Whitening injection:

Injectable skin whitening products are marked for injection into vein or muscle or under the skin. They are sold online and in some retail outlets and health spas. They often to lighten the skin, correct uneven skin tone, and reduce blemishes.

Skin whitening injections is a well-known and most demanding procedure that is also known as Glutathione injections.

Glutathione:

Glutathione is a naturally occurring substance produced by our liver. This naturally present antioxidant is useful for performing a number of activities in our body such as building and repairing of body tissues, neutralizing free radicals, helping in immunity, acting as an anti-cancer agent, delaying the process of aging, etc. Over the years, the level of glutathione decreases in our body and when this happens, it accelerates the process of aging in our body. Because of this, people tend to turn to glutathione injections which help in maintaining their youthful look along with skin whitening. This external agent helps to increase the level of glutathione in our body.

Based on various studies and research, the general consensus is that glutathione injection’s results are mostly positive for skin whitening. Though taking this injection will provide results for a longer time, you will have to get booster shots in between in order to maintain the effects. These booster shots can either be in the form of injections or glutathione pills. The results of this procedure will be more effective if they are combined with other cosmetic treatment such as laser skin lightening.

Glutathione injection dosage:

The exact glutathione injection dosage that you should take will vary from person to person, depending on various factors, including your height, weight, metabolic rate and why you’re taking the glutathione injection. It is essential to find the right dosage to experience the full beneficial effects of glutathione injections. Glutathione injections required a prescription. You should always consult with a healthcare professional to determine the right glutathione injection dosage and determine if you should take other vitamins on the side, such as vitamin C, to boost or maintain the effects.

The absorption of the glutathione by your body may be affected by factors such as alcohol consumption, smoking, and exercise, which may result in slower visible effects or required higher dosages.

Skin whitening injection benefits:

• Fight free radicals.
• Defy sign of aging
• Protect against UV rays.
• Detoxify the body.
• Reduce melanin pigments.
• Convert dark melanin pigments into lighter pigments.
• Promote fairer and brighter skin.

 Common Side Effects of glutathione injection:

Like every other cosmetic treatment out there, getting a shot of glutathione injection can also result in various side effects. If in case the dosage administered is much higher than what is required, a patient can suffer serious side effects such as kidney failure or blood poisoning. Apart from this some of the other glutathione injection side effects that can occur, if in case, the dosage given is more than 5grams or more include:

• Pain and redness at injection site.
• Nausea.
• Skin rashes, hives or allergic reactions.
• Diarrhea or other forms of stomach upset.
• Loss of hair.
• Breathing problem.
• Gain in weight.
• Toxic epidermal necrosis.
• Numbness.
• Aggravate symptoms of asthma.

How much does glutathione cost?

The cost of glutathione ranges greatly depending on dosage and location. Generally, a treatment of 1500 to 4000mg once or twice a week will cost anywhere from $150 to $400. It may be a less expensive treatment if you learn to self-administer after consulting with your health care provider and getting a prescription.

Introduction

Hair transplantation has gone through a big revolution with the pioneers in this field^[1–5]. To achieve a good cosmetic result in hair transplantation, a natural-looking hairline with adequate density shall be established. There are numerous modifications of defined techniques with each one explaining and suggesting verified solutions.

This note describes the available options in hair loss surgery and the concepts of non-surgical approaches, and an experience is shared with a few patients grafted via direct hair implantation (DHI) method. Moreover, to us, this is the only study demonstrating the opening of the nests with sliced razor blade just before the implantation of the hair follicles. Thus, the evolution with the future of hair transplantation is summarized as well. Moreover, this article focuses on the surgical techniques. The medical management of hair loss is out-of-scope

Methods

Between January and December 2014, hair transplantation was carried out in 207 patients. The patients with beard and/or moustache transplantation, multisession transplantations and female patients were excluded. The harvested grafts out of the scalp were also not evaluated.

