Search content

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.
- Read more about Xandrox
Scalp Micropigmentation (SMP)
A Cosmetic Tattooing Procedure to Conceal Hair Loss

Scalp Micropigmentation, the process of tattooing thinning or bald areas of the scalp to resemble shortly cropped hair, has been met with high amounts of enthusiasm from patients seeking alternative ways to mask and conceal their hair loss. This artistic and minimally invasive procedure, also referred to as SMP, provides men and women suffering from hair loss with an illusion of fullness or the appearance of thick, shortly cropped hair. SMP results (not the procedure) are often compared to topical concealers such as Toppik, DermMatch and Nanogen, because they also help conceal baldness and make thinning hair appear thicker and fuller.

Although scalp micropigmentation is increasing in popularity, it is still a new and evolving practice and its mystique may leave interested patients asking several important questions.

How does scalp micropigmentation work? What are the benefits, limitations and potential risks associated with the procedure? Who is a suitable candidate? What are the costs associated with SMP? What happens if consumers don't like the results? Is the ink associated with scalp micropigmentation permanent? Are all SMP practitioners equal or do some produce better, more natural looking results?

Scalp Micropigmentation is the artistic application of tattoo-like ink or pigmentation "dots" to bald or thinning areas of the scalp to recreate the appearance of shortly cropped hair (or "stubble") by a trained practitioner. SMP practitioners are typically experienced in the art but often aren't medical professionals or hair restoration physicians. Scalp micropigmentation is typically used for one of three purposes. These include:
- Creating the illusion of fullness or density to thinning hair by applying cropped, hair-like tattoos in between and around thinning hair.
- Creating the appearance of closely cropped or shaved hair on an otherwise bald scalp.
- Camouflaging a pre-existing hair transplant scar. Typically, this is a rare, but stretched, linear scars from follicular unit hair transplantation procedures via strip harvesting (FUT) can sometimes require revision.
Scalp micropigmentation ink is normally placed in the superficial dermis, a layer of skin between the epidermis (the outer layer of the skin) and subcutaneous tissues that consists of connective tissue and cushions the body from stress and strain. However, SMP practitioners often place ink at varying depths. Some practitioners are now beginning to use a “sweeping” technique when tattooing, in order to create a more three-dimensional appearance on the scalp.

Depending on the size of the balding/thinning area and the desired appearance, the procedure can take anywhere from 1-8 hours, and can now be completed with both permanent and temporary SMP ink.

According to Coalition hair transplant surgeon Dr. Robert Bernstein, the key to further achieving a natural result with SMP lies in holding the inking tool at an appropriate angle, controlling the depth at which the ink is placed, monitoring the amount of ink deposited at each site, and selecting appropriate ink tones.

To read more of Dr. Bernstein's input and discussion related to SMP at the 2012 annual ISHRS Scientific Meeting for hair restoration physicians, visit "Scalp Micropigmentation (Scalp Tattooing)at the 2012 ISHRS (International Society of Hair Restoration Surgery) Scientific Meeting".

Permanent Versus Temporary Scalp Micropigmentation (Advantages and Disadvantages)

Defining and understanding the difference between permanent and temporary ink is important for any consumer considering the procedure.

Permanent scalp micropigmentation is performed with micropigmentation ink that is not designed to fade or change over time. The ink is placed slightly deeper in the scalp tissue, and the procedure can be performed with ink containing both colored and black pigment.

Advantages of permanent SMP include the ability to undergo a single SMP treatment without frequent “touch ups" and potentially lower long-term costs.

Disadvantages include the possibility that the ink will eventually fade to a green or blue hue (due mainly to the black pigment used in permanent SMP ink) and the inability to reverse the procedure without laser pigment removal (i.e. “laser tattoo removal”) if the work is unsatisfactory.

Temporary scalp micropigmentation is performed with ink that is specially designed to gradually fade and disappear within 6 to 24 months after the procedure. The ink is placed into a superficial layer of the scalp, which allegedly helps to define the pigmentation and decrease the probability of “blurring” ink. Temporary SMP is performed with ink containing no black pigment. Because black pigmentation can eventually fade into a blue or green tone, it would inevitably produce an unnatural looking result as it gradually fades and disappears, and should be avoided.

