Over the past several years surgeons have used various techniques to perform follicular unit hair transplantation. One such technique is the Lateral Slit Technique, also known as Coronal or Perpendicular Grafting. This technique’s name is derived from the angle and direction in which the graft incisions are made.

While there are other techniques for performing densely packed and highly refined follicular unit transplantation, the lateral slit technique offers a high degree of control over the angle and direction in which the transplanted hairs will ultimately grow.

The lateral slit technique has been used both intuitively and systematically for years by hair restoration physicians. However, it has recently gained popularity as a systematic and precise way of performing follicular unit hair transplantation.

How our member physicians use the Lateral Slit Technique.

Many of our physician members use the Lateral Slit Technique exclusively or in combination with other techniques for creating graft incisions. The lateral slit technique enables a surgeon to create graft incisions at varying angles (ranging from 10 to 90 degrees to the scalp), including very acute angles that will make the transplanted hair grow out lying flatter to the scalp. The ability to create incisions at very acute angles is particularly useful in areas such as the front temples and sides where the hair normally grows out lying flat on the scalp.

The graft incision determines the direction of the hair growth

The lateral slit technique also helps enable a surgeon to determine the direction of the graft incisions. This then determines the ultimate direction of the transplanted hairs growth. Thus a surgeon can use this technique to control and vary both the direction and angle at which the transplanted hair will grow in order to mimic the subtle changes in hair direction that occur naturally.

Each graft incision is created by analyzing the neighboring hair so the surgeon can reproduce the correct hair pattern. As a result, as each transplanted hair emerges from the scalp it will grow and lay in a similar direction as its neighboring non-transplanted hairs.

Lateral slits can enable denser packing of grafts

Lateral slit incisions also tend to be more parallel to the scalp and thus more superficial and less invasive to the scalp’s underlying vascular structure. This parallel alignment also enables a physician to place more grafts per square centimeter with out the grafts compressing or popping up since the pressure exerted on the grafts does not push them upward from the scalp.

Using blades cut to the size of the grafts

Some of our members use custom blade cutters to create tiny blades to make incisions that match the size and depth of each follicular unit graft being transplanted. This enables a surgeon to safely dense pack more grafts into a given area during a surgical session. Healing time is also more rapid, with minimal scarring.

Typically most clinic’s blades range from 1.5mm to 2mm in size. However, by using the custom blade cutter our physicians can create blades as small as .7mm for a single hair graft and .9mm for a multi hair graft.

In addition, the blades created by the custom cutter are squared off to match the shape of the bulb end of a hair follicle. Non custom cut blades are typically spear pointed which requires them to be inserted deeper thus causing more trauma to the scalps vascular structure.

The ability to control the depth of the incision each blade makes is also critical. Each blade is placed in a blade holder that is set to not allow the blade to go any deeper than required for the graft to being placed in the incision. This minimizes unnecessary trauma to the deep vasculature of the scalp, thus enabling close tight incisions, minimal tissue swelling, and quick healing that leaves no visible scaring, pitting, or cobble stoning of the scalp.

Placing grafts to maximize their aesthetic result and coverage

The plane and direction in which each follicular unit graft is placed on the scalp can also impact the ultimate appearance of density that can be produced with a given number of grafts. This is because hairs within a follicular unit are typically next to each other inline.

Therefore by arranging each multiple hair graft on the scalp in a linear fashion to the line of sight, each follicular unit will provide the maximum appearance of fullness and scalp coverage. This also mimics how hair is normally aligned on the scalp.

Special thanks to Dr. DeYarman, Dr. Sharon Keene, Dr. Jerry Cooley, Dr. Alexander, and Dr. Glenn Charles for contributing their expertise and photos for this section.

One of the more popular hair loss products on the market today for those with thinning hair is Provillus. Available for both men and women, making promises to “re-grow beautiful healthy hair”, this product consists of a topical and oral solution with an FDA approved hair regrowth ingredient and a number of conjectured “all-natural” dihydrotestosterone (DHT) blockers.

Other ingredients that promote a healthy scalp and head of hair are also contained in this product. The theory behind Provillus is to revive the hair follicles with growth stimulators and attack hair loss at its source by blocking DHT.

