An Active Ingredient in Several Topical Hair Loss Treatments

Azelaic acid is a naturally occurring substance found in whole grains that contains a mild antibiotic designed to “clean” skin.  It is also said to be a potential inhibitor of 5-alpha-reductase in human skin.  A reduction of this enzyme may reduce the amount DHT (dihydrotestosterone) in the body and therefore, have a similar effect to finasteride; the active ingredient in FDA approved oral hair loss solution Propecia (finasteride). In theory, applying azelaic acid to the scalp may prevent or eliminate the binding of DHT to the hair follicle receptor, preventing hair loss and potentially stimulating hair regrowth.  Azelaic acid can be found in many prescription acne medication and topical hair loss products like Xandrox and Provillus. 

Combining azelaic acid with FDA approved hair regrowth solution minoxidil in a single topical product in theory, may prove to be a more powerful hair loss treatment for androgenic alopecia than minoxidil alone.  This is why some conjecture that Xandrox may be a more effective treatment than Rogaine (minoxidil). 

Azelaic acid has not been clinically proven effective as a standalone treatment for treating genetic female hair loss and male pattern baldness. It has also been known to irritate the scalp when applied topically.  Though there is a low percentage, azelaic acid may interact with other medications.  Be sure to consult your physician before using azelaic acid while on other medications.

The Era of the big Wig

Soon after the Middle Ages wigs became popular for women. Then in the 1600’s the flamboyant and incredibly vain King Louis XIV of France lost his hair from a severe illness and took to wearing gigantic wigs thus setting the fashion for most men of his day.

These enormous creations featured such items as cages with live birds and could weigh up to 20 lbs.!

By the 1700’s England made another contribution to bad hair loss concealers. This was the age of the long, curly, and powered wigs. Even today, English judges and lawyers continue this practice. Thus the expression for those in authority – “Big Wigs.”

The“Snake oil” Years

The early 1800’s is renowned in hair loss circles as the age of the con men. There were hundreds of so-called “hair loss solutions” and many lasted well into the late 1900’s.

These treatments were marketed by fast-talking “doctors,” skilled only in bravery and possessing nerves of steel 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, including rubbing grease into their hair to make it look thicker.

The “Modern” Era of Hair Loss Solutions

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

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 transplants are born.

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 continues to grow for a life time. This laid the foundation for modern hair transplantation.

During the 60’s and 70’s surgical hair restoration grew in popularity. However, the standard procedure used large grafts that were removed by round punches and often contained many hairs.

Completed Result after Multiple Sessions of Large Grafts

This now outdated technique could achieve 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 loss solutions that looked obvious and unnatural.

Such uncompleted hair restoration 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 hair transplants with today’s very refined techniques to achieve a natural look that they can style in any manner.

From big wigs to surgical hair restoration

The Era of the big Wig

Soon after the Middle Ages wigs became popular for women. Then in the 1600’s the flamboyant and incredibly vain King Louis XIV of France lost his hair from a severe illness and took to wearing gigantic wigs thus setting the fashion for most men of his day.

These enormous creations featured such items as cages with live birds and could weigh up to 20 lbs.!

By the 1700’s England made another contribution to bad hair loss concealers. This was the age of the long, curly, and powered wigs. Even today, English judges and lawyers continue this practice. Thus the expression for those in authority – “Big Wigs.”

The“Snake oil” Years

The early 1800’s is renowned in hair loss circles as the age of the con men. There were hundreds of so-called “hair loss solutions” and many lasted well into the late 1900’s.

These treatments were marketed by fast-talking “doctors,” skilled only in bravery and possessing nerves of steel 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, including rubbing grease into their hair to make it look thicker.

The “Modern” Era of Hair Loss Solutions

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

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 transplants are born.

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 continues to grow for a life time. This laid the foundation for modern hair transplantation.

During the 60’s and 70’s surgical hair restoration grew in popularity. However, the standard procedure used large grafts that were removed by round punches and often contained many hairs.

