Hair loss is a universal condition, affecting all ages, races, genders and nationalities. It’s estimated that “androgenetic alopecia,” or male and female pattern baldness affects 35 million men and 21 million women in the United States alone. This section examines how race, age and gender affect hair loss.

Race and Hair Loss

In physiological terms, human beings are all composed of the same bones, muscles, and everything else down to the cellular level. But there are specific differences.

Hair, in all of its variations, is one area in which human beings display their differences. Hair follicles can widely vary in terms of color, length, shape, thickness, strength and various other factors.

There are many ethnic groups to consider. But we will focus on the special considerations of Asians, Blacks (of African descent) and Caucasians.

Asian Hair Loss Considerations

Asian people typically have very straight hair. Their scalps contain fewer hairs per square centimeter, they actually have a lower hair density than that of Caucasian hair follicles. But because the individual hair follicles of East Asians are thicker, this gives the look and impression of greater hair density.

For these reasons, hair restoration techniques for East Asians, much like other races, must be sensitive to a variety of anatomic and cultural differences. For instance, East Asian females often have an increased likelihood of developing “diffuse alopecia,” or hair that thins evenly over the entire head than Caucasian females.

Even though it’s not a definite requirement, it’s very helpful for Asian patients to seek out doctors with experience in Asian hair.

Another consideration for East Asians considering hair restoration surgery is the increased chance of developing keloid scars. A keloid is a thick, irregularly shaped and elevated scar with uncontrolled growth that results from excess fibrous skin tissue. East Asians typically have a greater likelihood of keloid development than Caucasians, but less than that of people of African descent. Therefore, before undergoing surgery, East Asians may want to consider being medically evaluated for keloids.

African Hair Loss Considerations

People of African descent usually possess naturally curly hair. This curly hair gives the visual impression of increased hair density for a given amount of hair, which is beneficial in hair restoration surgery.

The hair follicles beneath the skin of people of African decent also typically curve more than Caucasians. This can make harvesting the donor hairs, without severing or transecting the hair follicles beneath the scalp, more difficult. A hair restoration physician needs to be very aware of this difference and adjust to its requirements.

As in the case of East Asians, people of African descent possess some unique hair and skin characteristics. Some of these medical conditions are more common in black skin than in white skin. This may increase the risk for post-surgical complications.

Those of African descent have a higher chance of developing keloid scarring when injured. This in turn leads to a greater chance of noticeable donor scars. Keloids aren’t a widespread problem. But those with a history of them are carefully evaluated in regard to their existing scars. The evaluation usually involves a small "test procedure" to determine if there’s a normal healing rate.

Another issue is that of postoperative skin discoloration. With darker skin, there’s often a greater risk of both increased and decreased skin color after injury or surgery. These risks can be determined by the patient’s medical and family history.

Ingrown hairs are also a more common problem in darker skin. If a patient has a history of ingrown hairs or other minor skin infections, this may signal a higher risk for ingrown hairs post-hair restoration surgery. Again, this risk can be determined by a small test procedure.

Caucasian Hair Considerations

Caucasians (white people) may have a wide range of hair and skin types. However, if someone has dense and or coarse hair, as well as skin color similar to their hair color, they will generally achieve the best results for a given amount of restored hair.

Learn more about aging and gender hair loss

Crinagen is an all natural alcohol-free topical scalp spray clinically backed to reduce the amount of DHT (dehydrotestosterone) in the scalp. It contains no alcohol, and has displayed no side effects. Crinagen is also equally safe for men and women and is most effective in men and women with thinning hair. In addition to blocking scalp DHT, they both are reported nourish the scalp’s hair follicles. Crinagen usually displays its effects on average in five months.

How It Works:

The product's main ingredients are Saw Palmetto, Zinc, and Azelaic Acid. All 3 ingredients are reported to reduce the production of scalp DHT and nourish the scalp's hair follicles.

Developing Realistic Expectations:

Crinagen has not been clinically proven nor approved by the FDA. Thus, like Revivogen and Tricomin, Crinagen should be used only after seriously considering proven treatments like Propecia (finasteride) and Rogaine (minoxidil).

Don't expect immediate results. It's recommended to use Crinagen 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 Crinagen is working for you.

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 consultation with one of our prescreened hair restoration physicians.

We believe that patients have a right to full disclosure and a complete understanding of exactly what hair restoration surgery involves.

This step by step presentation shows how today’s state of the art follicular unit hair transplant procedure is typically performed.

