Hair restoration in Chinese ethnic groups
Ethnicity has a strong influence on the distribution of hair
follicles in individuals. Ever since Dr. Bernstein popularized
follicular unit transplants as a state of the art technique, most
patients who have undergone the hair transplants have been Caucasians,
Hispanics and South East Asians. Hence most of the techniques
are modified to suit their needs. To broaden this field of study,
Dr. Tsai and his group have conducted systematic studies on normal
and balding patients of Chinese origin to give a better view to
surgeons treating patients of this ethnic group in the future.
One hundred patients were studied for hair characteristics with
the main emphasis on hair density and the number of follicular
units available for a hair transplant procedure. Half the number
of patients who were normal and with an average age of 27 years
had 1 sq cm area of their hairs shaved from three different regions
in the scalp, while the other half with the average age of 34
years who were in different stages of baldness were shaved in
the donor site area. The number of follicular units and the number
of hairs were counted in all these areas. In normal men and women
with no hair loss, the average number of follicular units was
71.78/sq cm, the average number of hairs/sq cm was 137.08 and
the number of hairs per follicular unit was 1.91. The results
from bald patients revealed 69.09 follicular units/sq cm, 127.39
hairs/sq cm and 1.84 hairs per follicular unit. The surgeons carried
out hair transplants in a hundred patients based on these results
for frontal hair reconstruction, and used about 700-1000 follicular
units to achieve an average hair density of 30 follicular units/sq
cm.
Follicular units vary according to the ethnicity of the individual. The number
of follicular units/ sq mm is 1 in Caucasians and Asians with the hair grouping
in two and average hair density/ sq mm also being 2. In Africans only 0.6
follicular units/sq mm with an average hair density of 1.6 and hair grouping
of three is recorded. Although oriental ethnic groups have hairs grouped in
two, the number of follicular units/sq mm is 0.7 and average hair density
is 1.4.
Why the authors chose follicular unit transplants is for the
usability of follicular units that results in retaining a natural
look. Since follicular units are always found in natural groups
of 2, 3 or 4 and single in areas where there is a finer transition
of the hairline with the rest of the skin, the use of follicular
units is very aesthetically pleasing to look at and looks natural.
In the Chinese patients, the number of hairs in a follicular unit
is mostly two, relatively fewer numbers of 1 and 3 and very rarely
4 or 5 follicle units were found. Hence Chinese have only 70%
of the hair density of Caucasians. Apart from a broad frontal
scalp, hair characteristics also differ in that Chinese typicaly
have straight and dark hair. Hence reconstruction of a natural
hairline is possible without compromise on aesthetic appeal only
using follicular unit transplants.
This study is useful since surgeons all over the world can understand
the differences of hair characteristics between races especially
when there is lot of cross cultural interaction and as doctors
need to cater to patients from across the globe.
Hair
restoration in Chinese ethnic groups references
- Tsai RY, Lee SH, Chan HL. The distribution
of follicular units in the Chinese scalp: implications for reconstruction
of natural-appearing hairlines
in Orientals. Dermatol Surg. 2002 Jun;28(6):500-3.
PMID: 12081679
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