Completed Result after Multiple Sessions of Large Grafts

This now outdated technique could achieve 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 loss solutions that looked obvious and unnatural.

Such uncompleted hair restoration 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 hair transplants with today’s very refined techniques to achieve a natural look that they can style in any manner.

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.

What is Traction Alopecia?

Traction alopecia is a form of hair loss resulting from the repeated yet unintentional pulling, twisting or rubbing of the hair. Traction alopecia can affect both men and women, though it's more commonly seen in women. Though it can be temporary, balding from traction alopecia may become permanent if these traumatic forces are applied to the hair and scalp repeatedly and for prolonged periods, resulting in scarring.

What Causes Traction Alopecia?

Practices that may result in traction alopecia include; wearing tight braids, ponytails or cornrows and extended use of hair extensions.  Due to the popularity of these hairstyles, traction alopecia has become one of the leading causes of hair loss among African America women.

Balding from traction alopecia can also occur from repeatedly wearing tight-fitting hats, helmets or other headgear.This is likely where the popular hair loss myth about hats causing hair loss derived, but it is important to note that, under normal circumstances, wearing a properly fitted hat will not negatively impact hair growth.

Treating Traction Alopecia

The first step in treating traction alopeciais to change the habits leading to the condition. This may mean adopting a new hairstyle or altering your wardrobe. Finally, applying a vaso dilator like Rogaine(minoxidil) to the affected area can increase blood flow to the damaged follicles and effectively speed up new hair growth. Assuming the hair follicles have not been permanently damaged, new hair growth will likely occur though it may take several months.

In cases of severe and permanent tractional opecia, the only effective method of restoring hair to the bald areas is surgical hair restoration. State of the art, ultra-refined follicular unit hair transplantation allows quality surgeons to harvest DHT resistant hair from the donor region at the rear and sides of the head. These hairs are then implanted into the balding areas of the scalp, resulting in a natural and undetectable appearance. To see which physicians we recommend and for a free virtual consult, visit the Coalition of Independent Hair Restoration Physicians.

To learn more about how surgical hair restoration can be used to treat traction alopecia hair loss, view the following results from our hair loss forum and social community:

• Dr.Robert Dorin - 1909 Grafts on a Traction Alopecia Patient
• Dr.Victor Hasson / 3560 Grafts / One Session / Traction Alopecia / One Year

Revolutionary Hair Growth Formula?

Anyone suffering the effects of an incurable and debilitating medical condition yearns for the promise of new and revolutionary treatment options and hair loss sufferers are no exception. Though often dismissed as insignificant by those who are unaffected by it, baldness and thinning hair can devastate the lives of millions of men and women susceptible to the effects of androgenic alopecia. The desperation to restore the flowing locks of youth make this demographic particularly susceptible to slick marketing campaigns promising to halt balding and regrow hair. One such product marketed in this fashion is Europe’s TRX2 Molecular Hair Loss Treatment. But, will hair loss sufferers find follicles behind the flash?

TRX2 Ingredients

TRX2 Molecular Hair Loss Treatment is not a drug or medication. It is an herbal, dietary supplement taken orally. A glance at its ingredients list reveals nothing new or revolutionary. Each component is readily available at your local nutritional supplement shop, though you may not find the same concentrations of each in a single product.  It's ingredients are listed below:

Ingredients: L-carnitine tartrate (800 mg), potassium chloride (191 mg), L-leucine (150 mg), isoleucine (75 mg), valine (75 mg), nicotinic acid (40 mg), and biotin (150 µg).

TRX2 Scientific Studies?

With these ingredients so readily available, one might wonder if the significant cost savings of purchasing them individually and mixing your own TRX2 at home is just as effective for hair growth. The official website’s FAQ addresses this notion with the following response.

