Jerry E. Cooley, MD
Dr. Jerry Cooley
Dr. Jerry Cooley and his staff were early adapters of using microscopes to do excellent all follicular unit hair transplantation.
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Robert J. Dorin, DO, ABHRS
Dr. Robert Dorin
Robert J. Dorin, DO has been a specialist in hair restoration since 2002 and a member of our network since 2006. He offers advanced FUE and FUT procedures as well as PRP therapy. Prospective patients seek out Dr. Dorin for his personalized care and ultra-refined results. -
What is Rogaine and how does it work?
Along with Propecia, Rogaine is one of the only proven hair loss medication options approved by the FDA for treating hair loss. Minoxidil, (Rogaine’s active ingredient), was originally created as a drug for treating hypertension (high blood pressure). It was then discovered that one of its side affects was growing hair. Minoxidil was then tested for use a topical application for regrowing hair. The results were sufficiently impressive that the FDA approved it as a treatment for hair loss.
Rogaine works by revitalizing shrunken hair follicles, thus increasing their size. When you use Rogaine every day, your follicles may increase in size, and the growing phase may become longer. This may then produce longer, thicker hairs.
Rogaine is a clear alcohol-based solution and should be applied to a person’s thinning area with its supplied dropper or spray twice a day.
The solution is approved and available in two strengths -- Regular (2%) and Extra Strength (5%). Individual users of Regular strength Rogaine have claimed success rates of 30-40%. Meanwhile, users of Extra Strength Rogaine have claimed success rates of 50-60%. Currently, the average price for a 2oz. bottle of Rogaine is about $20-30 per month. Minoxidil is also available as a generic and can be purchased over the counter without prescription.
It’s important to note that Rogaine (minoxidil) does not cure baldness and scientists have been unable to determine just how it works. What is known is that Rogaine increases the blood flow to the areas of the scalp that surround these balding areas. Currently some researchers believe that Rogaine (minoxidil) works by opening the follicle’s potassium channels located in the cells. It’s theorized that these channels, when opened, may regulate hair growth.
Rogaine can’t grow hair on completely bald scalps or in the frontal hairline areas. It has been found to be somewhat effective in maintaining or growing hair in the crown area (the top back of the head). However, Rogaine is only effective at delaying hair loss. It is also more effective in women than in men. And again, the reasons for this are not understood.
What can I expect with Rogaine?
Rogaine (minoxidil) generally only regrows hair in a minority of men and women. In most cases, the best case scenario for hair growth with these treatments is a thin coverage of thin hair.
The real benefits of Rogaine (minoxidil) is keeping what hair you have or slowing your thinning. Rogaine’s success depends on how advanced your hair loss has become.
You must apply it to your scalp twice a day for life to get and maintain any benefits. Research shows that using Rogaine (minoxidil) only once a day is ineffective. If you stop taking Rogaine (minoxidil) you will loose whatever hair you preserved or regrew within 2 to 4 months. And while Rogaine may stimulate hair growth, it may not prevent the hair follicles from their eventual deterioration.
It's also true that Rogaine's effects may diminish over time. Some doctors believe that patients can build up a tolerance after many years of use. But it's possible to fight this tolerance by taking a week or two off from the treatment every 3-4 months. However, it's not advised to take this break unless you've taken the hair loss medication consistently for at least 12 months.
Are there side effects from Rogaine?
There are only minor side effects with Rogaine. But some users do experience certain problems such as scalp irritation, itching, and dandruff. However, this can be treated with a good shampoo like Nizoral or Neutrogena T-Gel. There may also be an increase in hair shedding at the start of the treatment. You shouldn’t panic, as this may actually be a signal that the treatment is working.
Due to the medication’s alcohol content, some users may develop a contact rash or irritated skin. And with excessive doses, some users may experience dizziness or a rapid heartbeat. However, with normal use these effects are uncommon.
Rogaine users with severe, refractory high blood pressure experienced some problems. One such problem was “hypertrichosis,” hair growth on the face or other bodily areas. This side effect appears in about 3-5 % of women who use the 2% solution, and higher among women using the 5% solution.
Rogaine and Hair Transplants
Some hair restoration physicians have come to consider Rogaine to be instrumental right after surgery. This is especially true when grafts have been placed in and around existing hair.
