We diagnosis and provide hair loss treatment for men and women. The psychological effects of hair loss (alopecia) are vastly underappreciated. Hair is an essential and significant part of an individual’s identity and well-being. Dr. Al-Nuaimi has extensive training and has carved a specialist niche in hair loss diagnosis and treatment also known as the dermatological specialty of medical trichology.
During your hair consultation Dr Al-Nuaimi will complete a thorough assessment and evaluation of your hair and scalp and offer a customised approach to your hair loss, taking into account the multiple factors that may influence hair health.
https://devonhairandskininstitute.com/
Hair loss and scalp conditions treated
All hair and scalp disorders including Male pattern and Female pattern hair loss (otherwise known as Androgenetic alopecia, Male pattern baldness, Male hair thinning, Female pattern baldness), Frontal fibrosing alopecia, Lichen Planopilaris, Alopecia areata, hair shedding, Traction alopecia, Folliculitis, Scarring alopecia, seborrhoeic dermatitis, fungal infections, Psoriasis, Eczema.
The type of hair loss treatment recommended for individuals is determined by the type and underlying cause of the alopecia (hair loss).Some of the treatments include minoxidil or finasteride, corticosteroids, immunosuppressive drugs, Jak-inhibitors, stem cell therapy and hair transplant surgery.
Treatments for Male Pattern Hair Loss
Minoxidil Solution
Minoxidil solution is licensed at 2% and 5% strength for men. The lotion should be applied twice daily to the scalp. Treatment should be continued long term if benefit is seen.
Minoxidil Tablets
Unlike topical minoxidil, which is applied directly to the scalp, oral minoxidil is taken in tablet form. As oral minoxidil is taken systemically, it can have more widespread effects on the body than topical minoxidil. This means that it may be more effective for hair growth, but it may also have more side effects, such as low blood pressure, fluid retention, and hair growth in other areas of the body. For this reason, oral minoxidil is typically only prescribed for severe cases of hair loss that have not responded to other treatments. It is important to talk to a healthcare provider before starting any hair loss treatment, including oral minoxidil.
Reductase Inhibitors
Finasteride inhibits the conversion of testosterone to the more active dihydrotestosterone and is licensed at low strength to treat male pattern hair loss. Most people tolerate treatment with no side effects. Potential side effects include decreased libido, impotence and breast tissue tenderness. Side effects are infrequent and reversible on stopping treatment. Treatment works best when started early before hair loss is advanced. Treatment needs to be continued long term.
Hair Transplantation
Hair follicles can be harvested from the non-hormone dependent hair at the back of the head and transplanted to areas of hair loss in the frontal area.
We recommend seeing a medical professional to accurately diagnose and manage your hair loss. Active treatment should be trialled for a minimum of 12 months before deciding on whether it has been beneficial or not.
Treatments for Female Pattern Hair Loss
The cause of female pattern hair loss is not well understood. Most women do not have an excess of male hormones (androgens) but the hair follicle may be more sensitive to normal levels of hormone. This increased sensitivity may be inherited. Decreasing oestrogen levels may also play a role.
Minoxidil Solution
Minoxidil solution is licensed at 2% and 5% strength for men. The lotion should be applied twice daily to the scalp. Treatment should be continued long term if benefit is seen.
Minoxidil Tablets
Unlike topical minoxidil, which is applied directly to the scalp, oral minoxidil is taken in tablet form. As oral minoxidil is taken systemically, it can have more widespread effects on the body than topical minoxidil. This means that it may be more effective for hair growth, but it may also have more side effects, such as low blood pressure, fluid retention, and hair growth in other areas of the body. For this reason, oral minoxidil is typically only prescribed for severe cases of hair loss that have not responded to other treatments. It is important to talk to a healthcare provider before starting any hair loss treatment, including oral minoxidil.
Reductase Inhibitors
Finasteride inhibits the conversion of testosterone to the more active dihydrotestosterone and is licensed at low strength to treat male pattern hair loss. Most people tolerate treatment with no side effects. Potential side effects include decreased libido, impotence and breast tissue tenderness. Side effects are infrequent and reversible on stopping treatment. Treatment works best when started early before hair loss is advanced. Treatment needs to be continued long term.
Spironolactone
High dose spironolactone can be useful in female pattern hair loss. It is used off licence and requires regular blood tests.
Combined oral contraceptive pills
Combined contraceptive pills containing oestrogens and non-harmful progesterones can be useful in female pattern hair loss. Ensure you discuss your hair loss concerns with your general practitioner so that the appropriate pill is chosen. Progesterone only pills, implants, depot injections and progesterone containing intra-uterine devices should be avoided unless no other contraceptive is available.
Cyproterone Acetate
This can be combined with a contraceptive pill for additional benefit.
