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Dr. Steven Gabel
Dr. Steven Gabel is dedicated exclusively to performing ultra-refined follicular unit hair transplantation and follicular unit extraction with excellent results performed in the Portland area. -
Xandrox
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.
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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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Hair Transplant Surgery
Currently the only solution for regrowing hair, particularly in the hairline area, is hair transplant surgery, an advanced surgical hair restoration technique.

Done right, a hair transplant is so natural that even a hair stylist cannot detect that a person has had hair transplants.

The days of the "corn row" or "Barbie Doll" hair transplants are long gone.
To achieve such truly natural results requires a dedicated and highly skilled staff doing a state of the art hair transplant procedure. The state of the art micro hair transplant procedure that our member physicians perform is called "Ultra Refined Follicular Unit Hair Transplantation".
Hair transplant surgery involves relocating (transplanting) the bald resistant hair follicles from the back of the head to the balding areas on the top and front of the head.
This process is effective and will last a lifetime because the hair follicles taken from the back of the head are genetically resistant to baldness, no matter where they are transplanted.
This procedure is regarded by most hair restoration physicians to be the "gold standard in hair transplants". Learn more about this hair transplant procedure.
Because this very refined procedure is difficult to perform at the highest quality level only a minority of all hair restoration surgeons perform it successfully. Our member physicians have extensive experience performing this advanced and very refined procedure with excellent proven results.
Today, hair transplant surgical hair restoration is an out-patient procedure requiring only local anesthesia. Most patients are surprised by how little discomfort they experience during and after their surgery. Many patients watch TV or sleep during their procedure.
Hair transplant surgery is the only certain way of restoring significant amounts of hair in balding areas. View hair transplant photos of actual hair loss patients.
Sharing information in the Hair Loss Learning Center forum with patients who have successfully restored their hair is a good way to begin the process of selecting a hair transplant surgeon with a proven record of restoring a natural hairline. Online consultation can put you directly in touch with one of the world's top hair restoration physicians in your area who can help you assess your options.
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Finally Hair Loss Medication that works
While hair restoration surgery is now a proven treatment for restoring hair where it has been lost, Hair loss medication such as Rogaine (minoxidil) and Propecia (finasteride), have made real contributions toward stopping and even reversing hair loss.
During the late 70’s and early 80’s it was discovered that minoxidil, used as a heart medication, had hair growing side effects. Minoxidil was tested for use as a topical scalp treatment for hair loss and proved to inhibit hair loss in many test subjects.
It has proven to be effective to some degree in slowing the hair loss process. For a minority of people it can even grow back lost hairs in the crown area (back of the head). However, Rogaine (minoxidil) does not slow or reverse the balding process in the frontal hairline area.
Rogaine is typically applied topically on the scalp twice a day, morning and evening. But once usage is discontinued the hair loss which had been inhibited will resume and the hair that was saved will be lost.
Rogaine originally required a prescription, but in 1995, it became available in 2% strength Rogaine over-the-counter. Today, men and women can buy 5% strength lotion over-the-counter as Rogaine or as generic minoxidil.
To date Rogaine (minoxidil) and Propecia (finasteride)are the only hair loss medications with FDA approval. Propecia’s active ingredient, finasteride, was originally used to treat enlarged prostate glands. It was discovered that, like minoxidil, it had the “side effect” of stopping male pattern baldness and for some even regrowing hair.
Propecia is taken as a pill once daily and acts to inhibit the body’s ability to create dyhydrotestosterone or “DHT”. DHT acts as the active ingredient or catalyst in the balding process.
Rogaine and Propecia
The 90’s brought great advances in hair restoration, both surgical and non surgical. Now most people can realistically halt and reverse their hair loss with truly natural results.
In 1988 minoxidil, Rogaine, became the first hair loss medication to be approved by the FDA for the treatment of hair loss.

In 1998 the FDA approved Propecia for the treatment of hair loss. Propecia (finasteride) should NOT be taken by woman or children for any reason.
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How to Choose a Hair Restoration Clinic
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.
Since performing follicular unit hair transplantation is very demanding upon a clinic’s physician and staff only a minority of hair restoration clinics perform it successfully. Unfortunately, many clinics are still unwilling or unable to dedicate the time and resources required to master and perform this procedure successfully.
Therefore, those seeking only the most natural results need to be very selective. Keep in mind that in the United States any licensed physician can perform hair restoration surgery without any special certification or training. If you do not find an excellent hair restoration surgeon in your local area seriously consider traveling out of state to get your hair restored properly. After all, the results will last a lifetime.
Evaluating a potential hair restoration physician and clinic
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How many years has the physician been dedicated to doing hair restoration?
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How many hair restoration procedures does the surgeon perform in one day? Ideally the physician will be dedicated to working on you all day if you are doing a large mega session procedure.
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Does the physician perform hair restoration surgery full time or predominantly? If not, the clinic may not have a staff that is experienced enough to successfully perform large sessions of all microscopically prepared Follicular Unit (FU) grafts.
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What is the hair restoration surgeon's reputation among his or her peers?
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Does the physician take a holistic approach to hair loss treatment and also offer advice or Rogaine?
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What procedure does the clinic perform? Is it truly state of the art?
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Does the physician use microscopes for the dissection of the donor tissue into 1, 2, 3, and 4 hair Follicular Unit (FU) grafts?
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Large sessions of all microscopically prepared grafts are a team effort. But how "hands on" will your hair restoration surgeon be? Will he or she be making all the incisions in the graft recipient area, thus determining the design and hair direction of your transplanted hair? How involved will your surgeon be in the placing of the actual grafts?
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Trust but Verify – Review Patient Results
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Can the surgeon provide a list of names and phone numbers of patients willing to discuss their personal experiences? Patient testimonials will say a lot.
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Can the surgeon provide at least one dozen sets of clinical "before" and "after" case photos for your review? Be sure the photos offer good clarity and detail and include "before" views as well as "after" views that allow for critical evaluation.
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Verify claims by visiting online discussion forums and searching for previous posts regarding a hair transplant physician you are considering.
Consider our Quality Physicians

