• Saw Palmetto

    Saw Palmetto

    The "Active" Ingredient in Many Popular Hair Loss Treatment Products

    Many popular hair loss treatment options today such as Provillus, Procerin, and Avacor contain the “active” ingredient saw palmetto. It can also be purchased as a standalone supplement in most nutritional stores. But the age old question of whether or not it can effectively treat baldness in men and women with alopecia is still heavily debated. By taking a look at the scientific evidence available we are able to draw some conclusions as to its potential benefit for those with thinning hair.

    What is Saw Palmetto?

    Saw Palmetto berries are a deep red fruit that grow wild on palm trees in warmer climates, typically found in the Southeastern United States. The liposerolic berry extract is typically used as an herbal supplement for the promotion of a healthy prostate.

    Saw Palmetto Hair Loss Study:

    Similarly to finasteride (the active ingredient in Propecia and Proscar), studies have shown that when taken orally, it may be an effective anti-androgen by lowering dihydrotestosterone (DHT) levels in the body by blocking 5 alpha-reductase enzymes. Additionally it is said to block receptor cites on cells which is required for cells to absorb DHT.

    Tests have also been performed on its use in the treatment of benign prostatic disease, which similarly to androgenic alopecia, depends on the production of DHT.

    It is also noteworthy to state that a small preliminary study in 2002 was performed as reported by The Journal of Alternative and Complementary Medicine(2002;8:143-52) that shows a select group of 19 men between the ages of 23 and 64 taking either (400mg of saw palmetto and 100mg of Beta-sitosterol) or a placebo orally. Those who took the herbal combination had 60% improved hair growth over those who took the placebo. There have been no studies to date indicating the efficacy of saw palmetto applied topically for male pattern baldness, female hair loss, or anything to date.

    In our opinion, there are two potential difficulties with this study:

    • Many scientists would argue that the control study group was too small to determine any real efficacy and improved hair growth could have happened by chance. A larger study therefore may be necessary to determine any level of real efficacy.
    • “Improved hair growth” is not the same thing as newhair growth and hair regrowth, nor should it necessarily imply that it works to stop hair loss
    • There are no regulations or suggested daily value as to how much saw palmetto would be required to successfully treat baldness. The appropriate dosage therefore is questionable.
    • The above study was only performed on saw palmetto taken orally. Hair loss products that promote topical use for baldness are basing their belief in its efficacy on something other than published clinical evidence.

    The Dosage:

    But if there are no current standards on dosages of herbal medications in the United States, how do these popular hair loss treatments produce an appropriate dosage?

    Clinical studies on Benign Prostrate Hyperplasia (BPH) have used a dosage of 320mg of the berry extract daily (either one 320mg pill or 2 X 160 mg pill). A daily dosage of 480 mg of saw palmetto berry extract was not found to be any more effective in a six-month study. If the entire berry was used, up to 1000mg or 2000mg would be required to reach the same goal.

    The theory therefore is that if saw palmetto can successfully treat an enlarged prostate similarly to finasteride, it can effectively treat hair loss with a similar dosage Many popular “baldness cure” products contain approximately 1500mg of the berry which is equivalent to approximately 240-320mg of the berry extract.

    Side Effects and Warnings:

    One false assumption is that “all natural” treatments don’t have potential side effects. It is stated that use of saw palmetto has not proven to be safe for women with hair loss during pregnancy and lactation. Medical supervision is suggested for women of childbearing age. Similar warnings are listed about Propecia.

    Conclusions:

    Based on some anecdotal evidence, saw palmetto is said to treat baldness because of its tendency to act like finasteride by helping those suffering from BPH. However, authentic clinical studies have not been performed to date that support this claim. Dosage and how it should be used (orally or topically) therefore is based on conjecture rather that scientific evidence.

  • Recoverup: A Revolutionary Stem Cell Treatment or Hair Loss Hype?

    Female hair loss

    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.

