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Jon Keith Guo’s crowning glory, before and after he underwent a hair transplant. — Picture courtesy of Jon Keith Guo/TODAYJon Keith Guo’s crowning glory, before and after he underwent a hair transplant. — Picture courtesy of Jon Keith Guo/TODAYSINGAPORE, Nov 5 — With his savings of S$16,000 (RM49,649), Jon Keith Guo could have made a downpayment for a second-hand car or home renovation. Instead, he spent it on his hair — whatever was left of it.

The 33-year-old civil servant started experiencing male-pattern hair loss in his early twenties and underwent a hair transplant early this year that involved patching up balding areas with close to 2,000 follicular grafts harvested from the back of his scalp. His hair loss is genetic and most of the men in his family have not been spared.

Guo previously tried many anti-hair loss tonics but nothing worked. He resorted to creative ways to disguise his receding hairline and thinning crown, such as getting a perm and styling his hair using copious amounts of hairspray to make it look fuller.

“It actually worked. Everyone knew me as the creative hair guy,” he said candidly. “No one realised I was balding, which was why my wife had a shock when she saw how my hair really looked like for the first time during our dating days.”

Tired of covering up, Guo went ahead with a hair transplant to permanently restore his crowning glory.

Hair loss disorders are not uncommon.

Some local studies suggest androgenetic alopecia or pattern hair loss, which is the most common type of hair loss in adults here, affects around three in 10 men aged 17 to 26 and almost all of those above the age of 80. Androgenetic alopecia is often due to a combination of factors including hormones and genetic predisposition, said dermatologist Eileen Tan.

Losing one’s hair can be psychologically distressing.

A 2015 study published in Dermatology Reports found that individuals with alopecia areata are three times more likely to have anxiety and five times more likely to have depression. Alopecia areata is a type of hair loss condition that occurs when the immune system mistakenly attacks the hair follicles, leading to spot baldness.

“Previously, with the balding areas, I felt and looked so much older than my age. It affected my self-confidence and I spent a lot of time styling my hair to disguise the bald areas,” said Guo.

The Wayne Rooney effect

Increasingly open attitudes towards cosmetic procedures are driving more younger men to seek help early. And instead of getting a temporary fix, many now prefer to reverse hair loss using a more lasting measure in the form of a hair transplant.

Dr Harold Ma, medical director of Freia Medical, has seen a growing number of men requesting for “that Wayne Rooney thing” ever since the British footballer openly talked about his hair transplant in 2011 at the age of 25.

The number of hair transplantation procedures Dr Ma carries out has increased 10 per cent every year in the last five years. He performs at least one procedure nearly every day and about half of his patients are under 40.

“The late twenties to thirties is when hair thinning tends to manifest in men, particularly those destined to have male pattern hair loss. It is also a time when they are at the peak of their career and are in a relationship, so appearance matters a lot to them,” said Dr Ma, who carried out Guo’s hair transplant.

Dr Tan, who runs a hair restoration clinic in Mount Elizabeth Medical Centre and Mount Elizabeth Novena Hospital, has observed a 15 to 20 per cent increase in younger patients seeking consultation for hair loss disorders in the last five years.

At The Clifford Clinic, demand for hair transplant procedures increased by 50 per cent in the last five years, with some patients as young as 25. Men make up about 90 per cent of the clinic’s hair transplant clients, said its director Dr Gerard Ee.

“There is a lot more awareness (about hair loss disorders) these days. People are now moving away from traditional myths about hair regeneration and seeking proven medical therapies to reverse hair loss,” said Dr Ee.

A migration of healthy hair

Hair transplant procedures can only be performed in a licensed medical clinic by a doctor who is trained in the procedure and fulfils certain criteria. In Singapore, there are guidelines on hair transplants issued by the Singapore Aesthetics Practice Oversight Committee, said Dr Ma. Besides private clinics and hospitals, hair transplant procedures are also offered at some restructured hospitals including the National University Hospital.

Procedures involve harvesting either strips of hair (follicular hair transplant, or FUT) or individual tiny follicular grafts (follicular unit extraction, or FUE) from the back of the scalp, where hair tends to be plentiful, and then “planting” them in the balding areas.

The back of the scalp is a “safe zone” where hair follicles are typically resistant and less susceptible to hair loss due to a form of testosterone called dihydrotestosterone (DHT), said Dr Ma.

“In principle, even if you’re genetically predisposed to hair loss due to the DHT, the transplanted hair from the safe zone will provide long-lasting results for around 10 to 20 years. But should your own existing hair continue to thin over the next few years, which is beyond our control, you may find new gaps forming,” he said.

Dr Chow Yuen Ho, director of The Clifford Clinic, said the FUE technique, which is carried out under local anaesthesia, is more popular among patients due to its minimal downtime compared to the FUT, also known as the strip technique. After the procedure, patients may wear their hair short or shaved without noticeable scarring.

“Also, fewer doctors are training to do FUT now,” said Dr Ma. Patients may even request for a designer hairline. Guo’s newly-transplanted hairline accentuates his widow’s peak, a V-shaped dip in the centre of the forehead.

Dr Ma said it is also possible to transplant follicular grafts to the face using the FUE technique, to create fuller eyebrows or beards.

But such treatments do not come cheap. According to Dr Ma, the cost of FUE depends on the severity of the hair loss and the complexity of each case. Costs typically range from about S$7,000 to S$15,000. The strip technique costs about 15 per cent less.

A word of caution

Hair transplants should be seen as a last resort for hair restoration, cautioned Dr Tan. She does not encourage patients in their early twenties to undergo the procedure as hair loss tends to progress at this age.

“If a hair transplant is carried out too early, there may not be sufficient donor hair if patient requires a few more hair transplantation sessions later in life. Another reason is if it is done too early, the hair line created may be too low and may not look natural later in life,” she said.

The treatment may not work if there is too little donor hair left on the patient’s scalp as the grafts cannot be taken from another person, she said.

There is no one-size-fits all formula for hair restoration, said Dr Ma. In some patients, hair loss can be stabilised using medication that addresses underlying hormonal imbalances. Other medically-proven dermatological treatment options for hair restoration include topical treatment such as minoxidil, oral medications such as finasteride and low-level hair laser therapy for the treatment of pattern hair loss, said Dr Tan.

As with other medical procedures, hair transplants carry risks such as infection, scarring and anaesthesia risks, said the doctors.

Dr Ma has also seen botched cases of hair transplants where the angle and direction of the transplanted hair are “all wrong”.

“Some people go overseas and get their hair transplant done cheaply, and then return with an infection,” he said.

Dr Tan said patients can check the credentials of their physicians, such as certification by the American Board of Hair Restoration Surgery, which involves passing a theory and practical tests.

Seven months after Guo’s hair transplant, his self-esteem has grown along with his new hairline and crown, which is expected to achieve its maximum effect in about a year’s time.

“Many friends with hair thinning issues have come up to me and asked how (a hair transplant is) like. I tell them it’s great,” he said with a smile. — TODAY

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