Brunilda Nazario, MD
What’s the latest in hair care and hair health? If you’ve been getting the same cut or using the same shampoo since the Clinton administration, or if you’ve been despairing over thinning hair for years, it’s time to look into new and exciting options for your hair.
You may have given up on coloring your hair when it meant spending the entire day in the salon. But with new color techniques, you’re no longer chained to your stylist’s chair for hours. "New techniques for foiling and balayage are much quicker than the one-hour wrapping time we were used to years ago," says Rowena Yeager, stylist and owner of Salon Wish in Streetsboro, Ohio. "The products we use to color the hair today are also far more gentle than in the past."
"Balayage" means "to sweep" in French. It literally involves the stylist painting colors directly onto chosen hair strands. It is applied with a sweeping motion, sparingly at the roots and heavier towards the ends. It is less time-consuming than traditional color approaches, and it also looks much subtler. It’s more complicated than traditional approaches to color, so if you want balayage, ask about your stylist’s training and experience.
Many salons now offer what they call a "shine shot" added to your color. "It aids in the condition and shine of the hair and in the longevity of the color," says Yeager. "Once our guests have a shine shot, they ask for it again and again."
New hair lighteners can now be used without heat, says George Gonzalez, stylist and owner of George-The Salon in Chicago and a former freelance stylist for TheOprah Winfrey Show. "Added heat can open the cuticle, which can leave your hair dry or looking brittle. Therefore, processing your color at room temperature could be beneficial in maintaining healthier hair when you get blonde highlights."
The big trend in hair care products today is the move toward organic choices. "People care more about what goes on their hair and their skin," says Yeager. For example, many organic lines offer sulfate-free shampoos and other products, which are generally milder and more moisturizing, and particularly beneficial for people with damaged, dry, or frizzy hair.
Paraben-free styling products are another popular option. "Parabens are chemicals used to preserve the shelf life of your shampoos, conditioners and styling products," says Gonzalez. "I feel the more that we can avoid using chemicals, the better."
Many of the new conditioning treatments available in salons today use nanotechnology, meaning that the protein or moisturizing molecules are small enough to penetrate the hair without using heat. "That means you don’t have to sit under a hot dryer to get all the benefits of conditioners," Gonzalez notes.
Your products, style, and preferences can also be customized to a degree that was never possible in the past. "Technology has allowed us the ease of saving formulas, hair care, and skin care notes on the computer so that we can give you precisely what you want," says Yeager.
When you think about hair loss, you may picture Uncle Fred’s bald spot or Dad’s receding hairline. But surprisingly, women actually make up 40% of people dealing with hair loss -- and there are more ways than ever to treat it. You need to be careful. Although people with hair loss spend more than $ 3.5 billion a year in an attempt to treat it, most hair loss treatment products and techniques on the market are useless. What’s new and what really works?
Men have more effective options for medical hair loss treatment than women do. Finasteride, the generic name for brand-name drugs Proscar and Propecia, is the "gold standard" drug for male hair loss, according to Jeffrey Epstein, MD, a hair transplant surgeon with offices in Miami and New York, and past president of the Florida Society of Facial Plastic and Reconstructive Surgery. It lowers the body’s levels of an androgen called DHT, which shrinks hair follicles and eventually leads to baldness.
Another drug, dutasteride (Avodart), has the same effect. "It’s a stronger drug, so there was the hope that it would be even more effective than Propecia, but so far, studies don’t show that," says Epstein. "These drugs have also been tried in women who are postmenopausal -- you should never become pregnant while taking them -- but it’s not clear whether they’re as effective in women as in men."
For women, minoxidil (Rogaine) is the primary medical treatment available. It’s used topically and has some effectiveness. About 20% of women report moderate hair regrowth after using it. Doctors may also prescribe spironolactone, a type of blood pressure medication that also slows down the production of hormones that can lead to hair loss, and hormones or oral contraceptives. Both of these treatments are used in women that have hair loss secondary to hormonal abnormalities such as those with polycystic ovarian syndrome.
But what’s really advanced in recent years is the surgical capability to do more complete and more natural-looking hair replacement. "The state of the art for the last decade has been follicular unit transplantation, or FUT," says Epstein. In FUT, hair from an area of your head that’s not yet balding is grafted to the thinning area, in naturally occurring groups of 1 to 4 hairs.
"Once, the most grafts anyone would do was about 1,500 to 2,000," says Epstein. "Now, we can routinely do 3,000 grafts, which offers much more impressive results. With a bald scalp, we can fill in the frontal half with reasonable to good density in just one procedure. For women, smaller grafts allow us to place more of them in a single procedure and treat not only female pattern hair loss, but also hairline advancement. So women can have a high hairline restored back down." The small size of the newer grafts also creates a more natural appearance.
Of course, to obtain the hair for the transplant, you have to remove it from your head (or, less commonly, another part of the body), a process called follicular unit grafting (FUG). New techniques for this process make it much easier -- and the results are virtually unnoticeable.
"Today, we can use a technique called follicular unit extraction, which means we don’t have to make an incision at the donor site," explains Epstein. "The grafts are harvested one at a time with tiny 0.8 mm punches, which then heal as essentially undetectable dots in the scalp. This leaves patients with no detectable donor site scar. They can cut their hair even shorter than before, or even shave their head." Not everyone has the expertise to use this newer approach, and it takes a lot longer than FUG -- around eight hours.
What might be the future of hair restoration and replacement? There are a number of approaches in the works, but none has been shown to work yet in scientific studies, says Epstein. "The holy grail would be cloning, or hair multiplication. If you could take parts of the hair follicle ... and multiply them, and implant them back in the scalp to get new hairs growing, that would be the ideal. There’s a lot of research going on into that."
But it’s nowhere near ready for prime time, nor is the use of platelet rich plasma (PRP). With this approach, doctors take blood from individual patients, isolate the growth factors, and inject them into the scalp. "This may stimulate the regrowth of hair, and may also help with healing of a donor site," says Epstein. "But it’s still unproven."
One new advance that Epstein says does appear to be effective, based on general experience, is laser light treatment. "In men who are actively shedding large amounts of hair, getting laser light therapy twice a week for about six months does seem to stop the shedding in about 75% of them, and stimulate regrowth in a smaller group. It’s still a little controversial; there hasn’t been a lot in the literature yet."
SOURCES:Rowena Yeager, stylist/owner, Studio Wish, Streetsboro, Ohio.George Gonzalez, stylist/owner, George the Salon, Chicago.American Hair Loss Association, Calabasas, Calif.Jeffrey Epstein, MD, hair transplant surgeon and past president, American Academy of Facial, Transplant and Reconstructive Surgeons.
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