The shock of surgery can result in temporary hair loss. Rogaine is thought to possibly help prevent this temporary loss of healthy preexisting hair. The 5% solution has been found to be more effective for men and women. However, some physicians believe that the hair loss medication should be stopped a week or two before surgery. They feel that Rogaine may increase bleeding, while dilating blood vessels.
After surgery, most patients wait a week or two before restarting Rogaine. This gives the graft areas time to heal. However, taking Propecia is not interrupted by surgery.
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Find a Hair Restoration Treatment and Physician
Reviewed by Hundreds of Patients!
This Learning Center offers in-depth reviews of hair loss treatments and the leading physicians who provide them. Today, there are treatments that can stop or even reverse hair loss. Hair transplant surgery, when done right, can now produce results so natural that even hair stylists cannot spot them.
But it is critical to choose the right hair loss treatment and hair restoration physician, since the skill, talent, and experience of physicians vary widely, as do their results.
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Recoverup: A Revolutionary Stem Cell Treatment or Hair Loss Hype?
It seems that lately, new hair loss treatments based on “revolutionary scientific research” hit the rumor mill on a monthly basis. Some of these treatments come to light via reputable scientific journals while others, like Recoverup, materialize one day with a flashy website, a lot of promises and very little verifiable data. Recoverup is a UK based company that claims to offer stem cell treatments for hair loss through clinics in Taipei, Taiwan and Penang, Malaysia. According to their website, this treatment is so quick and easy it can be performed in a single day with startling results visible in only one month. Does this sound too good to be true?
Recoverup’s baldness treatment process claims to rely upon Autologous Adipose Adult Stem Cells (AAA). Unlike controversial embryonic stem cell treatments, Autologous Adipose Stem Cells are derived from the patient’s own fat cells through a small liposuction procedure and are then grown into a culture to increase volume. These stem cells are then “differentiated” with “growth factors” and injected into the scalp in order to induce new hair growth. This multistage process from extraction to injection can be performed in two appointments scheduled in the same day.
The question is, does Recoverup’s baldness treatment really grow hair? They state that “Empirical data indicates patients would expect to see at least 40% of all treated areas showing one of four results; (1) darker hair (2) thicker hair (3) faster growing hair or (4) more hair per follicle. Overall the effect is of more volume, and density, in those areas which were treated.” However, the Recoverup website offers very little in the way of photo documentation. The few photos that are presented are of poor quality and covered in text making them very difficult to evaluate.
The estimated cost for the one day hair loss treatment is between $8,000 and $13,000 depending upon the area to be treated. However, if the area to be treated is sufficiently large enough to merit a second day of treatments then this fee increases. Recoverup states that the long-term effects of the treatment are unknown and are dependent upon such factors as the patient’s age and quality of the source stem cells. “However, as a general guide, in other areas of stem cell treatment, data indicates approximately 3-5 years of positive results from each treatment.” Recoverup does offer a 30-day money back guarantee if a patient experiences no new hair growth but is also quick to point out that the results will vary. One can imagine quibbling over whether or not a single follicle that didn’t appear to exist prior to treatment would constitute success under their definition. In summary, assuming Recoverup’s AAA stem cell treatment does stimulate hair regrowth, a patient can expect to pay upwards of $13,000 plus travel expenses to Asia for a treatment that is, by their own estimates, about 40% effective and may last between 3 and 5 years. This hardly sounds like an attractive alternative or even supplement to today’s state of the art, ultra-refined follicular unit hair transplantation combined with the clinically proven medical treatments Propecia (finasteride) and Rogaine (minoxidil). It is recommended that patients approach all unproven, “revolutionary” medical treatments with cautious optimism. Androgenic alopecia is progressive and avoiding proven surgical and medical treatments in favor of experimental procedures may lead to further hair loss.
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Surgical Hair Restoration - View our procedures in detail
Our physician members perform a very refined hair transplant procedure called "Follicular Unit Hair Transplantation". Today there are two methods for doing this procedure. They differ only in the methods used to harvest and prepare the grafts.
Follicular Unit Extraction Video is provided courtesy of Dr. Alan Bauman.
How the follicular unit extraction (FUE) hair transplant procedure is different than standard strip excision hair transplant surgery.
How the minimally invasive hair transplant procedure known as Follicular Unit Extraction or FUE is performed.
