Hair loss is a universal condition, affecting all ages, races, genders and nationalities. It’s estimated that “androgenetic alopecia,” or male and female pattern baldness affects 35 million men and 21 million women in the United States alone. This section examines how race, age and gender affect hair loss.

Race and Hair Loss

In physiological terms, human beings are all composed of the same bones, muscles, and everything else down to the cellular level. But there are specific differences.

Hair, in all of its variations, is one area in which human beings display their differences. Hair follicles can widely vary in terms of color, length, shape, thickness, strength and various other factors.

There are many ethnic groups to consider. But we will focus on the special considerations of Asians, Blacks (of African descent) and Caucasians.

Asian Hair Loss Considerations

Asian people typically have very straight hair. Their scalps contain fewer hairs per square centimeter, they actually have a lower hair density than that of Caucasian hair follicles. But because the individual hair follicles of East Asians are thicker, this gives the look and impression of greater hair density.

For these reasons, hair restoration techniques for East Asians, much like other races, must be sensitive to a variety of anatomic and cultural differences. For instance, East Asian females often have an increased likelihood of developing “diffuse alopecia,” or hair that thins evenly over the entire head than Caucasian females.

Even though it’s not a definite requirement, it’s very helpful for Asian patients to seek out doctors with experience in Asian hair.

Another consideration for East Asians considering hair restoration surgery is the increased chance of developing keloid scars. A keloid is a thick, irregularly shaped and elevated scar with uncontrolled growth that results from excess fibrous skin tissue. East Asians typically have a greater likelihood of keloid development than Caucasians, but less than that of people of African descent. Therefore, before undergoing surgery, East Asians may want to consider being medically evaluated for keloids.

African Hair Loss Considerations

People of African descent usually possess naturally curly hair. This curly hair gives the visual impression of increased hair density for a given amount of hair, which is beneficial in hair restoration surgery.

The hair follicles beneath the skin of people of African decent also typically curve more than Caucasians. This can make harvesting the donor hairs, without severing or transecting the hair follicles beneath the scalp, more difficult. A hair restoration physician needs to be very aware of this difference and adjust to its requirements.

As in the case of East Asians, people of African descent possess some unique hair and skin characteristics. Some of these medical conditions are more common in black skin than in white skin. This may increase the risk for post-surgical complications.

Those of African descent have a higher chance of developing keloid scarring when injured. This in turn leads to a greater chance of noticeable donor scars. Keloids aren’t a widespread problem. But those with a history of them are carefully evaluated in regard to their existing scars. The evaluation usually involves a small "test procedure" to determine if there’s a normal healing rate.

Another issue is that of postoperative skin discoloration. With darker skin, there’s often a greater risk of both increased and decreased skin color after injury or surgery. These risks can be determined by the patient’s medical and family history.

Ingrown hairs are also a more common problem in darker skin. If a patient has a history of ingrown hairs or other minor skin infections, this may signal a higher risk for ingrown hairs post-hair restoration surgery. Again, this risk can be determined by a small test procedure.

Caucasian Hair Considerations

Caucasians (white people) may have a wide range of hair and skin types. However, if someone has dense and or coarse hair, as well as skin color similar to their hair color, they will generally achieve the best results for a given amount of restored hair.

Learn more about aging and gender hair loss

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.

Diffuse Hair Loss and How to Treat It

Unlike male pattern baldness (MPB) and female pattern hair loss (FPHL), which tends to follow one of the hair loss patterns defined by the NorwoodScale and the LudwigScale, Diffuse Patterned Alopecia (DPA) is characterized by diffuse thinning throughout the front, crown and vertex(crown) with no distinct pattern evident. However, like male and female pattern balding,Diffuse Patterned Alopecia patients typically preserve the stable "permanent zone" on the sides and back of the scalp and may sometimes retain a well-defined hairline. DPA is also a type of hereditary balding condition like and rogenetic alopecia (genetic hair loss).

Diffuse Patterned Alopecia (DPA) can be difficult to diagnose and, particularly in its early stages, may be confused with a similar condition known as Diffused Unpatterned Alopecia (DUPA). While both conditions are characterized by diffuse thinning, DUPA sufferers lack the stable permanent zone necessary for surgical hair restoration.

