• Steven Gabel, M.D.

    Dr. Steven Gabel
    Dr. Steven Gabel is dedicated exclusively to performing ultra-refined follicular unit hair transplantation and follicular unit extraction with excellent results performed in the Portland area.
  • The Coalition of Independent Hair Restoration Physicians

    Coalition of Independent Hair Restoration Physicians

    Chosen by Patients and Peers for meeting the highest standards.

    This Learning Center is sponsored by the Coalition of Independent Hair Restoration Physicians.

    This elite group of independent surgeons have been carefully selected by patients and leading physicians and are committed to providing Ultra Refined Follicular Unit Hair Transplantation.

    This minimally invasive hair restoration procedure enables patients to achieve very natural and dense hair growth after only one surgical session.

    Coalition members agree to have their results openly critiqued and reviewed on the world’s most respected online patient based community - the Hair Restoration Network. Learn more about the high standards Coalition physicians must meet for membership.

    Find an an elite Coalition Physician in your area and consult for free about how to restore your own natural hair.

  • Non Genetic Causes of Hair Loss

    Non Genetic Causes of Hair Loss

    We know that and rogenetic alopecia or male pattern baldness is by far the most common cause of hair loss, accounting for 95% of hair loss in men and women. But there are a variety of other causes for hair loss in men and women. These include disease, aging, improper hair care, poor nutrition, and stress.

    Disease and Illness

    It's a proven fact that medical conditions, as well as treatments and procedures, may lead to hair loss. Many people have experienced sudden and large amounts of hair loss about 3 or 4 months after an illness or a major surgery. Fortunately, this hair loss is usually temporary, and is related to the stress of the illness.

    Hair loss may also signal a previously hidden disease,including lupus, thyroid disease or diabetes. Because hair loss may be an early sign, it's a good idea to identify the problem and begin treating it at this time.

    Psychological disorders such as Trichotillomaniamay be responsible for self-inflicted hair loss Men and women suffering from this condition pull their own hair out by the roots.

    Hair loss may stem from taking certain medicines, but this normally stops once the medication is no longer taken.

    Hormonal Changes

    Another cause of medical hair loss is hormonal problems. Essentially, having an overactive or under active thyroid gland may cause your hair to fall out. Treating the thyroid disease will usually help this hair loss. Hormones can also cause hair loss if male hormones (androgens), or female hormones (estrogens), are out of balance. However, if the hormone imbalance is corrected, the hair loss should stop.

    Aging

    Did you know that 40% of men have noticeable hair loss by age 35, and 65% by age 60?

    Aging is one of the factors necessary for and rogenetic alopecia to occur, along with a genetic predisposition and the presence of hair loss-inducing hormones. Hair loss is dependent on exposing the vulnerable hair follicles to the proper hormones over time.

    Improper Hair Care

    Isn't it frustrating to see people with thick, full heads of hair treat it so badly? Dyes, bleaching, pigtails -- it all takes its toll on hair.

    The chemicals used for dying, tinting, bleaching, straightening or any other hair-altering procedures can lead to hair becoming strained or damaged. Eventually, this hair may even break off.

    But it's not any better in the hair salon, as excessive styling that pulls the hair too tightly may also lead to a type of hair loss, called "traction alopecia." As long as this pulling is stopped before the scalp scars, the hair will grow back normally. But be warned, scarring can cause permanent hair loss.

    It's also not a good idea to subject your hair to hot oil treatments or the chemicals used in permanents. These may cause inflammation of the hair follicle. This too, may lead to scarring and hair loss.

    Improper Nutrition

    Researchers have found that some hair loss may be due to insufficient protein or iron in your diet, as well as malnutrition, in general. As effective as "miracle" or "fad" diets sound, they may cause damage. Vitamin deficiencies, as well as certain illnesses related to eating, such as bowel disease or eating disorders, can also cause poor nutrition. These may all cause hair loss.

    Stress

    Stress can be harmful to the entire body, and the hair on our heads is no exception. Regardless of the cause - illness, a traumatic experience, nutritional deficiency - our rate of hair loss may increase.

