• Dr. Bessam Farjo

    Dr. Bessam Farjo
    Dr. Bessam Farjo
    The Farjo Hair Institute is a family run clinic solely devoted to performing excellent follicular unit hair transplantation in Manchester and London.
  • Menopause and Female Hair Loss

    Many cases of female hair lossare caused by hormonal fluctuations or changes in the body including those who have PCOS (polycystic ovarian syndrome), birth control pillside effects, a recent pregnancy,postmenopausal trauma, or menopause. Women with hair loss experience varying balding patterns These patterns can help determine the type of alopecia you have along with a thorough examination by a physician.

    Because of an imbalance between estrogen and testosterone due to declining estrogen levels, thinning hair and accelerated hair loss is common in women during menopause. Hair on certain areas of the head that is more sensitive to androgen hormones like DHT(associated with male pattern baldness) may thin or fall out. Similarly, declining estrogen levels may result in unwanted facial hair growth.

    In some cases, polycystic ovarian syndrome(PCOS), may accompany menopause and hair loss.

    Be sure to speak with your doctor on the most effective ways to cope with menopause and minimize hair loss during this transitional time.

  • COUVRé Alopecia Masking Lotion: Product Review

    COUVRé Alopecia Masking Lotion

    For many hair loss sufferers, scalp "tinting" solutions are the most effective type of topical concealer. Tinting solutions like COUVRé, also commonly referred to as "masking lotions" or "concealing lotions," eliminate the contrast between thinning hair and the bald scalp by naturally darkening the skin and matching the tone to one's existing hair. By matching bald scalp to an individual's natural hair color, the harsh contrast of thinning hair is eliminated, and a fuller, denser appearance is achieved.

    Although several types of masking lotions currently exist, one of the most popular and trusted is COUVRé. However, what makes COUVRé distinct from other masking lotions, or different types of concealers in general? Is COUVRé a quality concealer for both hair loss suffering men and women? Most importantly, what are other concelears users saying, and where can balding individuals purchase their own supply of COUVRé masking lotion?

    COUVRé: What is it, and how does it work?

    Unlike comparable "shaker" application products (such as Toppik – a popular topical applicator product from the same makers as COUVRé), COUVRé is a tinted lotion, meant to minimize the contrast between dark, thinning hair and the balding scalp. According to the manufacturers, COUVRé is applied to the scalp using a specialized sponge applicator. Once the masking formula is on the scalp and providing sufficient camouflage, users are instructed to simply style hair normally and go about their day.  The manufacturer of COUVRé assert that the application appears subtle, natural, will not appear "greasy or sticky," will not stain clothing or towels, and does not interfere with pores or affect natural hair growth.

    The Benefits of COUVRé

    According to both the manufacturers and satisfied users, COUVRé offers various benefits over comparable concealer products. First, because the makers of COUVRé are confident in the product, they ensure that, unlike some other concealers, COURVe will create a natural appearance without looking greasy or sticky, and does not clog scalp pores or interfere with existing hair shafts. Because of this, not only is COUVRé useful for those with thinning hair, but also for patients awaiting new growth from hair transplant surgery. What's more, COUVRé does not contain any harmful chemicals, can allegedly withstand perspiration, rain, wind, and even physical contact (such as touching the scalp).  COUVRé comes in 8 different colors/tones (to match all hair types) and is equally effective in both male and female hair loss sufferers.  Although COUVRé will withstand a variety of situations without smearing or smudging, it easily washes completely away with water and shampoo.

    COUVRé Color Chart COUVRé Colour Chart

    Why COUVRé has Become Popular and Trusted within the Hair Restoration Community

    While COUVRé does offer many benefits above other concealer products, its popularity and reputation within the hair restoration community is likely due to several important factors. First, unlike some other concealing products, COUVRé application is both simple and fast. For many individuals, the ability to naturally conceal thinning hair without spending an excessive amount of time "getting ready," is a huge benefit. Furthermore, because COUVRé contains natural ingredients and does not interfere with native or implanted hairs, it is safe to use with other proven hair loss medications (like Rogaine/minoxidil and Propecia/finasteride) and during the new growth phase of hair restoration surgery. Because of its ease of use, effective nature, and ability to conceal hair loss in a variety of situations, COUVRé has become a reputable hair loss treatment and remains popular within the hair restoration community.

