This document discusses a new method called hair bundle cross-section trichometry (HMI) for quantitatively measuring hair growth over time. HMI allows physicians to (1) distinguish between different types of hair loss, (2) establish baselines for patient hair growth, and (3) track patient responses to various hair loss treatments over time. The author conducted a study using HMI on over 400 non-surgical hair loss patients over 24 months. HMI measurements found that hair growth improved in many patients and allowed physicians to better evaluate treatment effectiveness and compliance.

1. INTRODUCTION: HAIR MASS INDEX (HMI):
Distinguish “patterned” hair loss vs. diffuse Assess hair growth changes over time
For a physician or patient, the quantitative evaluation and tracking of changes in hair growth Establish baseline data Improve patient compliance
can be a challenging task. Current methods are fraught with inaccuracies and inefficiencies. Track treatment-response Improve medical management outcomes
For example, global patterns of scalp coverage provide little information on the degree of
miniaturization, a hallmark of early hair loss, or a patient’s subtle response to treatment over
time. Even in the most controlled photo studio environments, standardized global
photography can be inconsistent due to changes in hair length and styling. Video
magnification of the scalp (40-200x) and hair count densitometry provides additional
CONCLUSION:
The implementation of any new diagnostic tool requires an investment in time, effort,
information and raw data, but also have limitations including having to trim hair to obtain
personnel and other resources. Each physician must make his own judgment whether
accurate measurements as well as equipment costs.
these investments are “worth the return” of the benefits received in terms of patient care.
In our opinion, hair bundle cross-section measurements have provided us and our patients
“Cross-Sectional Bundle Trichometry” is a patented, scientifically accurate, repeatable non-
with easily understandable clinical information within minutes that was previously not
invasive method of measuring the cross-sectional area of hair (Hair Mass Index or HMI) in a
attainable.
predetermined area of scalp. A patient’s HMI measurements can be accurately obtained in
minutes by a physician or another staff member without the need to trim hair.
For example, during this initial trial period we were able to detect and quantify non-visible
thinning in male patients with early balding and quickly differentiate diffuse from pattern
In a hair loss patient, comparing HMI between various areas of scalp can yield valuable
balding in females with hair loss. We have able to track patients with thinning, telogen
diagnostic information. Comparing HMI measurements obtained in the same area of scalp
Sample of an HMI report effluvium, and we were able to critically evaluate our patient’s response to minoxidil,
over time allows the quantification of subtle hair growth changes such as the progression of Two technicians obtaining and
provided to a patient. finasteride, dutasteride, low level laser therapy and nutritional modification in a shorter
hair loss or response to treatment. HMI can be utilized for research purposes to track the US Patent #6,993,851 recording HMI measurements timeframe than ever possible before. We also discovered that when patients related to their
response to monotherapy. In a ‘real-world’ clinical setting, patients will typically utilize more B.H. Cohen during a routine follow-up visit. hair loss in quantitative terms and could see hair growth changes in shorter intervals than
than one treatment modality in their hair loss regimen and their compliance with treatment
previously obtainable, communication and education were significantly improved and this
can vary greatly over time. The individual and overall success of a multi-therapy hair loss
resulted in enhanced compliance and treatment outcomes. Furthermore we expect to
management program can be measured by comparing cohorts of patient HMI’s over time.
publish and present scientifically valid ‘real-world’ data as it pertains to the efficacy of hair
METHODS / RESULTS: regrowth in mono-therapy treatment regimens.
BACKGROUND INFORMATION:
As a practice, we are proud to be able to communicate to patients our track record and
‘success rate’ in the medical management of hair loss in not only stopping its progression,
RETROSPECTIVE STUDY (n=439)
but also offering patients proof of significant improvement in their condition without surgical
A retrospective chart review was undertaken to examine HMI data from 439
ΔFrontal HMI intervention.
consecutive non-surgical patients who received a total of 1490 cross-sectional
ISHRS Practice Census Data (2004-2010) reveals a 17% (n=130)
REFERENCES:
bundle measurements during a 24-month time period between 12/2009 and
dramatic increase in the number of non-surgical patients 1,000,000 12/2011. Patients had been counseled to begin and stay compliant with a multi- 6%
seeking treatment from physicians worldwide. Because therapy treatment regimen and return for HMI measurements at 90-day intervals.
