COHEN ppt 2012
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This document summarizes a presentation on using trichometry and cross-sectional trichometry (CST) to objectively measure hair loss and monitor treatment outcomes. CST allows clinicians to accurately track changes in hair mass index (HMI) over time to determine treatment effectiveness and progression of hair loss. The document provides examples of how CST can answer questions about treatment responses, compare different treatments, and distinguish shedding from permanent hair loss. CST provides a quantitative tool to optimize hair loss management.
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COHEN ppt 2012
- 1. CROSS SECTION TRICHOMETRY UPDATE A NEW TOOL FOR MANAGING PATIENTS WITH HAIR LOSS ISHRS – ANNUAL SCIENTIFIC MEETING Nassau, Bahamas – October 18-21, 2012 Bernard Cohen, MD Diplomate, American Board of Dermatology Diplomate, American Board of Hair Restoration Surgery
- 3. Disclosure: Speaker owns US and foreign patents pertaining to Trichometer technology.
- 4. HAIR MASS Trichometry measures “HOW MUCH HAIR” is actually present Based on density and diameter. (...and not density alone)
- 8. Chapter 11C Unger & Shapiro “Hair Transplantation” 5th edition
- 9. DIAMETER – smaller and smaller FOLLICLE – smaller and smaller ANAGEN PHASE – shorter and shorter AGA or Thinning
- 10. HAIR DENSITY COUNT AVERAGE DENSITY = 230 HAIRS /CM2 NORMAL SCALP BALDING SCALP
- 11. CROSS SECTION TRICHOMETRY How it works...
- 12. Locating strip & 4 legged inked template
- 13. 2 X 2cm area is defined by 4 dots Hair is isolated
- 14. Arms open – Hook extends Arms closed – Hook retracts
- 15. 1. Hook captures bundle 2. Arms are closed 3. Hook retracts 4. Bundle is compressed
- 16. HMI displayed on LED screen
- 17. HMI (HAIR MASS INDEX) mm2 of hair / cm2 of scalp Normal range: 75 fine hair 100 coarse hair .
- 18. HMI (BUNDLE CROSS SECTION) will change if or when A full-sized hair falls out A miniaturized hair eventually vanishes A full-sized hair emerges from the skin A hair diameter increases A hair diameter decreases
- 19. CROSS SECTION TRICHOMETERY Accurate Precise Reproducible Sensitive Fast & Easy No hair is cut Works equally well for shedding or thinning Equivalent to dry hair weight (INDUSTRY GOLD STANDARD LAB TEST)
- 20. THE MEDICAL MANAGEMENT OF HAIR LOSS IS SUDDENLY SIMPLE!
- 22. With CST you’ll be able to answer these questions: How quickly is untreated AGA getting worse? What percent per year? Is it time to advance my patient from MNX to FIN? Does FIN work as well if taken 2x per week? Is MNX 2% bid equivalent to MNX 5% daily? Is generic MNX equivalent to Rogaine? Is MNX more effective with added RetinA? Do HairMax and LaserCap work better than MNX? Is there an added benefit of adding MNX and/or laser to FIN? If I correct a patient’s iron deficiency, does her shedding improve?
- 23. BASELINE 4972 65 ONE YEAR LATER 72-65/72= 10% WORSENING IN ONE YEAR
- 24. Questions that CST can easily answer: How quickly is untreated AGA getting worse? What percent per year? Should I advance my patient from MNX to FIN? Does FIN work as well if taken 2x per week? Is MNX 2% bid equivalent to MNX 5% daily? Is generic MNX equivalent to Rogaine? Is MNX more effective with added RetinA? Do HairMax and LaserCap work better than MNX? Is there an added benefit of adding MNX and/or laser to FIN? If I correct a patient’s iron deficiency, does her shedding improve?
- 25. BASELINE 4978 71 AFTER ONE YEAR OF MNX TIME TO CONSIDER ADVANCING TO FINASTERIDE
- 26. Questions that CST can easily answer: How quickly is untreated AGA getting worse? What percent per year? Is it time to advance my patient from MNX to FIN? Does FIN work as well if taken 2x per week? Is MNX 2% bid equivalent to MNX 5% daily? Is generic MNX equivalent to Rogaine? Is MNX more effective with added RetinA? Do HairMax and LaserCap work better than MNX? Is there an added benefit of adding MNX and/or laser to FIN? If I correct a patient’s iron deficiency, does her shedding improve?
- 27. on FINASTERIDE 1mgm daily reduce to1mgm 2x/wk 4963 62 Theoretical example – NOT clinical observation One year later
- 28. Questions that CST can easily answer: How quickly is untreated AGA getting worse? What percent per year? Is it time to advance my patient from MNX to FIN? Does FIN work as well if taken 2x per week? Is MNX 2% bid equivalent to MNX 5% daily? Is generic MNX equivalent to Rogaine? Is MNX more effective with added RetinA? Do HairMax and LaserCap work better than MNX? Is there an added benefit of adding MNX and/or laser to FIN? If I correct a patient’s iron deficiency, does her shedding improve?