Advantages of temporary SMP include: the ability to redesign or discontinue the process (when the ink fades after 6-24 months) if the results are not satisfactory; the decreased rates of ink blurring, running, and definition loss with the superficial placement into the scalp; and the ability to use the three-dimension technique (which was designed by Beauty Medical in Milan, Italy, and is now utilized by several leading clinics recommended by this patient community).

Disadvantages of temporary SMP include ongoing maintenance and costs associated with undergoing subsequent SMP applications every 6 to 24 months, and the possibility of discoloration as the ink fades (though the temporary ink is purposely designed to fade evenly and without discoloration).

To learn more about the advantages and disadvantages of permanent and temporary SMP, visit "Temporary Scalp Micropigmentation: Advantages, Disadvantages, and Clinics Currently Offering the Procedure".

Scalp Micropigmentation Costs

The cost of SMP is variable and depends upon the type of procedure (temporary versus permanent), size of the procedure, and the practitioner/clinic performing the micropigmentation. While rates typically vary and change, permanent SMP can cost anywhere from $800 for a small procedure and $6000 for a large one. The cost of temporary SMP is approximately half the cost of permanent SMP and typically ranges from $500 to $2500 depending on the size of the procedure. Subsequent procedures, which are needed 6 to 24 months after the initial results fade are typically 50% of the original costs.

What Makes a Good SMP Candidate?

Although a wide variety of men and women are interested in scalp micropigmentation, the procedure is actually only ideally suited for a small, select number of hair loss consumers.
SMP is likely best suited for individuals interested in aiding the appearance of density in shortly cropped, diffusely thinned hair, and for patients trying to camouflage a hair transplant scar. It may also be suitable in creating a greater illusion of fullness in those who've already undergone surgical hair restoration.

SMP consumers should also consider a naturally asymmetrical hairline design and “fading” effect (from decreased pigmentation in the hairline to denser, increased pigmentation in the middle scalp) if hairline restoration is performed. This approach will likely create a more natural result in eligible candidates.

Creating Realistic Expectations

While scalp micropigmentation may be a useful adjunct therapy for a select group of consumers interested in concealing their hair loss, it should be approached with realistic expectations and performed by a trusted clinic. Individuals considering the procedure must remember that SMP is a two-dimensional process and cannot provide the texture and growth of real hair. Undergoing SMP without respecting its limitations may create unrealistic expectations and disappointing results.

Evolving Procedure or Just a Fad?

Is SMP just a fad or will it continue to evolve and cultivate additional interest from hair loss sufferers and hair restoration physicians?

While some hair loss experts are quickly embracing the procedure, others are more resistant, and liken scalp micropigmentation to less popular "niche" treatments like hair systems, laser caps, and topical concealers. Whether or not it will continue increasing in popularity and retain its momentum is not yet clear.

Hair restoration is a rapidly changing field and new and evolving therapies may eventually render scalp micropigmentation and other hair loss treatments obsolete. Altogether, only time will tell whether SMP is a lasting adjunct therapy or a passing fad.

Clinics Currently Offering Scalp Micropigmentation

As of January 2013, the following hair restoration clinics recommended by this website are offering some form of Scalp Micropigmentation: Hasson and Wong (Drs. Victor Hasson and Jerry Wong), and Shapiro Medical Group (Drs. Ron and Paul Shapiro).

Dr. Feller, Dr. Lindsey, Hasson and Wong, and Shapiro Medical Group trained with Beauty Medical and offer the temporary SMP procedure; Dr. William Rassman performs his own variation of Scalp Micropigmentation with permanent ink.

Note that in many cases, a trained technician and not the physician will be performing scalp micropigmentation.

This website does not currently recommend one SMP clinic over another. Those considering scalp micropigmentation as a tool to conceal hair loss and create an illusion of hair are encouraged to do their own diligence in researching each technique, practitioner and clinic.

