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
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
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?
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?
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
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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
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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%
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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?
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
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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
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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?
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?
.
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!”
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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?
.
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?
.
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?
.