Patient is prepared for surgery

During surgery hair follicles from the back of the head that are genetically resistant to going bald will be removed and relocated (transplanted) to the balding areas.

Donor area is trimmed

Prior to surgery, the hair in donor area that will be surgically removed is trimmed.

Donor area is prepared for surgery

Once the donor area has been prepared it is given local anesthesia.

Donor tissue is removed

The donor tissue containing the bald resistant hair follicles is then surgically removed.

Donor area is sutured

The donor tissue containing the bald resistant hair follicles is then surgically removed.

Hair combed over sutures

When patient’s hair is combed over the donor area the sutures are not visible. These sutures are typically removed approximately ten days after surgery.

Donor tissue is trimmed into follicular unit grafts

Surgical technicians then use microscopes to view the donor tissue in order to dissect and prepare follicular units hair grafts.

Bald recipient area is prepared

After being given local anesthesia, the balding recipient area is ready for surgery. No trimming or shaving of hair is needed in the top recipient area.

Incisions are made in the balding areas

Tiny incisions are made in the recipient areas in irregular patterns that mimic nature. The follicular unit grafts will then be placed carefully into these tiny incisions.

Grafts are placed into the incisions

Follicular unit grafts are gently placed into the recipient incisions.

Grafts are placed in varying densities

Typically the smallest one and two hair grafts are placed in the very front of the hairline, with three and four hair grafts placed behind them.

Patient immediately following surgery

Following surgery a patient will have hundreds of tiny incisions with short hair stubble showing from the new grafts.

Close up of recipient area after surgery

The tiny graft incisions heal rapidly. The redness and scabbing in the recipient area normally clears up within about one week.

Hair has always been an important symbol of status throughout history. Whether it signified social, financial, gender, or professional status, hair has come to be considered a sign of success. And this idea appears to go all the way back to the cavemen.

 A few years ago, the frozen body of a man on the Austrian-Italian border was discovered by scientists. Upon examining the clothing and weapons found on the specimen, they were astounded to find that the body was from the Neolithic Age, making him more than 5,000 years old. They had previously thought that the body was only a few years old, based on his trimmed beard and short hairstyle. So even during prehistoric times hair care was in practice.

Even 4,000 years ago, the ancient Egyptians were searching for a hair loss cure. One “cure” used around 1500 B.C. in Egypt called for reciting a magic spell to the sun god and then swallowing a mixture of onions, iron, red lead, honey and alabaster.

Around 1100 B.C. in ancient Egypt it was popular to rub the fats of various animals onto the scalp, including those of the lions, hippopotamuses, crocodiles, ibex, serpents and geese.

Another recipe for growing hair prepared for the King of Upper and Lower Egypt included toes of a dog, refuse of dates, and a hoof of an ass. Of course, these “cures” failed to re-grow hair.

But with baldness regarded as shameful in ancient Egypt, men and women were willing to put such things on their head in the hope they would work. During these times it was believed that baldness stood for the public announcement of a man’s loss of virility.

The Gospel on hair loss

Yes, hair loss is even mentioned in the Bible. According to this Old Testament passage God does not condone ridiculing the bald.

Kings 2: 23 “From there Elisha went to Bethel. As he was walking along the road, some youths came out of the town and jeered at him. "Go on up, you baldhead!" they said "go on up, you baldhead!" He turned round, looked at them and called down a curse on them in the name of the Lord. Then two bears came out of the woods and mauled forty-two of the youths. And he went on to Mount Carmel and from there returned to Samaria.”

As a hair loss sufferer you can take solace in knowing that today you have treatments for hair loss only dreamed of by the Kings of ancient Egypt and the emperors of Rome.

Hair loss and attempts to stop or reverse it have been around for centuries.

How mankind has treated hair loss over time.

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.

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.

Reviving Thinning Hair

These types of treatments work by stimulating hair growth. However, they can't stop hair loss completely as they don't address the root causes of hair loss. Products that act to stimulate hair growth include Rogaine, Tricomin, Folligen, Proxiphen (along with Prox-N and Nano Shampoo) and Retin-A.

Tricomin

Tricomin, which is used by men and women, is a topical spray that has undergone a wide variety of scientific testing. The spray’s main ingredient is copper, which has been proven to be beneficial for hair.

