• Dr. Bernard Nusbaum

    Dr. Bernard Nusbaum
    Dr. Bernard  Nusbaum
    Dr. Bernard Nusbaum performs highly artistic ultra refined follicular unit hair transplantation with very natural looking results.
  • Hair transplantation FAQs

    Hair restoration procedure results

    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.

    Learn more about hair transplantation.

    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.

    View tips on selecting a hair restoration clinic.

    Find an excellent hair restoration physician in your area.

  • Child Birth

    Child Birth

    Childbirth may result in hair loss. It's common for many women to notice hair loss about 3 months after they've had a baby. This too, is caused by hormones. But this is not something to worry about. You see, during pregnancy, hair that normally falls out is kept in by high levels of hormones. Once the hormones have returned to pre-pregnancy levels, this extra hair falls out. The normal cycle of hair growth and loss then begins again.

  • Kevis 8 Hair Loss Treatment Product Review

    Kevis 8

    Kevis 8Is it Effective in Treating Baldness?

    Hair loss suffering men and women are always seeking new and credible treatments and with good reason. Medical science is still years from producing a true hair loss cure and current treatment options are vastly limited. Women with hair loss have even fewer options than their balding male counterparts when it comes to proven, non-surgical hair loss treatments. Additionally, there is no shortage of cunning charlatans waiting to take advantage of the unwary consumer. Thus, when a new product like Kevis Hair Rejuvenation Formula comes along claiming to be a “permanent” solution and “the most successful and potent hair loss treatment on the planet”, potential customers would be wise to remain skeptical.

    Kevis hair loss treatment is not an entirely new solution. In fact, their website states that it has been sold throughout Europe and Asia for over 25 years but has only been available in the United States for 15 years. This is simply the 8th generation of the formula; hence their new name Kevis 8. But how can such an impressive treatment exist for 10 years yet remain virtually unknown to roughly 70 million balding American men and women? What’s even more surprising is that Kevis claims that published clinical studies give this solution for baldness an average success rate of 92%. So why are so many people still seeking viable hair loss treatments today?

    Kevis 8 is a drug-free topical lotion developed and manufactured by Italian pharmaceutical company, Farmaka, and distributed by Kevis Rejuvenation Programs in North and South America and by Pfizer in Europe and Asia. As such, it does not come under the regulatory supervision of the United States Food and Drug Administration (FDA). It is applied directly to the scalp and can be used by both men and women. Ingredients are listed as:

    Water, SD Alcohol 40-c+SD Alcohol 3-c, Propylene Glycol, Hydrolized Glycosaminoglycans (Thioglycoran), Panthenol, Sorbic Acid, Methylparaben, Hyaluronic Acid (H.U.C.P.), Thurfylnicotinate HCL, Propylparaben, Sodium Hydroxide, Biotin, Fragrance.

    H.U.C.P is a high concentrate of pharmaceutical grade hyaluronic acid which purportedly aids in the breakdown of accumulated DHT in the follicle and creates a binding effect in the follicle's receptor sites preventing further DHT buildup. Kevis also lists the ingredient Tricozyme™. Tricozyme is a protein enzyme that they claim attaches itself to free-floating DHT molecules rendering them “inactive and inoperable”.

    Kevis claims that results from using their product are “permanent”. Once hair follicles are protected from the effects of DHT they will remain DHT resistant for life. Thus, their claim is that once the desired result is reached, there is no need to continue using Kevis.  This is a hefty claim considering all other non-surgical balding solutions are required to be used for life in order to experienced continued benefits.

    In an effort to demonstrate its efficacy, Kevis provides complete, downloadable copies of seven clinical studies conducted by various institutions in France and Italy and provides summaries of each. They also offer several before and after photos (including those of company founder and President Brian Reichenberg) and written testimonials. What seem to be conspicuously missing are references to third-party studies and publications in peer reviewed journals. Without these critical components it’s impossible to verify the company’s hair growth claims.

    Balding men and women may want to stick with clinically proven and FDA approved medical hair loss treatments.  For men those treatments are Rogaine (minoxidil) and Propecia (finasteride). Rogaine is also approved for use by females. However, women should not ingest or even come in contact with finasteride due to the risk of specific birth defects. Men and women who are unable or unwilling to use these drugs can find credible alternatives.

    When it comes to purchasing and using hair loss treatments, there is much more at stake than your hard earned money. Dedicating months or years to ineffective treatments may result in the unnecessary loss of valuable and irreplaceable hair follicles.

  • Saw Palmetto

    Saw Palmetto

    The "Active" Ingredient in Many Popular Hair Loss Treatment Products

    Many popular hair loss treatment options today such as Provillus, Procerin, and Avacor contain the “active” ingredient saw palmetto. It can also be purchased as a standalone supplement in most nutritional stores. But the age old question of whether or not it can effectively treat baldness in men and women with alopecia is still heavily debated. By taking a look at the scientific evidence available we are able to draw some conclusions as to its potential benefit for those with thinning hair.

    What is Saw Palmetto?