In order to fully evaluate the efficacy of this product, we must further explore each ingredient to determine whether or not this hair loss treatment delivers what it promises. Below you will find a list of ingredients and information that will help you determine whether or not Provillus is right for you.

Topical Ingredients:

Minoxidil (found in Rogaine, Xandrox and other solutions) is an FDA approved hair growth treatment and many balding men and women use it with great success. This particular ingredient is what allows Provillus to advertise their product as FDA approved.

Azelaic acid has been found to clean the skin and potentially inhibit DHT, the hormone responsible for androgenic alopecia.

Combining these two “forces” therefore in theory, may be a more powerful treatment than minoxidil alone. However, no clinical studies have been performed on azelaic acid as a standalone product therefore, whether or not it can stop hair loss is purely conjecture.

Oral Ingredients:

The Provillus oral solution contains a number of supposed DHT blockers including saw palmetto for hair loss, Vitamin B6 and Zinc, pumpkin or cucurbita maxima, and nettle root. Because evidence exists that these ingredients may be an effective treatment for benign prostatic hypertrophy (BPH), theories have been produced that they might also effectively treat baldness. Though we can appreciate the aspiration for balding men and women to use herbal products as an “all-natural” replacement for Propecia (finasteride), the problem we have is that most of them only contain anecdotal if any evidence at all that they can successfully treat baldness.

Provillus oral solution also contains a number of components that are said to promote healthy hair growth and cleanse the scalp. These include eleuthero, uva-ursi, muria puama, horsetail, para-aminobenzoid acid (PABA), and magnesium. Understand however, that promoting a healthy scalp and hair is not the same as stimulating newhair growth and hair regrowth, nor does it signify an effective hair loss treatment.

Possible Side Effects

The only side effect that we could find listed on the Provillus website is an upset stomach. It is reported that taking it with food often stops this. Be sure to follow the links to the ingredients listed above as many of them also have potentially reported side effects. Consulting with a physician before taking any herbal hair loss medication is advised.

Dosage

Currently there are no standards on dosages of herbal medications in the United States. In addition, no formal clinical studies have been performed on them for treating baldness. Therefore, the suggested daily value listed on the ingredient package is based on something other than government regulation and scientific study.

Costs

A one month supply of Provillus topical and oral supplement for men or for women costs about $50 per month. Discounted prices are available when bought in bulk.

For the cost of Provillus, one can purchase generic finasteride and generic minoxidil which are FDA approved hair loss treatments for safety and efficacy.

Conclusions and Our Opinion

Given that Provillus topical treatment contains FDA approved hair regrowth ingredient minoxidil; we can at least agree that it may have some marginal benefit for men and women suffering from androgenic alopecia. However, due to the lack of compelling evidence in these other conjectured hair loss solutions, it may be more beneficial and cost effective to spend your money on Propecia (finasteride)for men only and Rogaine (minoxidil) that has helped balding men and women worldwide.

Instantly Provides the Appearance of a Full Head of Hair? Product Review

For many balding men and women worldwide, credible hair loss concealers like DermMatch are an important part of their daily routine. By utilizing concealers, individuals with thinning hair are able to increase the appearance of follicular density and recreate a thicker, fuller head of hair all with a single topical application.

Like any other hair loss treatment, concealers must be reviewed, clinically tested, and proven before receiving any endorsement from this website community. However, after reviewing both the product and patient testimonials on our open hair loss forum, one thing is clear: DermMatch is a dependable, hair loss concealer that has been proven effective by the overall patient community.

DermMatch: What is it and how it works.

Unlike other "sprinkle," "spray," or "lotion" concealers, DermMatch utilizes a patented "EZ Grip, EZ Reach" applicator to evenly distribute a hard-packed powder formula over a hair loss sufferer’s scalp. In addition to "matching" the patient’s scalp to their natural hair color (minimizing the contrast between scalp and hair, and truly concealing baldness), the DermMatch powder formula coats, thickens, and volumizes existing hair.

Because DermMatch minimizes the appearance of hair loss by matching scalp to hair tone, the product is available in 8 different shades, and creates an integrated, natural look for all hair colors and types. Furthermore, if consumers require a highly specialized color, DermMatch shades can be mixed to truly mimic the appearance of any complex hair tone. Additionally, because of the ease of the "EZ Grip, EZ Reach" applicator, DermMatch is particularly useful for recreating or matching shortly cropped hair, mimicking natural hairlines, and diminishing the appearance of previous hair transplant surgery scars.