To discuss scalp micropigmentation with hair loss sufferers and other interested parties and to view results showing before and after pictures, visit the Scalp Micropigmentation Forum.
- Read more about Scalp Micropigmentation (SMP)
PABA – Popular Ingredient in Several Herbal Hair Loss Treatments
Para-Aminobenzoic Acid (PABA) has been called the anti-gray hair vitamin and is considered one of the lesser known members of the vitamin B complex family (despite the fact that it’s not really a vitamin at all). PABA is a non-protein amino acid and isn’t essential in the human body. It can be found in foods such as liver, whole grain, yeast, and kidney and is listed as an active ingredient in several popular herbal hair loss treatments such as Provillusfor women and Procerin.

The potassium salt in PABA called POTABA is available on prescription. POTABA is indicated for Peyronie’s Disease and scleroderma. The dose for Peyronie’s disease and scleroderma is very high (12 grams daily in 4 to 5 distributions) and must only be used under medical supervision. Because of the high doses needed to achieve clinical efficacy, patient compliance is typically poor.

But can PABA actually treat male pattern baldnessor genetic female hair loss?

Some tests conclude that PABA when combined with other elements such as folate, biotin, and pantothenic acid, may restore pre-maturely graying hair to its natural color. Some anecdotal reports suggest it might also stop hair loss, however; there are at least as many reports that contradict this. Moreover, we haven’t seen any evidence to suggest it can stimulate new hair growth or hair regrowth.

PABA comes in doses of 100mg, 250mg, and 500mg as a standalone product. However, since no formal clinical studies have been performed on PABA for hair loss, a suitable dosage is mostly speculation. Additionally, since no regulations have been placed on herbal medication, one should proceed with extreme caution before taking any herbal supplement. Consulting with a doctor is advised.

Side Effects and warnings:

Some manufacturers of herbal replacements to medication would have you believe that herbal treatments come without potential side effects. However, this is a farce.

The following side effects have been reported from consumers of PABA: Anorexia, vomiting, nausea, hypersensitivity, fever and rash (particularly with larger doses). These symptoms went away when PABA is stopped.

Ironically, Provillusonly includes PABA in the woman’s formula. However, women should know that pregnant women, nursing mothers, and children should avoid using PABA.

For those with renal disease, PABA should be used with caution. PABA should be stopped if hypersensitivity develops. Those taking pharmaceutical doses of PABA must be under medical supervision.
- Read more about PABA – Popular Ingredient in Several Herbal Hair Loss Treatments
Superoxide Dismutase (SODS)
Excessive DHT in the hair follicle causes specific immune responses. These responses cause the cells to release a substance known as Superoxide. This substance combats against any viruses, cells, or foreign tissues. SOD's claim to fight hair loss by reducing the presence of Superoxide.

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

Click to learn more about Anti Inflammatories
- Read more about Superoxide Dismutase (SODS)
What Causes Hair Loss?
As you see yourself balding, while others retain their hair, you may ask - why me?

The basic answer is – your hair loss is due to your genetic make up. Your thinning hair is not due to anything you have done, whether wearing too many hats, washing your hair too much or too little or any other hair loss myths. Alopecia or hair loss is primarily genetic and is referred to as "Androgenetic Alopecia" in the medical community.

Your hair's future is largely determined before you're even born. Your follicles have been genetically programmed as to when, where and how much baldness (if any), you'll experience in your lifetime. But the fate of your hair can be altered or compensated for with modern hair loss treatments.

So what are the specific causes of hair loss?

Baldness is largely the result of certain hormones interacting over time with those hair follicles that are vulnerable to their effects.

Both men and women produce "male" hormones. The three most common are testosterone, androsteinedione, and dihydrotestosterone (DHT). Hair follicles, as well as the sebaceous glands, contain high levels of an enzyme called 5-alpha-reductase. This enzyme converts testosterone into DHT, via the blood. DHT is the source of most male pattern balding.

In some people, their follicles on the top of the head are genetically vulnerable to baldness. Over time, these genetically vulnerable follicles are acted upon by the hormone DHT. This hormone binds with the receptor sites of these vulnerable follicles and cause the hair follicle to weaken over time. Propecia is a drug that has been shown to slow the creation of DHT and can be helpful in slowing, stopping or in some cases, reversing hair loss when it is used early enough.