All the procedures were carried out under local anesthesia. The hair was cut 1-2 mm in length. Micromotor system was used in the harvesting of the hair follicles This system consists of punches attached to the hand-piece of the micromotor system (1500-3000 rpm). Punches were chosen according to the diameter of the follicles ranging between 0.8 and 1.2 mm. Harvesting of the follicles was handled in supine position. With the aid of the sharp punch attached to the motorized system, the follicle was detached from the surrounding tissue (approximately 3-4 mm in depth=deep dermis layer). Later on, it is released manually with fine-curved microforceps produced for this purpose. Temporooccipital region was used as donor site.

The harvested grafts were aligned in Petri dishes with cooled saline (4 °C). A dressing is made with sterile saline coated gauze to the donor area and the patient was turned to the supine position.

In follicular unit extraction (FUE) technique, razor blade that was cut into pieces was used to open the nests in vertically-oriented fashion that are to be grafted . With this, we aimed to diminish the incarceration of the implanted follicles. However, in DHI technique, the grafts were loaded to the DHI pens with one charged staff for this purpose  . The implantation of the follicles was carried out in accordance with the natural hair angles by the author under loupe magnification

Hair transplantation is comprised of consecutive steps: planning, preparation, anesthesia, graft harvesting, secure of the harvested grafts, graft transplantation, and dre

Technique

While several surgical treatment options (plug grafts, scalp reductions, transposition flaps) have been used historically to treat androgenic alopecia, we outline the two most common techniques of HT based on the follicular unit-principle, namely the follicular unit transplantation (FUT) and the follicular unit excision (FUE)

FUT Donor Site Harvest 

• The patient placement is in a prone position.
• If not done already, the donor site hair is trimmed to 2 mm.
• The calculated strip length is marked, and a local anesthetic is injected superficially into the dermis. A tumescent solution may be injected as well to increase anesthesia, hemostasis, and dermal turgor.
• A beveled incision is made parallel to the exiting follicles, into but not beyond the subcutaneous tissue (about 4 to 5 mm in depth).
• With lateral retraction around the periphery using sharp skin hooks, the donor strip gets dissected off the galea aponeurosis and occipital fascia which minimizes bleeding and sensory nerve damage. NOTE: cauterization should be used sparingly to decrease the risk of permanent FU damage.
• The donor strip gets prepared by removing excess subcutaneous tissue, with care to leave 2 mm of fat beneath the FU to avoid damage to the follicle.
• The strip is then dissected (usually by a technician) under magnification into vertical segments one FU thick.
• Individual FUs are then isolated with further sharp strip dissection and placed immediately into a holding medium of chilled saline. NOTE: the FU is susceptible to desiccation in just a few minutes, which renders the graft unusable.
• The donor strip is then closed either primarily or with a two-layer closure using sutures and/or staples per surgeon preference.
• The patient transitions to a sitting position for recipient site preparation and graft implantation.

FUE Donor Site Harvest

• The donor site is shaved to 2 mm to visualize the angle of the follicles.
• The patient placement is in a prone position for ease of harvesting.
• Local and tumescent anesthesia gets injected into the donor site.
• If manual FUE is being performed, a sharp punch (diameter 0.8 to 1.2 mm) is oriented within the center of the hair follicle at the same angle and advanced in an oscillating motion to a depth of 4 mm or less to prevent transection.
• The FU is removed using delicate forceps in an atraumatic fashion and placed either directly into the recipient site (after inspection of FU integrity) or a holding medium of chilled sterile saline.
• The patient then gets transitioned to a sitting position in preparation for recipient site implantation.
• NOTE: Modifications of the manual sharp FUE technique include the manual dull punch technique, the use of powered devices with oscillatory or rotating punches, or employing a vacuum apparatus to facilitate atraumatic extraction. Regardless of the technique used, a 5% transection rate is generally acceptable.

