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Dr. Thomas Nakatsui
Dr. Nakatsui performs large sessions of ultra refined follicular units using the lateral slit technique with extremely natural results. -
Parsa Mohebi, M.D
Dr. Parsa Mohebi
Dr. Parsa Mohebi provides large sessions of high quality follicular unit transplantation with excellent results -
Concealers - Disguising Hair Loss Remedy for Adding Fullness
There are a variety of hair loss remedy "concealer" products that are applied to the scalp and/or hair in the thinning areas to mask a person's baldness and increase the look of fullness of thinning hairs. These products such as Toppik, Couvré, and Prothik can work surprisingly well at creating the illusion of fuller hair.
Some of our member physicians advise their hair restoration patients to use such hair loss remedy products to enhance the look of fullness in their transplanted areas. These products can also be used post operatively to hide the immediate surgery.
Toppik - Toppik is an effective, safe, and easy-to-use product that completely covers up the scalp's thinning areas.
Couvre - COUVRe is safe for men and women, easy to use, and is totally undetectable to the world's toughest critics.
Caboki - Caboki is comprised of a series of charged microfibers that, when applied to the scalp, tightly bind hair shafts and create a denser, fuller appearance.
DermMatch - DermMatch is a safe and easy way to cover-up thinning areas and instantly provides the appearance of a natural looking head of hair.
Nanogen - Nanogen is one of the fastest, easiest ways to conceal thinning hair and hair loss.
Prothik - Prothik does an exceptional job of adding thickness and fullness to thinning hair while reducing the contrast between thinning hair and the scalp.
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From big wigs to surgical hair restoration
The Era of the big Wig
Soon after the Middle Ages wigs became popular for women. Then in the 1600’s the flamboyant and incredibly vain King Louis XIV of France lost his hair from a severe illness and took to wearing gigantic wigs thus setting the fashion for most men of his day.
These enormous creations featured such items as cages with live birds and could weigh up to 20 lbs.!
By the 1700’s England made another contribution to bad hair loss concealers. This was the age of the long, curly, and powered wigs. Even today, English judges and lawyers continue this practice. Thus the expression for those in authority – “Big Wigs.”
The“Snake oil” Years
The early 1800’s is renowned in hair loss circles as the age of the con men. There were hundreds of so-called “hair loss solutions” and many lasted well into the late 1900’s.
These treatments were marketed by fast-talking “doctors,” skilled only in bravery and possessing nerves of steel considering they were conning hardened cowboys and outlaws!
The salesmen hawked their products from the safety of their side shows and “Wild West” spectaculars. They used endless tricks to get people to buy their products, including rubbing grease into their hair to make it look thicker.
The “Modern” Era of Hair Loss Solutions
During the past several decades, superstition, old wives tales, and guess work has gradually been replaced by science.
In 1939, a Japanese dermatologist, Dr. Okuda, published a revolutionary method in a Japanese medical journal that would lay the ground work for modern hair transplantation.This method involved using hair transplant grafts to correct lost hair from various areas, including the scalp, eyebrow, and moustache areas. However, this study didn’t make an impact in the Western Hemisphere due to the interruption of World War II.
Hair transplants are born.
In the late 50’s one physician in particular, Dr. Norman Orentriech, began to experiment with the idea of relocating or transplanting the hair on the back and sides of the head to the balding areas.
Dr. Orentriech’s experiments showed that when bald resistant hairs from the back and sides of the head were relocated, they maintained their bald resistant genetic characteristic regardless of where they were transplanted.
This principle, known as “Donor Dominance”, established that hair could be transplanted from the bald resistant donor areas to the balding areas and continues to grow for a life time. This laid the foundation for modern hair transplantation.During the 60’s and 70’s surgical hair restoration grew in popularity. However, the standard procedure used large grafts that were removed by round punches and often contained many hairs.
Completed Result after Multiple Sessions of Large Grafts
This now outdated technique could achieve a full look if a patient completed all planned sessions. However, a patient was typically limited in the manner they could style their hair.
Patients who stopped short of completing all planned sessions were left with hair loss solutions that looked obvious and unnatural.
Such uncompleted hair restoration results are some times referred to as “barbie doll hair” or “corn rows”.
Many who have had these older techniques now refine or complete their hair transplants with today’s very refined techniques to achieve a natural look that they can style in any manner.From big wigs to surgical hair restoration
The Era of the big Wig
Soon after the Middle Ages wigs became popular for women. Then in the 1600’s the flamboyant and incredibly vain King Louis XIV of France lost his hair from a severe illness and took to wearing gigantic wigs thus setting the fashion for most men of his day.
These enormous creations featured such items as cages with live birds and could weigh up to 20 lbs.!
By the 1700’s England made another contribution to bad hair loss concealers. This was the age of the long, curly, and powered wigs. Even today, English judges and lawyers continue this practice. Thus the expression for those in authority – “Big Wigs.”
