• What is Rogaine and how does it work?

    Along with Propecia, Rogaine is one of the only proven hair loss medication options approved by the FDA for treating hair loss. Minoxidil, (Rogaine’s active ingredient), was originally created as a drug for treating hypertension (high blood pressure). It was then discovered that one of its side affects was growing hair. Minoxidil was then tested for use a topical application for regrowing hair. The results were sufficiently impressive that the FDA approved it as a treatment for hair loss.

    Rogaine works by revitalizing shrunken hair follicles, thus increasing their size. When you use Rogaine every day, your follicles may increase in size, and the growing phase may become longer. This may then produce longer, thicker hairs.

    Rogaine is a clear alcohol-based solution and should be applied to a person’s thinning area with its supplied dropper or spray twice a day.

    The solution is approved and available in two strengths -- Regular (2%) and Extra Strength (5%). Individual users of Regular strength Rogaine have claimed success rates of 30-40%. Meanwhile, users of Extra Strength Rogaine have claimed success rates of 50-60%. Currently, the average price for a 2oz. bottle of Rogaine is about $20-30 per month. Minoxidil is also available as a generic and can be purchased over the counter without prescription.

    It’s important to note that Rogaine (minoxidil) does not cure baldness and scientists have been unable to determine just how it works. What is known is that Rogaine increases the blood flow to the areas of the scalp that surround these balding areas. Currently some researchers believe that Rogaine (minoxidil) works by opening the follicle’s potassium channels located in the cells. It’s theorized that these channels, when opened, may regulate hair growth.

    Rogaine can’t grow hair on completely bald scalps or in the frontal hairline areas. It has been found to be somewhat effective in maintaining or growing hair in the crown area (the top back of the head). However, Rogaine is only effective at delaying hair loss. It is also more effective in women than in men. And again, the reasons for this are not understood.

    What can I expect with Rogaine?

    Rogaine (minoxidil) generally only regrows hair in a minority of men and women. In most cases, the best case scenario for hair growth with these treatments is a thin coverage of thin hair.

    The real benefits of Rogaine (minoxidil) is keeping what hair you have or slowing your thinning. Rogaine’s success depends on how advanced your hair loss has become.

    You must apply it to your scalp twice a day for life to get and maintain any benefits. Research shows that using Rogaine (minoxidil) only once a day is ineffective. If you stop taking Rogaine (minoxidil) you will loose whatever hair you preserved or regrew within 2 to 4 months. And while Rogaine may stimulate hair growth, it may not prevent the hair follicles from their eventual deterioration.

    It's also true that Rogaine's effects may diminish over time. Some doctors believe that patients can build up a tolerance after many years of use. But it's possible to fight this tolerance by taking a week or two off from the treatment every 3-4 months. However, it's not advised to take this break unless you've taken the hair loss medication consistently for at least 12 months.

    Are there side effects from Rogaine?

    There are only minor side effects with Rogaine. But some users do experience certain problems such as scalp irritation, itching, and dandruff. However, this can be treated with a good shampoo like Nizoral or Neutrogena T-Gel. There may also be an increase in hair shedding at the start of the treatment. You shouldn’t panic, as this may actually be a signal that the treatment is working.

    Due to the medication’s alcohol content, some users may develop a contact rash or irritated skin. And with excessive doses, some users may experience dizziness or a rapid heartbeat. However, with normal use these effects are uncommon.

    Rogaine users with severe, refractory high blood pressure experienced some problems. One such problem was “hypertrichosis,” hair growth on the face or other bodily areas. This side effect appears in about 3-5 % of women who use the 2% solution, and higher among women using the 5% solution.

    Rogaine and Hair Transplants

    Some hair restoration physicians have come to consider Rogaine to be instrumental right after surgery. This is especially true when grafts have been placed in and around existing hair.

    The shock of surgery can result in temporary hair loss. Rogaine is thought to possibly help prevent this temporary loss of healthy preexisting hair. The 5% solution has been found to be more effective for men and women. However, some physicians believe that the hair loss medication should be stopped a week or two before surgery. They feel that Rogaine may increase bleeding, while dilating blood vessels.

    After surgery, most patients wait a week or two before restarting Rogaine. This gives the graft areas time to heal. However, taking Propecia is not interrupted by surgery.

    Click to learn more about DHT Blockers

  • Hair Restoration Evolution

    Hair Restoration Evolution

    Hair transplant procedures have evolved a long, long way since they began in the early 1950's. The "corn row" or "doll's" hair look that was associated with hair transplantation has evolved into today's "follicular unit" procedure that, when done right, is undetectable even by a hair stylist.

