Guide to Hair Loss Treatment In Singapore 2022 by Dr Isaac Wong

Many men and women in Singapore face the problem of hair loss, whether it is a receding hairline or thinning hair. Many people assume that it is permanent and that there is no cure for it. Well, we’re here to tell you that there are solutions out there that actually work!

Many a time, people go for ineffective treatments that don’t actually solve their hair loss problems. Here, we’ll explain all the details of hair loss treatment methods that actually live up to their name.

Losing 100 to 150 strands of hair each day is considered to be normal.¹ Any increase in hair loss is something you should be worried about. This means that if you used to drop only 15 strands of hair whenever you wash your hair, but recently started dropping double that amount, you should take note of it. An increase in hair loss is more important than the actual amount of hair you are dropping. 

There are many reasons why hair loss occurs, and they include: 

• Genetics 
• Ageing 
• Illnesses 
• Hormones 
• Stress
• Poor diet / Lack of nutrition
• Excessive force 
• Artificial hair treatments and styling 
• Medication side effects 

Sometimes, the cause is a mix of different factors. I’ve had patients with hair loss due to a combination of stress and recent surgery. 

The good news is that all of these causes can be effectively tackled by medical treatments, only if you seek help from the right doctors who prescribe proper treatments. 

Male pattern hair loss, also known as androgenic alopecia, occurs in those who have a genetic sensitivity to the hormone dihydrotestosterone (DHT). Testosterone is converted into DHT which binds to scalp receptors, causing hair thinning, weakening hair grafts (miniaturisation) and hair loss.²

Here are some facts about male pattern hair loss:

• It is the most common type of hair loss among Singaporean men.
• It affects up to 70% of men.
• It can start in the teenage years 
• It usually worsens with a receding hairline, followed by hair loss over the top of the head. 
• The back of the head is usually not affected. 

To diagnose male pattern hair loss, your doctor will usually examine your scalp and determine whether you have lost a significant amount of hair, how much miniaturisation of your hair follicles there is, and how much space there is between the hair follicles. 

There is usually no need for any laboratory tests unless there is another abnormal hair loss condition. The Norwood-Hamilton classification is used to determine the stage of hair loss. 

If you feel that you have hair loss, you should seek help from a doctor or a dermatologist to diagnose the root cause of your hair loss. 

The diagnosis process may involve: 

• A medical history – where you tell the doctor about your lifestyle and medical information 
• Scalp examination – to look for patterns of hair loss 
• Blood tests – to look for nutritional deficiencies

Once you have determined the root cause of the hair loss, you can do targeted treatments. For example, if the root cause is nutrient deficiencies, you may just need to replenish the nutrients to solve the problem of your hair loss. 

Usually, hair growth can be encouraged simply by addressing any underlying issues, although it may take a while to see any improvements due to the natural length of time that hair takes to grow. 

The longer you wait to seek treatment, the less likely you are to recover the hair that you have lost. This is due to the fact that hair follicles can actually miniaturise, which means they shrink and the hair becomes finer and shorter. Eventually, the hair follicles shrink to a size where new hairs are unable to grow. Hence, the earlier you seek help the better. Hair regrowth is possible with treatment. 

There are many hair treatment centres and businesses in Singapore that capitalise on our deep, psychological fear of going bald and use that to sell us their expensive and non-scientific hair loss treatments. These cost thousands of dollars and patients often see no improvements.

When these treatments don’t work, the staff simply blame it on how you haven’t bought enough hair products, or that you need more sessions or a pricer treatment plan. 

These treatment centres often have no doctors to do proper medical consultations. Just check out their website and you’ll see that they do not have any doctors around, despite the use of claims that their treatment is “medically proven”. 

There are FDA-approved treatments for male pattern hair loss such as: 

Oral Finasteride (Propecia)

Facts about Finasteride: 

1. • Finasteride is more effective in treating the areas of the scalp that do not involve the temples, such as the vertex and superior-frontal regions. 
   • The recommended dosage is 1mg once per day, taken with or without food. 
   • It prevents or slows the progression of male pattern hair loss and many see noticeable improvements after 3-6 months. 
   • A common mistake many people make is to stop the medication within one or two months because it does not seem effective. In fact, it just takes some time to see the results. 

