• How hair loss medication can inhibit DHT and Alopecia Areata

    Propecia or Avodart

    If you are going bald you should seriously consider hair loss medication treatments to halt or even reverse your hair loss. While there is no “Hair Loss Cure”, hair loss drugs like finasteride (Propecia) and dutasteride (Avodart) can often stop or even reverse alopecia areata in most people.

    However, just like any other drug, Propecia is accompanied by a list of potential side effects, some of which have been more recently reported as potentially long term.  You can read more about this in the "What About Side Effects" section further down this page.

    Studies have shown that 80% of men using Propecia stopped or even reversed their hair loss to some degree. Preliminary clinical trials for Avodart appear even more effective than Propecia.

    However, neither Propecia nor Avodart has been proven to restore hair in the frontal areas. For reasons yet unknown these drugs, along with Rogaine, only generally work in regrowing thinning hair in crown area of the scalp. Only hair transplant surgery has been successful in restoring hair in the frontal hairline area once it has been lost.

    Propecia and Avodart are also less effective in growing hair in older men. These hair loss drugs work best for men who have been balding for less than five years.

    Women must NOT USE Propecia

    Both Propecia and Avodart are not recommended for use by women or children.

    It’s been found that these drugs can cause birth defects. More specifically, these birth defects may occur when large amounts of the drug are absorbed into the body during the period of foetal development.

    Physicians advise pregnant women to not handle Propecia tablets, as this may harm male foetuses. But as of yet, there has not been a single reported case of birth defects caused by handling these tablets.

    Furthermore, there’s also no evidence that pregnant women exposed to the semen of Propecia or Avodart patients will risk any birth defects.

    Propecia and Avodart are also not advisable for men with liver disease or prostate cancer.

    Get a Prescription for Propecia or Avodart.

    Often our member physicians will prescribe Propecia or Avodart to halt a patient’s hair loss and then restore the hair already lost with hair transplant surgery. These treatments in combination can work synergistically. The drugs work to halt the hair loss, while hair restoration surgery restores what was lost.

    To get a prescription for Propecia or Avodart schedule a free no obligation consultation with any of our quality hair restoration physicians. Find a physician in your area.

    Propecia and Avodart should be taken once a day. It has been found that after two years of treatment, Propecia effectively grows hair in about 66% of patients. Also, about 83% of the subjects receiving this treatment continue to maintain their existing hair after two years.

    Propecia (Finasteride) was originally a drug called Proscar, which was used to treat and reduce men's prostate conditions such as benign prostatic hyperplasia (BPH).

    Its parent company, Merck & Co., soon realized that the drug had a unique side effect - it grew hair on bald men's heads.

    In December 22, 1997 the FDA approved Propecia as a hair loss pill. Merck & Co. then marketed the drug as a hair loss treatment under the trade name of Propecia.

    More recently Dutasteride, sold as Avodart, has generated interest as a promising new hair loss medication. Like finasteride (Propecia) it inhibits the creation of DHT and was originally developed as a treatment for men’s prostate condition.

    However, unlike Propecia, Avodart inhibits the creation of both type one and type two 5 alpha reductase enzymes. Dutasteride has been shown to decrease levels of DHT by 90% after only two weeks, making it a more powerful and faster acting weapon against hair loss than Propecia (Finasteride).

    Dutasteride is not yet FDA approved for the treatment of hair loss. However, some hair restoration physicians also prescribe it for the treatment of hair loss. Like Propecia, Avodart is not safe for women and children.

    Sticking with the program to see results

    Losing your hair took time. So too will regrowing your hair using Propecia or Avodart. These drugs require patients to take the drug daily for at least three months before any obvious changes will be noticeable. Most physicians advise taking these drugs for a year before evaluating their effectiveness.

    At this time, Propecia and Avodart are only available by prescription. Our member physicians are available to discuss these hair loss drugs with you and prescribe them if appropriate. To find a quality hair restoration physician in your area.

