• The Psychology of Hair Loss

    Hair transplants - Are they right for you?

    Long ago, a full head of hair was valued as a means of protection, heat retention, and camouflage.

    Today we value hair for other reasons. Whether we admit it or not, good hair still is associated with power, virility and youth.

    Such associations date back to ancient times. Remember the story of Samson and Delilah? When Delilah cut Samson’s long hair he lost his power.

    Samson

     "And Delilah made him sleep on her knees; and she called for a man, and she caused him to shave off the seven locks of Samson’s head. . . and his strength went from him."(Judges 16:19)

    As “enlightened” as we are today, stereotypes associated with hair loss persist. The bald or balding are sometimes passed over and teased at work, in the media, and in the social scene. The media idolizes the young and the attractive and often lampoons the bald or balding.Of course, it’s not fair. But at least losing your hair is not health threatening. However, it can result in various psychological and emotional issues. These include insecurity, isolation, panic, a sense of loss, and even depression. But let’s first look at the role of hair (and the lack of it) in our society.How is Hair Loss seen by Society? So why does something as superficial as hair seem so important to so many men and women? Studies have shown that hair is a symbol of social, professional, cultural, and/or religious affiliations. Good hair implies power, virility, strength and youth.

    Studies reveal how baldness is perceived.In a study done in 1971, a picture of one person was distributed to 60 people. But each picture had been altered by a commercial artist to reflect a non bald, balding, or bald condition. The results revealed some negative stereotypes.

    1971 Hair loss study

    When the person was shown with a balding head of hair he was rated as weak, dull, and inactive. This same person with a bald head of hair was rated as unkind, bad, and ugly. Yet this same person with a full head of hair was rated as handsome, virile, strong, active, and sharp.

    Today, more than 30 years later, it is hard to know if things have really changed. But maybe some of these tired negative stereotypes about being bald are starting to change, at least in the media.

    NYPD

    Today, bald NYPD Blue's -Dennis Franz, a multiple Emmy Award-winner, is considered a sex symbol.

    Sopranos

    As is Tony Soprano of the popular HBO TV show the Sopranos.

    Kojak

    And, of course, let’s not forget Telly Savalas of the 70’s TV show Kojak who was once voted by People magazine as the “sexiest man alive.”

    Studies about Baldness and Self Esteem

    Those who are bald or balding are generally thought of as older, weaker, and more ineffectual, both in the work world and on the social scene.

    According to a 1995 article in the “British Journal of Psychology,” balding men have been found to have lower levels of self-esteem than their peers, are less sociable, suffer more from depression,and are less likely to succeed in life.

    Hair loss, especially when first occurring, can lead to rash decisions. So it is important to slow down and look at the many viable options that are available for dealing successfully with hair loss.

    Our Hair Treatments section offers in-depth information on many viable treatments.

    1992, researchers from the Old Dominion University in Norfolk, Virginia surveyed 145 balding men and found that 84% were preoccupied with baldness.

    Their responses showed that they were filled with self-consciousness and helplessness. They were also envious of men with full heads of hair.

    Additional research indicated that single men and woman who had begun losing hair in their early twenties were more likely to suffer from extremely low self-esteem.

    Hair loss often creates emotional distress.

    Loosing your hair can be disturbing, especially if you're a young man or woman. This unwanted loss forces those afflicted to face new issues, such as the perceived loss of youth and sexual attractiveness.

    It's common for young people who are balding to have feelings of isolation. They may feel uncomfortable among their peers and in public. Young people with hair loss often lose their confidence and may also become less productive at work.

    For older people hair loss is often just one more sign that they're reaching middle or old age. It may prompt them to question the direction of their lives or fear that their lives are closer to the end than the beginning. This can result in a sense of loss, insecurity, or even depression.

    And as bad as men have it, hair loss can be even worse for women. Balding women must deal not only with the thought of aging, but also that they may not be considered attractive.

    Coming to terms with hair loss.

    Yes, hair loss can be disturbing. But there are many effective options available to you, ranging from hair loss drugs that often halt thinning to restoring the hair you’ve lost with surgical hair restoration.

    However, prior to choosing a hair loss treatment, it is wise to deal with the psychological effects of hair loss.

    Hair loss at any age, while not painful or dangerous, can cause emotional damage and distress.

    Finding support and advice to cope with hair loss.

    You can find support and share ideas and advice privately with other hair loss sufferers by reading and posting on our popular hair loss discussion forum.

    By sharing with others you will realize that others share your same concerns and feelings about going bald. You will also learn about what hair loss treatments actually work or not from those who have already tried them.

    Find a "Hair Loss Mentor" for - one on one - support and guidance.

    In addition to our discussion forum, you can also view Hair Loss Weblogs created by actual hair restoration patients. These blogs contain photos journals documenting the person's hair restoration. Often you can correspond with these blog authors by email.