Possible side effects (temporary): 

1. • Loss of libido (sex drive) 
   • Ejaculatory dysfunction 
   • Gynaecomastia (growth of breast tissue in men and nipple swelling) 

Dutasteride

Facts about Dutasteride:

1. • Superior hair growth compared to Finasteride 
   • Used off-label in Singapore 
   • Side effects are reported to occur more frequently

Possible side effects: 

1. • Loss of libido (sex drive) 
   • Trouble getting or keeping an erection
   • Ejaculatory dysfunction 
   • Breast disorders 
   • Testicle pain or swelling 

Topical (spray) Minoxidil (Rogaine) 

Facts about Minoxidil 

1. • The topical (spray) form is FDA-approved for the treatment of male pattern hair loss. 
   • The recommended dosage is 1ml applied twice daily on dry scalp, left in place for a minimum of 4 hours. 
   • For maximum effectiveness, we recommend that you rub the Minoxidil into the scalp after applying. 
   • Minoxidil only slows down hair loss and is unlikely to result in the growth of new hair. 
   • You may combine Minoxidil with other treatments so that you get hair thickening results. 
   • You may buy Minoxidil over-the-counter (OTC) in Singapore as Rogaine. 
   • Some places add Minoxidil to expensive shampoos and charge unreasonable prices, so you want to avoid those and purchase OTC instead. 

Possible side effects:

1. • Skin irritation 
   • Hypertrichosis (excessive hair growth) on the face and hands 
   • Tachycardia (fast heart rate) 

Low-Level Laser Therapy (LLLT) 

• How it works 

It was discovered by chance in the 1960s that mice irradiated with low fluence red lasers grew hair. More than 10 clinical studies have been conducted and published to demonstrate itseffectiveness.³

LLLT works by increasing the blood flow to the scalp, similar to how Minoxidil works, and by reducing scalp inflammation. 

• Facts about LLLT
  • You can expect stronger and thicker hair shafts.
  • Recommended treatment regimes are 20 minutes of treatment thrice per week.
  • Medical grade LLLT devices are available in Singapore only at medical clinics.
  • There are no side effects to this treatment.

Surgical Hair Transplant in Singapore

• How it works

Hair is transplanted from the areas of your head that have hair onto the balding areas. Hair transplants typically take place in the doctor’s office with local anaesthesia. 

Hair grafts extracted from the donor area must be implanted to mimic the direction and density of hair as per the original such that it looks as natural as possible. 

• Facts about Surgical Hair Transplant 
  • It is a permanent solution that increases hair density on a bald scalp
  • It is suitable for: 
    1. Male pattern hair loss 
    2. Female pattern hair loss 
    3. Alopecia areata (if stable for more than 1 year) 
    4. Scarring alopecia (hair loss due to causes like burns, trauma and surgery) 
  • Your scalp might be sore after a hair transplant, and you will need to take the following medications 
    1. Pain medication
    2. Antibiotics to reduce risks of infections
    3. Anti-inflammatory medications to keep the swelling down
  • Most people can return to work several days after the surgery.
  • Transplanted hair may fall out after 2-3 weeks to make way for new hair growth, which happens after 3 – 18 months. 
  • Many doctors prescribe Finasteride to improve hair regrowth. 
  • The best time to get a hair transplant is at least 9 months before any important social events. 

Hair follicles at the side and back are NOT sensitive to DHT. Thus, hair transplanted from the side and back to the front and top of the head continue to be DHT-independent after implantation. This is good news because the transplanted hair will not shed again if the transplantation was done properly. 

Always seek help from licensed medical professionals, and stop wasting time on ineffective treatments. Get an early diagnosis before miniaturisation sets in, and ask your doctor if you are suitable for a hair transplant. It is the only permanent solution that really works! 

This article is medically reviewed by Dr Isaac Wong from The Artisan Clinic on 15 October 2021. 

Got questions? Feel free to contact me through these various methods:

• Direct message me on Instagram (Instagram.com/dr.isaac.wong)
• Whatsapp me @ +65 88089887
• Email me @ dr.isaac.kj.wong@gmail.com

References

(1) Sinclair, R. (2015). Hair shedding in women: how much is too much. Br J Dermatol, 173(3), 846-8.

(2) Urysiak-Czubatka, I., Kmieć, M. L., & Broniarczyk-Dyła, G. (2014). Assessment of the usefulness of dihydrotestosterone in the diagnostics of patients with androgenetic alopecia. Postepy dermatologii i alergologii, 31(4), 207–215. https://doi.org/10.5114/pdia.2014.40925

(3) Egger, A., Resnik, S. R., Aickara, D., Maranda, E., Kaiser, M., Wikramanayake, T. C., & Jimenez, J. J. (2020). Examining the safety and efficacy of low-level laser therapy for male and female pattern hair loss: a review of the literature. Skin appendage disorders, 6(5), 259-267.