    However, it should be noted that stress-induced hair loss is not a cause of male-pattern baldness. Rather, this type of balding is known as "telogen effluvium." Telogen effluvium is caused when the body senses a problem and diverts its energies there. This results in hair being shed, although it's usually reversible.

    Stress affects the hair of men and women differently. It's been foundthat women's hair is more sensitive to stress' effects than men's hair. One possibility is that stress (along with DHT and other things) may facilitate hair loss for women who are genetically predisposed towards it While the cause of genetic female hair lossis a bit of a mystery, women experiencing hair loss are advised to consult a dermatologist or hair restoration specialist to determine its cause Many causes of thinning hair in females are non-genetic and hair loss is often reversible by treating whatever condition is promoting it.

  • Menopause and Female Hair Loss

    Many cases of female hair lossare caused by hormonal fluctuations or changes in the body including those who have PCOS (polycystic ovarian syndrome), birth control pillside effects, a recent pregnancy,postmenopausal trauma, or menopause. Women with hair loss experience varying balding patterns These patterns can help determine the type of alopecia you have along with a thorough examination by a physician.

    Because of an imbalance between estrogen and testosterone due to declining estrogen levels, thinning hair and accelerated hair loss is common in women during menopause. Hair on certain areas of the head that is more sensitive to androgen hormones like DHT(associated with male pattern baldness) may thin or fall out. Similarly, declining estrogen levels may result in unwanted facial hair growth.

    In some cases, polycystic ovarian syndrome(PCOS), may accompany menopause and hair loss.

    Be sure to speak with your doctor on the most effective ways to cope with menopause and minimize hair loss during this transitional time.

  • Hair Loss - It’s more than skin deep

    A Hair Transplant - How to do it right.

    Hair loss suffers often don’t want to admit that going bald bothers them. But there's nothing wrong or vain about being concerned with hair loss.No matter what people say, having hair or not does matter. We are judged by our appearance. And hair loss, also known as alopecia, is generally seen as a sign of weakness and aging.

    Does hair loss matter? You be the judge...

    Hair loss before and after

    "At first I just didn't feel comfortable admitting that I wanted my hair back."– Dean, restored his hair with Propecia and hair restoration surgery.

    Hair loss Statistics – Hair loss affects about 35 million men and 21 million women in the United States alone.40% of men have noticeable hair loss by age 35 and 65% by age 60.

    So how can you remedy hair loss and its effects?

    First you need to understand why hair loss occurs. In Cause of Thinning Hair and Baldness you'll learn that your hair loss has little or nothing to do with shampooing, hats, or any other practices. Alopecia is largely genetic.

    It's also important to deal with the psychological and emotional effects of hair loss. In the Psychology of hair loss these personal issues and how society views hair loss are uncovered.

    Regardless of our differences, hair loss can affect anyone. However,there are a variety of gender and racial differences to consider.Age is also a prime factor. In Race, Age and Hair Loss these differences are explored.

    Hair loss is not a new phenomenon, as our Ancient Hair Loss "Cures" section reveals. Whether it's Julius Caesar using wreaths to hide his thinning, or French King Louis XIV's elaborate 15-20 pound wigs -- history's filled with interesting tales of balding cover-ups. This section also explores the reality behind many Hair Loss Myths and “cures”, from electro-shock treatments to headstands.

  • Saw Palmetto

    Saw Palmetto

    The "Active" Ingredient in Many Popular Hair Loss Treatment Products

    Many popular hair loss treatment options today such as Provillus, Procerin, and Avacor contain the “active” ingredient saw palmetto. It can also be purchased as a standalone supplement in most nutritional stores. But the age old question of whether or not it can effectively treat baldness in men and women with alopecia is still heavily debated. By taking a look at the scientific evidence available we are able to draw some conclusions as to its potential benefit for those with thinning hair.

    What is Saw Palmetto?

    Saw Palmetto berries are a deep red fruit that grow wild on palm trees in warmer climates, typically found in the Southeastern United States. The liposerolic berry extract is typically used as an herbal supplement for the promotion of a healthy prostate.