The Benefits of DermMatch versus other Concealers

In addition to simple application and a natural appearance, DermMatch is extremely resilient, and can withstand excessive sweating, wind stress, and even full water submersion. According to the makers of DermMatch, the product’s all natural ingredients, including emollients, botanicals, and other organic elements, coat the hair and scalp, and protect from unwanted and unexpected stessors. By adding this level of protection, DermMatch will resist the running, flaking, and smudging associated with other, less effective concealers. Furthermore, because DermMatch does not contain any unsafe dyes or colorants, it will not dry/irritate the scalp or affect any new or existing hair growth.

Why DermMatch has become so popular and credible in the hair loss patient community

According to the makers of DermMatch, the product is useful for all hair loss sufferers (both male and female), and provides aesthetically pleasing results in patients with up to 80% decreases in hair density. Furthermore, DermMatch can be used with other proven hair loss treatments like Propecia (finasteride), Rogaine (minoxidil), and surgical hair transplantation. Because of its efficacy, usability, and popularity with hair loss sufferers, DermMatch is highly recommended to any individual seeking a quality concealer.

See what Real Patients are Saying about DermMatch on our Hair Loss Forum

For step by step instructions on how to apply DermMatch to thinning areas including photos and an in-depth discussion with other hair loss sufferers, visit the discussion topic "DermMatch (Pictures)". To see what other members and DermMatch consumers are saying, you are encouraged to use the "search" feature of our hair restoration discussion forum.

This hair loss product is a 5% custom solution that combines Minoxidil with Azelaic Acid. Developed by Dr. Richard Lee, a hair loss physician, it’s available by prescription only.

Xandrox’s two main ingredients tackle hair loss in two ways. The minoxidil stimulates hair growth, while the Azelaic Acid, which contains the 5 Alpha Reductase enzyme, blocks DHT. However, while minoxidil is a proven hair loss treatment, Azelaic Acid is only proven as an acne medication. Many patients feel that Xandrox is preferable to Rogaine because it’s less greasy.

As of yet, Xandrox has shown few side effects, and may cause less itching and flaking than Rogaine.

There may be some burning irritation though, due to the Azelaic Acid. But one type of Xandrox counteracts this side effect. It contains a Betamethasone Valerate, a corticosteroid.

However, you need to know that corticosteroids may cause problems. Short-term use is pretty safe, but if used long-term, they may cause thinning of the skin or skin damage. It may also lead to brittle bones or diabetes. For this reason, it’s recommended that if you have no itching problems that you should use the Betamethasone-free Xandrox. It is available, and it works as well as regular Xandrox.

There are other types of Xandrox, including the Day Formula, the Night Formula, and Xandrox 12.5%, a cream that’s used for more stubborn areas, such as the frontal hair line, and contains 12.5% Minoxidil. One ml of Xandrox should be applied twice per day, and a routine should be established.

Revolutionary Hair Growth Formula?

Anyone suffering the effects of an incurable and debilitating medical condition yearns for the promise of new and revolutionary treatment options and hair loss sufferers are no exception. Though often dismissed as insignificant by those who are unaffected by it, baldness and thinning hair can devastate the lives of millions of men and women susceptible to the effects of androgenic alopecia. The desperation to restore the flowing locks of youth make this demographic particularly susceptible to slick marketing campaigns promising to halt balding and regrow hair. One such product marketed in this fashion is Europe’s TRX2 Molecular Hair Loss Treatment. But, will hair loss sufferers find follicles behind the flash?

TRX2 Ingredients

TRX2 Molecular Hair Loss Treatment is not a drug or medication. It is an herbal, dietary supplement taken orally. A glance at its ingredients list reveals nothing new or revolutionary. Each component is readily available at your local nutritional supplement shop, though you may not find the same concentrations of each in a single product.  It's ingredients are listed below:

Ingredients: L-carnitine tartrate (800 mg), potassium chloride (191 mg), L-leucine (150 mg), isoleucine (75 mg), valine (75 mg), nicotinic acid (40 mg), and biotin (150 µg).

