Men and women who have the impulse to pull their own hair out may be suffering from trichotillomania. Trichotillomania is an impulse control disorder characterized by the repeated urge to and behavior of pulling out one's own hair. Impulse control disorders resemble substance addictions because the patient feels out of control of his or her own behaviors. Men and women with trichotillomania live relatively normal lives but typically show signs of hair loss, thinning, and bald spots all over the scalp and body from pulling it out.

Treating trichotillomaniagoes far beyond trying to stimulate hair regrowth.Even if Rogaineor laser therapy for hair losswere to regrow hair, there is a strong possibility that trichotillomania patients will continue to pull their hair out. Patients with trichotillomania therefore, should be treated at the source of the disorder in conjunction with using proven hair loss treatments.

In addition to medication, Habit Reversal Training (HRT) by a trained counselor has proven to be successful in treating trichotillomania. With Habit Reversal Training, the individual is taught to recognize and redirect their impulse to other more constructive activities. Often times, trichotillomaniapatients are asked to keep a journal of their hair pulling episodes. This can help the counselor and patient to identify and develop strategies to avoid situations that might trigger hair pulling episodes. Journals often include the location of the incident, number of hairs pulled, date, time, and their feelings and thoughts during the episode.

Treating a trichotillomania patient's baldness may be done simultaneously or after proper treatment of the disorder. Rogaine (minoxidil)can be a helpful aid to HRT by stimulating the follicles underneath the scalp, potentially facilitating or expediting hair growth.Treating a patient’s hair loss while they continue to pull their hair out is not constructive. Since this type of balding is not genetic due to the production of DHT, Propecia (finasteride)won't likely help.

Patients who've suffered from trichotillomania for awhile may damage or even remove the hair roots by excessive pulling, making non-surgical hair regrowth next to impossible. Surgicalhair restorationmay be an option for trichotillomania patients whose hair roots are too damaged to produce new hair on their own. Hairrestoration surgeryshould be reserved only for patients who've been successfully treated and no longer suffers from trichotillomania.

Catching and treating trichotillomania early will most likely reduce damage done to the hair follicles and eliminate the need for hair loss treatment, since undamaged hair will return on its own.

It seems that lately, new hair loss treatments based on “revolutionary scientific research” hit the rumor mill on a monthly basis. Some of these treatments come to light via reputable scientific journals while others, like Recoverup, materialize one day with a flashy website, a lot of promises and very little verifiable data. Recoverup is a UK based company that claims to offer stem cell treatments for hair loss through clinics in Taipei, Taiwan and Penang, Malaysia. According to their website, this treatment is so quick and easy it can be performed in a single day with startling results visible in only one month. Does this sound too good to be true?

Recoverup’s baldness treatment process claims to rely upon Autologous Adipose Adult Stem Cells (AAA). Unlike controversial embryonic stem cell treatments, Autologous Adipose Stem Cells are derived from the patient’s own fat cells through a small liposuction procedure and are then grown into a culture to increase volume. These stem cells are then “differentiated” with “growth factors” and injected into the scalp in order to induce new hair growth. This multistage process from extraction to injection can be performed in two appointments scheduled in the same day.

The question is, does Recoverup’s baldness treatment really grow hair? They state that “Empirical data indicates patients would expect to see at least 40% of all treated areas showing one of four results; (1) darker hair (2) thicker hair (3) faster growing hair or (4) more hair per follicle. Overall the effect is of more volume, and density, in those areas which were treated.” However, the Recoverup website offers very little in the way of photo documentation. The few photos that are presented are of poor quality and covered in text making them very difficult to evaluate.

The estimated cost for the one day hair loss treatment is between $8,000 and $13,000 depending upon the area to be treated. However, if the area to be treated is sufficiently large enough to merit a second day of treatments then this fee increases. Recoverup states that the long-term effects of the treatment are unknown and are dependent upon such factors as the patient’s age and quality of the source stem cells. “However, as a general guide, in other areas of stem cell treatment, data indicates approximately 3-5 years of positive results from each treatment.”  Recoverup does offer a 30-day money back guarantee if a patient experiences no new hair growth but is also quick to point out that the results will vary. One can imagine quibbling over whether or not a single follicle that didn’t appear to exist prior to treatment would constitute success under their definition. In summary, assuming Recoverup’s AAA stem cell treatment does stimulate hair regrowth, a patient can expect to pay upwards of $13,000 plus travel expenses to Asia for a treatment that is, by their own estimates, about 40% effective and may last between 3 and 5 years. This hardly sounds like an attractive alternative or even supplement to today’s state of the art, ultra-refined follicular unit hair transplantation combined with the clinically proven medical treatments Propecia (finasteride) and Rogaine (minoxidil). It is recommended that patients approach all unproven, “revolutionary” medical treatments with cautious optimism. Androgenic alopecia is progressive and avoiding proven surgical and medical treatments in favor of experimental procedures may lead to further hair loss.

Today's evolutionary high point - Ultra Refined Follicular Unit Transplantation

By relocating these carefully prepared bald-resistant follicular units, physicians doing "follicular unit hair transplantation" recreate a natural pattern of hair in the balding areas.

