How hair thins, and what can be treated
In pattern hair loss, follicles shrink over repeated cycles until they stop producing hair. This is called miniaturisation. Male pattern loss is staged on the Norwood scale and female pattern loss on the Ludwig scale.
The cause comes first. Pattern thinning, diffuse shedding, patchy autoimmune loss and traction loss are each treated differently. Dr Sin Yong uses trichoscopy to establish the stage, the pattern of miniaturisation and the state of the donor area. In women, non-androgenetic causes such as thyroid, iron and hormonal drivers are screened for. Blood tests are added where needed.
Hair regrowth treatment Singapore: the parts of a plan
| Part | What it is | Its limit |
|---|---|---|
| Prescription medicine | Finasteride and minoxidil, the foundation for pattern thinning | Does not restore follicles already lost |
| Regenera Activa | A small scalp graft processed into a cell-rich suspension and delivered to thinning areas in the same session | Suited to areas where follicles survive |
| H2LT laser | A non-drug scalp laser protocol, used as an adjunct or for people who avoid medicine | Cannot regrow follicles already lost |
| Adjuncts | Polynucleotides and topical exosomes, used where they fit a case | They support a plan and do not replace its main parts |
Medicine and what to expect
Finasteride blocks the conversion of testosterone to DHT, the hormone behind pattern thinning. Minoxidil prolongs the growth phase. Each is available in more than one form, and every medicine is prescribed only after assessment. Oral minoxidil is off-label and needs heart and blood pressure review. Anti-androgen hormonal therapy is used only in selected women. Pattern hair loss is ongoing, so benefit generally depends on continued use. Stopping oral therapy typically leads to hair loss resuming within 3 to 6 months. Baseline bloods are taken, and follow-up bloods at 3 to 6 months. Topical finasteride is available only on prescription, and women who may become pregnant should avoid handling finasteride.
Regenera Activa and H2LT
Regenera Activa is autologous micrografting. Millimetre punch grafts are taken from the back of the scalp, processed at the chairside and delivered to thinning areas in one session. The donor site is anaesthetised for the harvest, and most people describe pressure rather than pain. H2LT is a laser protocol applied to the scalp with no incision, graft or anaesthetic. It suits early pattern loss with surviving follicles, diffuse thinning while causes are addressed, and people who cannot or prefer not to take medicine. It can also support native hair after a transplant. Dr Sin Yong performs both himself. Regenera Activa suits areas where follicles survive, so it is not a route for bald zones.
How men and women are assessed
In men, pattern loss is staged on the Norwood scale, and medicine that addresses the androgen driver is usually the foundation. In women, the Ludwig scale is used, and non-androgenetic causes are screened for first. These include thyroid disease, low iron and hormonal drivers. Anti-androgen hormonal therapy is used only in selected women. Baseline blood tests may cover ferritin, iron, thyroid, zinc, liver function and hormones as appropriate. Medicines are prescribed only after assessment and are not sold over the counter.
Who this suits
Men and women with miniaturised but living follicles.
After thyroid, iron and hormonal causes have been screened. See female hair loss.
Medicine is usually the foundation. See male hair loss.
A laser-led route may be offered.
Who should wait or avoid it
Treatment waits. Finasteride-type medicines are not given to women who are or may become pregnant, and they should avoid handling it.
Active scalp infection, open wounds or an inflamed scalp come first. Suspicious lesions are examined.
Low iron, thyroid disease and other causes are addressed first.
These and certain other medical conditions and medicines are reviewed.
Liver disease, heart conditions or low blood pressure are reviewed before oral therapy.
These are discussed before starting.
What it cannot do
Smooth, shiny, bald areas will not respond. Transplant is the discussion there.
Exosomes and polynucleotides are not standalone treatments.
Benefit from medicine generally depends on continued use.
That is not a realistic goal, and no regrowth is promised.
When referral is the right step
Hair transplants are not done here. A transplant is considered only where follicles are already lost, a zone is bare and the donor area is adequate, and patients are referred to a surgical team. It does not stop the underlying process, so medical therapy usually continues. Scarring alopecia and sudden patchy loss are referred to a dermatologist. Abnormal blood results or a suspected endocrine disease are also referred on.
Risks and side effects
Shedding may briefly increase early in treatment. Finasteride can cause changes in libido, erection or ejaculation in a minority of men, and mood changes have been reported. It also lowers PSA readings. Topical finasteride has lower but not zero absorption, and it can irritate the scalp. Minoxidil can cause scalp irritation, early shedding and unwanted facial or body hair. Oral minoxidil can cause fluid retention, a faster heartbeat, light-headedness and dizziness. H2LT can cause mild warmth or scalp tightness, and less often temporary redness, tenderness, headache or dryness. Contact the clinic about low mood, lasting sexual side effects, rash, facial swelling, breathing difficulty, chest pain, breast or testicular changes, or blistering or spreading redness of the scalp.
Timeline, sessions and fees
Change takes months, because follicle cycles are long. Reviews compare your progress against baseline trichoscopy and standardised photographs. After micrografting, normal activity typically resumes the next day. The number of laser sessions and any maintenance are planned individually at consultation. Fees depend on the type and stage of hair loss, the parts of the plan chosen and how long each runs. They are quoted in writing after consultation. Progress is tracked rather than assumed, and no regrowth is promised.