Our member physicians are carefully reviewed and granted membership in the Coalition based on their high level of ethics, skill, and the quality of their patient results.
Learn more about our network of quality prescreened physicians.
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Toppik Hair Loss Concealer
Truly a "Full Head of Hair in 30 Seconds?"
Of all the hair loss concealers available, like topical powder applications or "sprinkle solutions," Toppik is amongst the most popular. What's more, of all the "shaker" options currently available to hair loss suffering men and women, Toppik is one of the most recognized and trusted.
Since its inception, Toppik has been featured in various media outlets, including Time magazine, the Oprah Winfrey show, Fox News, NBC, and Eyewitness news. Throughout this media exposure and positive word of mouth, this hair loss product has been utilized by an estimated 3 million balding men and women worldwide. So what makes Toppik so popular? How does it work? How does it compare to other types of concealers? Most importantly, what are real consumers saying about Toppik and where can interested parties purchase this popular concealer?
Toppik Hair Loss Concealer: What is it, and how does it work?
Toppik, like many other concealers available today, is a topical powder application. The powder formula is comprised of a series of charged, keratin-based, "hair binding fibers" that, when sprinkled on thinning hair, tightly adhere to individual hair strands. With each "shake" of the Toppik product, thousands of these particles are applied to the head and bind to hair shafts via opposing electrical activity (much like the way magnetized material attracts metal).
By tightly binding to hair shafts in such significant numbers, Toppik naturally recreates the appearance of a thick, dense head of hair. According to the makers of Toppik, the bond created by the hair shaft and keratin particle is so strong that it will withstand wind, rain and perspiration, and will continue to naturally thicken and volumize the hair until "washed out" by shampoo. Additionally, because Toppik is available in a variety of different tones, the product is able to precisely match any hair color/texture and still remain completely undetectable.
What Benefits Does Toppik Offer Over Other Concealers?
Although Toppik is popular and well known within the hair restoration community, hair loss sufferers should still ask one crucial question: what benefits does Toppik offer over other, similar concealers? According to the manufactures, Toppik offers a variety of benefits that other, comparable products simply cannot match. First, Toppik's keratin fibers are completely safe, organic, all natural, and utilize electric energy to adhere to hair fibers with unmatched efficacy.
Next, not only is Toppik available in a variety of colors, but these tones can also be "mixed" to match any color and can even cover gray hair and new growth from hair transplant surgery. Toppik colors include black, dark brown, medium brown, light brown, medium blonde, blonde, auburn, gray and white.

Furthermore, Toppik can be used in conjunction with other hair styling products (though the powder needs to be applied to dry scalp, and styling products should be applied before usage), will not "rub off" on clothing or pillows, can be safely utilized with other hair restoration products and medications, will not clog pores or dry out the scalp, is equally effective in balding men and women, and is easily applied via the shaking method or by applying the popular "spray applicator" to the shaker apparatus.
Why is Toppik so Popular in the Hair Loss Community?
Because of its innovative design, positive "track record," ease of use, and effective nature, Toppik has developed a trusted reputation and large fan base in the hair restoration community. Hair loss sufferers not only trust the history behind the Toppik brand, but appreciate the product's single use longevity and lasting strength of the fiber-hair shaft bond. The fact that the product is effective for male and female hair loss sufferers and can be easily used with other styling and hair restoration products makes Toppik an even better option for any individual considering a topical concealer.
What Real Consumers are Saying About Toppik?
To see what real hair loss suffering men and women are saying and to read helpful tips about applying Toppik in a variety of situations and in conjunction with other hair loss treatments, visit our Hair Loss Forum and Social Community. You can also read our product review by visiting "Product Review: Nanogen Versus Toppik".
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Dr. Ron Shapiro
Dr. Ron Shapiro
A true pioneer, with a worldwide reputation for outstanding follicular unit hair transplantations among both colleagues and patients. -
Female Hair Loss and Birth Control Pills
Birth control pills can be a great way of preventing conception however;all medication comes with potential side effects. In addition to the many serious possible side effects associated with birth control pills, some come with a risk of female hair loss. By suppressing ovulation due to the combined actions of hormones progestin or estrogen, women who are predisposed to hormonal related hair loss may experience varying degrees of balding while on the pill, or even more likely, a few weeks to months after coming off of it.
Yasmin is a birth control pill that combine sethinyl estradiol and drospirenone Because Yasmin may induce hair follicles into the telogen phase (hair shedding) of the hair growth cycle, hair loss is a reported side effect
We recommend women to use only low-androgenindex birth control pills. For women with a strong predisposition for genetic hair lossin their family, we recommend use of other non-hormonal birth control pills or other forms of contraceptives for the prevention of conception.
For your reference, here is a list of birth control pills ranging from the lowest androgen index to the highest: Desogen,Ortho-Cept, Ortho-Cyclen, Ortho Tri-Cyclen, Micronor, Nor-Q D, Ovcon-35,Brevicon/Modicon, Ortho Norvum 7/7/7, Ortho Novum 10-11, Tri-Norinyl, Norinyland Ortho 1/35, Demulen 1/35, Triphasil/Tri-Levien, Nordette, Lo/Ovral,Ovrette, Ovral, Loestrin1/20, Loestrin 1.5/30.
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Viviscal Hair Loss Treatment Product Review - Can it Really Promote New Hair Growth?
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.
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