Recipient Site Creation and Implantation

• No matter the harvest technique used (FUE or FUT), the implantation process must also take place in an atraumatic and meticulous fashion. For instance, grafts should only be manipulated using the perifollicular tissue. Furthermore, grafting should be done expeditiously, since prolonged exposure of the FU will cause graft desiccation.
• Attention to the recipient’s hair pattern is important to promote a natural-looking result. For example, hair along the frontal scalp hairline points anteriorly at an angle of 15 to 20 degrees, while hair follicles in the temporal region are oriented inferiorly. Also, the surgeon should strive to recreate a sharp temporal recess in males and a rounded temporal recess in females. Lastly, the angles and spiraled orientation of the crown should be followed to create a natural result.
• The recipient sites for the FUs are then created in a random and irregular pattern under magnification using either flat-edged blades or a combination of needles (19 or 21 gauge), with care not to transect the native follicles.
• The graft is gently placed into the recipient site, with light pressure applied for several seconds with a wet cotton-tip applicator to promote hemostasis and to avoid graft extrusion or “popping.”
• An emollient or antibiotic ointment and a non-adhesive bandage are placed gently across the donor and recipient sites.

Miscellaneous

• ROBOT Follicular Unit Extraction: More recently, robotic devices have been developed with potential advantages including more accurate and faster graft harvesting, decreased FU transection rate, and increased implantation accuracy at the recipient site, though comparative studies are lacking. Regardless, the robot offers a promising technique to maximize HT outcomes.
• Facial Hair Restoration: While the focus of this article was to discuss the nuances of HT for the scalp, facial HT techniques may also be applied to obtain dramatic results when restoring facial hair such as eyebrows, beards, and sideburn

Hair transplantation aims to restore a more youthful appearance for those distressed by hair loss, particularly androgenetic alopecia. This activity reviews the evaluation and management of patients undergoing hair transplantation and explains the role of the inter professional team in improving care for patients who undergo this procedure

Objectives:

• Identify the anatomical structures, indications, and contraindications of hair transplantation.
• Describe the equipment, personnel, preparation, and technique in regards to hair transplantation.
• Review the appropriate evaluation of the potential complications and clinical significance of hair transplantation.
• Summarize interprofessional team strategies for improving care coordination and communication to advance hair transplantation and improve outcomes.

Anatomy and Physiology

t is essential to understand the relevant anatomy and physiology of hair, and the hair cycle, in order to maximize the outcomes of hair transplantation. Key elements in hair restoration include[5]:

• Hair follicle – composed of a hair shaft, two surrounding sheaths (inner and outer), and a germinative bulb. The follicle divides into three sections: infundibulum (from the skin surface to the sebaceous gland duct), the isthmus (from the sebaceous duct to the arrector pili muscle insertion), and the inferior segment (from the muscle insertion to the base of the matrix) 
• Bulb – the deepest segment of the hair follicle which contains the hair matrix (creates the hair shaft), dermal papilla (regulates growth), and melanocytes (produce color).
• Terminal hair – thick, pigmented hairs at the top of the scalp, beard, axillary, and pubic regions, all of which are androgen-sensitive. The hair elsewhere on the body, including the parietal and occipital scalp, are androgen-independent.
• Vellus hair – this is fine, short, non-pigmented hairs (“peach fuzz”) found on the adult that covers much of the body.
• Follicular Unit (FU) – a naturally occurring group of hair(s) seen on the scalp consisting of several terminal hairs (usually 1 to 4), a sebaceous gland and duct, and an arrector pili muscle. The collagen band which surrounds the FU is called the perifolliculum

Clinical Significance

Hair transplantation represents a powerful tool that can restore a more youthful appearance to those affected by androgenic alopecia. When performing hair transplantation, proper patient evaluation and execution of a comprehensive treatment plan can produce safe, reliable, and satisfactory outcome

Nursing, Allied Health, and Interprofessional Team Monitoring

Close follow-up during the initial post-operative period, either by a wound care nurse and/or clinician experienced in the post-operative care of HT, should monitor the patient for possible complications including infection and ingrown hair formation. The patient should receive counsel that loss of the implanted hairs normally occurs after several days and may take several months to grow. There may also be surrounding native hair loss at the donor or recipient site, though the patient should understand that this “shock loss” is normally transient and to expect a full recovery after a few months