10 things you need to know about having a hair transplant

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Crown Clinic's consultant hair transplant surgeon Asim Shahmalak is one of the best-known hair transplant surgeons in the world.

He gets asked all the time by the media for his key tips on having a hair transplant – here are 10 important things you need to know.

1 A hair transplant is the only permanent cure for male pattern baldness. The problem of thinning hair affects the majority of men at some point in their lifetime. According to the National Institute for Health Care and Excellence, around a third of white men under the age of 30 are losing their hair – this increases to 80% by the age of 70. Rates of hair loss are slower in black and Asian men.

2 Hair transplant procedures have never been more popular. According to the International Society of Hair Restoration Surgery there has been a 60% rise in the number of hair transplants globally in the last five years.

3 There are two common types of hair transplant procedure. The most popular is FUE (follicular unit extraction) – chosen by 80% of the clients at Crown Clinic including most of our celebrity patients: Calum Best, Homes Under The Hammer star Martin Roberts, former footballer Didi Hamann and Gogglebox star Chris Butland-Steed. Around 20% of our patients opt for the more traditional method known as FUT (follicular unit transplantation). The TV doctor Christian Jessen has had two FUT hair transplants at Crown Clinic with Dr Shahmalak.

With FUE, the donor hairs are removed individually from the back and sides of the scalp and then replanted in the balding areas. This means any scarring is minimal. 

With FUT, the donor hairs are removed all in one go by surgically cutting a strip of skin from the back or side of the scalp. The scarring for this method is more noticeable which is why it is not recommended for men who like to wear their hair shaved or short at the back and sides.

4 What causes male pattern baldness? The most popular cause is your genes. If you dad is bald, chances are you will be too. The baldness gene can also be passed down on your mother's side of the family – from her father, for instance. What happens biologically is a modified form of testosterone, the hormone dihydrotestosterone (DHT), attacks hair follicles on the scalp. The hairs produced by the affected follicles become progressively smaller in diameter, shorter in length and lighter in colour until eventually they shrink completely and hair stops being produced. DHT does not tend to affect hair on the back and sides of the scalp – which is why even the most heavily bald men (think Bobby Charlton) still have a horseshoe-shaped area of hair on the back and side of their scalp. This is where the donor hair for a transplant is sourced.

Your hair style can also contribute to hair loss. Crown Clinic's client Calum Best believe his baldness was accelerated by pulling his hair tight into a ponytail in his early 20s.

5 Can you slow down hair loss? Yes, you can. Dr Shahmalak recommends the use of clinically proven hair loss medication such as Finasteride (also known as Propecia) and Minoxidil (often applied as a mousse). These won't grow any new hair but scientific trials have shown that they can halt or slow down natural hair loss. It is why Dr Shahmalak sometimes recommends their use in conjunction with a hair transplant.

6 At what age should you consider a transplant? Dr Shahmalak will not operate on any patient younger than 25. He needs to establish the pattern of hair loss in a patient and that cannot be done prior to 25. 

7 How do you find a hair transplant surgeon who is right for you? You want to check that they are members of a reputable professional body such as the British Association of Hair Restoration Surgery of which Dr Shahmalak is a member. Look at a surgeon's testimonials – it is always a good sign if they have lots of recent happy patients.

8 Should you go abroad for surgery? Remember that all hair restoration clinics in the UK are tightly regulated by the Quality Care Commission. They are inspected every year and closed down if they don't meet rigorous standands. You do not get that kind of regulation in countries like Turkey where many clinics are unregulated. We have all read horror stories of patients having nightmare treatments at foreign clinics. The problem you have is remedying the damage or getting compensation if you have a poor treatment abroad. Would you want to take legal action through the Turkish courts?

9 What aftercare is needed? We recommend that patients take a week off work after a procedure. Almost all our operations are done on the day with patients travelling home on the day, but we ask them to take it easy for a week afterwards so they don't dislodge any of the transplanted hair. So, for instance, we recommend that you wear button down shirts rather than pull-overs or T-shirts – because pulling these over the head can dislodge the new hair. Patients also have to sleep upright for a few days afterwards.

10 When will I notice the difference? The transplanted hair starts growing back three to four months after a procedure. You will see a real diffference after six months but you won't see the full effects of the transplant until a year afterwards.

Our Surgeon

Dr. Asim Shahmalak

Dr Asim Shahmalak is a world-renowned hair transplant surgeon who performed the UK’s first eyelash transplant in 2009. He runs Crown Clinic – one of Britain’s most successful and best known hair transplant clinics. He has treated a number of high-profile industry leaders and celebrities including the medical broadcaster Dr Christian Jessen, best known for Channel 4’s Embarrassing Bodies.

Expert hair transplant surgery by Dr Shahmalak

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When the sun comes out, we know that we need to apply sunscreen to protect our skin, but many people forget to pay the same care to protecting their hair. Between the sun, sea and swimming pools, many of our favourite summer activities can significantly damage our hair – so the next time you go out to enjoy the sunshine, find out what you can do to protect it.


Why does sun damage the hair?


Sun damage to the hair is caused by the harmful UVA and UVB rays, which damage the outermost layer of the layer – the cuticle – and weaken the protein structure of the hair, making it dry, brittle and more prone to breaking. Some people find that their hair lightens in the sun, as the rays act in a similar fashion to bleach, stripping the melanin from the hair.