Hair grows naturally in cycles of approximately 3 to 8 years. At the end of the growth cycle, the hair shaft is shed from the follicle and a new hair grows. With thinning hair or balding, each successive growth cycle is shorter and the hair produced is thinner and finer. This is called 'miniturization'.

Men and women don't go bald overnight, it is a slow progression of thinning hair and hair loss that eventually produces baldness. In many cases, the balding has progressed to such a stage that hair loss treatment products aren't enough to reverse the balding process.

Few treatments have the dramatic effect of restoring hair like hair restoration surgery. Click here to learn more about hair restoration.

Not all hair loss is permanent. There are many causes of temporary hair loss that can be treated with diet, stress reduction and a visit to your doctor. Click here to learn about other causes of hair loss.

Androgenetic Alopecia

And rogenetic Alopecia, commonly referred to as 'genetic balding', is the main cause of male and female hair loss. This genetic 'programming' accounts for 95% of male hair loss.

For baldness to occur three factors need to be present:

1.The presence of and rogens, or male hormones.

2. A genetic pre-disposition to balding.

3. Time for the DHT to degrade the vulnerable hair follicles.

While they comprise less than ten percent of permanent hair loss, there are several other Causes of Hair Loss like stress, nutrition, health, age and hormones, that can cause temporary as well as permanent hair loss.

There are also several categories of treatments for hair loss which include drugs, topical lotions, hair care products, hair replacement systems and hair restoration surgery. To learn more about each, please visit our Hair Loss Treatment section.
- Read more about What Causes Hair Loss?
Hair transplants - Are they right for you?
Most hair loss sufferers can benefit from hair transplants. However, some are better candidates than others and will achieve more dramatic results.

Different Patients Achieve Different End Results

Two Hair Transplant Sessions one totaling 1860 grafts the other 2995 grafts

It is important to have realistic expectations and to find a hair transplant surgeon who can meet or exceed your expectations.

Surgical hair restoration is largely a matter of "Supply and Demand".

The look you can and will achieve with hair transplants is determined by several factors. But the most critical factor is really a question of "supply and demand".

The supply of hair is how much viable bald resistant donor hair you have. The demand is how much bald area you want to cover and to what degree of thickness.

Your “Donor Hair” determines what you can achieve.

For virtually all hair loss sufferers, even those with severe baldness, there is typically hair that grows for life on the sides and back of the head. This is because the hair in this "donor area" is genetically different from the hair on the top of the head in people who go bald.

The hair follicles in the "donor area" are genetically resistant to the effects of such baldness causing hormones as (DHT) dihydrotestosterone. That's why they continue to grow, while the hair on the top (in the male pattern baldness area) thins and goes bald over time.

How much viable donor hair you have will largely determine how much you can accomplish with hair transplants. Most people have enough viable donor hair to do at least one or two hair transplant procedures.
- Read more about Hair transplants - Are they right for you?
Books - Your in-depth guide to hair restoration
Finding excellent in-depth information about hair restoration, beyond infomercials and brochures, can be difficult. We recommend the below books for those interested in-depth and reliable hair restoration information.

MODERN HAIR RESTORATION

Hair Restoration has made great progress over the last several years with new techniques that have helped improve the quality and efficiency of hair transplants. Dr. Parsa Mohebi, one of the premier hair restoration surgeons, describes these groundbreaking methods, which include new, surgical techniques, hair loss medications, and non-invasive treatments in his book.

Hair loss can have a devastating effect on our self-image and can impact our personal and professional lives in innumerable ways. Dr. Mohebi assures those who are suffering with this condition that there are many medical and surgical treatments available today to help treat patients with different types of hair loss, including specific treatments for male and female patterned baldness. Dr. Mohebi gives his readers tips that can help them evaluate their current hair loss situation in order to find the best treatment available.