    What Real Hair Loss Sufferers are Saying About COUVRé

    To read real reviews on COUVRé alopecia masking lotion from other hair loss suffering men and women, visit our hair loss forum and social community.

  • The Future of Medical Hair Restoration

    Hair Restoration Future

    Today's evolutionary high point - Ultra Refined Follicular Unit Transplantation

    By relocating these carefully prepared bald-resistant follicular units, physicians doing "follicular unit hair transplantation" recreate a natural pattern of hair in the balding areas.

    To do this properly is a very time consuming and exacting process. It requires a team of meticulous medical technicians working hand-in-hand with the hair transplant surgeon in a very lengthy surgical procedure.

    Ultra Refined Grafting - Smaller Blades, Smaller Incisions, Smaller Grafts

    Today's micro surgical blades, like the size of hair grafts, have become ever smaller and now enable hair transplant surgeons to safely make more tiny graft incisions in a given area then ever before. Surgeons are then able to "dense pack" select areas with as many as 40 to 60 follicular unit grafts per square centimeter. This graft density is as much as twice that of the standard follicular unit hair transplant procedure.

    Such high densities of transplanted hair typically produce the appearance of fullness even after only one surgical session. Patients also experience rapid healing and no visible skin distortions due to the tiny size of these incisions.

    Ultra Refined Follicular Unit Grafting - Hard on the clinic but easy on the patient.

    Ultra refined follicular unit grafting raises the bar for physicians and their staff. This delicate and demanding hair transplant procedure requires more skill and careful attention to be performed properly. The smaller and more tightly packed incisions require more closely dissected follicular unit grafts that are carefully trimmed under microscopes. These small and densely packed incisions are also more difficult to place the grafts into.

    This procedure also requires more careful patient selection, as "dense packing" of grafts is not appropriate for all patients.

    Ultra Refined Follicular Unit Transplantation - the new "Gold Standard"

    In the hands of a highly skilled physician and staff the Ultra refined follicular unit hair transplant procedure can achieve excellent new hair growth that is so natural that it is undetectable even under close scrutiny.

    While the standard micro "follicular unit" hair transplant does produce natural looking results, its ability to achieve high density in only one surgical session is limited. Thus patients may have to do subsequent surgical sessions in a transplanted area to achieve a full look.

    The many patient benefits of this new ultra refined procedure are significant and include:

    • The ability to get excellent hair density in only one surgical session.
    • Minimal trauma in the graft recipient area with rapid post surgical healing.
    • Little or no visible pitting or distortions in the transplanted areas.
    • More natural direction and angulation of the transplanted hair.

    All physician members of the Coalition perform Ultra Refined Follicular Unit Hair Transplantation.

    While many hair transplant physicians perform quality follicular unit hair transplants, only some of them are capable of performing large sessions of ultra refined follicular hair transplantation. However, all members of the Coalition of Independent Hair Restoration Physicians perform ultra refined grafting with excellent results.

    The Future of Surgical Hair Restoration

    The amount of hair you can transplant is ultimately limited by the amount of hair follicles you can safely relocate from the bald resistant donor area at the back and sides of your head.

    Some day it may be possible for physicians to create multiple hair follicles from one original follicle. This process typically called Hair Multiplication or more incorrectly Hair Cloning is currently being investigated by several research scientists and hair restoration physicians.

    If and when this process is successfully developed patients would no longer be limited by the finite amount of bald resistant hairs that can be relocated from their donor area. Hair multiplication would result in a virtually limitless supply of hair available for hair transplants.

    This would be especially good news for men or women with extensive baldness and a very limited supply of donor hair. Even those with extensive baldness would theoretically be able achieve thick full heads of hair.

    However, experts believe that we are at least ten years away from hair multiplication being available, if even then. But perhaps some day scientists will be able to use gene therapy to halt the balding process without drugs or surgery.

    Learn about modern hair loss drug treatments that work.

  • 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.

  • Kevis 8 Hair Loss Treatment Product Review

    Kevis 8

    Kevis 8Is it Effective in Treating Baldness?