    Saw Palmetto Hair Loss Study:

    Similarly to finasteride (the active ingredient in Propecia and Proscar), studies have shown that when taken orally, it may be an effective anti-androgen by lowering dihydrotestosterone (DHT) levels in the body by blocking 5 alpha-reductase enzymes. Additionally it is said to block receptor cites on cells which is required for cells to absorb DHT.

    Tests have also been performed on its use in the treatment of benign prostatic disease, which similarly to androgenic alopecia, depends on the production of DHT.

    It is also noteworthy to state that a small preliminary study in 2002 was performed as reported by The Journal of Alternative and Complementary Medicine(2002;8:143-52) that shows a select group of 19 men between the ages of 23 and 64 taking either (400mg of saw palmetto and 100mg of Beta-sitosterol) or a placebo orally. Those who took the herbal combination had 60% improved hair growth over those who took the placebo. There have been no studies to date indicating the efficacy of saw palmetto applied topically for male pattern baldness, female hair loss, or anything to date.

    In our opinion, there are two potential difficulties with this study:

    • Many scientists would argue that the control study group was too small to determine any real efficacy and improved hair growth could have happened by chance. A larger study therefore may be necessary to determine any level of real efficacy.
    • “Improved hair growth” is not the same thing as newhair growth and hair regrowth, nor should it necessarily imply that it works to stop hair loss
    • There are no regulations or suggested daily value as to how much saw palmetto would be required to successfully treat baldness. The appropriate dosage therefore is questionable.
    • The above study was only performed on saw palmetto taken orally. Hair loss products that promote topical use for baldness are basing their belief in its efficacy on something other than published clinical evidence.

    The Dosage:

    But if there are no current standards on dosages of herbal medications in the United States, how do these popular hair loss treatments produce an appropriate dosage?

    Clinical studies on Benign Prostrate Hyperplasia (BPH) have used a dosage of 320mg of the berry extract daily (either one 320mg pill or 2 X 160 mg pill). A daily dosage of 480 mg of saw palmetto berry extract was not found to be any more effective in a six-month study. If the entire berry was used, up to 1000mg or 2000mg would be required to reach the same goal.

    The theory therefore is that if saw palmetto can successfully treat an enlarged prostate similarly to finasteride, it can effectively treat hair loss with a similar dosage Many popular “baldness cure” products contain approximately 1500mg of the berry which is equivalent to approximately 240-320mg of the berry extract.

    Side Effects and Warnings:

    One false assumption is that “all natural” treatments don’t have potential side effects. It is stated that use of saw palmetto has not proven to be safe for women with hair loss during pregnancy and lactation. Medical supervision is suggested for women of childbearing age. Similar warnings are listed about Propecia.

    Conclusions:

    Based on some anecdotal evidence, saw palmetto is said to treat baldness because of its tendency to act like finasteride by helping those suffering from BPH. However, authentic clinical studies have not been performed to date that support this claim. Dosage and how it should be used (orally or topically) therefore is based on conjecture rather that scientific evidence.

  • Dr. Christian Bisanga

    Dr. Christian Bisanga
    Dr. Christian Bisanga
    Dr. Christian Bisanga performs world class FUT and FUE hair transplants with excellent results exclusively at his clinic Brussels, Belgium
  • Ultra Refined Follicular Unit Hair Transplantation

    Ultra Refined Follicular Unit Hair Transplantation

    The Ultimate in fullness and naturalness in one surgery session.

    We’ve all seen the “pluggy” hair transplants of the past. But we don’t see today’s state of the art hair transplants because they go unnoticed.

    Corn RowsMini MicroFollicular units
    Plugs Mini Micros Follicular Units

    Follicular Evolution - from plugs to micro grafts to ultra refined grafts

    Surgical hair restoration has dramatically evolved from the big round “plug” grafts of the 1960 ’s and 70’s, to the “mini micrografts” of the 80’s and early 90’s, to modern hair transplant procedures using entirely follicular unit grafts .

    Now hair restoration surgery is going through another important evolution that is improving both the naturalness and fullness that can be achieved from any one surgical hair transplant session.

    Ultra Refined Grafting - Smaller Blades, Incisions and 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.

    FUT result

    FUT Result

    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”

    Natural hair hair transplant hair line

    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 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.