How follicular unit grafts are created under microscopic dissection and then placed into tiny incisions in the balding areas.
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Dr. Tsvetalin Zarev
Dr. Tsvetalin Zarev
Dr. Zarev performs gigasession hair transplant surgery with an extremely high yield and density. He can restore extreme cases of baldness with density and coverage. -
Spectral.DNC by DS Laboratories: A Breakthrough Hair Loss Treatment?
As the field of medical hair restoration continues advancing and evolving, hair loss sufferers look toward new, cutting edge clinics and corporations for faster, more effective, and less invasive hair loss treatments. In various but not all cases, the breakthroughs achieved through oral medications and topical solutions (seen in proven hair loss treatments like Rogaine (minoxidil) and Propecia (finasteride) are fantastic. Thus, hair restoration entities continue striving to create the next advancement and bring the world closer to a “hair loss cure.” However, for each hair restoration treatment that’s proven safe, effective, and efficient, it seems as if a dozen others are rejected for being unproven, inefficient, or unsafe.
For this reason, it’s always advantageous to thoroughly research the newest hair loss solutions and determine whether they are safe and effective, or if they fail to live up to the high expectations set by the current gold standard treatments such as proven solutions Propecia and Rogaine. Below, we evaluate whether Spectral.DNC, a topical solution created by Divine Skin Laboratories (DS Laboratories) can help stop hair loss and regrow hair.
Spectral.DNC is a topical treatment formulated by DS Laboratories which claims its “the world’s most effective topical hair loss treatment.” But can Spectral.DNC live up to these lofty claims and offer a more effective solution, or will it suffer the fate of many therapies before it and fail to gain the approval of the hair restoration patient community?
According to DS Laboratories, Spectral.DNC is applied (as an atomized mist or liquid) to the balding scalp twice daily, once in the morning and once at night. Along with a series of vitamins and herbal supplements (herbal extracts, copper peptides, and a vitamin complex), the active ingredients in Spectral. DNC are 5% minoxidil, Aminexil (SP94), and Retinol. Since minoxidil is also the proven, active ingredient in topical Rogaine, Divine Skin utilizes a frequently asked questions feature on its website to explain how Spectral.DNC is different and more effective than minoxidil. According to Divine Skin, it’s the two other active ingredients – Aminexil and Retinol that make Spectral.DNC more effective than Rogaine.
Aminexil (or Aminexil SP94) is a compound currently featured as an active ingredient in a line of healthy hair shampoos by L’Oreal. Aminexil is allegedly helpful in the treatment of perifollicular fibrosis – a pre-mature aging of hair shafts caused by inflammation and an overproduction of collagen proteins. It’s worth noting that while some reputable sources have researched its connection to perifollicular fibrosis, it hasn’t been conclusively linked to hair loss (especially androgenic alopecia hair loss), nor is Aminexil proven to treat perifollicular fibrosis. Furthermore, Aminexil is not recognized or approved by the United States Food and Drug Administration (FDA) as a treatment for any type of hair loss.
DS Laboratories indirectly counters these statements by sharing the results of a “worldwide” study which demonstrated an 8% increase in hair growth and a 6% increase in hair shaft diameter in hair loss sufferers using Aminexil (compared to a placebo group). This study however, is not without its limitations. This study was conducted in 1994, only contained 130 participants, lasted for 42 days, and doesn’t appear to be published in any sort of peer reviewed publication. Because of this, it’s difficult to evaluate whether or not the addition of Aminexil as an improvement over simple 5% minoxidil. But what about the Retinol?
Retinol (and its derivatives) is a form of Vitamin A, often used in medical dermatology for maintaining healthy skin and treating specific types of acne. Allegedly, certain forms of Retinol act as hair restoration drugs (after periods of long term usage) by preventing hair loss hormones from binding to target receptors and killing healthy hair follicles. While evidence of these claims was difficult to find, many Retinol users claim that the drug is harsh on skin and utilizing it in the scalp would cause irritation and require small, likely ineffective dosages. Much like Aminexil, there’s no solid evidence to suggest that Retinol makes Spectral.DNC a more effective hair loss solution than Rogaine or other minoxidil related products. Interestingly enough, while copper peptidesare listed as in inactive ingredient, research supports that copper peptides may play a role in transforming thin vellus hairs into thicker terminal hairs, increasing follicular size, and regenerating healthy scalp skin. However, because copper peptides aren’t listed as an official “active ingredient” by DS Laboratories nor do we know its concentration, it’s difficult to gauge its efficacy within Spectral.DNC.
