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.

A Thicker Fuller Head of Hair in 30 Seconds?

A staggering 50% of men and 30% of women will experience some degree of thinning hair by the age of 50. Along with state of the art hair transplant surgery and credible drug treatments like Propecia (finasteride) and Rogaine (minoxidil), many balding men (and women) have added credible concealers like Nanogen to their daily treatment regimen.

As the term implies, concealers do not actually regrow hair but rather cosmetically enhance the appearance of balding areas of the scalp by reducing the contrast between scalp and hair color and/or adding fullness to thin, wispy hair follicles.  Nanogen is no exception however, Nanogen is very popular and differs from other topical concealers in several areas.

How Nanogen Works

Nanogen is made of microscopic keratin fibers. Keratin is the same material that natural hair is composed of, giving the product a natural look and feel when applied to existing thinning hair. Unlike other fiber-based hair loss concealers, Nanogen’s “nanofibers” have a patent pending, “dipolar” electrostatic charge coating that causes them to cling to existing hairs in a fashion resembling needles on a Christmas tree rather than lying flat against the follicles. It’s this perpendicular binding that gives what some users have described as an immediate “lift” to the hair.  By increasing the diameter of each individual follicle from root to tip, Nanogen is able to enhance the appearance of hair density resulting in the illusion of a full head of hair.

Applying Nanogen

Nanogen is available in ten different shades. These colors can even be combined to invisibly blend with your natural hair. The fibers are sprinkled onto the balding scalp from an applicator reminiscent of a large pepper shakerand then blended with the fingertips. Once the desired effect is achieved, there is an optional locking mist available to help the fibers stay in place through inclement weather conditions, intense exercise and perspiration.

Users should take care when applying Nanogen near the hairline. Over application can result in accumulation and an unnatural appearance.

Conclusion

Nanogen’s keratin-based nanofibers are an excellent choice for balding men and women wishing to improve the appearance of thinning hair. Unlike some creams, sprays or make-up type concealers, Nanogen fibers are odor-free, non-itchy, wash out easily and won’t stain your clothing or pillowcase. With practice, the application is clean, quick and simple.

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

For an in-depth comparison of Nanogen and similar fiber-based hair loss concealer Toppik, see the discussion topic, Product Review: Nanogen. To see what other members and Nanogen users are saying, you are encouraged to use the "search" feature of our hair restoration discussion forum.

Scalp Med TV infomercials, like many hair loss products, claim to sell FDA approved hair loss products. Pictures, videos, and testimonies on television show hair loss sufferers regrowing hair even when men and women were completely bald. Is this really what balding people can expect from Scalp Med? Below we examine Scalp Med and unlock the mystery ingredients and whether or not any clinical proof exists that this hair loss solution can treat baldness.

Scalp Med includes 3 distinct products including topical Vitadil-5A for men or Vitadil-2A for women, topical NutriSol-RM, and Cortex Enlarger hair thickening spray.

Vitadil-5A for men or Vitadil-2A for women is a topical solution that contains the proven hair regrowth solution minoxidil, also found in Rogaine and Xandrox. It's also said to include a unique delivery agent formulated to increase the absorption of 5% minoxidil for men, 2% for women.

Scalp Med is a bit more vague as to the ingredients found in the NutriSol-RM topical and the Cortex Enlarger thickening spray. While NutriSol-RM topical is designed to add essential nutrients to the scalp for healthier hair, the Cortex Enlarger hair thickening spray's primary purpose is to temporarily fatten the hair follicles making hair appear thicker.

Scalp Med is upfront that the ingredients found in the NutriSol-RM shampoo and Cortex Enlarger hair thickener will not stop hair loss or cause hair regrowth.

Scalp Med also offers a detoxifying cleanser kit which includes a detoxifying shampoo called Panthenol-DX Scalp Detoxifier. This shampoo is designed to deeply cleanse the scalp without stripping the hair of its natural oils and nutrients. Unless your thinning hair is due to pollutants or toxins affecting natural hair growth, Panthenol-DX Scalp Detoxifier won't stimulate new hair growth. Scalp Med's Panthenol-DX does nothing to stop the natural progression of genetic female hair loss and male pattern baldness.

To supplement Scalp Med's hair loss treatment program, Scalp Med offers a Mega-Multi Vitamin to increase overall body health.

Scalp Med can legally claim that it's product contains an FDA approved ingredient since Scalp Med does contain minoxidil, which is a FDA approved topical treatment for hair loss. However, Scalp Med its self has not been granted FDA approval. Though Scalp Med's other products may work to promote healthy hair, it's the minoxidil that gives balding men and women any hope of restoring their hair.

Unfortunately, Scalp Med's marketing infomercials makes it appear that completely bald men and women have hope of regrowing a full head of thick and healthy hair. However, the words “Results seen are not typical” can be seen in small fine print at the bottom of your television.  Additionally, Scalp Med's website FAQ makes it clear that no non-surgical hair loss solution is proven to grow hair in completely bald areas.

There are several proven success stories that minoxidil can stimulate hair regrowth in areas of thinning hair. Therefore, Scalp Med's Vitadil-5A should be as effective as 5% minoxidil just as Vitadil-2A should be as effective as the 2% solution.