To do this properly is a very time consuming and exacting process. It requires a team of meticulous medical technicians working hand-in-hand with the hair transplant surgeon in a very lengthy surgical procedure.

Ultra Refined Grafting - Smaller Blades, Smaller Incisions, Smaller Grafts

Today's micro surgical blades, like the size of hair grafts, have become ever smaller and now enable hair transplant surgeons to safely make more tiny graft incisions in a given area then ever before. Surgeons are then able to "dense pack" select areas with as many as 40 to 60 follicular unit grafts per square centimeter. This graft density is as much as twice that of the standard follicular unit hair transplant procedure.

Such high densities of transplanted hair typically produce the appearance of fullness even after only one surgical session. Patients also experience rapid healing and no visible skin distortions due to the tiny size of these incisions.

Ultra Refined Follicular Unit Grafting - Hard on the clinic but easy on the patient.

Ultra refined follicular unit grafting raises the bar for physicians and their staff. This delicate and demanding hair transplant procedure requires more skill and careful attention to be performed properly. The smaller and more tightly packed incisions require more closely dissected follicular unit grafts that are carefully trimmed under microscopes. These small and densely packed incisions are also more difficult to place the grafts into.

This procedure also requires more careful patient selection, as "dense packing" of grafts is not appropriate for all patients.

Ultra Refined Follicular Unit Transplantation - the new "Gold Standard"

In the hands of a highly skilled physician and staff the Ultra refined follicular unit hair transplant procedure can achieve excellent new hair growth that is so natural that it is undetectable even under close scrutiny.

While the standard micro "follicular unit" hair transplant does produce natural looking results, its ability to achieve high density in only one surgical session is limited. Thus patients may have to do subsequent surgical sessions in a transplanted area to achieve a full look.

The many patient benefits of this new ultra refined procedure are significant and include:

• The ability to get excellent hair density in only one surgical session.
• Minimal trauma in the graft recipient area with rapid post surgical healing.
• Little or no visible pitting or distortions in the transplanted areas.
• More natural direction and angulation of the transplanted hair.

All physician members of the Coalition perform Ultra Refined Follicular Unit Hair Transplantation.

While many hair transplant physicians perform quality follicular unit hair transplants, only some of them are capable of performing large sessions of ultra refined follicular hair transplantation. However, all members of the Coalition of Independent Hair Restoration Physicians perform ultra refined grafting with excellent results.

The Future of Surgical Hair Restoration

The amount of hair you can transplant is ultimately limited by the amount of hair follicles you can safely relocate from the bald resistant donor area at the back and sides of your head.

Some day it may be possible for physicians to create multiple hair follicles from one original follicle. This process typically called Hair Multiplication or more incorrectly Hair Cloning is currently being investigated by several research scientists and hair restoration physicians.

If and when this process is successfully developed patients would no longer be limited by the finite amount of bald resistant hairs that can be relocated from their donor area. Hair multiplication would result in a virtually limitless supply of hair available for hair transplants.

This would be especially good news for men or women with extensive baldness and a very limited supply of donor hair. Even those with extensive baldness would theoretically be able achieve thick full heads of hair.

However, experts believe that we are at least ten years away from hair multiplication being available, if even then. But perhaps some day scientists will be able to use gene therapy to halt the balding process without drugs or surgery.

Learn about modern hair loss drug treatments that work.

Follicular unit extraction is a minimally invasive procedure for performing follicular unit hair transplantation. However, unlike the predominant follicular unit transplant procedure, in which a strip of donor tissue is removed and dissected under magnification, the FUE procedure uses a small punch to extract each follicular unit one by one.

Both the strip excision and FUE procedures create 1, 2, 3, and 4 hair follicular unit grafts that are then transplanted into the balding area in the same manner. The primary difference between these two procedures is the technique used to harvest the follicular unit grafts.

Comparing the Strip Excision procedure to the Extraction (FUE) procedure

The common strip excision method of performing follicular unit hair transplantation involves surgically excising a thin horizontal strip of bald resistant skin from the donor area.

Strip Excision Procedure 

Donor strip being excised

Incision sutured together

Hair combed down after suturing

This donor area is then sutured together. These sutures (either stitches or staples) are then typically removed about ten days after surgery. Some physicians use dissolvable sutures so that no removal is needed.

Patient’s donor area 2 months after surgery

Once this linear incision is fully healed the patient is left with a thin horizontal scar in the back of the head. This scar is typically hard to detect since the surrounding hair conceals it, even when the hair is cut short.

To view a video of an actual strip excision surgery.

How the FUE Procedure is performed

With the Follicular Unit Extraction or FUE procedure 1, 2, 3, and 4 hair follicular unit grafts are carefully extracted one at a time using a tiny punch of one millimeter or less. Often the surgeon requires the patient to buzz cut a portion of their donor area so that they are able to see the patient’s scalp.

The follicular units are extracted

The follicular units are extracted by placing the punch around a single follicular unit and cutting a small circle through the skin around that follicular unit. The follicular unit is then gently pulled up and away from the loose tissue underneath the skin.