- 29. MNX 2% bid x 1 year Change to MNX 5% once daily 4975 79 MNX 5% once daily at end of following year Theoretical example – NOT clinical observation
- 30. Questions that CST can easily answer: How quickly is untreated AGA getting worse? What percent per year? Is it time to advance my patient from MNX to FIN? Does FIN work as well if taken 2x per week? Is MNX 2% bid equivalent to MNX 5% daily? Is generic MNX equivalent to Rogaine? Is MNX more effective with added RetinA? Do HairMax and LaserCap work better than MNX? Is there an added benefit of adding MNX and/or laser to FIN? If I correct a patient’s iron deficiency, does her shedding improve?
- 31. MNX 5% generic at end of year #1 Switch to Rogaine 5% 4961 62 Rogaine 5% at end of following year Theoretical example – NOT clinical observation
- 32. Questions that CST can easily answer: How quickly is untreated AGA getting worse? What percent per year? Is it time to advance my patient from MNX to FIN? Does FIN work as well if taken 2x per week? Is MNX 2% bid equivalent to MNX 5% daily? Is generic MNX equivalent to Rogaine? Is MNX more effective with added RetinA? Do HairMax and LaserCap work better than MNX? Is there an added benefit of adding MNX and/or laser to FIN? If I correct a patient’s iron deficiency, does her shedding improve?
- 33. On MNX 5% Switch to MNX + RetinA 4972 79 One year later
- 34. Questions that CST can easily answer: How quickly is untreated AGA getting worse? What percent per year? Is it time to advance my patient from MNX to FIN? Does FIN work as well if taken 2x per week? Is MNX 2% bid equivalent to MNX 5% daily? Is generic MNX equivalent to Rogaine? Is MNX more effective with added RetinA? Do HairMax and LaserCap work better than MNX? Is there an added benefit of adding MNX and/or laser to FIN? If I correct a patient’s iron deficiency, does her shedding improve?
- 35. On MNX 5% bid x 3 years then switch patient to Laser Rx 4963 61 24 MONTHS LATER Theoretical example – NOT clinical observation
- 36. Questions that CST can easily answer: How quickly is untreated AGA getting worse? What percent per year? Is it time to advance my patient from MNX to FIN? Does FIN work as well if taken 2x per week? Is MNX 2% bid equivalent to MNX 5% daily? Is generic MNX equivalent to Rogaine? Is MNX more effective with added RetinA? Do HairMax and LaserCap work better than MNX? Is there an added benefit of adding MNX and/or laser to FIN? If I correct a patient’s iron deficiency, does her shedding improve?
- 37. FIN 1mgm daily 4957 58 FIN 1 mgm daily plus Laser Rx Theoretical example – NOT clinical observation
- 38. Questions that CST can easily answer: How quickly is untreated AGA getting worse? What percent per year? Is it time to advance my patient from MNX to FIN? Does FIN work as well if taken 2x per week? Is MNX 2% bid equivalent to MNX 5% daily? Is generic MNX equivalent to Rogaine? Is MNX more effective with added RetinA? Do HairMax and LaserCap work better than MNX? Is there an added benefit of adding MNX and/or laser to FIN? If I correct a patient’s iron deficiency, does her shedding improve?
- 39. Female patient With low Serum Ferritin 4971 85 After 12 months of Iron supplement
- 40. Questions that CST can easily answer: When has the woman with telogen effluvium stabilized? My patient is convinced that MNX has made her “worse.” How does FUE affect donor site density? What percent improvement does my patient have after HT surgery? Is this woman’s hair loss caused by shedding or AGA? .
- 41. Patient with active Telogen effluvium 4971 71 2 months later ...still no improvement
- 42. Questions that CST can easily answer: When has the woman with telogen effluvium stabilized? My patient is convinced that MNX has made her “worse.” How does FUE affect donor site density? What percent improvement does my patient have after HT surgery? Is this woman’s hair loss caused by shedding or AGA? .
- 43. Baseline HMI, then 4 months of MNX. Phone call: “I’m much worse!” 4971 71 On re-exam the next day she is no worse.
- 44. Questions that CST can easily answer: When has the woman with telogen effluvium stabilized? My patient is convinced that MNX has made her “worse.” How does FUE affect donor site density? What percent improvement does my patient have after HT surgery? Is this woman’s hair loss caused by shedding or AGA? .
- 45. 7896 Pre-op FUE Post-op FUE
- 46. Questions that CST can easily answer: When has the woman with telogen effluvium stabilized? My patient is convinced that MNX has made her “worse.” How does FUE affect donor site density? What percent improvement does my patient have after HT surgery? Is this woman’s hair loss caused by shedding or AGA? .
- 47. Pre HT surgery 4945 78 Post HT surgery
- 48. Questions that CST can easily answer: When has the woman with telogen effluvium stabilized? My patient is convinced that MNX has made her “worse.” How does FUE affect donor site density? What percent improvement does my patient have after HT surgery? Is this woman’s hair loss caused by shedding or AGA? .
- 49. Woman with SHEDDING 68 67
- 50. Woman with Pattern loss (AGA) NOTE – Hair loss will NOT be visible until HMI is less than 49 81 98
- 51. END