  • Viviscal Hair Loss Treatment Product Review - Can it Really Promote New Hair Growth?

    Viviscal Hair Loss Treatment

    Viviscal's hair growth vitamin and dietary supplement taken twice daily promises to "reverse hair loss" and grow thicker hair in both men and women experiencing balding and thinning hair.  Its primary activeingredient, AminoMar C™ Marine Complex, is said to be a proprietary blend of ingredients and proteins that "provides the essential nutrients needed to nourish thinning hair and promote existing hair growth".

    The entire Viviscal product line includes an "all natural" dietary supplement, a shampoo and conditioner, and a scalp lotion.  Viviscal is promoted as being 100% natural, drug-free, gluten-free and safe from harmful side effects. But can Viviscal deliver on its promises to reverse hair loss and grow new hair?

    In 2011, Viviscal advertisement was banned in the United Kingdom by the Advertising Standard Authority (ASA) who deemed that its claims to maintain optimum hair health were unproven. The ASA concluded:

    "Because the evidence sent did not show that the ingredients in Viviscal had been shown to have a positive effect on hair health, we concluded the claims that the product could 'nourish hair follicles' had not been substantiated' and ruled the advert cannot be broadcast until it is changed."

    However, as with many similar products promising to grow hair, substantiating their hair growth claims may not be a simple task.

    Viviscal’s manufacturer does reference a number of studies that seem to support their claims of growing thicker hair. For example, the results of "Scientific Pilot Study #1" on 40 hair loss suffering females with an average age of 35 concluded, "Viviscal was well received by test subjects and the analysis of hair counts showed a mean reduction in hair loss of 46% in only 10 weeks." Additional studies are cited on Viviscal’s website.

    Recently, we learned that Dr. Glenn Charleshas publicly endorsed Viviscal.  Dr. Charles has an outstanding reputation for performing state of the art hair transplant surgery and is a highly esteemed member of the Coalition of Independent Hair Restoration Physicians.When asked to comment on his public endorsement of Viviscal, Dr. Charles stated:

    "I have never had any hair loss patients display any negative effects. I describe it to my patients as a natural supplement that can promote a healthier scalp and hair. It may also, in turn, slow down the hair loss process. I tell all my patients that there are no guarantees with this product.  Although most patients believe that they did have improvement after using this product, I admit that some patients do not see any noticeable changes that either they or I can identify."

    Other hair loss experts are not as optimistic regarding Viviscal’s hair growth potential. Coalition member Dr. Bill Rassmanof Los Angeles states:

    "I am skeptical of the photographs (results) and the changes shown make me doubt what the Viviscal marketing department wants me to see. Viviscal reportedly contains ‘special marine extracts and a silica compound’ - and yet I’m to believe this will regrow hair? If these photos were real, the product would have taken over the market years ago."

    It's also important to note that Viviscal does notmake any claims on their website that their products can reverse the effects of genetic hair loss.  Instead, it simply states, "Viviscal works to reverse hair loss due to stress, poor nutrition, and many health related ailments".

    So is Viviscal an effective hair loss treatment? More research may be needed before this question can be effectively answered. 

    While there may be no harm (potential side effects) in trying it, at an average cost of $600 per year there are certainly more affordable and proven treatments available. The only clinically proven and FDA approved medical hair loss treatments currently available are Rogaine (minoxidil) and Propecia (finasteride). While Rogaine may be used by both male and female patients, Propecia is safe and approved only for male hair loss sufferers. Always consult your physician before adding any treatment to your hair loss regimen.

  • Revita Shampoo for Hair Loss

    Revita Hair Loss Treatment

    Revita ShampooThe new and revolutionary Revita Shampoo has all the right stuff to stop DHT and promote healthy hair growth. Revita contains the proven DHT inhibitor ketoconazoleand vitamins and minerals essential for nourishing and cleansing the scalp and hair, including the same copper peptide technology included in Tricominproducts.