    The Concept of the Hair Transplant is Born

    During the past several decades superstition, old wives tales, and guess work has gradually been replaced by science.

    The early 1800's is renowned in hair restoration circles as the age of the con men. There were hundreds of hair restoration treatments released and many lasted well into the late 1900's. These "cures" were marketed by "doctors", whose only skills were those of fast-talking and nerves of steel (as well as bravery, considering they were conning hardened cowboys and outlaws!).

    The salesmen hawked their products from the safety of their side shows and "Wild West" spectaculars. They used endless tricks to get people to buy their products, such as rubbing grease into people's hair, to make it look thicker.

    In 1939, a Japanese dermatologist, Dr. Okuda, published a revolutionary method in a Japanese medical journal that would lay the ground work for modern hair transplantation.

    This method involved using hair transplant grafts to correct lost hair from various areas, including the scalp, eyebrow, and moustache areas. However, this study didn't make an impact in the Western Hemisphere due to the interruption of World War II.

    Hair Restoration Comes of Age

    In the late 50's one physician in particular, Dr. Norman Orentriech, began to experiment with the idea of relocating or transplanting the hair on the back and sides of the head to the balding areas.

    Dr. Orentriech's experiments showed that when bald resistant hairs from the back and sides of the head were relocated they maintained their bald resistant genetic characteristic regardless of where they were transplanted.

    This principle, known as "Donor Dominance", established that hair could be transplanted from the bald resistant donor areas to the balding areas and continue to grow for a life time. This laid the foundation for modern hair transplantation.

    The Scientific Era of Hair Restoration

    During the 60's and 70's hair transplants grew in popularity. However, the standard of care used larger grafts that were removed by round punches and often contained many hairs.

    This now outdated hair transplant technique could achieve good results with a full look if a patient completed all planned sessions. However, a patient was typically limited in the manner they could style their hair.

    Patients who stopped short of completing all planned sessions were left with hair transplants that looked obvious and unnatural. Such uncompleted hair transplant results are some times referred to as "Barbie doll hair" or "corn rows".

    Many who have had these older techniques now refine or complete their bad hair transplants with today's very refined techniques to achieve a natural look that they can style in any manner.

    Continue reading Hair Restoration Evolution - Hair Loss Solution

  • Superoxide Dismutase (SODS)

    Superoxide Dismutase (SODS)

    Excessive DHT in the hair follicle causes specific immune responses. These responses cause the cells to release a substance known as Superoxide. This substance combats against any viruses, cells, or foreign tissues. SOD's claim to fight hair loss by reducing the presence of Superoxide.

    As a result, the body is less prone to reject any offending hair follicles, which helps to ward off hair loss. SOD's actually treat hair loss in more than one way. Besides reducing Superoxide, they also stimulate growth and they have anti-inflammatory properties. SOD’s are topical, as well. They include Tricomin, Proxiphen, Proxiphen-N and Folligen.

    Click to learn more about Anti Inflammatories

  • Surgical Hair Restoration - View our procedures in detail

    Surgical Hair Restoration

    Our physician members perform a very refined hair transplant procedure called "Follicular Unit Hair Transplantation". Today there are two methods for doing this procedure. They differ only in the methods used to harvest and prepare the grafts.

    Follicular Unit Extraction Video is provided courtesy of Dr. Alan Bauman.

     

     

    How the follicular unit extraction (FUE) hair transplant procedure is different than standard strip excision hair transplant surgery.

     

     

    How the minimally invasive hair transplant procedure known as Follicular Unit Extraction or FUE is performed.

     

     

    How follicular unit grafts are created under microscopic dissection and then placed into tiny incisions in the balding areas.

  • Hair loss - Race, Age, and Gender Considerations

    Hair loss - Race, Age, and Gender Considerations

    Hair loss is a universal condition, affecting all ages, races, genders and nationalities. It’s estimated that “androgenetic alopecia,” or male and female pattern baldness affects 35 million men and 21 million women in the United States alone. This section examines how race, age and gender affect hair loss.

    Race and Hair Loss

    In physiological terms, human beings are all composed of the same bones, muscles, and everything else down to the cellular level. But there are specific differences.

    Hair, in all of its variations, is one area in which human beings display their differences. Hair follicles can widely vary in terms of color, length, shape, thickness, strength and various other factors.

    There are many ethnic groups to consider. But we will focus on the special considerations of Asians, Blacks (of African descent) and Caucasians.