The FDA has conducted some clinical studies, with the subjects applying the treatment twice per day for 24 weeks. These results were shown to be very positive. However, the product’s parent company, ProCyte Corporation, chose to release Tricomin as a cosmetic. They wanted to avoid the FDA approval process, which tends to be very lengthy.

Tricomin may be an effective option for those who want a treatment that’s undergone scientific testing, yet isn’t drug-based.

The product can be used safely by men, women and children. It’s also non-irritating and has no known side effects. Tricomin can be used for any type of hair loss

The product should be sprayed to damp or dry hair twice each day. But if you’re using another topical treatment, such as Rogaine, you should wait a few hours before applying Tricomin. This is because the scalp may turn a greenish color when mixed with other products. However, this discoloration isn’t permanent and washes out. And like other treatments, Tricomin needs to be used regularly to maintain its results.

Besides the spray, Tricomin is available as a shampoo and conditioner. They should be used as an addition and not as a replacement, though.

For more detailed information of Tricomin Follicle Therapy Spray, Shampoo and Conditioner, click here.

Folligen

The makers of Tricomin make this product, available as a cream, lotion and spray. It was originally designed as a skin repair cream in the Dermatology Department at the University of California at San Francisco.

However, a 41-year-old woman with severe hair loss re-grew lost hair in two and one-half months with the cream. The company, Skin Biology, has since marketed this cream, which also contains copper-peptide as a hair loss treatment. The blue-colored copper-peptide complexes are meant to improve hair vitality and the health of the scalp and hair follicles.

Folligen products are meant for both men and women. They feature a cream for hairline application, spray for overall use, and lotion for bald spots. While Folligen may work on its own, its best results may be seen when it’s used with products like Rogaine.

Essentially, Folligen’s products soothe irritated scalps. They also relieve the itching and burning associated with Rogaine. However, the Folligen spray may cause itching or burning. Also, because the cream and lotion are bright green, it’s better to use them at night, while covering your pillow.

And while you can wash Folligen off easily, it’s not advisable for people with very light blonde hair to use the product. They may develop a greenish tinge to their hair.

Proxiphen, Proxiphen-N, NANO Shampoo

Proxiphen is a prescription formula topical cream that has not yet received FDA approval. It combines the power of minoxidil and other chemicals. The cream should be applied everyday for the first 8 - 12 months, and after that, every other day. Proxiphen is dispensed only when a physician gives a diagnosis of hair loss.

Proxiphen-N, the non-prescription Proxiphen is less expensive and is also not as strong. It’s advisable for patients to use minoxidil with Proxiphen-N.

NANO (nicotinic acid N-Oxide) shampoos and conditioners are an excellent compliment to your existing minoxidil treatment. They contain NANO, which is a minoxidil-like hair growth stimulator. They also have agents that stimulate hair growth. These products are beneficial when used with Proxiphen and Proxiphen-N.

In order to see some results, Proxiphen-N and the NANO products need to be diligently used for at least 8-10 months at the very least.

A one-month supply at prescription strength is about $100. A 2-month supply of Proxiphen - N will cost $59.95. A 90-day supply of NANO Shampoo and Conditioner will cost $39.95 and $29.95, respectively.

Retin-A

Retin-A (also known by its scientific name, tretinoin gel 0.1%), is a topical treatment that’s primarily used as an acne medication. However, research has shown that Retin-A, either by itself or with Rogaine, may grow some hair in those with male pattern baldness or female pattern baldness.

To use Retin-A, you should apply a thin layer with a gauze pad or cotton swab to the affected areas at bedtime. Remember to wash your hands immediately after using the product! You should also take care not to get any Retin-A near the eyes, mouth, or open cuts. The medication may irritate sensitive skin.

It should also be mentioned that if Retin-A is used more often, the results will not improve. Rather, the side effects may increase. These effects include an immediate warming of the skin. Other skin problems may include peeling, itching, scaling, redness and maybe mild stinging. Luckily, once your skin adjusts to the medication, these effects should subside.

Retin-A may also cause increased sensitivity to sunlight as well as wind and cold. For these reasons, you should avoid prolonged exposure to the sun and sunlamps. You should also use effective sunscreens, and wear protective clothing.

In regards to pregnant mothers, research hasn’t shown any risk of birth defects, as of yet. Nevertheless, physicians recommend using Retin-A during pregnancy only if necessary. You should also consult your doctor before breast-feeding. One tube of Retin-A Cream can be purchased for about $28.00.

Click to learn more about Superoxide Dismutase (SOD's)