    If you have a hair loss question please post it on our Hair Loss Q & A Blog. This blog can also be searched for dozens of answers on many hair restoration topics.

    Empowering yourself with information and sharing your feelings and concerns will also make you feel much more in control of your hair loss. Then, if and when you finally do choose a hair loss treatment option, you will feel much more confident in your decision.

    Many who once were preoccupied by their hair loss find a solution and move on in life, sometimes with a "new lease on life". While others choose to remain bald and simply accept it.

    The choice is yours to make. This site is dedicated to helping you successfully resolve your hair loss issue on the inside as well as on the outside.

    The disturbing truth about hair loss

    In 1999, the psychological impact of hair loss, as well as its leading treatments, was the subject of the American Academy of Dermatology's summer scientific meeting in New York. At this meeting it was revealed that there were direct links between androgenetic alopecia (male and female pattern baldness) and personality disorders in those afflicted.

    In one study of 116 subjects with hair loss it was determined that 76.3% of the participants had at least one actual personality disorder. This was an extremely high rate of disorder compared to the much lower rate of 10% of the general public suffering from personality disorders.

    Another study showed that twice as many women than men with hair loss rated themselves as “very” or “extremely” upset about their hair loss.

  • Hair Loss from Cavemen to Hair Cloning

    Hair Loss from Cavemen to Hair Cloning

    Hair has always been an important symbol of status throughout history. Whether it signified social, financial, gender, or professional status, hair has come to be considered a sign of success. And this idea appears to go all the way back to the cavemen.

     A few years ago, the frozen body of a man on the Austrian-Italian border was discovered by scientists. Upon examining the clothing and weapons found on the specimen, they were astounded to find that the body was from the Neolithic Age, making him more than 5,000 years old. They had previously thought that the body was only a few years old, based on his trimmed beard and short hairstyle. So even during prehistoric times hair care was in practice.

    Even 4,000 years ago, the ancient Egyptians were searching for a hair loss cure. One “cure” used around 1500 B.C. in Egypt called for reciting a magic spell to the sun god and then swallowing a mixture of onions, iron, red lead, honey and alabaster.

    Around 1100 B.C. in ancient Egypt it was popular to rub the fats of various animals onto the scalp, including those of the lions, hippopotamuses, crocodiles, ibex, serpents and geese.

    Another recipe for growing hair prepared for the King of Upper and Lower Egypt included toes of a dog, refuse of dates, and a hoof of an ass. Of course, these “cures” failed to re-grow hair.

    But with baldness regarded as shameful in ancient Egypt, men and women were willing to put such things on their head in the hope they would work. During these times it was believed that baldness stood for the public announcement of a man’s loss of virility.

    The Gospel on hair loss

    Yes, hair loss is even mentioned in the Bible. According to this Old Testament passage God does not condone ridiculing the bald.

    Kings 2: 23 “From there Elisha went to Bethel. As he was walking along the road, some youths came out of the town and jeered at him. "Go on up, you baldhead!" they said "go on up, you baldhead!" He turned round, looked at them and called down a curse on them in the name of the Lord. Then two bears came out of the woods and mauled forty-two of the youths. And he went on to Mount Carmel and from there returned to Samaria.”

    As a hair loss sufferer you can take solace in knowing that today you have treatments for hair loss only dreamed of by the Kings of ancient Egypt and the emperors of Rome.

    Hair loss and attempts to stop or reverse it have been around for centuries.

    How mankind has treated hair loss over time.

  • 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

     

  • Follicular Unit Hair Transplantation - Step by Step

    Follicular Unit Hair Transplantation - Step by Step

    We believe that patients have a right to full disclosure and a complete understanding of exactly what hair restoration surgery involves.

    This step by step presentation shows how today’s state of the art follicular unit hair transplant procedure is typically performed.

    Step 1 - hair transplant donor area

    Patient is prepared for surgery

    During surgery hair follicles from the back of the head that are genetically resistant to going bald will be removed and relocated (transplanted) to the balding areas.

    Step 2 - Patient is prepared for surgery

    Donor area is trimmed

    Prior to surgery, the hair in donor area that will be surgically removed is trimmed.

    Donor area is prepared for surgery

    Once the donor area has been prepared it is given local anesthesia.

    Donor tissue is removed

    Donor tissue is removed

    The donor tissue containing the bald resistant hair follicles is then surgically removed.

    Donor area is sutured

    Donor area is sutured

    The donor tissue containing the bald resistant hair follicles is then surgically removed.

    Hair combed over sutures

    Hair combed over sutures

    When patient’s hair is combed over the donor area the sutures are not visible. These sutures are typically removed approximately ten days after surgery.