    Saw Palmetto berries are a deep red fruit that grow wild on palm trees in warmer climates, typically found in the Southeastern United States. The liposerolic berry extract is typically used as an herbal supplement for the promotion of a healthy prostate.

    Saw Palmetto Hair Loss Study:

    Similarly to finasteride (the active ingredient in Propecia and Proscar), studies have shown that when taken orally, it may be an effective anti-androgen by lowering dihydrotestosterone (DHT) levels in the body by blocking 5 alpha-reductase enzymes. Additionally it is said to block receptor cites on cells which is required for cells to absorb DHT.

    Tests have also been performed on its use in the treatment of benign prostatic disease, which similarly to androgenic alopecia, depends on the production of DHT.

    It is also noteworthy to state that a small preliminary study in 2002 was performed as reported by The Journal of Alternative and Complementary Medicine(2002;8:143-52) that shows a select group of 19 men between the ages of 23 and 64 taking either (400mg of saw palmetto and 100mg of Beta-sitosterol) or a placebo orally. Those who took the herbal combination had 60% improved hair growth over those who took the placebo. There have been no studies to date indicating the efficacy of saw palmetto applied topically for male pattern baldness, female hair loss, or anything to date.

    In our opinion, there are two potential difficulties with this study:

    • Many scientists would argue that the control study group was too small to determine any real efficacy and improved hair growth could have happened by chance. A larger study therefore may be necessary to determine any level of real efficacy.
    • “Improved hair growth” is not the same thing as newhair growth and hair regrowth, nor should it necessarily imply that it works to stop hair loss
    • There are no regulations or suggested daily value as to how much saw palmetto would be required to successfully treat baldness. The appropriate dosage therefore is questionable.
    • The above study was only performed on saw palmetto taken orally. Hair loss products that promote topical use for baldness are basing their belief in its efficacy on something other than published clinical evidence.

    The Dosage:

    But if there are no current standards on dosages of herbal medications in the United States, how do these popular hair loss treatments produce an appropriate dosage?

    Clinical studies on Benign Prostrate Hyperplasia (BPH) have used a dosage of 320mg of the berry extract daily (either one 320mg pill or 2 X 160 mg pill). A daily dosage of 480 mg of saw palmetto berry extract was not found to be any more effective in a six-month study. If the entire berry was used, up to 1000mg or 2000mg would be required to reach the same goal.

    The theory therefore is that if saw palmetto can successfully treat an enlarged prostate similarly to finasteride, it can effectively treat hair loss with a similar dosage Many popular “baldness cure” products contain approximately 1500mg of the berry which is equivalent to approximately 240-320mg of the berry extract.

    Side Effects and Warnings:

    One false assumption is that “all natural” treatments don’t have potential side effects. It is stated that use of saw palmetto has not proven to be safe for women with hair loss during pregnancy and lactation. Medical supervision is suggested for women of childbearing age. Similar warnings are listed about Propecia.

    Conclusions:

    Based on some anecdotal evidence, saw palmetto is said to treat baldness because of its tendency to act like finasteride by helping those suffering from BPH. However, authentic clinical studies have not been performed to date that support this claim. Dosage and how it should be used (orally or topically) therefore is based on conjecture rather that scientific evidence.

  • Future Hair Loss Treatments

     medical hair loss treatment

    Some day, perhaps in the distant future, baldness may become a curable aliment. Scientists are currently researching gene therapies to alter a person's genetic vulnerability to hair loss. However, the actual implementation of such hair loss treatments may be decades away.

    In the near future, drug treatments which inhibit the balding process seem more promising. The hair loss drug Propecia (finasteride) has been proven successful in slowing and/or stopping hair loss by blocking the conversion of testosterone into dihydrotestosterone (DHT) in the scalp.

    Another promising drug that inhibits the development of hair loss causing DHT hormones is Dutasteride.

    Like Propecia, it also inhibits the creation of DHT. And based on preliminary clinical studies, dutasteride promises to be even more successful than Propecia in inhibiting the production of DHT.

    In addition, Dutasteride inhibits the activities of two types of 5-alpha-reductase enzymes. In contrast, Propecia (Finasteride) only inhibits one type. 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, it is being marketed as Avodart by GlaxoSmithKline as a hair loss treatment. Some hair restoration physicians also prescribe it for the treatment of hair loss. Like Propecia, Avodart is not safe for women and children.

    In time, perhaps even more effective hair loss drugs will be developed to inhibit the hair loss process.

    Future Hair Transplants - an endless supply of bald resistant donor hairs?

    The amount of hair you can transplant is ultimately limited by the amount of hair follicles you can safely relocate from the bald resistant donor area at the back and sides of your head.

    Some day it may be possible for physicians to create multiple hair follicles from one original follicle. This process typically called "hair cloning" or more correctly "Hair Multiplication" is currently being investigated by several research scientists and hair restoration physicians.

    If and when this process is successfully developed patients would no longer be limited by the finite amount of bald resistant hairs that can be relocated from their donor area. Hair multiplication would result in a virtually limitless supply of hair available for hair transplantation.

