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.

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.

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.

If you are going bald you should seriously consider hair loss medication treatments to halt or even reverse your hair loss. While there is no “Hair Loss Cure”, hair loss drugs like finasteride (Propecia) and dutasteride (Avodart) can often stop or even reverse alopecia areata in most people.

However, just like any other drug, Propecia is accompanied by a list of potential side effects, some of which have been more recently reported as potentially long term.  You can read more about this in the "What About Side Effects" section further down this page.

Studies have shown that 80% of men using Propecia stopped or even reversed their hair loss to some degree. Preliminary clinical trials for Avodart appear even more effective than Propecia.

However, neither Propecia nor Avodart has been proven to restore hair in the frontal areas. For reasons yet unknown these drugs, along with Rogaine, only generally work in regrowing thinning hair in crown area of the scalp. Only hair transplant surgery has been successful in restoring hair in the frontal hairline area once it has been lost.

Propecia and Avodart are also less effective in growing hair in older men. These hair loss drugs work best for men who have been balding for less than five years.

Women must NOT USE Propecia

Both Propecia and Avodart are not recommended for use by women or children.

It’s been found that these drugs can cause birth defects. More specifically, these birth defects may occur when large amounts of the drug are absorbed into the body during the period of foetal development.

Physicians advise pregnant women to not handle Propecia tablets, as this may harm male foetuses. But as of yet, there has not been a single reported case of birth defects caused by handling these tablets.

Furthermore, there’s also no evidence that pregnant women exposed to the semen of Propecia or Avodart patients will risk any birth defects.

Propecia and Avodart are also not advisable for men with liver disease or prostate cancer.

Get a Prescription for Propecia or Avodart.

Often our member physicians will prescribe Propecia or Avodart to halt a patient’s hair loss and then restore the hair already lost with hair transplant surgery. These treatments in combination can work synergistically. The drugs work to halt the hair loss, while hair restoration surgery restores what was lost.

To get a prescription for Propecia or Avodart schedule a free no obligation consultation with any of our quality hair restoration physicians. Find a physician in your area.

Propecia and Avodart should be taken once a day. It has been found that after two years of treatment, Propecia effectively grows hair in about 66% of patients. Also, about 83% of the subjects receiving this treatment continue to maintain their existing hair after two years.

Propecia (Finasteride) was originally a drug called Proscar, which was used to treat and reduce men's prostate conditions such as benign prostatic hyperplasia (BPH).

Its parent company, Merck & Co., soon realized that the drug had a unique side effect - it grew hair on bald men's heads.

In December 22, 1997 the FDA approved Propecia as a hair loss pill. Merck & Co. then marketed the drug as a hair loss treatment under the trade name of Propecia.

More recently Dutasteride, sold as Avodart, has generated interest as a promising new hair loss medication. Like finasteride (Propecia) it inhibits the creation of DHT and was originally developed as a treatment for men’s prostate condition.

However, unlike Propecia, Avodart inhibits the creation of both type one and type two 5 alpha reductase enzymes. Dutasteride has been shown to decrease levels of DHT by 90% after only two weeks, making it a more powerful and faster acting weapon against hair loss than Propecia (Finasteride).

Dutasteride is not yet FDA approved for the treatment of hair loss. However, some hair restoration physicians also prescribe it for the treatment of hair loss. Like Propecia, Avodart is not safe for women and children.

Sticking with the program to see results

Losing your hair took time. So too will regrowing your hair using Propecia or Avodart. These drugs require patients to take the drug daily for at least three months before any obvious changes will be noticeable. Most physicians advise taking these drugs for a year before evaluating their effectiveness.

At this time, Propecia and Avodart are only available by prescription. Our member physicians are available to discuss these hair loss drugs with you and prescribe them if appropriate. To find a quality hair restoration physician in your area.

Other DHT Blockers

Aside from Propecia and Dutasteride, there are other treatment options (all topical) that may or may not work to block the effects of DHT on vulnerable hair follicles. These include Revivogen, Crinagen, Progesterone Creams, and Xandrox (a type of minoxidil). Other DHT Blockers

To learn more about these treatments, as well as all other topical options, visit our Topical Hair Loss Products and Treatments section.

How hair loss drugs inhibit DHT and Alopecia Areata

Baldness is largely the result of dihydrotestosterone (DHT) interacting with those hair follicles that are genetically vulnerable to their effects.

DHT is essentially the active ingredient or catalyst for the hair loss process. DHT binds with the receptor sites of genetically vulnerable follicles and gradually degrades the follicles ability to produce healthy hair. This eventually results in baldness in the affected areas.

Hair loss drugs like Propecia or Avodart work by inhibiting the conversion of testosterone into dihydrotestosterone (DHT). By reducing the amount of DHT present in the scalp the hair loss process is slowed and in some cases even reversed.

What about side effects?

Up until a couple of years ago, side effects when taking Propecia or Avodart were only considered temporary. However, over the last several years, many me have reported ongoing side effects from Propecia even after stopping treatment.  This more permanent condition has become known as "Post Finasteride Syndrome" or (PFS). Side effects included but aren't limited to reduced semen production, a reduced libido and softer erections.

As a result, in April of 2012, the FDA mandated labeling changes to finasteride related products.  Labeling changes to Propecia include "libido disorders, ejaculation disorders, and orgasm disorders that continued after discontinuation of the drug".  Labeling changes to Proscar include "decreased libido that continued after discontinuation of the drug".  Labeling changes to both Propecia and Proscar include "reports of male infertility and/or poor semen quality that normalized or improved after drug discontinuation".

While most men don't experience any side effects at all, it should be known that a small percentage of men may experience persistent side effects even after stopping treatment.  Most men who experience side effects however, only experience them temporarily and stopping treatment makes them go away.

For a list of potential side effects and more information on Post Finasteride Syndrome", visit http://www.pfsfoundation.org/.