    Donor tissue is trimmed into follicular unit grafts

    Donor tissue is trimmed into follicular unit grafts

    Surgical technicians then use microscopes to view the donor tissue in order to dissect and prepare follicular units hair grafts.

    Bald recipient area is prepared

    Bald recipient area is prepared

    After being given local anesthesia, the balding recipient area is ready for surgery. No trimming or shaving of hair is needed in the top recipient area.

    Incisions are made in the balding areas

    Incisions are made in the balding areas

    Tiny incisions are made in the recipient areas in irregular patterns that mimic nature. The follicular unit grafts will then be placed carefully into these tiny incisions.

    Grafts are placed into the incisions

    Grafts are placed into the incisions

    Follicular unit grafts are gently placed into the recipient incisions.

    Grafts are placed in varying densities

    Grafts are placed in varying densities

    Typically the smallest one and two hair grafts are placed in the very front of the hairline, with three and four hair grafts placed behind them.

    Patient immediately following surgery

    Patient immediately following surgery

    Following surgery a patient will have hundreds of tiny incisions with short hair stubble showing from the new grafts.

    Close up of recipient area after surgery

    Close up of recipient area after surgery

    The tiny graft incisions heal rapidly. The redness and scabbing in the recipient area normally clears up within about one week.

  • 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.

  • Dr. Ron Shapiro

    Dr. Ron Shapiro
    Dr. Ron Shapiro
    A true pioneer, with a worldwide reputation for outstanding follicular unit hair transplantations among both colleagues and patients.
  • Xandrox

    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.

  • A Hair Transplant - How to do it right.

    A Hair Transplant - How to do it right.

    Today it is a very refined outpatient procedure that can produce full and natural looking results, even after only one hair transplant session.

    When performed correctly not even a hair stylist will detect that a person has had a hair transplant.

    However, to achieve such natural results it is critical that the hair transplant procedure be "performed correctly". To do so requires a hair restoration clinic that can perform a follicular unit hair transplant at the highest levels of skill, experience, and dedication.

    What it takes to create natural results.

    A great hair transplant is the result of using a state of the art surgical procedure and performing it with great skill and artistry. Today the acknowledged "gold standard" in hair transplant surgery is called "Ultra Refined Follicular Unit Hair Transplantation".

    This relatively new hair transplant procedure enables a patient to achieve extremely natural results because it recreates and mimics the way a person's hair grows naturally, hair for hair.

    Recreating Nature Hair for Hair

    To understand this procedure you must first understand how hair grows naturally.

    If you look closely at naturally growing hair using magnification you will see that hair actually grows in groupings of one, two, three, and four hairs.

    These naturally occurring hair groupings grow in irregular patterns on the scalp similar to trees growing in the forest. These groupings are technically referred to as "follicular units".

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

    Follicular Unit Hair Transplant tough on the clinic but easy on the patient.

    To do this properly is a very time consuming process. It requires a team of skilled and meticulous medical technicians working closely with the lead physician.

    All our physician members perform this hair transplant procedure with excellent results. They are granted membership in the Coalition of Independent Hair Restoration Physicians strictly based on their proven high level of experience, ethics, and skill in successfully performing this patient friendly procedure.

    While the follicular unit procedure is more demanding upon the medical staff, it produces dramatic and life long advantages for the patient such as undetectable naturalness, rapid healing, and optimal use of their limited donor hair.

    The Standard Hair Transplant, easy on the clinic but not on the patient.

    Only a minority of hair transplant surgeons are committed to doing the follicular unit procedure properly. Many physicians continue to dissect grafts without regard to the integrity of the follicular units. Follicular units are often transected and damaged as donor tissue is cut to conform to the size of the recipient holes rather than to maintain the integrity of the follicular units.

    Such common standard hair transplant procedures are quicker and simpler to perform than follicular unit hair transplantation from the hair transplant surgeon's perspective. The standard hair transplant procedure is also often more profitable for the clinic since it requires less staff time, training, resources, and skill. However, the results are generally suboptimal for the patient.

    Respecting the Follicular Unit

    Respecting the Follicular Unit

    Each follicular unit is surrounded by small glands, blood vessels, nerves, and a connective tissue sac making it a tiny self contained unit.

    If these follicular units are damaged during removal or dissection, the hair may grow poorly.

    Therefore it is important to cut only in the loose tissue between the follicular units to keep each follicular unit intact and avoid damaging it.

  • Viviscal Hair Loss Treatment Product Review - Can it Really Promote New Hair Growth?

    Viviscal Hair Loss Treatment

    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.

  • Bijan Feriduni, MD

    Dr. Bijan Feriduni
    Dr. Bijan Feriduni
    Dr. Bijan Feriduni has been dedicated exclusively to advanced hair restoration since 1995 and now performs large sessions of ultra refined strip and FUE hair transplantation with outstanding results.