Modern Hair Restoration is a one of a kind A-Z guide for most types of hair loss sufferers. It is based on the latest advancements in treating male and female patterned baldness and the newest techniques of hair restoration. The medical breakthroughs described in this book have successfully treated thousands of patients and should continue to help the lives of many more hair loss sufferers for years to come.

Buy MODERN HAIR RESTORATION - A Complete Hair Loss Guide For Men And Women

The Hair Replacement Revolution

"The Hair Replacement Revolution" offers hair loss suffers atruly expert and comprehensive guide to all legitimate hair loss treatments.

This guidebook is written by two credible and respected physicians, Dr.Emmanuel Marrit and Dr. JamesHarris. It alsooffers suggestions for excellent hair restoration surgeons, which are NOTdetermined by financial contributions. This book can be purchased at Amazonfor $12.00 and is truly a "Must Read"!

Read exerpts from this great book.

Hair Restoration Surgery in Asians

Hair Restoration is in demand worldwide, but because Asian hair tends to be more sparse and coarse than Caucasian hair, transplantation procedures need to be adapted to Asian patients. This book, exclusively devoted to Asian hair, is a complete and comprehensive text written by a group of authors sharing their experience in their specialized fields of hair restoration. Included are many practical tips as well as chapters on regional transplantation such as eyebrows, eyelashes, sideburns, beards, and mustaches, in addition to the usual scalp hair restoration.

With its many illustrations, the book gives readers a complete knowledge of hair restoration surgery and provides a quick, easy-to-use reference on Asian hair and the differences in patients' demands. With an influx of new physicians in this challenging field of medicine, further education and training are imperative and must be available to provide a high standard of medical practice. This compilation meets that objective and ultimately makes the valuable contribution of restoring patients' self-confidence.

Buy Hair Restoration Surgery in Asians

To Bald or Not to Bald

Although it is usually an unwanted sign of ageing, hair loss may no longer be inevitable. Hopefully, by the time you finish this book you will understand the proven, effective treatment options that have become so popular. In subsequent chapters you will realize that hair loss is a problem that can be solved with new and exciting methods that will be explained in detail as we move along. We live in a new era of medical innovation and possibilities. Advances in medical research, technology and surgical techniques have restored patient's faith in the field of medical and surgical hair restoration. This books explains the entire process of hair restoration today.

Buy To Bald or Not to Baldon Amazon.

Hair Loss and Replacement For Dummies

What are the causes of hair loss? Can you prevent it? Can lost hair be restored? Hair Loss & Replacement For Dummies helps you understand why men and women lose their hair and offers thorough, objective reviews of a wide array of hair replacement options, including hair replacement surgery, prescription and over-the-counter medicinal treatments, hairpieces, natural remedies, and a variety of other options.

This authoritative, user-friendly guide explains the pros and cons of hairpieces, fibers, foundations, and hair thickening techniques. You’ll learn about pharmaceutical, laser, and topical treatments, and you’ll find out how to determine whether you’re good candidate for hair restoration surgery. You’ll even find help in assessing costs, controlling expectations, avoiding hair replacement scams, and determining which option truly is best for you. You’ll discover:
- What you need to know about hair and hair loss
- How to take better care of your hair
- Ways to prevent or reduce hair loss
- Creative techniques for concealing hair loss
- Shopping tips for hair-replacement systems
- How finesteride, minoxidil, and other medications might help
- Advice about low level laser treatments
- The low-down on hair restoration surgery
Complete with helpful myth-busting information about the causes of hair loss and the benefits of FDA-approved treatments, and helpful comparisons of the advantages of non-surgical and surgical hair replacement, Hair Loss & Replacement For Dummies is the resource to consult before you decide on any hair replacement treatment.

Buy Hair Loss and Replacement For Dummies on Amazon
- Read more about Books - Your in-depth guide to hair restoration
Thomas Chung Wai Nakatsui, MD

Dr. Thomas Nakatsui

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

Dr. Taleb Barghouthi

Dr. Barghouthi performs Ultra Refined Follicular Unit Extraction (FUE) and Follicular Unit Strip Surgery (FUSS) with excellent results. He and his staff can perform extensive mega sessions with dense natural results.