    This product includes a 6 ounces or 180ML bottle with 1% of the active ingredient ketoconazole. To view the clinical abstract proving the effectiveness of ketoconazole in the treatment of androgenetic alopecia, view Ketoconazole as a hair loss treatment.

    Unlike Nizoral, the revolutionary Revita shampoo can and should be used daily. Revita leaves your scalp and hair feeling great daily with no signs of dryness or flakiness. It's also a magnificent volumizing shampoo, promoting maximum fullness.

    Developing Realistic Expectations:

    Men and women sometimes suffer from hair loss for different reasons. Thus, diagnosing its cause is necessary to facilitate and promote proper treatment.

    Don't expect immediate results. It's recommended to use Revita in conjunction with proven treatments for at least 6 to 12 months before determining its effectiveness. Documenting your progress with bi-monthly photos can help you determine whether or not Revita has been successful in helping you maintain existing hair.

    Hair shedding is a common symptom the first few months and a sign that Revita may be working for you. It's crucial to push past this stage with continued use for the recommended period of time.

    To date, only surgical hair restoration is proven to grow hair in completely bald areas. You are invited to have a free virtual consultation with one of our prescreened hair restoration physicians.

    Ingredients (Full List)

    Apple PolyphenolProcyanidin B2 & C1
    Copper Peptides
    Spin Traps
    Ketoconazole
    Rooibos
    MSM
    Caffeine 4%
    Carnitine Tartrate
    Amino Acids
    Emu Oil
    Biotin

  • Jerry E. Cooley, MD

    Dr. Jerry Cooley
    Dr. Jerry Cooley
    Dr. Jerry Cooley and his staff were early adapters of using microscopes to do excellent all follicular unit hair transplantation.
  • Ancient Greece – The quest for a hair loss “cure” continues.

    The quest for a hair loss “cure”

    It was Hippocrates, the “Father of Modern Medicine”, who first recognized a connection between hair loss and the sexual organs. Hippocrates’ studies of eunuchs (men castrated before puberty) observed that these men did not suffer from hair loss.

    We know today that this is due to the absence of testosterone, which is normally converted into dyhydrotestosterone or DHT – the active ingredient in baldness. In March 1995, Duke University researchers came to the conclusion that " . . . while castration may be a cure, it is not commercially acceptable."

    Hippocrates had a personal interest in finding a cure for baldness as he suffered from hair loss. He developed a number of different treatments including a mixture of horseradish, cumin, pigeon droppings, and nettles to the scalp. This and other treatments failed to work and he lost the rest of his hair. The area of permanent hair on the back and sides of the head (from which donor hair is taken for hair transplants) is also known as the “Hippocratic wreath.”

    Ancient Rome and Hair Loss

    Moving from Greece to the Roman Empire, we find that Julius Caesar employed a variety of methods to hide his thinning hair. In addition to the laurel wreath that he wore, he first grew his hair long in the back, and then combed it forward over his bald spot. Yes, the “Comb Over” is ancient.
    Learn how man has treated hair loss up to modern times.
    Being a Eunuch – the sure way to stop baldness

    In the 1940’s, the studies of Hippocrates and Aristotle were continued. Both men had concluded that eunuchs always kept all their hair.

    This finding was backed up by the work of Dr. James Hamilton.

    He discovered that certain male hormones (missing in eunuchs) were critical to the development of male pattern baldness.

  • Steven Gabel, M.D.

    Dr. Steven Gabel
    Dr. Steven Gabel is dedicated exclusively to performing ultra-refined follicular unit hair transplantation and follicular unit extraction with excellent results performed in the Portland area.
  • Rogaine 2% Liquid for Women

    Rogaine for womenRogaine for women is the most recommended treatment for hair loss on the market for women today, and the only FDA approved and clinically proven treatment available for female hair loss sufferers.