    Other DHT Blockers

    Aside from Propecia and Dutasteride, there are other treatment options (all topical) that may or may not work to block the effects of DHT on vulnerable hair follicles. These include Revivogen, Crinagen, Progesterone Creams, and Xandrox (a type of minoxidil). Other DHT Blockers

    To learn more about these treatments, as well as all other topical options, visit our Topical Hair Loss Products and Treatments section.

    How hair loss drugs inhibit DHT and Alopecia Areata

    Baldness is largely the result of dihydrotestosterone (DHT) interacting with those hair follicles that are genetically vulnerable to their effects.

    DHT is essentially the active ingredient or catalyst for the hair loss process. DHT binds with the receptor sites of genetically vulnerable follicles and gradually degrades the follicles ability to produce healthy hair. This eventually results in baldness in the affected areas.

    Hair loss drugs like Propecia or Avodart work by inhibiting the conversion of testosterone into dihydrotestosterone (DHT). By reducing the amount of DHT present in the scalp the hair loss process is slowed and in some cases even reversed.

    What about side effects?

    Up until a couple of years ago, side effects when taking Propecia or Avodart were only considered temporary. However, over the last several years, many me have reported ongoing side effects from Propecia even after stopping treatment.  This more permanent condition has become known as "Post Finasteride Syndrome" or (PFS). Side effects included but aren't limited to reduced semen production, a reduced libido and softer erections.

    As a result, in April of 2012, the FDA mandated labeling changes to finasteride related products.  Labeling changes to Propecia include "libido disorders, ejaculation disorders, and orgasm disorders that continued after discontinuation of the drug".  Labeling changes to Proscar include "decreased libido that continued after discontinuation of the drug".  Labeling changes to both Propecia and Proscar include "reports of male infertility and/or poor semen quality that normalized or improved after drug discontinuation".

    While most men don't experience any side effects at all, it should be known that a small percentage of men may experience persistent side effects even after stopping treatment.  Most men who experience side effects however, only experience them temporarily and stopping treatment makes them go away.

    For a list of potential side effects and more information on Post Finasteride Syndrome", visit http://www.pfsfoundation.org/.

  • Hair Transplant Surgery

    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.

  • 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.
  • Female Hair Loss - Treatment and Restoration

    Female hair loss

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

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

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

    Women with thinning hair compared to Men

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

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

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

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

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

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

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

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

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

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

    David Whiting in Dallas, Texas - 214 824-2087

    Vera Price in San Francisco, California 415 353-4163

    Maria Hordinsky in Minneapolis, Minnesota 612 625-1493

    Wilma Bergfeld in Cleveland, Ohio 216 444-5722

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

  • Bernardino A. Arocha, M.D., ABHRS

    Dr. Bernardino Arocha
    Dr. Bernardino Arocha and his staff perform high quality ultra refined follicular unit hair transplantation sessions in Houston, with free physician consultations available in Dallas.
  • Does Nourkrin Hair Nutrient Work to Stop Hair Loss?

    Nourkrin

    Balding men and women considering any hair loss treatment should take caution to believe the many magnificent claims made by today’s advertising. Far too often, a lot of time and money is wasted on questionable treatments with little or no proof of success.
    Nourkrin hair nutrient claims to promote hair growth and strengthen thinning hair in 80% of men and women suffering from almost any hair loss condition other than the self-inflicted trichotillomania (hair pulling) or traction alopecia. Below we evaluate Nourkrin, the "clinical study", and its ingredients to find out whether or not this hair loss treatment lives up to its promises.

    What is Nourkrin?

    Nourkrin recommends using their complete regime of products for at least 6 months for the best results. This includes extra strength, Man, and Maintain oral tablets, a shampoo, a conditioner, and a scalp lotion.  Nourkrin claims their products can promote hair growth in men and women suffering from androgenic alopecia (genetic baldness), alopecia areata, alopecia totalis, alopecia universalis, and telogen effluvium. This is a very bold claim considering each balding condition occurs for varying reasons.