TRX2 Scientific Studies?

With these ingredients so readily available, one might wonder if the significant cost savings of purchasing them individually and mixing your own TRX2 at home is just as effective for hair growth. The official website’s FAQ addresses this notion with the following response.

“The benefit of taking TRX2™ Molecular Hair Growth Supplement singularly, as opposed to buying each ingredient separately, is based on several facts:

The precise amount and ratio of ingredients in our supplement are carefully chosen and engineered based on credible scientific studies. The ingredients in our capsule were specifically formulated to work in concert with one another and are manufactured in accordance with strict European quality controls. For the consumer, the convenience of taking all compounds at the optimum ratio in one capsule and delivered via our proprietary potassium channel stimulating complex is crucially important.”

Perhaps this is true. However, at a hefty €54.95 (about $72) for a one month supply, those seeking to save some money may want to give the home brew option a shot first.

Additionally, referencing scientific studies is an effective way to add legitimacy to a product but one must always consider the source. While the TRX2 website provides detailed data gathered from a “randomized, double-blind, placebo-controlled study”, it is unclear who conducted the study and there is no mention of publication in a peer reviewed journal.  Peer review is the industry standard for evaluation of clinical trial results and its absence is cause for concern.

Does TRX2 Work?

TRX2 claims to stop hair loss and regrow hair through the “rejuvenation of potassium ion channels within hair follicles”. This theory is based on research suggesting that the opening of potassium channels is an important regulatory mechanism for hair growth.

A bold statement at the top of the TRX2 website states that it has been shown to regrow hair in nearly 9 out of 10 men and women. But, does TRX2 really do what it claims? The bottom of the company’s website provides a very important disclaimer.

“These statements have not been evaluated by the medicines regulatory agencies. This product is not a drug or medicine, and is therefore not intended to diagnose, treat, cure or prevent any disease. This patent-pending food supplement contains nutrients that help promote and sustain healthy hair growth. Results may vary and are subject to your individual metabolism. Regarding risks and side-effects please see the package insert and ask your physician or healthcare specialist.”

Careful wording in the above statement may give consumers the wrong idea. Helping to “promote and sustain healthy hair growth” is not the same as stopping hair loss or regrowing hair lost due to the effects of androgenic alopecia. A quality shampoo and condition can make hair more manageable and appear fuller.

TRX2 Side Effects

While TRX2 contains "drug-free" ingredients that are all natural or synthesized as normal metabolites in the human body, there is a potential for certain side effects.

Some consumers of TRX2 have reported transitory gastrointestinal effects including an upset stomach.  Thus, it is recommended to take TRX2 after eating.  Additional side effects include the possibility of allergic reactions such as skin flushes.  If any of these conditions occur, it is recommended to consult a physician.

 It is also recommended that any potential customers suffering from digestive system disorders, diabetes or those who are glucose-intolerant consult with their physician before taking TRX2.

Moreover, pregnant women and nursing mothers should avoid taking TRX2 due to its lack of long term safety data.

Conclusion

The role of potassium channels in hair growth is still being investigated and it’s unclear if TRX2 truly has the potential to significantly affect these channels. However, there is a clinically proven and FDA approved medical hair loss treatment that is known to do so. Rogaine (minoxidil) has been used successfully by balding men and women for more than 20 years. The exact mechanisms by which minoxidil affects hair growth are not fully understood but it is a known vasodilator and has also been shown to enhance the flow of potassium ions. Given that minoxidil is relatively inexpensive, clinically proven and comes with very little risk of side effects, it may be a better option for hair loss suffering men and women.

Additionally, balding men should seriously consider adding Propecia (finasteride) to their hair growth regimen. Propecia stops hair loss  at its core by inhibiting the production of DHT (the hormone responsible for genetic baldness) and is arguably the most effective treatment for male pattern balding currently available.

When it comes to “new and revolutionary” hair loss treatments, proceed with caution. There is nothing wrong with trying a new treatment provided it is safe and purchased from a reliable source. However, forgoing tried and true medical treatment s in favor of experimental products may result in further loss of precious and irreplaceable hair.

To share your thoughts and experience with TRX2 on our hair loss forum, join the discussion “TRX2: Any Feedback?”.