The small hole left behind after the follicle is extracted then heals over the following week. Normally this small round incision contracts as it heals making the resulting round scar smaller than the size of the 1mm punch that made the incision. The FUE patient ultimately ends up with hundreds of small round white scars, which are normally not detectable once the patient’s hair grows out.View a video of an actual FUE surgery.

To Extract or to Excise, that is the question.

Advocates for the relatively new FUE procedure claim that this procedure produces less noticeable scarring and no tightness or numbness in the donor area since no donor tissue has been pulled together and sutured. Many patients and physicians find the claim that FUE produces less visible scarring to be debatable.

Some physicians and patients also have concerns about the relatively new FUE procedure, such as the lack of formal studies regarding the percentage of follicles that may or may not be transected during the sight unseen extraction process.

In addition, since the physician must personally extract all follicles, one by one, the FUE procedure is very physician dependent and thus very expensive. The FUE procedure also requires considerably more time in surgery to move a given amount of hair to the balding area.

The standard strip excision procedure has the advantage of utilizing a collaborative team to carefully create the grafts once the donor tissue is removed in a strip. This collaborative approach enables a well trained staff to do sessions of 2,000 to 3,000 all follicular unit grafts in a single day. This team approach enables a patient to get a much larger number of grafts/hairs in one sitting at a much lower cost per hair than with the FUE procedure.

However, some believe that despite being relatively costly the FUE procedure may be appropriate for patients who have very limited elasticity in their donor area or who only need a small number of grafts.

We know that and rogenetic alopecia or male pattern baldness is by far the most common cause of hair loss, accounting for 95% of hair loss in men and women. But there are a variety of other causes for hair loss in men and women. These include disease, aging, improper hair care, poor nutrition, and stress.

Disease and Illness

It's a proven fact that medical conditions, as well as treatments and procedures, may lead to hair loss. Many people have experienced sudden and large amounts of hair loss about 3 or 4 months after an illness or a major surgery. Fortunately, this hair loss is usually temporary, and is related to the stress of the illness.

Hair loss may also signal a previously hidden disease,including lupus, thyroid disease or diabetes. Because hair loss may be an early sign, it's a good idea to identify the problem and begin treating it at this time.

Psychological disorders such as Trichotillomaniamay be responsible for self-inflicted hair loss Men and women suffering from this condition pull their own hair out by the roots.

Hair loss may stem from taking certain medicines, but this normally stops once the medication is no longer taken.

Hormonal Changes

Another cause of medical hair loss is hormonal problems. Essentially, having an overactive or under active thyroid gland may cause your hair to fall out. Treating the thyroid disease will usually help this hair loss. Hormones can also cause hair loss if male hormones (androgens), or female hormones (estrogens), are out of balance. However, if the hormone imbalance is corrected, the hair loss should stop.

Aging

Did you know that 40% of men have noticeable hair loss by age 35, and 65% by age 60?

Aging is one of the factors necessary for and rogenetic alopecia to occur, along with a genetic predisposition and the presence of hair loss-inducing hormones. Hair loss is dependent on exposing the vulnerable hair follicles to the proper hormones over time.

Improper Hair Care

Isn't it frustrating to see people with thick, full heads of hair treat it so badly? Dyes, bleaching, pigtails -- it all takes its toll on hair.

The chemicals used for dying, tinting, bleaching, straightening or any other hair-altering procedures can lead to hair becoming strained or damaged. Eventually, this hair may even break off.

But it's not any better in the hair salon, as excessive styling that pulls the hair too tightly may also lead to a type of hair loss, called "traction alopecia." As long as this pulling is stopped before the scalp scars, the hair will grow back normally. But be warned, scarring can cause permanent hair loss.

It's also not a good idea to subject your hair to hot oil treatments or the chemicals used in permanents. These may cause inflammation of the hair follicle. This too, may lead to scarring and hair loss.

Improper Nutrition

Researchers have found that some hair loss may be due to insufficient protein or iron in your diet, as well as malnutrition, in general. As effective as "miracle" or "fad" diets sound, they may cause damage. Vitamin deficiencies, as well as certain illnesses related to eating, such as bowel disease or eating disorders, can also cause poor nutrition. These may all cause hair loss.

Stress

Stress can be harmful to the entire body, and the hair on our heads is no exception. Regardless of the cause - illness, a traumatic experience, nutritional deficiency - our rate of hair loss may increase.

However, it should be noted that stress-induced hair loss is not a cause of male-pattern baldness. Rather, this type of balding is known as "telogen effluvium." Telogen effluvium is caused when the body senses a problem and diverts its energies there. This results in hair being shed, although it's usually reversible.

Stress affects the hair of men and women differently. It's been foundthat women's hair is more sensitive to stress' effects than men's hair. One possibility is that stress (along with DHT and other things) may facilitate hair loss for women who are genetically predisposed towards it While the cause of genetic female hair lossis a bit of a mystery, women experiencing hair loss are advised to consult a dermatologist or hair restoration specialist to determine its cause Many causes of thinning hair in females are non-genetic and hair loss is often reversible by treating whatever condition is promoting it.