The only proven and FDA approved ingredient in Spectral.DNC is 5% minoxidil. While minoxidil is safe and efficient, it’s unclear what the additional ingredients in Spectral.DNC may actually accomplish. Furthermore, the cost of Spectral.DNC runs between $35.00 and $45.00 for a month supply, compared to around $ 25.00 for a three month supply of generic 5% minoxidil. According to DS Laboratories, the only known side effects revolve around minoxidil (which are no different than those associated with Rogaine). Although minoxidil is relatively safe and effective, it’s been used as a hair loss treatment for decades.
Those hair loss sufferers considering using Spectral.DNC as a treatment for thinning hair can feel confident knowing that they will, at the very least, obtain similar results to using minoxidil 5%. Until the other active ingredients are peer reviewed, whether or not Spectral.DNC is more effective than Rogaine 5% is mostly conjecture.
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What Causes Hair Loss?
As you see yourself balding, while others retain their hair, you may ask - why me?
The basic answer is – your hair loss is due to your genetic make up. Your thinning hair is not due to anything you have done, whether wearing too many hats, washing your hair too much or too little or any other hair loss myths. Alopecia or hair loss is primarily genetic and is referred to as "Androgenetic Alopecia" in the medical community.
Your hair's future is largely determined before you're even born. Your follicles have been genetically programmed as to when, where and how much baldness (if any), you'll experience in your lifetime. But the fate of your hair can be altered or compensated for with modern hair loss treatments.
So what are the specific causes of hair loss?
Baldness is largely the result of certain hormones interacting over time with those hair follicles that are vulnerable to their effects.
Both men and women produce "male" hormones. The three most common are testosterone, androsteinedione, and dihydrotestosterone (DHT). Hair follicles, as well as the sebaceous glands, contain high levels of an enzyme called 5-alpha-reductase. This enzyme converts testosterone into DHT, via the blood. DHT is the source of most male pattern balding.
In some people, their follicles on the top of the head are genetically vulnerable to baldness. Over time, these genetically vulnerable follicles are acted upon by the hormone DHT. This hormone binds with the receptor sites of these vulnerable follicles and cause the hair follicle to weaken over time. Propecia is a drug that has been shown to slow the creation of DHT and can be helpful in slowing, stopping or in some cases, reversing hair loss when it is used early enough.
Hair grows naturally in cycles of approximately 3 to 8 years. At the end of the growth cycle, the hair shaft is shed from the follicle and a new hair grows. With thinning hair or balding, each successive growth cycle is shorter and the hair produced is thinner and finer. This is called 'miniturization'.
Men and women don't go bald overnight, it is a slow progression of thinning hair and hair loss that eventually produces baldness. In many cases, the balding has progressed to such a stage that hair loss treatment products aren't enough to reverse the balding process.
Few treatments have the dramatic effect of restoring hair like hair restoration surgery. Click here to learn more about hair restoration.
Not all hair loss is permanent. There are many causes of temporary hair loss that can be treated with diet, stress reduction and a visit to your doctor. Click here to learn about other causes of hair loss.
Androgenetic Alopecia
And rogenetic Alopecia, commonly referred to as 'genetic balding', is the main cause of male and female hair loss. This genetic 'programming' accounts for 95% of male hair loss.
For baldness to occur three factors need to be present:
1.The presence of and rogens, or male hormones.
2. A genetic pre-disposition to balding.
3. Time for the DHT to degrade the vulnerable hair follicles.
While they comprise less than ten percent of permanent hair loss, there are several other Causes of Hair Loss like stress, nutrition, health, age and hormones, that can cause temporary as well as permanent hair loss.
There are also several categories of treatments for hair loss which include drugs, topical lotions, hair care products, hair replacement systems and hair restoration surgery. To learn more about each, please visit our Hair Loss Treatment section.
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Dr. Rafael De Freitas
Dr. Rafael De Freitas
Dr. De Freitas is an expert in performing Follicular Unit Extraction (FUE). He's regarded as one of the world's best FUE surgeons. He performs dense-packed ultra-refined follicular unit grafting at an affordable price.