Anagen Hair Selection

Some Body hair transplant (BHT) practitioners have already adopted in their methodology, the harvesting of only actively growing hair for BHT purposes.

Background:
Some Body hair transplant (BHT) practitioners have already adopted in their methodology, the harvesting of only actively growing hair for BHT purposes. This idea is premised on the supposition that even more anagen hair would be derived for transplantation by this approach. The popular modality used to achieve this has entailed so far, shaving the body donor area several days before harvesting. We conducted a cursory study to put this assumption to the test.

Methods:
Three areas of the leg were designated (A); (B) and (C) were marked for the study. Area (A) measuring 5x4cm had not been shaved in over 6 months. Areas (B) -7x5cm and (C) -4x3cm had been wet shaved 7 days prior. Next, a physician using one follicular unit separation and extraction (FUSE) technique harvested all follicles with hair exiting the ostia as viewable with X2.5 magnification from area (A). Next, all follicles bearing growing hair (stubbles) were extracted from area (B). Next, all follicles with no surface evidence of hair re-growth were extracted from area (C).

Results:
From area (A): A total of 47 hair follicles were derived in all. Of the 47, no transections were noted. Of these intact follicles, 28(59.6%) exhibited characteristics that were consistent with anagen hair lengthening phase characteristics (shaft length and sub bulge reach, length of auber's line, shaft color etc) -see figure 1. The remaining hair 19(40.4%) did not exhibit sub bulge reach and were considered to be mostly in telogen/catagen phase (figure 2).

From area (B): A total of 72 hair follicles were derived in all. Of these, 68 (94.4%) were intact with 4(5.6%) transections. Of the intact follicles, 7 (9.7%) exhibited no significant sub bulge reach and were considered to be mostly telogen/catagen hair. The remainder 61(84.7%), exhibited characteristics that were consistent with anagen hair lengthening phase characteristics (shaft length and sub bulge reach, length of auber's line, shaft color etc).

From area (C): A total of 24 hair follicles were derived in all. Of the 24, no transections were noted. Of these intact follicles, 20(83.3%) exhibited no significant sub bulge reach and were considered to be mostly telogen/catagen hair. The remainder 4 (16.7%), exhibited characteristics that were consistent with anagen hair lengthening phase characteristics (shaft length and sub bulge reach, length of auber's line, shaft color etc).

Figure 1:

Figure 2:

Conclusion:
In the instance of this study, harvesting only growing hair from leg hair donor sites that have been shaved few days preoperatively would yield a significantly higher proportion of anagen hair compared to the harvesting of all visible hair follicles from unshaved areas.

Discussions:
The presence/lack of anagen characteristics of BH can be determined by close examination of the follicle that is derived by any standard FUSE form of follicular unit extraction technique. Hence the sorting of anagen Vs telogen/catagen hair can be done during surgery without pre-operative selection. However, doing so blindly could yield a higher number of telogen/catagen hair as well. Pre operative targeting of only grown hair few days post shaving should cut down on the number of telogen/catagen hair extracted Zinadvertently.
The merits/demerits of transplanting strictly anagen hair during BHT is outside the purview of this study although speculations can be made in that regard.

Thus a valid question at this point is: what to do with telogen hair follicles extracted during the course of BHT. Should they be transplanted or simply returned back from where they came?
Umar, S H. Poswal A.

Please direct all enquiries to S. Umar, MD. 819 North Harbor Drive, Suite 400, Redondo Beach, California drumar@dermhairclinic.com tel 1-877-DERMHAIR