    Hair loss suffering men and women are always seeking new and credible treatments and with good reason. Medical science is still years from producing a true hair loss cure and current treatment options are vastly limited. Women with hair loss have even fewer options than their balding male counterparts when it comes to proven, non-surgical hair loss treatments. Additionally, there is no shortage of cunning charlatans waiting to take advantage of the unwary consumer. Thus, when a new product like Kevis Hair Rejuvenation Formula comes along claiming to be a “permanent” solution and “the most successful and potent hair loss treatment on the planet”, potential customers would be wise to remain skeptical.

    Kevis hair loss treatment is not an entirely new solution. In fact, their website states that it has been sold throughout Europe and Asia for over 25 years but has only been available in the United States for 15 years. This is simply the 8th generation of the formula; hence their new name Kevis 8. But how can such an impressive treatment exist for 10 years yet remain virtually unknown to roughly 70 million balding American men and women? What’s even more surprising is that Kevis claims that published clinical studies give this solution for baldness an average success rate of 92%. So why are so many people still seeking viable hair loss treatments today?

    Kevis 8 is a drug-free topical lotion developed and manufactured by Italian pharmaceutical company, Farmaka, and distributed by Kevis Rejuvenation Programs in North and South America and by Pfizer in Europe and Asia. As such, it does not come under the regulatory supervision of the United States Food and Drug Administration (FDA). It is applied directly to the scalp and can be used by both men and women. Ingredients are listed as:

    Water, SD Alcohol 40-c+SD Alcohol 3-c, Propylene Glycol, Hydrolized Glycosaminoglycans (Thioglycoran), Panthenol, Sorbic Acid, Methylparaben, Hyaluronic Acid (H.U.C.P.), Thurfylnicotinate HCL, Propylparaben, Sodium Hydroxide, Biotin, Fragrance.

    H.U.C.P is a high concentrate of pharmaceutical grade hyaluronic acid which purportedly aids in the breakdown of accumulated DHT in the follicle and creates a binding effect in the follicle's receptor sites preventing further DHT buildup. Kevis also lists the ingredient Tricozyme™. Tricozyme is a protein enzyme that they claim attaches itself to free-floating DHT molecules rendering them “inactive and inoperable”.

    Kevis claims that results from using their product are “permanent”. Once hair follicles are protected from the effects of DHT they will remain DHT resistant for life. Thus, their claim is that once the desired result is reached, there is no need to continue using Kevis.  This is a hefty claim considering all other non-surgical balding solutions are required to be used for life in order to experienced continued benefits.

    In an effort to demonstrate its efficacy, Kevis provides complete, downloadable copies of seven clinical studies conducted by various institutions in France and Italy and provides summaries of each. They also offer several before and after photos (including those of company founder and President Brian Reichenberg) and written testimonials. What seem to be conspicuously missing are references to third-party studies and publications in peer reviewed journals. Without these critical components it’s impossible to verify the company’s hair growth claims.

    Balding men and women may want to stick with clinically proven and FDA approved medical hair loss treatments.  For men those treatments are Rogaine (minoxidil) and Propecia (finasteride). Rogaine is also approved for use by females. However, women should not ingest or even come in contact with finasteride due to the risk of specific birth defects. Men and women who are unable or unwilling to use these drugs can find credible alternatives.

    When it comes to purchasing and using hair loss treatments, there is much more at stake than your hard earned money. Dedicating months or years to ineffective treatments may result in the unnecessary loss of valuable and irreplaceable hair follicles.

  • Azelaic Acid

    Azelic Acid

    Azelic AcidAn Active Ingredient in Several Topical Hair Loss Treatments

    Azelaic acid is a naturally occurring substance found in whole grains that contains a mild antibiotic designed to “clean” skin.  It is also said to be a potential inhibitor of 5-alpha-reductase in human skin.  A reduction of this enzyme may reduce the amount DHT (dihydrotestosterone) in the body and therefore, have a similar effect to finasteride; the active ingredient in FDA approved oral hair loss solution Propecia (finasteride). In theory, applying azelaic acid to the scalp may prevent or eliminate the binding of DHT to the hair follicle receptor, preventing hair loss and potentially stimulating hair regrowth.  Azelaic acid can be found in many prescription acne medication and topical hair loss products like Xandrox and Provillus

    Combining azelaic acid with FDA approved hair regrowth solution minoxidil in a single topical product in theory, may prove to be a more powerful hair loss treatment for androgenic alopecia than minoxidil alone.  This is why some conjecture that Xandrox may be a more effective treatment than Rogaine (minoxidil)

    Azelaic acid has not been clinically proven effective as a standalone treatment for treating genetic female hair loss and male pattern baldness. It has also been known to irritate the scalp when applied topically.  Though there is a low percentage, azelaic acid may interact with other medications.  Be sure to consult your physician before using azelaic acid while on other medications.