    Ingredients

    The active ingredients in the extra strength tablet include shark cartilage and shellfish extract containing glucosamine.  Other active ingredients include silica kieselguhr (a natural form of silica), horsetail extract, acerola cherry extract with vitamin C, microscyrstaline cellulose, immunogloblin G protein, and fatty acids. In addition to the above, the Man product contains Omega 3 fatty acids and Fenugreek designed to improve scalp circulation. Maintain includes additional marine life proteins, minerals, silica, and vitamin C. The scalp lotion contains marine life protein extract compounds and aloe vera.

    Nourkrin claims that the primary active ingredient glucosamine can rebuild and grow new tissue, including dormant hair follicles - suggesting successful hair regrowth. Though clinical studies prove that glucosamine might be effective in reducing joint pain, increasing joint lubrication, preserving joint space, protecting cartilage breakdown by inhibiting specific enzymes, stimulating cartilage matrix repair, and other anti-inflammatory actions, we couldn't find any evidence to support claims that it can stop hair loss or promote hair regrowth.

    Clinical Study

    Nourkrin conducted a clinical study of 60 people who took their products for 12 months. All subjects were over 18 years of age and suffered from at least some form of hair loss for at least one year prior to the study. During a 6 month double blind clinical study, 30 subjects took Nourkrin while the other 30 took a placebo. After 6 months, the 30 participants taking Nourkrin continued taking it for another 6 months while the 30 on the placebo were switched to Nourkrin for 12 months.

    In the first 6 months, Nourkrin reports that 77% taking their hair loss treatment experienced an increase in hair growth and shaft thickness. After 12 months, 75% reported a decrease in overall thinning hair. 90% of women in the study reported overall hair improvement after 12 months. The hair counting method showed an average increase in hair count of 45 percent during the clinical study.

    Though the above study sounds impressive, we don't know a lot about the participants nor can we be certain of the reliability of the study. All participants suffered from some form of thinning, but its cause for each patient hasn’t been disclosed.  Additionally, clinical studies are considered more credible when they've been conducted or verified by third parties not interested in its financial success.

    Another problem is that none of the active ingredients in Nourkrin are proven to stop hair loss. Therefore, their study is the only one balding men and women have to support such claims.

    Possible Side Effects

    Anyone allergic to shellfish should avoid using Nourkrin. Women who are pregnant or breast feeding should not use Nourkrin hair loss products. Consulting with a doctor before using this treatment is advisable.

    Dosage

    Nourkrin recommends taking 2 tablets daily for at least 6 months. Men and women over 176 lbs or those who smoke are advised to take 3 tablets daily. After 6 months, dosage can be cut down to one a day. Nourkrin also recommends using the shampoo, conditioner, and scalp lotion daily. The scalp lotion may be best applied in the evening and left on overnight.

    Cost

    60 tablets of the extra strength tablet costs about $75, the Man $65, the shampoo and scalp cleanser $12, the conditioner $13, and the scalp lotion $30. All in all, the Nourkrin Hair Recovery Program can get pricey after 6 months. FDA approved products like Rogaine (minoxidil)only runs approximately $15 a month or less and male treatment Propecia (finasteride)costs approximately $60 per month, not as expensive as Nourkrin.

    Conclusions

    Nourkrin boasts a big game, claiming high rates of success in reversing hair loss in men and women caused by varying conditions. Their clinical study also confirms its success rate however; the reliability of this study has not been verified by third parties uninterested in its financial success. Additionally, no clinical proof exists that any of the ingredients found in Nourkrin work to treat baldness.

    Whether or not Nourkrin is the "real deal" is hard to determine with little evidence to support its claims. Therefore, those considering this treatment should proceed with caution and may want to consider exhausting proven treatments like Propecia and Rogaine first.

  • Dr. David Josephitis

    Dr. David Josephitis
    Dr. David Josephitis
    Dr. David Josephitis performs ultra refined FUT/strip and FUE with outstanding results along side with Coalition members Drs. Ron and Paul Shapiro.
  • Dr. Tsvetalin Zarev

    Dr. Tsvetalin Zarev
    Dr. Zarev
    Dr. Zarev performs gigasession hair transplant surgery with an extremely high yield and density. He can restore extreme cases of baldness with density and coverage.
  • 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.

  • From big wigs to surgical hair restoration

    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.

    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.