Treatment for Diffuse Patterned Alopecia

DPA often responds well to medical hair loss treatments like Propecia (finasteride) and Rogaine(minoxidil) and, due to the preservation of the permanent donor region, many DPA sufferers are candidates for hairrestoration surgery.

Conclusion

It’s essential that hair loss suffering men and women seeking medical and/or surgical treatment for diffuse thinning consult with a skilled and experienced hair restoration physician. Differentiating between DPA and DUPA is critical because Diffuse Patterned Alopecia patients frequently make good hair transplant candidates, whereas DUPA patients rarely do.

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/.

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.

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.

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

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

Donor area is sutured

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

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

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

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

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

Follicular unit grafts are gently placed into the recipient incisions.

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

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

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

Scalp Med TV infomercials, like many hair loss products, claim to sell FDA approved hair loss products. Pictures, videos, and testimonies on television show hair loss sufferers regrowing hair even when men and women were completely bald. Is this really what balding people can expect from Scalp Med? Below we examine Scalp Med and unlock the mystery ingredients and whether or not any clinical proof exists that this hair loss solution can treat baldness.

Scalp Med includes 3 distinct products including topical Vitadil-5A for men or Vitadil-2A for women, topical NutriSol-RM, and Cortex Enlarger hair thickening spray.

Vitadil-5A for men or Vitadil-2A for women is a topical solution that contains the proven hair regrowth solution minoxidil, also found in Rogaine and Xandrox. It's also said to include a unique delivery agent formulated to increase the absorption of 5% minoxidil for men, 2% for women.

Scalp Med is a bit more vague as to the ingredients found in the NutriSol-RM topical and the Cortex Enlarger thickening spray. While NutriSol-RM topical is designed to add essential nutrients to the scalp for healthier hair, the Cortex Enlarger hair thickening spray's primary purpose is to temporarily fatten the hair follicles making hair appear thicker.

Scalp Med is upfront that the ingredients found in the NutriSol-RM shampoo and Cortex Enlarger hair thickener will not stop hair loss or cause hair regrowth.

Scalp Med also offers a detoxifying cleanser kit which includes a detoxifying shampoo called Panthenol-DX Scalp Detoxifier. This shampoo is designed to deeply cleanse the scalp without stripping the hair of its natural oils and nutrients. Unless your thinning hair is due to pollutants or toxins affecting natural hair growth, Panthenol-DX Scalp Detoxifier won't stimulate new hair growth. Scalp Med's Panthenol-DX does nothing to stop the natural progression of genetic female hair loss and male pattern baldness.

To supplement Scalp Med's hair loss treatment program, Scalp Med offers a Mega-Multi Vitamin to increase overall body health.

Scalp Med can legally claim that it's product contains an FDA approved ingredient since Scalp Med does contain minoxidil, which is a FDA approved topical treatment for hair loss. However, Scalp Med its self has not been granted FDA approval. Though Scalp Med's other products may work to promote healthy hair, it's the minoxidil that gives balding men and women any hope of restoring their hair.

Unfortunately, Scalp Med's marketing infomercials makes it appear that completely bald men and women have hope of regrowing a full head of thick and healthy hair. However, the words “Results seen are not typical” can be seen in small fine print at the bottom of your television.  Additionally, Scalp Med's website FAQ makes it clear that no non-surgical hair loss solution is proven to grow hair in completely bald areas.

There are several proven success stories that minoxidil can stimulate hair regrowth in areas of thinning hair. Therefore, Scalp Med's Vitadil-5A should be as effective as 5% minoxidil just as Vitadil-2A should be as effective as the 2% solution.

Scalp Med is about 3 times the cost of minoxidil. A two month supply of Scalp Med is approximately $160.00. Discounts are available if you buy in bulk. However, even in bulk, the net cost ends up around $64 per month as opposed to the $20 per month cost of Rogaine. Generic minoxidil costs even less.

Childbirth may result in hair loss. It's common for many women to notice hair loss about 3 months after they've had a baby. This too, is caused by hormones. But this is not something to worry about. You see, during pregnancy, hair that normally falls out is kept in by high levels of hormones. Once the hormones have returned to pre-pregnancy levels, this extra hair falls out. The normal cycle of hair growth and loss then begins again.