We recommend seeing a medical professional to accurately diagnose and manage your hair loss. Active treatment should be trialled for a minimum of 12 months before deciding on whether it has been beneficial or not.
Alopecia Areata
Alopecia areata is an autoimmune disorder in which the body’s immune system attacks hair follicles, causing patchy hair loss on the scalp and other parts of the body.
Topical Steroids
Topical steroids are applied topically to the scalp or skin surface as creams, ointments, lotions, or foams. Topical steroids work by reducing the skin’s inflammatory response. There are several formulas and strengths available. In order to effectively treat alopecia areata, a strong or extremely strong topical corticosteroid is typically required. The formulation recommended is crucial because some products (such ointments or creams) are frequently too greasy to be tolerated on the scalp on a regular basis.
Localised Steriod Injections
These steroids are administered by using a fine needle to inject them just below the skin into the affected areas. The advantage of these injections are that they have been found to be more effective than topical corticosteroids. Within four to six weeks of injection, hair growth at the injection site is typically visible when intralesional corticosteroids are successful.
Potential side effects include skin thinning which can lead to a dimple at the injection site. It is typically only used for fairly localised patches and smaller regions of alopecia areata because the injections can be painful and the total area that can be treated at once is quite modest. It is uncommon to administer intralesional corticosteroids to widespread hair loss areas.
Contact Immunotherapy
Inducing a local allergic skin reaction (contact dermatitis) is the goal of this type of therapy in order to encourage hair growth by diverting the immune system’s attention away from attacking the hair follicles. The most frequently prescribed medication in the UK is diphenylcyclopropenone (DPCP). This treatment requires time commitment as it involves initial sensitization to the solution and then weekly applications to the scalp skin.
Oral Immounosuppressant Medications
Ciclosporin
This is a tablet treatment that suppresses the immune system. There are a small number of trials that show Ciclosporin can stimulate hair regrowth in Alopecia Areata. It requires regular blood tests and blood pressure checks. Side effects include increased risk of infection, increased blood pressure, headaches and gum swelling. The treatment course is usually limited to six-twelve months.
Methotrexate
This tablet is taken once a week and suppressed the immune system. It can be taken for longer durations compared to ciclosporin. Larger groups of patients have been studied using this treatment for Alopecia Areata and hair regrowth has been seen especially when combined with treatments such as corticosteroids. It also requires regaulr blood testing. Common side effects include tiredness, nausea (vomiting) and headaches; serious side effects include increased risk of infections, bleeding problems and liver abnormalities.
Azathioprine
This works by suppressing the immune system. It is a tablet taken every day and can be taken for longer periods of time. It requires regular blood monitoring. The side effects include increased risk of infection and may cause diarrhoea, tiredness and increase the risk of skin cancer. Some studies suggest that Azathioprine can help hair regrowth and potentially work better than Methotrexate and Ciclosporin.
Topical JAK Inhibitors
Current research studies have shown that topical JAK inhibitors do not produce satisfactory scalp hair regrowth; but reveal some improvement with eyebrow and eyelash regrowth. The two main topical JAK inhibitors that have been tested and have shown some success with eyelash and eyebrow regrowth are Tofacitinib 2% ointment and Ruxolitinib 0.6% cream.These have been fairly well tolerated with no complications. The application on the skin reduces the risk of side effects compared with the oral form.
Topical and Oral Minoxidil
Minoxidil is available off prescription, as a liquid or foam that is applied to the scalp. It is usually applied once or twice a day. Minoxidil is only licensed to treat male and female pattern hair loss (Androgenetic Alopecia); however, it is also used to treat Alopecia Areata, either alone or combined with corticosteroid treatment. Low dose oral minoxidil is prescribed by Hair specialists to treat Alopecia areata.
Bimatoprost
Eye drops containing the solution bimatoprost 0.03% were first used to treat glaucoma. It was seen that the eyelashes of those receiving this treatment became thicker and longer. Since then, the US has approved the cosmetic drug bimatoprost (sold under the brand name Latisse®) to treat short, slowly growing eyelashes. Bimatoprost should never be put directly into the eyes while treating eyelashes; instead, it should only be applied at night (with a little brush or cotton bud) to the upper eyelid edge. It can take up to four months for hair re-growth to be visible; however, people have reported a noticeable difference in two months.
Bitamoprost may cause irritation of the skin and can sometimes result in permanent changes in the colour of the eyes (to brown) if applied directly into the eye. Skin pigment can also be affected (turning the eyelid skin either lighter or darker).
Scarring Alopecia
Some rare hair conditions can result in permanent damage to the structure of the hair follicles. Scar tissue replaces the hair follicle structure as a result leaving irreversible hair loss to the affected area/s. Some inflammatory skin disorders, like lichen planopilaris and discoid lupus, cause gradual scarring hair loss.
To stop additional hair loss, an accurate diagnosis and prompt treatment is required.