    Asian Hair Loss Considerations

    Asian people typically have very straight hair. Their scalps contain fewer hairs per square centimeter, they actually have a lower hair density than that of Caucasian hair follicles. But because the individual hair follicles of East Asians are thicker, this gives the look and impression of greater hair density.

    For these reasons, hair restoration techniques for East Asians, much like other races, must be sensitive to a variety of anatomic and cultural differences. For instance, East Asian females often have an increased likelihood of developing “diffuse alopecia,” or hair that thins evenly over the entire head than Caucasian females.

    Even though it’s not a definite requirement, it’s very helpful for Asian patients to seek out doctors with experience in Asian hair.

    Another consideration for East Asians considering hair restoration surgery is the increased chance of developing keloid scars. A keloid is a thick, irregularly shaped and elevated scar with uncontrolled growth that results from excess fibrous skin tissue. East Asians typically have a greater likelihood of keloid development than Caucasians, but less than that of people of African descent. Therefore, before undergoing surgery, East Asians may want to consider being medically evaluated for keloids.

    African Hair Loss Considerations

    People of African descent usually possess naturally curly hair. This curly hair gives the visual impression of increased hair density for a given amount of hair, which is beneficial in hair restoration surgery.

    The hair follicles beneath the skin of people of African decent also typically curve more than Caucasians. This can make harvesting the donor hairs, without severing or transecting the hair follicles beneath the scalp, more difficult. A hair restoration physician needs to be very aware of this difference and adjust to its requirements.

    As in the case of East Asians, people of African descent possess some unique hair and skin characteristics. Some of these medical conditions are more common in black skin than in white skin. This may increase the risk for post-surgical complications.

    Those of African descent have a higher chance of developing keloid scarring when injured. This in turn leads to a greater chance of noticeable donor scars. Keloids aren’t a widespread problem. But those with a history of them are carefully evaluated in regard to their existing scars. The evaluation usually involves a small "test procedure" to determine if there’s a normal healing rate.

    Another issue is that of postoperative skin discoloration. With darker skin, there’s often a greater risk of both increased and decreased skin color after injury or surgery. These risks can be determined by the patient’s medical and family history.

    Ingrown hairs are also a more common problem in darker skin. If a patient has a history of ingrown hairs or other minor skin infections, this may signal a higher risk for ingrown hairs post-hair restoration surgery. Again, this risk can be determined by a small test procedure.

    Caucasian Hair Considerations

    Caucasians (white people) may have a wide range of hair and skin types. However, if someone has dense and or coarse hair, as well as skin color similar to their hair color, they will generally achieve the best results for a given amount of restored hair.

    Learn more about aging and gender hair loss

     

  • Avacor. Is it worth the price?

    Avacor

    One product you used to see quite often in advertising is Avacor. According to Response magazine, Avacor was the third best selling product on the Internet in April, 2002. Avacor was originally manufactured by Global Vision Products. After being taken over by new management, it is now being manufactured by Avacor Products LLC.

    Like most products that advertise 'Stop Hair Loss and Regrow Hair!', Avacor contains the only FDA approved topical drug minoxidil. Avacor, like other products with similar claims, mixes FDA approved drugs in their generic form with other ingredients in a multiple regimen of products like shampoo, lotion and vitamins.

    Avacor historically cost approximately $239 for a two to three month supply and over $1000 for a year’s worth.  New prices are much more reasonable which range from $180 for a 3 month supply to $400 for a year’s supply of the men’s and women’s formula. Note that the ingredients in Avacor can be bought over the counter at your local store at a fraction of the cost for which they are sold in Avacor. However, they do offer 24/7 customer service and a 90 day money back guarantee.

    Marketing Practices

    Avacor, like other products with similar claims, has taken a lot of slack over the years for their controversial marketing tactics. Avacor has a checkered past and has previously been the focus of lawsuits and investigative reporting by major media like ABC news. Recently however, new management has taken over and claims they are very serious about selling quality products at more reasonable prices, without the hype and controversial marketing strategies. In looking at their website, while Avacor still uses slick marketing language to promote their products, the vast majority of their claims are much more realistic.

    Avacor includes 3 distinct products that claim to provide “total hair care”. This includes a 'Scalp Detoxifying Shampoo', a 'Physicians Topical Formulation' and finally a 'Nutricap'. Avacor's Nutricap ingredients consist mainly of common herbs like saw palmetto, gingko biloba, keratin, resveratrol, and bilberry. While conjectured to inhibit the production of DHT, none of these ingredients are FDA approved or proven to stop hair loss. Avacor’s Physician’s Topical Formulation however, does contain 5% of the FDA approved hair regrowth agent minoxidil.

