitamin B7)A deficiency in biotin can cause hair thinning. While its benefit for those without a deficiency is debated, supplementation is often prescribed as a precautionary measure.
- PRP Therapy (Platelet-Rich Plasma)PRP involves drawing the patient’s blood, concentrating the platelets, and injecting them into thinning areas of the scalp. Rich in growth factors, PRP stimulates dormant follicles, enhancing hair thickness and regrowth within 3–4 months. It is safe, minimally invasive, and autologous (from your own body).
- FUT (Follicular Unit Transplant)A strip of hair-bearing scalp is removed from the back, dissected into individual follicles, and implanted into bald areas. These transplanted hairs are genetically resistant to hair loss and grow for life. Ideal for those with sufficient donor hair.
- FUE (Follicular Unit Extraction)Hair follicles are individually extracted using a specialized tool and transplanted without removing a skin strip. Suitable for patients with limited donor areas and allows body hair use. It requires a larger donor area and has slightly higher follicle loss.
- Hair Flap SurgeryLess commonly used, this involves transferring a flap of hair-bearing scalp to a bald area. While it provides high density, it's a more invasive surgical procedure.
- Biofibre Hair Implants (Artificial Hair)For those lacking adequate donor hair, biofibre implants offer a cosmetic solution. Biocompatible synthetic fibers are implanted into the scalp and provide instant visual results. A small test patch is done first to check for allergic reaction. While non-growing, 10–20% of fibers may shed annually and require periodic replacement.
- Laser Hair CombLow-level laser therapy (650–670nm) increases cellular energy and nutrient uptake in hair follicles, potentially counteracting DHT effects and supporting scalp health.