    Note: Despite what the insert says, Rogaine works just as well for frontal hair loss, recession, and thinning hair.

    This product includes the original 2% minoxidil solution manufactured over 15 years ago. While it only reports a 46% success rate as opposed to the 5% liquid solution's 64% and the foam's impressive 85%, Rogaine for women reduces the possibility of unwanted side effects, including the unpopular unwanted facial and body hair growth.

    How It Works:

    Rogaine works by stimulating the hair follicles and revitalizing them. This sometimes stimulates the regrowth of miniaturizing hairs, promoting a thicker and fuller appearance of hair.

    Developing Realistic Expectations:

    Rogaine for women is a good starting point for women with thinning hair. While it's not as effective as the 5% liquid solution or Rogaine foam, the possibility of side effects are reduced. Thus, women may want to start small and work their way up to the more advanced Rogaine solutions.

    Don't expect immediate results. Just as hair loss is a slow process, regrowing it is too. Thus, it's recommended to use Rogaine for approximately 6 to 12 months before determining its effectiveness. Documenting your progress with bi-monthly photos can help you better evaluate the results.

    Hair shedding is a common symptom the first few months and a sign that the medication may be working for you. It's crucial to push past this stage with continued use for the recommended period of time.

    To date, only surgical hair restoration is proven to grow hair in completely bald areas. You are invited to have a free virtual consultationwith one of our prescreened hair restoration physicians.

  • Damkerng Pathomvanich, MD

    Dr. Damkerng Pathomvanich
    Dr. Damkerng Pathomvanich
    Dr. Damkerng Pathomvanich and his experienced staff regularly perform large densely packed megasessions with outstanding results.
  • Trichotillomania and Treating Hair Loss

    Trichotillomania and Treating Hair Loss

    Men and women who have the impulse to pull their own hair out may be suffering from trichotillomania. Trichotillomania is an impulse control disorder characterized by the repeated urge to and behavior of pulling out one's own hair. Impulse control disorders resemble substance addictions because the patient feels out of control of his or her own behaviors. Men and women with trichotillomania live relatively normal lives but typically show signs of hair loss, thinning, and bald spots all over the scalp and body from pulling it out.

    Treating trichotillomaniagoes far beyond trying to stimulate hair regrowth.Even if Rogaineor laser therapy for hair losswere to regrow hair, there is a strong possibility that trichotillomania patients will continue to pull their hair out. Patients with trichotillomania therefore, should be treated at the source of the disorder in conjunction with using proven hair loss treatments.

    In addition to medication, Habit Reversal Training (HRT) by a trained counselor has proven to be successful in treating trichotillomania. With Habit Reversal Training, the individual is taught to recognize and redirect their impulse to other more constructive activities. Often times, trichotillomaniapatients are asked to keep a journal of their hair pulling episodes. This can help the counselor and patient to identify and develop strategies to avoid situations that might trigger hair pulling episodes. Journals often include the location of the incident, number of hairs pulled, date, time, and their feelings and thoughts during the episode.

    Treating a trichotillomania patient's baldness may be done simultaneously or after proper treatment of the disorder. Rogaine (minoxidil)can be a helpful aid to HRT by stimulating the follicles underneath the scalp, potentially facilitating or expediting hair growth.Treating a patient’s hair loss while they continue to pull their hair out is not constructive. Since this type of balding is not genetic due to the production of DHT, Propecia (finasteride)won't likely help.

    Patients who've suffered from trichotillomania for awhile may damage or even remove the hair roots by excessive pulling, making non-surgical hair regrowth next to impossible. Surgicalhair restorationmay be an option for trichotillomania patients whose hair roots are too damaged to produce new hair on their own. Hairrestoration surgeryshould be reserved only for patients who've been successfully treated and no longer suffers from trichotillomania.

    Catching and treating trichotillomania early will most likely reduce damage done to the hair follicles and eliminate the need for hair loss treatment, since undamaged hair will return on its own.