“The benefit of taking TRX2™ Molecular Hair Growth Supplement singularly, as opposed to buying each ingredient separately, is based on several facts:

The precise amount and ratio of ingredients in our supplement are carefully chosen and engineered based on credible scientific studies. The ingredients in our capsule were specifically formulated to work in concert with one another and are manufactured in accordance with strict European quality controls. For the consumer, the convenience of taking all compounds at the optimum ratio in one capsule and delivered via our proprietary potassium channel stimulating complex is crucially important.”

Perhaps this is true. However, at a hefty €54.95 (about $72) for a one month supply, those seeking to save some money may want to give the home brew option a shot first.

Additionally, referencing scientific studies is an effective way to add legitimacy to a product but one must always consider the source. While the TRX2 website provides detailed data gathered from a “randomized, double-blind, placebo-controlled study”, it is unclear who conducted the study and there is no mention of publication in a peer reviewed journal.  Peer review is the industry standard for evaluation of clinical trial results and its absence is cause for concern.

Does TRX2 Work?

TRX2 claims to stop hair loss and regrow hair through the “rejuvenation of potassium ion channels within hair follicles”. This theory is based on research suggesting that the opening of potassium channels is an important regulatory mechanism for hair growth.

A bold statement at the top of the TRX2 website states that it has been shown to regrow hair in nearly 9 out of 10 men and women. But, does TRX2 really do what it claims? The bottom of the company’s website provides a very important disclaimer.

“These statements have not been evaluated by the medicines regulatory agencies. This product is not a drug or medicine, and is therefore not intended to diagnose, treat, cure or prevent any disease. This patent-pending food supplement contains nutrients that help promote and sustain healthy hair growth. Results may vary and are subject to your individual metabolism. Regarding risks and side-effects please see the package insert and ask your physician or healthcare specialist.”

Careful wording in the above statement may give consumers the wrong idea. Helping to “promote and sustain healthy hair growth” is not the same as stopping hair loss or regrowing hair lost due to the effects of androgenic alopecia. A quality shampoo and condition can make hair more manageable and appear fuller.

TRX2 Side Effects

While TRX2 contains "drug-free" ingredients that are all natural or synthesized as normal metabolites in the human body, there is a potential for certain side effects.

Some consumers of TRX2 have reported transitory gastrointestinal effects including an upset stomach.  Thus, it is recommended to take TRX2 after eating.  Additional side effects include the possibility of allergic reactions such as skin flushes.  If any of these conditions occur, it is recommended to consult a physician.

 It is also recommended that any potential customers suffering from digestive system disorders, diabetes or those who are glucose-intolerant consult with their physician before taking TRX2.

Moreover, pregnant women and nursing mothers should avoid taking TRX2 due to its lack of long term safety data.

Conclusion

The role of potassium channels in hair growth is still being investigated and it’s unclear if TRX2 truly has the potential to significantly affect these channels. However, there is a clinically proven and FDA approved medical hair loss treatment that is known to do so. Rogaine (minoxidil) has been used successfully by balding men and women for more than 20 years. The exact mechanisms by which minoxidil affects hair growth are not fully understood but it is a known vasodilator and has also been shown to enhance the flow of potassium ions. Given that minoxidil is relatively inexpensive, clinically proven and comes with very little risk of side effects, it may be a better option for hair loss suffering men and women.

Additionally, balding men should seriously consider adding Propecia (finasteride) to their hair growth regimen. Propecia stops hair loss  at its core by inhibiting the production of DHT (the hormone responsible for genetic baldness) and is arguably the most effective treatment for male pattern balding currently available.

When it comes to “new and revolutionary” hair loss treatments, proceed with caution. There is nothing wrong with trying a new treatment provided it is safe and purchased from a reliable source. However, forgoing tried and true medical treatment s in favor of experimental products may result in further loss of precious and irreplaceable hair.

To share your thoughts and experience with TRX2 on our hair loss forum, join the discussion “TRX2: Any Feedback?”.