The“Snake oil” Years
The early 1800’s is renowned in hair loss circles as the age of the con men. There were hundreds of so-called “hair loss solutions” and many lasted well into the late 1900’s.
These treatments were marketed by fast-talking “doctors,” skilled only in bravery and possessing nerves of steel considering they were conning hardened cowboys and outlaws!
The salesmen hawked their products from the safety of their side shows and “Wild West” spectaculars. They used endless tricks to get people to buy their products, including rubbing grease into their hair to make it look thicker.
The “Modern” Era of Hair Loss Solutions
During the past several decades, superstition, old wives tales, and guess work has gradually been replaced by science.
In 1939, a Japanese dermatologist, Dr. Okuda, published a revolutionary method in a Japanese medical journal that would lay the ground work for modern hair transplantation.This method involved using hair transplant grafts to correct lost hair from various areas, including the scalp, eyebrow, and moustache areas. However, this study didn’t make an impact in the Western Hemisphere due to the interruption of World War II.
Hair transplants are born.
In the late 50’s one physician in particular, Dr. Norman Orentriech, began to experiment with the idea of relocating or transplanting the hair on the back and sides of the head to the balding areas.
Dr. Orentriech’s experiments showed that when bald resistant hairs from the back and sides of the head were relocated, they maintained their bald resistant genetic characteristic regardless of where they were transplanted.
This principle, known as “Donor Dominance”, established that hair could be transplanted from the bald resistant donor areas to the balding areas and continues to grow for a life time. This laid the foundation for modern hair transplantation.During the 60’s and 70’s surgical hair restoration grew in popularity. However, the standard procedure used large grafts that were removed by round punches and often contained many hairs.
Completed Result after Multiple Sessions of Large Grafts
This now outdated technique could achieve a full look if a patient completed all planned sessions. However, a patient was typically limited in the manner they could style their hair.
Patients who stopped short of completing all planned sessions were left with hair loss solutions that looked obvious and unnatural.
Such uncompleted hair restoration results are some times referred to as “barbie doll hair” or “corn rows”.
Many who have had these older techniques now refine or complete their hair transplants with today’s very refined techniques to achieve a natural look that they can style in any manner. -
Provillus as a Hair Loss Treatment
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.
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Crinagen Hair Loss Treatment
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.
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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. -
Hair transplantation FAQs
Hair transplantation is really about relocating (transplanting) the bald resistant hair follicles from the back of the head to the balding areas on the top of the head.
This process works for a lifetime because the hair follicles taken from the back of the head are genetically resistant to baldness, regardless of where they are relocated to.
Hair transplantation, when done right, can be so natural that even your hair stylist will not know that you've had it done.
But the skill and techniques of hair transplant surgeons does vary widely, as do their results. It's important to choose the right procedure and clinic to assure that you will get completely natural results.
The state of art hair transplantation procedure that we recommend is called "Follicular Unit Hair Transplantation".
To learn more about the leading hair transplantation physicians who perfrom this procedure, visit our recommended physicians page.
A typical session of between 1,500 to 3,000 grafts normally involves a full day of surgery on an out patient basis. Most patients will arrive in the morning and will have their procedure completed by late afternoon.
View a step by step overview of a typical hair transplant procedure.
Patients are given local anesthesia in the donor and recipient areas. Most patients find that once the anesthesia is given that they feel no pain or discomfort during the surgery. Following surgery patients will typically feel some amount of soreness and numbness, with some mild discomfort. Most patients are pleasantly surprised by how minimal the discomfort from the surgical procedure is.
Today hair restoration clinics typically provide free no obligation consultations, with surgical sessions priced either per graft or by the session. Prices typically average around $5 to $6 per graft.
It is normal for the price per graft to drop as the size of the surgical session increases. Many clinics will offer a reduced rate per graft once a certain surgical session size (i.e. 1,000 or 2,000 grafts) is exceeded.
To compare the long term costs of hair transplantation to other hair loss treatments, visit our hair transplant cost section.
The amount of grafts you will need ultimately depends on your degree of hair loss, now and in the future, and on how full you desire your hair to be.
For help estimating the amount of grafts/hairs you may need, click here.
To use our interactive graft calculator, click here
With today’s very refined micro hair transplantation procedure the incisions are very small and less invasive than past procedures. This results in more rapid healing. Most patients feel fine within a day or two following surgery, although some numbness and mild soreness can be expected for several days following surgery.
Immediately following surgery a patient’s recipient area is typically pink with scabs forming around the micro incisions. These hundreds of tiny incisions will heal rapidly within a week to ten days.
During the first few days after the surgery a person’s hair transplants will be noticeable if there is no previous hair to mask these temporary scabs. However, most patients feel comfortable being in public without wearing a hat within 5 to 7 days following surgery.
Once the transplanted hair grows out the results should look entirely natural, even under close examination.
Normally it takes between three to five months following surgery before the transplanted hair follicles begin to grow new hair. The transplanted hair grows in very thin initially and gradually grows thicker and fuller over time. After one year a patient’s transplanted hair will be fully mature and will continue to grow for a life time.