Scalp Med is about 3 times the cost of minoxidil. A two month supply of Scalp Med is approximately $160.00. Discounts are available if you buy in bulk. However, even in bulk, the net cost ends up around $64 per month as opposed to the $20 per month cost of Rogaine. Generic minoxidil costs even less.

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.

Balding men and women considering any hair loss treatment should take caution to believe the many magnificent claims made by today’s advertising. Far too often, a lot of time and money is wasted on questionable treatments with little or no proof of success.
Nourkrin hair nutrient claims to promote hair growth and strengthen thinning hair in 80% of men and women suffering from almost any hair loss condition other than the self-inflicted trichotillomania (hair pulling) or traction alopecia. Below we evaluate Nourkrin, the "clinical study", and its ingredients to find out whether or not this hair loss treatment lives up to its promises.

What is Nourkrin?

Nourkrin recommends using their complete regime of products for at least 6 months for the best results. This includes extra strength, Man, and Maintain oral tablets, a shampoo, a conditioner, and a scalp lotion.  Nourkrin claims their products can promote hair growth in men and women suffering from androgenic alopecia (genetic baldness), alopecia areata, alopecia totalis, alopecia universalis, and telogen effluvium. This is a very bold claim considering each balding condition occurs for varying reasons.

Ingredients

The active ingredients in the extra strength tablet include shark cartilage and shellfish extract containing glucosamine.  Other active ingredients include silica kieselguhr (a natural form of silica), horsetail extract, acerola cherry extract with vitamin C, microscyrstaline cellulose, immunogloblin G protein, and fatty acids. In addition to the above, the Man product contains Omega 3 fatty acids and Fenugreek designed to improve scalp circulation. Maintain includes additional marine life proteins, minerals, silica, and vitamin C. The scalp lotion contains marine life protein extract compounds and aloe vera.

Nourkrin claims that the primary active ingredient glucosamine can rebuild and grow new tissue, including dormant hair follicles - suggesting successful hair regrowth. Though clinical studies prove that glucosamine might be effective in reducing joint pain, increasing joint lubrication, preserving joint space, protecting cartilage breakdown by inhibiting specific enzymes, stimulating cartilage matrix repair, and other anti-inflammatory actions, we couldn't find any evidence to support claims that it can stop hair loss or promote hair regrowth.

Clinical Study

Nourkrin conducted a clinical study of 60 people who took their products for 12 months. All subjects were over 18 years of age and suffered from at least some form of hair loss for at least one year prior to the study. During a 6 month double blind clinical study, 30 subjects took Nourkrin while the other 30 took a placebo. After 6 months, the 30 participants taking Nourkrin continued taking it for another 6 months while the 30 on the placebo were switched to Nourkrin for 12 months.

In the first 6 months, Nourkrin reports that 77% taking their hair loss treatment experienced an increase in hair growth and shaft thickness. After 12 months, 75% reported a decrease in overall thinning hair. 90% of women in the study reported overall hair improvement after 12 months. The hair counting method showed an average increase in hair count of 45 percent during the clinical study.

Though the above study sounds impressive, we don't know a lot about the participants nor can we be certain of the reliability of the study. All participants suffered from some form of thinning, but its cause for each patient hasn’t been disclosed.  Additionally, clinical studies are considered more credible when they've been conducted or verified by third parties not interested in its financial success.

Another problem is that none of the active ingredients in Nourkrin are proven to stop hair loss. Therefore, their study is the only one balding men and women have to support such claims.

Possible Side Effects

Anyone allergic to shellfish should avoid using Nourkrin. Women who are pregnant or breast feeding should not use Nourkrin hair loss products. Consulting with a doctor before using this treatment is advisable.

Dosage

Nourkrin recommends taking 2 tablets daily for at least 6 months. Men and women over 176 lbs or those who smoke are advised to take 3 tablets daily. After 6 months, dosage can be cut down to one a day. Nourkrin also recommends using the shampoo, conditioner, and scalp lotion daily. The scalp lotion may be best applied in the evening and left on overnight.

Cost

60 tablets of the extra strength tablet costs about $75, the Man $65, the shampoo and scalp cleanser $12, the conditioner $13, and the scalp lotion $30. All in all, the Nourkrin Hair Recovery Program can get pricey after 6 months. FDA approved products like Rogaine (minoxidil)only runs approximately $15 a month or less and male treatment Propecia (finasteride)costs approximately $60 per month, not as expensive as Nourkrin.

Conclusions

Nourkrin boasts a big game, claiming high rates of success in reversing hair loss in men and women caused by varying conditions. Their clinical study also confirms its success rate however; the reliability of this study has not been verified by third parties uninterested in its financial success. Additionally, no clinical proof exists that any of the ingredients found in Nourkrin work to treat baldness.

Whether or not Nourkrin is the "real deal" is hard to determine with little evidence to support its claims. Therefore, those considering this treatment should proceed with caution and may want to consider exhausting proven treatments like Propecia and Rogaine first.

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?”.