Protecting your hair from the sun


Wearing a hat is an easy way to protect your hair and scalp from the sun, especially if you’re outside when the sun is at its strongest. Hair SPF is also an option, which can usually be bought as a spray to be misted over the hair. Pay extra attention to the scalp – many people forget that the scalp can burn just as easily as the rest of the skin, ending up with an itchy, flaky, burnt scalp. If you do burn your scalp, rinse your hair in cool water and apply aloe vera to the affected areas, and make sure to keep your head covered when going outdoors.

If your hair is looking dry, try a deep conditioning treatment to restore some of the lost moisture to the hair, and avoid wearing your hair in any tight styles that may pull on the scalp. Summer is also a good time to temporarily stop using hairdryers, straighteners and any other hot tools to avoid adding to the sun damage.


Protecting your hair from the sea


Salt water is notorious for drying out the hair. It leaches moisture out of it, making it incredibly brittle and tangled, which can cause significant breakage. Before you go swimming, saturate your hair with clean water to prevent it from absorbing as much salt water, and don’t let it sit in your hair – rinse it thoroughly as soon as you get out of the sea. Deep conditioners and hair masks will also help replenish the moisture.


Protecting your hair in a swimming pool


Just like salt water, chlorinated water is very harsh and drying on the hair, so you can take similar precautions to swim in the sea. You could also try a swimming cap, as this not only prevents the chlorine from damaging your hair, but it will also protect your scalp from sunburn. If you have highlighted or blonde hair, be especially careful when in a swimming pool, as the copper and chlorine in the water have been known to form a film that sticks to the proteins in hair, turning it a green shade. Thankfully, this isn’t permanent, but make sure to enter the pool with wet hair and rinse it as soon as you get out.

However you are spending your summer, if you have any questions or queries about your hair, take a look at our hair advice or give our team a call.

Over the past few months, there have been a significant number of reports in the news of people experiencing hair loss after being diagnosed with COVID-19. As a result, the Centres for Disease Control and Prevention (CDC) has listed hair loss as a possible long-term effect of the illness, along with symptoms such as fatigue, dizziness and joint pain. 

A study published by the medical journal The Lancet reported that 22% of the patients it had observed suffered from some degree of hair loss six months after falling ill, with women being more affected than men. 


Why does COVID-19 cause hair loss? 


Although there are several studies linking coronavirus and hair loss, many of the reports we hear about are anecdotal – at the moment, it’s too soon for scientists to officially establish a link between the two. 

However, the type of hair loss that COVID-19 sufferers are reporting seems to be consistent with telogen effluvium. Telogen effluvium occurs when more hairs than usual suddenly enter the shedding phase of the hair growth cycle at once, causing a more noticeable amount of hair to shed at once. It’s normal to lose up to 150 hairs per day, but if you spot that you’re losing much more than that – such as clumps coming out when you’re brushing or washing your hair – it could be telogen effluvium. 

Due to the length of the hair cycle, telogen effluvium typically occurs two or three months after a period of significant stress, which can include illnesses such as COVID-19. When undergoing stressful situations, the body puts all its resources into maintaining essential functions only – which, unsurprisingly, does not include hair growth. As a result, you end up with hair loss. 

However, several other conditions can cause hair loss – such as thyroid issues or nutritional deficiencies – so if you are concerned, visit your GP, who can rule out other underlying causes with a simple blood test. 


Will my hair grow back after having COVID? 


If the hair loss is the result of telogen effluvium, most people will find that the hair will eventually grow back without the need for treatment. Typically, once the trigger or stressor is removed, the hair will grow back on its own. 

If you notice that the hair loss is persisting, there are a number of medical, cosmetic and hair transplant treatments available to help – Crown Clinic offers a range of options to support those struggling with hair loss, so don’t hesitate to get in touch

When performed by a qualified, experienced hair transplant surgeon, hair transplants are a very safe procedure. Hair restoration is a minimally invasive treatment that allows patients to return home the same day, with the procedure only requiring local anaesthetic. 

However, if you undergo a hair transplant abroad – such as in Turkey – the risk attached is much higher. 


Risks of hair transplants in Turkey 


It’s no secret that undergoing hair transplant surgery in countries such as Turkey is a gamble. Every year, countless patients are reeled in by the low prices and package deals offered by overseas clinics. Many of the clinics boast ‘five-star’ ratings and an active social media presence, duping unsuspecting patients into thinking they are visiting a reputable clinic. Although, when you dig a little deeper, you may discover the reviews are faked and the ‘after’ pictures are heavily edited or taken from other clinics. 

Another trick that patients fall for is believing that a surgeon will be carrying out the procedure, as many of the clinics advertise that a surgeon leads them to convince patients that they are legitimate. Unfortunately, that doesn’t mean a surgeon will be carrying out the hair transplant itself. In fact, many clinics hire under-qualified technicians with little training to keep the costs down, only seeking the supervision of a surgeon if the procedure goes wrong. 

Over the years, Crown Clinic has fixed countless botched hair transplants, mainly from overseas clinics. The most common problems that we see are unnatural-looking hairlines and unsightly scarring as the result of the surgery being carried out by unlicensed practitioners. Other risks are infections, as sanitation is often extremely poor at the clinics and damage to the scalp due to the result of the incorrect tools being used to carry out the surgery. 


Are there any side effects to having a hair transplant? 


If you choose to have a hair transplant in the UK with a reputable surgeon, side effects will be minimal. The hygiene standards will be incredibly high, meaning the risk of infection is negligible, and you will be given clear instructions on how to take care of your scalp after the procedure. Crown Clinic has an excellent aftercare service, offering a day-by-day guide to ensure optimum healing and results.  

Unlike at overseas clinics, where it can be impossible to follow up after the procedure to discuss any concerns related to your hair transplant, Crown Clinic is more than happy to answer any questions you may have during this phase.