800,000
hair loss is a chronic and progressive condition, both As expected, compliance with regard to treatment and follow-up appointments Marritt E. The death of the density debate, Dermatol Surg 1999;5:654-660.
600,000
surgical and non-surgical patients will require “Medical Sx varied greatly in addition to response to treatment. Worse ISHRS Practice Census Survey Data 2004-2010 (http://www.ishrs.org/mediacenter/media-statistics.htm)
77% Cohen BH. The cross section trichometer: A new device for measuring hair quantity, hair loss, and hair growth. Derm Surg
Management” of their hair loss condition over time. 400,000 Non-Sx Same
2008; 34:900-910.
Improved
200,000 Study interval 12/2009-12/2011 Cohen BH. Hair breakage: an under appreciated cause of hair loss in women. Hair Transplant Forum Intl, May/June, 2008
Bauman AJ. Hair bundle cross-section trichometry in the Medical Management of 250 cases of hair loss. ISHRS 18th Annual
A significant decrease of hair density and caliber can occur 0 Of 439 non-surgical patients total, 18 were excluded from the data because one or Scientific Meeting, Anchorage, Alaska. Oct. 2011.
during the early subclinical phase of hereditary hair loss 2004 2006 2008 2010 more HMI measurements could not be obtained for technical reasons: e.g. hair Hendriks MAE, et.al. The usefulness of Cohen’s cross-section trichometer for measuring hair quantity.
before coverage of the scalp diminishes. ISHRS Practice Census Data 2004-2010
length, hair replacement use or elected to undergo hair transplantation. “You can’t manage what you can’t measure.” - Dr. Bernard Cohen
1490 HMI measurements performed (occipital, vertex and/or anterior mid-scalp) ΔVertex HMI
Non-Surgical Cohort = 421 patients (289 Female and 123 Male) (n=114)
ABOUT THE AUTHOR:
Oftentimes, patients will squander precious time and resources on ineffective treatments 26%
during the early phases of hair loss. Other patients may become non-compliant with
130 patients had two or more Frontal HMI measurements within the study interval.
medically prescribed treatments during early phases of treatment when their beneficial
(ave +8.4, range of -33 to +82, 100 improved, 8 no change, 22 worse) 5% Dr. Alan J. Bauman is the Founder and Medical Director of Bauman Medical Group located in Boca Raton,
effects are too subtle to be noted by causal observation. In 2009, the author began to utilize FL since 1997. He is a full-time Hair Restoration Physician, Diplomate of the American Board of Hair
hair bundle cross section measurements (HMI) as part of routine evaluations for hair loss 68% Worse Restoration Surgery and active member of the International Society of Hair Restoration Surgery. Dr.
114 patients had two or more Vertex HMI measurements within the study interval. Same Bauman personally treats approximately 1,000 hair loss patients and performs over 250 hair transplants
diagnosis and follow-up visits for patients under treatment. Improved
(ave +8.2, range of -19 to +66, 78 improved, 6 no change, 30 worse) annually. In the course of the medical management of hair loss, thousands of HMI measurements using
hair bundle cross-section trichometry have been performed at Bauman Medical Group since 2009. Alan J. Bauman, M.D.
TITLE
THE USE OF HAIR BUNDLE CROSS-SECTION TRICHOMETRY
TO CONFIRM SUCCESS IN THE MEDICAL MANAGEMENT OF HAIR LOSS Scan to download .pdf
or visit
hai.rs/hmiposter2012
DATE
ISHRS OCTOBER 2012 AUTHOR
ALAN J. BAUMAN, M.D.
The following conflicts of interest are germane to my presentation: NONE.