Since the hair follicles that are transplanted to the balding areas are genetically resistant to going bald, they will continue to grow for a life time – just as if they had been left in the bald resistant donor area.
To understand why some hair follicles are genetically resistant to going bald, while other are not, click here.
The most important decision in restoring your hair is the physician you choose. The skill, talent, and experience of hair restoration physicians vary widely, as do the end results. Who you choose will determine how natural and full your new hair will be for the rest of your life.
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Extreme Hair Therapy (EXT)
Is this hair loss treatment effective?Extreme Hair Therapy (EXT) for thinning hair is a 5 "step" hair loss treatment solution created by Hair Club that claims not only to rejuvenate your hair, but "rejuvenate your life". Making claims to be FDA approved, EXT claims to stimulate hair regrowth in thinning areas by keeping hair in the anagen (hair growth) phase longer.
Balding men and women seeking hair loss solutions should be careful to do their due diligence in researching all products they are considering. Is this one of the hair loss products that really works to treat baldness? Can Extreme Hair Therapy really deliver what it promises?
Below we take a look at each of the 5 “steps” and separate treatments and analyze whether or not EXT can remedy alopecia in men and women.
What is the 5 Step Process of Extreme Hair Therapy?
Step One: Moisturizing or Revitalizing Cleanser
This moisturizing shampoo is rich with vitamins and works to cleanse the scalp. Though it claims to revitalize and strengthen thinning hair, the ingredients are not listed on their website. Many hair rejuvenators and thickening agents (commonly referred to as volumizing shampoos) help to make hair appear thicker as they take on hydration and swell. Unfortunately, these thickening agents do nothing to stop the progression of male pattern baldness, even if it temporarily makes the hair shaft appear fatter.Step Two: Enzyme Scalp Cleanser
Claiming to be a “new breakthrough”, this organic formula removes sebum oils that can sometimes hinder hair growth. Though sebum buildup, excessive dandruff, and scalp dermatitis are sometimes responsible for certain non-genetic types of balding such as diffuse alopecia or telogen effluvium, it does not promote androgenic alopecia (hereditary male or female hair loss).Step Three: Energizing Conditioner
Adding nutrients such as proteins and wheat amino acids, this conditioner helps to promote a healthy scalp and hair growth. It should be noted that nothing in this step claims to stop hair loss or stimulate hair regrowth.Step Four: Hair Revitalizing Complex
This dietary supplement containing Vitamins B3, D, and E, Biotin, saw palmetto and nettle root is taken twice daily, once in the morning and once at night. Some of these ingredients can also be found in several other hair loss products such as Provillus, Procerin, and Avacor.Though some of these ingredients work to treat benign prostatic hyperplasis (BPH) in men by inhibiting DHT (the hormone responsible for female and male pattern baldness), no formal clinical studies have been performed on successful hair loss treatment. It should be noted that tocotrienol molecules in Vitamin E may effectively treat alopecia but its counterpart tocopherol (commonly found in alternative herbal hair loss treatments such as HairMax MD), is not supported. Additionally, because there are no regulations on herbal medications in the United States, the daily recommended value and dosage in Extreme Hair Therapy is based on something other than FDA regulation.
Step Five: Minoxidil (2% or 5%)
Minoxidil (the active ingredient in Rogaine and Xandrox) is an FDA approved hair regrowth formula and is used by many balding men and women with great success. Because Extreme Hair Therapy includes this, they are legally allowed to claim it to be FDA approved.Costs:
Unfortunately, this information is not available on the Hair Club website. Upon calling the toll free number for this information, we are told that we must schedule a consultation with a Hair Club specialist. Customer service representatives are apparently not provided with this information.
Side Effects and Warnings:
No EXT side effects are reported on the Hair Club website however, Minoxidil may cause scalp irritation or redness, chest pain, a rapid heartbeat, faintness, swelling of the hands and/or feet, and unwanted facial hair growth. Be sure to discuss the use of herbal medication with your physician before taking them. Saw Palmetto should be avoided by pregnant women with hair loss.
Conclusions:
The only FDA proven ingredient in Hair Club’s Extreme Hair Therapy hair loss treatment is Minoxidil. Though Saw Palmettoand nettle root may be effective in treating men with an enlarged prostate by inhibiting DHT, no formal tests have been performed on them.
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Nizoral Shampoo (Regular Strength) for Hair Loss
While Nizoral 2% shampoo is more effective at inhibiting DHT production and its binding to hair follicles, Nizoral regular strength offers a smoother, gentler approach to treating hair loss while minimizing scalp irritating effects from other topical treatments such as Rogaine 5% liquid.
This product includes 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". Alternatively, you can obtain a prescription from your medical practitioner for the more concentrated 2%.
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 Nizoral in conjunction with other 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 Nizoral has been successful in helping you maintain existing hair.
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.
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