The Power of Analogies in Dermatology
WDS Editorial Highlight
By Nicole Rogers, MD
I love analogies. I try to use them every day in my private practice, multiple times if I can. I use them with my patients. I use them with my nurses. I even try to use them with the cleaning people if they let me.
My practice is devoted to treating hair loss. We offer both medical hair loss and hair transplantation (surgery). And, living in New Orleans, we have lots of colorful expressions to use. Watching the trends over the years as new devices enter the market is not as exciting as using lasers in dermatology but for me the fun is educating my patients about the nuances of the hair follicle cycle, learning new FUE (follicular unit extractions) techniques, and seeing how we can optimize the role of PRP (platelet rich plasma) in treating hair loss.
I love it when patients say things like, “I started that new hair supplement and immediately my hair felt different all over!” Really? Do they really think that an over the counter supplement taken for 2 weeks will alter the quality of their hair 12 inches away from their scalp? But alas, I try not to roll my eyes. Instead, I patiently try to educate them. One of my first analogies was explaining how making changes to your hair was like driving a big ship down the Mississippi River. We may make a small turn at the helm but it often takes 3 or more months to slowly turn the boat in the right direction.
When explaining male and female pattern hair loss, I show patients the variation in hair caliber and explain how it is a “dirty trick on God’s part” because they are getting “less bang for their buck.” Not only are the hairs coming in finer and thinner, but they are also growing for a shorter period of time. They laugh when I say, “You know how hard you are working at your job/school/etc? Well this is what your follicles are doing.” And then I lean back in my stool and put my feet up on the counter. “Your follicles are getting lazy! So you need to tell them who’s boss!”
Telogen effluvium can often unmask an underlying male or female pattern hair loss. When they first present with such massive shedding I liken their situation to a plane crashing. “Imagine,” I say, “the plane is losing altitude, your hairs are coming out, flames are coming out, and so the first thing we have to do is stabilize the plane (halt the hair loss) and then we can work on regaining some altitude (regrowing some hair). We can’t get that hair to come back overnight.
My favorite is when they say, “But Doc! If I keep going at the same rate I am I am going to be BALD!” and I try to remind them that their hair is like the stock market. They are going to have good days, and they are going to have bad days. But so long as they are on some kind of medical therapy it will continue to hopefully trend upwards in the right direction (toward regrowth).
Recently we operated on a gentleman who was in the crawfish business. For those of you outside Louisiana, this is a fragile business because they only harvest once per year and people like to buy them live for their weekend crawfish boils. He asked, “How do you keep those grafts live while they are out of the body?” And I said, “Well, just like you have to worry about minimizing the time your crawfish are out of water, we have to minimize the time your grafts are out of the body. Those follicles don’t like drying out, or getting pinched, or sitting in sun. We keep them moist and well-hydrated, just like your crawfish!”
Comments
Post a Comment