    This would be especially good news for men or women with extensive baldness and a very limited supply of donor hair. Even those with extensive baldness would theoretically be able achieve thick full heads of hair.

    However, experts believe that we are at least ten years away from hair multiplication being available, if even then.

    For most men and women, hair loss can be effectively halted or even reversed with current hair loss treatments. But the future holds the promise of even more effective treatments and perhaps some day even a "hair loss cure".

  • Female Hair Loss - Treatment and Restoration

    Female hair loss

    Female hair loss, otherwise known as Female Pattern Baldness (FPB), affects 1 out of every 4 women in the United States. Recent findings have found that the incidence of FPB has been reported to be as low as 8% and as high as 87%. And, it does appear to be as common for women as for men. Most often, menopause is the most frequent time for hair loss in women to become apparent.

    For a woman to lose her hair can be even more troubling than for men. A woman with thinning hair is not generally accepted as part of the normal aging process. Society has come to expect a thick, luxurious head of hair as part of the attractiveness in women.

    While males and females can both experience thinning hair, they typically do not lose their hair in the same order or appearance.

    Women with thinning hair compared to Men

    Typically men observe their hair loss earlier, whereas women will first notice it in their late 20's through their early 40's. Female Pattern Baldness (FPB) is often seen during hormonal changes. These include the use of birth control pills, following childbirth, or during or after the time of menopause.

    Top view of patient
    Top view of patient, showing excellent growth of transplanted hair.

    In addition, men typically have localized areas (patterns) of thinning, whilein women this usually occurs as thinning across the top, or over an even wider area. When women have very diffuse thinning over much of their scalp they are generally not good candidates for hair restoration surgery. However, women with localized hair loss, similar to the typical male pattern baldness, can successfully undergo hair restoration surgery.

    Thinning hair in females is also characterized by an increase in the combination of normal thick hairs mixed in with finer, smaller hairs. This results in decreased density, and not total hair loss.

    A woman's hair has also been proven to be more sensitive to the effects of stress than men's hair. Stress can result in hair loss in women and men. But this type of loss is not female pattern baldness. Rather, it is known as “telogen effluvium.” This type of hair loss is the shedding of hair in the resting phase when the body senses that it needs to divert its energies elsewhere. Therefore stress can temporarily changes the amount of hair that is shed. But the lost hair is likely to grow back.

    The production of the hair loss-inducing androgens is also different among men and women. A woman produces a small quantity of androgens in the adrenal glands and the ovaries. The ovaries also produce pre-hormones, which are then converted to androgens on the outside of the ovaries or adrenal glands.

    Generally speaking, a woman with hair loss will probably not experience total balding in a given area. But if there is total hair loss, this is most likely a sign of a previously hidden disease. For this reason, it’s important for females to have their hormone levels checked by a physician if they are experiencing heavy hair loss.

    Finally, men and women react differently to various hair loss treatment options. In men, hair loss may be halted or even reversed by finasteride (brand named "Propecia"). However, Propecia is not safe for females or children. Minoxidil (Rogaine) can be effective for both men and women in treating hair loss.

    However, for some women the causes of their hair loss are much more complex than the classic "male pattern baldness". Thus proper diagnosis of the underlying cause is vital before any hair loss treatments are attempted.

    The following physicians are nationally well known experts in female hair loss. Feel free to contact them.

    David Whiting in Dallas, Texas - 214 824-2087

    Vera Price in San Francisco, California 415 353-4163

    Maria Hordinsky in Minneapolis, Minnesota 612 625-1493

    Wilma Bergfeld in Cleveland, Ohio 216 444-5722

    For a web community that is dedicated to female hair loss visit HerAlopecia.com

  • PCOS (Polycystic Ovarian Syndrome) and Female Hair Loss

    PCOS (Polycystic Ovarian Syndrome) and Female Hair Loss

    In women with PCOS(polycystic ovarian syndrome), high levels of androgens (male hormones) in the body may cause hair loss. DHT (dihydrotestosterone), more abundant in men, is created from a combination of testosterone and5-alpha-reductase enzymes. DHT can bind to hair follicle sites, accelerate the natural hair growth cycle, and cause hair to go into resting (catagen) sooner causing thinning hair with each cycle.

    Women with PCOS are more susceptible to androgenic alopecia, more commonly referred to as male pattern baldness or genetic female hair loss. Androgenic alopecia is also the number one cause of hair loss and thinning hair in the world.Women with androgenic alopecia typically lose hair in a pattern similar to the ludwig scale,and less commonly the norwood scale.

    If you suspect you have PCOS, you should consult with a physician and get tested for it. Only a physician can diagnose you and recommend a proper treatment.

  • Dr. David Josephitis

    Dr. David Josephitis
    Dr. David Josephitis
    Dr. David Josephitis performs ultra refined FUT/strip and FUE with outstanding results along side with Coalition members Drs. Ron and Paul Shapiro.
  • Nanogen Hair Loss Concealer Review

    Nanogen Hair Loss Concealer

    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.

    Nanogen colors

    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.