    Other than minoxidil, no other ingredient is proven to regrow hair. A number of studies have been done that suggest saw palmetto inhibits the production of DHT, like Propecia. But, unlike Propecia, it has never been proven to stop or reverse hair loss.

    Avacor Products

    Avacor admits on their website that the only product proven to regrow hair is the Avacor Physician’s formulation which includes the FDA approved ingredient minoxidil (5% for men and 2% for women). The other products claim to provide hair with the essential nutrients for healthy hair growth but are careful not to claim to prevent the progression of male or female pattern baldness (androgenic alopecia). Perhaps this is why the Avacor Physician’s formulation can now be purchased separately. Costs of the Physician’s Formulation are still, but only a little more expensive than Rogaine topical hair loss treatment, one of the first and most popular topical minoxidil products.

    The Avacor Study

    At this time, Avacor’s proof comes in the form of the FDA approved study showing that minoxidil can stop and reverse hair loss.  No other study is provided with their product.  Their website also is much more realistic as to what their product line can accomplish for hair loss suffering consumers.

    Confidence in Products and Services

    Before you consider spending hundreds of dollars for any product or service, do a review. Legitimate products will have legitimate studies and have been reviewed on many quality websites. Doctors with real talent and satisfied patients will be able to show you dozens of photos and allow you to talk with past patients. Proven physicians will make available their resumes along with their formal education and associations they belong to.

    It is always best to review a product or doctor for information on their background before you make a decision for something as important as hair loss and hair restoration.

    Conclusion

    At the very least, the Avacor Physician’s formulation will be as effective as the Rogaine liquid formula or generic minoxidil. However, to date, both Rogaine and generic minoxidil are more cost effective than Avacor.  The nutricap, shampoo, conditioner and other products may promote healthy hair and provide it with volume, but make no claims of stopping hair loss or regrowing hair.

  • The Future of Medical Hair Restoration

    Hair Restoration Future

    Today's evolutionary high point - Ultra Refined Follicular Unit Transplantation

    By relocating these carefully prepared bald-resistant follicular units, physicians doing "follicular unit hair transplantation" recreate a natural pattern of hair in the balding areas.

    To do this properly is a very time consuming and exacting process. It requires a team of meticulous medical technicians working hand-in-hand with the hair transplant surgeon in a very lengthy surgical procedure.

    Ultra Refined Grafting - Smaller Blades, Smaller Incisions, Smaller Grafts

    Today's micro surgical blades, like the size of hair grafts, have become ever smaller and now enable hair transplant surgeons to safely make more tiny graft incisions in a given area then ever before. Surgeons are then able to "dense pack" select areas with as many as 40 to 60 follicular unit grafts per square centimeter. This graft density is as much as twice that of the standard follicular unit hair transplant procedure.

    Such high densities of transplanted hair typically produce the appearance of fullness even after only one surgical session. Patients also experience rapid healing and no visible skin distortions due to the tiny size of these incisions.

    Ultra Refined Follicular Unit Grafting - Hard on the clinic but easy on the patient.

    Ultra refined follicular unit grafting raises the bar for physicians and their staff. This delicate and demanding hair transplant procedure requires more skill and careful attention to be performed properly. The smaller and more tightly packed incisions require more closely dissected follicular unit grafts that are carefully trimmed under microscopes. These small and densely packed incisions are also more difficult to place the grafts into.

    This procedure also requires more careful patient selection, as "dense packing" of grafts is not appropriate for all patients.

    Ultra Refined Follicular Unit Transplantation - the new "Gold Standard"

    In the hands of a highly skilled physician and staff the Ultra refined follicular unit hair transplant procedure can achieve excellent new hair growth that is so natural that it is undetectable even under close scrutiny.

    While the standard micro "follicular unit" hair transplant does produce natural looking results, its ability to achieve high density in only one surgical session is limited. Thus patients may have to do subsequent surgical sessions in a transplanted area to achieve a full look.

    The many patient benefits of this new ultra refined procedure are significant and include:

    • The ability to get excellent hair density in only one surgical session.
    • Minimal trauma in the graft recipient area with rapid post surgical healing.
    • Little or no visible pitting or distortions in the transplanted areas.
    • More natural direction and angulation of the transplanted hair.