  • Dr. Ron Shapiro

    Dr. Ron Shapiro
    Dr. Ron Shapiro
    A true pioneer, with a worldwide reputation for outstanding follicular unit hair transplantations among both colleagues and patients.
  • Female Hair Loss - Treatment and Restoration

    Female hair loss

    Female hair loss, otherwise known as Female Pattern Baldness (FPB), affects 1 out of every 4 women in the United States. Recent findings have found that the incidence of FPB has been reported to be as low as 8% and as high as 87%. And, it does appear to be as common for women as for men. Most often, menopause is the most frequent time for hair loss in women to become apparent.

    For a woman to lose her hair can be even more troubling than for men. A woman with thinning hair is not generally accepted as part of the normal aging process. Society has come to expect a thick, luxurious head of hair as part of the attractiveness in women.

    While males and females can both experience thinning hair, they typically do not lose their hair in the same order or appearance.

    Women with thinning hair compared to Men

    Typically men observe their hair loss earlier, whereas women will first notice it in their late 20's through their early 40's. Female Pattern Baldness (FPB) is often seen during hormonal changes. These include the use of birth control pills, following childbirth, or during or after the time of menopause.

    Top view of patient
    Top view of patient, showing excellent growth of transplanted hair.

    In addition, men typically have localized areas (patterns) of thinning, whilein women this usually occurs as thinning across the top, or over an even wider area. When women have very diffuse thinning over much of their scalp they are generally not good candidates for hair restoration surgery. However, women with localized hair loss, similar to the typical male pattern baldness, can successfully undergo hair restoration surgery.

    Thinning hair in females is also characterized by an increase in the combination of normal thick hairs mixed in with finer, smaller hairs. This results in decreased density, and not total hair loss.

    A woman's hair has also been proven to be more sensitive to the effects of stress than men's hair. Stress can result in hair loss in women and men. But this type of loss is not female pattern baldness. Rather, it is known as “telogen effluvium.” This type of hair loss is the shedding of hair in the resting phase when the body senses that it needs to divert its energies elsewhere. Therefore stress can temporarily changes the amount of hair that is shed. But the lost hair is likely to grow back.

    The production of the hair loss-inducing androgens is also different among men and women. A woman produces a small quantity of androgens in the adrenal glands and the ovaries. The ovaries also produce pre-hormones, which are then converted to androgens on the outside of the ovaries or adrenal glands.

    Generally speaking, a woman with hair loss will probably not experience total balding in a given area. But if there is total hair loss, this is most likely a sign of a previously hidden disease. For this reason, it’s important for females to have their hormone levels checked by a physician if they are experiencing heavy hair loss.

    Finally, men and women react differently to various hair loss treatment options. In men, hair loss may be halted or even reversed by finasteride (brand named "Propecia"). However, Propecia is not safe for females or children. Minoxidil (Rogaine) can be effective for both men and women in treating hair loss.

    However, for some women the causes of their hair loss are much more complex than the classic "male pattern baldness". Thus proper diagnosis of the underlying cause is vital before any hair loss treatments are attempted.

    The following physicians are nationally well known experts in female hair loss. Feel free to contact them.

    David Whiting in Dallas, Texas - 214 824-2087

    Vera Price in San Francisco, California 415 353-4163

    Maria Hordinsky in Minneapolis, Minnesota 612 625-1493

    Wilma Bergfeld in Cleveland, Ohio 216 444-5722

    For a web community that is dedicated to female hair loss visit HerAlopecia.com

  • Carlos K. Wesley, M.D.

    Dr. Carlos Wesley
    Dr. Carlos Wesley
    Dr. Carlos Wesley is a board certified diplomat of the ABHRS and performs high quality follicular unit hair transplants with excellent results in NYC.