“Baldness” is the term used to describe the state of lack of hair on the head and androgenetic alopecia is the commonest cause of baldness. Approximately 50% of men are affected by the age of 50 years. One of the hallmarks of androgenetic alopecia is the conversion of thick terminal hairs into miniaturized; extremely thin (vellus) hairs. This process of miniaturization (i.e., shrinking of hair volume and growth length) is usually an indication that one is undergoing hair loss. The main mechanism for miniaturization relates to the shortening of the growth phase, i.e., the hair becomes “lazy” and does not grow to its full term. It typically begins in the frontal scalp and the vertex (crown area).
A significant proportion of women also suffer from hair loss. Unlike men, hair loss in females does not have any social acceptance. The chief complaint of women with female pattern hair loss (FPHL) is the ‘see through’ appearance of frontal hairline. These women suffer in silence for years together. The causes of hair loss in females can be: Female patterned hair loss (FPHL), telogen effluvium, hormonal imbalance, poor diet, diffuse alopecia areata. The progression hair loss in females (FPHL) is different from that of men. They experience diffuse thinning with no bald regions. Their frontal hairlines are relatively stable.

Hair transplantation is a cosmetic surgery which provides extra hair ranging in number from 1000 to 5000 to the bald scalp. The hairs along with the roots (follicular units) are taken from the back of scalp and are transplanted on to bald area on the frontal scalp and the vertex. The modern methods of hair transplantation involve transplantation of individual follicular units and provide completely natural appearance. These hairs remain life-long. They grow and undergo cutting just like natural hair. However, the progression of baldness is not arrested after surgery and the transplanted hair grow after 3-4 months. A combination of medicines and surgery thus provides the best final result. There are two methods of surgery:

Follicular unit transplantation (FUT): A horizontal strip, 1-2 cm wide and 10-20 cm long is harvested from the back of head, and dissected under stereomicroscopes to yield follicular units. It leaves a single linear scar hidden by the hair at the back of head.
Follicular unit extraction (FUE): The individual follicular units are harvested from the back and are then transplanted on to the frontal bald area. This propels the field of HT surgery one step closer to the elite minimally invasive status.

DHT (direct hair transplantation) is the latest innovation in the existing FUE technique. The idea behind DHT has been conceived and implemented by us at National Skin Clinic, Dehradun. It promises to yield better results