    Coalition of Independent Hair Restoration Physicians All members of the Coalition of Independent Hair Restoration Physiciansare required to perform ultra refined grafting with excellent results. Learn more about the membership standards.

  • Nettle Root Extract

    Nettle Root Extract

    Contained in Several Popular Hair Loss Treatments for Men

    Nettle root extract can be found in a number of popular hair loss treatments, such as Provillus and Procerin, and at your local health food store as a standalone product. Conjectured to effectively inhibit the production of DHT, below we examine whether or not nettles are as effective as Propecia (finasteride) in blocking DHT and stopping the progression of male or female pattern hair loss.

    DescriptionNettle Root

    “Nettles” is the common name for Urtica Dioica, an herbal plant also known as the Stinging Nettle. This perennial herb is often eaten in many parts of the world and is often added to soups, salads or cooked as greens, though less frequently. Nettle leaves are long and pointy, but only the shoots and top of the plant are eaten. Nettle plants have dark green leaves and typically grow about 2 or 3 feet tall and its flowers are covered with tiny stinging hairs that contain an irritant. Allergic reactions are common if they come in contact with human skin.

    Use of Nettles

    Nettle root extract was found to partially block 2 enzymes by researchers such as R. Hartmann.  The first is 5-alpha-reductase that when combined with testosterone, produces DHT (dihydrotestosterone). DHT is the hormone responsible for androgenic alopecia hair loss. The second enzyme is aromatase, which makes estrogen.  Combining nettle root extract with another herbal agent pygeum has been found to inhibit these two enzymes more effectively than either one alon It was shown that nettle root extract had to be used at high dosages in order to effective whereas lower doses of pygeum worked well.  Prostatonin, the combination product of nettles and pygeum have been used to treat BPH (benign prostatic hypertrophy).

    Studies by researchers JJ Lichius and others have shown a reduction in prostate growth in mice when large doses of nettle extract were taken orally. Combining nettle root extracts with saw palmetto berries in BPH patients reduced the amount of testosterone and estrogen. Conversely, it has been conjectured that nettles can block testosterone from binding to the sex hormone globulin, a carrier protein that binds testosterone and limits its bioavailability in the body. As a result, nettles have been called an aphrodisiac since it may help maintain testosterone levels.

    Other uses of Nettles include treatment for arthritis, asthma, kidney, urinary tract infections, and last but not least, baldness.

    Nettle Root ExtractNettle Root as a Hair Loss Treatment

    Like many other herbal supplements with some clinical evidence suggesting efficacy in treating enlarged prostates (BPH), some have claimed that nettle root extract may stop hair loss and maybe even aid hair regrowth.  Because Propecia (finasteride) works to stop the progression of male pattern baldness by inhibiting the production of DHT, it is conjectured that nettle root extract may be of similar benefit.

    Nettle root is a popular ingredient taken orally in a couple big name hair loss products such as Provillus and Procerin.  Some have also conjectured that applying nettle root extract topically to the scalp may also facilitate new hair growth. Because many topical irritant type products are used to treat alopecia areata hair loss, some suggest nettle root extract applied topically may be effective in treating it. Those who conjecture its efficacy to treat baldness recommend doses of 500mg or more daily.

    Though some have declared that nettle root extract may be an effective hair loss treatment, no clinical controlled studies have been performed proving its efficacy for androgenic alopecia (genetic female hair loss and male pattern baldness) or alopecia areata. 

    Possible Side Effects of Nettles

    Despite claims made that “all natural” herbal supplements are free from side effects, nettle root has its share of warnings. When topically applied, irritation of the scalp or an allergic reaction can occur. When taken orally, it can cause upset stomach, burning, difficulty with urination, bloating and edema.  Nettle root extract should not be used in patients with heart or kidney problems, due to fluid retention properties.
    Those who want to try nettle root extract as a hair loss treatment should proceed with caution and consult their doctor before using it.

  • Dr. Bessam Farjo

    Dr. Bessam Farjo
    Dr. Bessam Farjo
    The Farjo Hair Institute is a family run clinic solely devoted to performing excellent follicular unit hair transplantation in Manchester and London.