    All physician members of the Coalition perform Ultra Refined Follicular Unit Hair Transplantation.

    While many hair transplant physicians perform quality follicular unit hair transplants, only some of them are capable of performing large sessions of ultra refined follicular hair transplantation. However, all members of the Coalition of Independent Hair Restoration Physicians perform ultra refined grafting with excellent results.

    The Future of Surgical Hair Restoration

    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 Multiplication or more incorrectly Hair Cloning 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 transplants.

    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. But perhaps some day scientists will be able to use gene therapy to halt the balding process without drugs or surgery.

    Learn about modern hair loss drug treatments that work.

  • Recoverup: A Revolutionary Stem Cell Treatment or Hair Loss Hype?

    Female hair loss

    It seems that lately, new hair loss treatments based on “revolutionary scientific research” hit the rumor mill on a monthly basis. Some of these treatments come to light via reputable scientific journals while others, like Recoverup, materialize one day with a flashy website, a lot of promises and very little verifiable data. Recoverup is a UK based company that claims to offer stem cell treatments for hair loss through clinics in Taipei, Taiwan and Penang, Malaysia. According to their website, this treatment is so quick and easy it can be performed in a single day with startling results visible in only one month. Does this sound too good to be true?

    Recoverup’s baldness treatment process claims to rely upon Autologous Adipose Adult Stem Cells (AAA). Unlike controversial embryonic stem cell treatments, Autologous Adipose Stem Cells are derived from the patient’s own fat cells through a small liposuction procedure and are then grown into a culture to increase volume. These stem cells are then “differentiated” with “growth factors” and injected into the scalp in order to induce new hair growth. This multistage process from extraction to injection can be performed in two appointments scheduled in the same day.

    The question is, does Recoverup’s baldness treatment really grow hair? They state that “Empirical data indicates patients would expect to see at least 40% of all treated areas showing one of four results; (1) darker hair (2) thicker hair (3) faster growing hair or (4) more hair per follicle. Overall the effect is of more volume, and density, in those areas which were treated.” However, the Recoverup website offers very little in the way of photo documentation. The few photos that are presented are of poor quality and covered in text making them very difficult to evaluate.

    The estimated cost for the one day hair loss treatment is between $8,000 and $13,000 depending upon the area to be treated. However, if the area to be treated is sufficiently large enough to merit a second day of treatments then this fee increases. Recoverup states that the long-term effects of the treatment are unknown and are dependent upon such factors as the patient’s age and quality of the source stem cells. “However, as a general guide, in other areas of stem cell treatment, data indicates approximately 3-5 years of positive results from each treatment.”  Recoverup does offer a 30-day money back guarantee if a patient experiences no new hair growth but is also quick to point out that the results will vary. One can imagine quibbling over whether or not a single follicle that didn’t appear to exist prior to treatment would constitute success under their definition. In summary, assuming Recoverup’s AAA stem cell treatment does stimulate hair regrowth, a patient can expect to pay upwards of $13,000 plus travel expenses to Asia for a treatment that is, by their own estimates, about 40% effective and may last between 3 and 5 years. This hardly sounds like an attractive alternative or even supplement to today’s state of the art, ultra-refined follicular unit hair transplantation combined with the clinically proven medical treatments Propecia (finasteride) and Rogaine (minoxidil). It is recommended that patients approach all unproven, “revolutionary” medical treatments with cautious optimism. Androgenic alopecia is progressive and avoiding proven surgical and medical treatments in favor of experimental procedures may lead to further hair loss.

  • How to Choose a Hair Restoration Clinic

    Male hair loss

    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

    • How many years has the physician been dedicated to doing hair restoration?

    • 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.

    • 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.

    • What is the hair restoration surgeon's reputation among his or her peers?

    • Does the physician take a holistic approach to hair loss treatment and also offer advice or Rogaine?

    • What procedure does the clinic perform? Is it truly state of the art?

    • Does the physician use microscopes for the dissection of the donor tissue into 1, 2, 3, and 4 hair Follicular Unit (FU) grafts?

    • 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?

    • Trust but Verify – Review Patient Results

    • 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.

    • 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.

    • Verify claims by visiting online discussion forums and searching for previous posts regarding a hair transplant physician you are considering.

    Consider our Quality Physicians

    hair transplant doctors

    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.

  • Thomas Chung Wai Nakatsui, MD

    Dr. Thomas Nakatsui
    Dr. Thomas Nakatsui
    Dr. Nakatsui performs large sessions of ultra refined follicular units using the lateral slit technique with extremely natural results.