Our physician members perform a very refined hair transplant procedure called "Follicular Unit Hair Transplantation". Today there are two methods for doing this procedure. They differ only in the methods used to harvest and prepare the grafts.
Follicular Unit Extraction Video is provided courtesy of Dr. Alan Bauman.
How the follicular unit extraction (FUE) hair transplant procedure is different than standard strip excision hair transplant surgery.
How the minimally invasive hair transplant procedure known as Follicular Unit Extraction or FUE is performed.
How follicular unit grafts are created under microscopic dissection and then placed into tiny incisions in the balding areas.
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During the past several decades, superstition, old wives tales, and guess work has gradually been replaced by science.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.
Dr. Munib Ahmad in the Netherlands, performs every part of the hair transplant procedure to ensure his patients receive the highest quality. He is the first point of contact from the consultation to the aftercare. His results show aesthetic artistry with keen attention to detail.
Nioxin is an excellent product including both a shampoo and conditioner formulated specifically for men and women with thinning hair."> While neither the shampoo nor conditioner hasn't been proven to have any effects on DHT (the hormone responsible for male pattern baldness); Nioxin's ability to strengthen follicles and energize cellular activity can improve the overall health of your scalp and hair. Nioxin therefore may have the ability to delay the effects of hair loss. For best results, use both the shampoo (refered to as Nioxxin Shampoo Scalp Cleanser) and conditioner (referred to as Nioxin Scalp Therapy) in conjunction with one another.
Nioxin Scalp Cleanser's cooling properties refreshes and cools the scalp promoting maximum cleanliness and freshness. Because of this, Nioxin shampoo, especially when combined with the conditioner also significantly reduces scalp itchiness and tenderness after hair transplant surgeryin both the recipient and donor areas.
Nioxin Scalp Therapy is an excellent volumizing scalp and hair conditioner that moisturizes and improves your hairs' natural resilience, while promoting a healthy scalp environment for optimal hair growth. Nioxin Conditioner is the perfect conclusion to the Nioxin Shampoo Scalp Cleanser.
Nioxin Scalp Therapy's minty fresh cooling sensation literally refreshes and cools the scalp promoting maximum cleanliness and freshness. Because of this, Nioxin also significantly reduces scalp itchiness and tenderness after hair transplant surgery in both the recipient and donor areas.
We strongly recommend using Nizoral shampooevery 2 or 3 days in conjunction with Nioxin. Its active ingredient ketoconazoleat 2% concentration has proven to be a moderate DHT inhibitor and has growth properties approximately as effective as Rogaine2%.
Developing Realistic Expectations:
Men and women sometimes suffer from hair loss for different reasons. Thus, diagnosing its cause is necessary to facilitate and promote proper treatment.
The Nioxin product line is an excellent scalp and hair cleansing shampoo and conditioning therapy but is not proven to stop hair loss. Thus, we strongly recommend using Nioxin in conjunction with the "Big 3" (Propecia, Rogaine, and Nizoral.
Hair transplantation is really about relocating (transplanting) the bald resistant hair follicles from the back of the head to the balding areas on the top of the head.
This process works for a lifetime because the hair follicles taken from the back of the head are genetically resistant to baldness, regardless of where they are relocated to.
Hair transplantation, when done right, can be so natural that even your hair stylist will not know that you've had it done.
But the skill and techniques of hair transplant surgeons does vary widely, as do their results. It's important to choose the right procedure and clinic to assure that you will get completely natural results.
To learn more about the leading hair transplantation physicians who perfrom this procedure, visit our recommended physicians page.
A typical session of between 1,500 to 3,000 grafts normally involves a full day of surgery on an out patient basis. Most patients will arrive in the morning and will have their procedure completed by late afternoon.
Patients are given local anesthesia in the donor and recipient areas. Most patients find that once the anesthesia is given that they feel no pain or discomfort during the surgery. Following surgery patients will typically feel some amount of soreness and numbness, with some mild discomfort. Most patients are pleasantly surprised by how minimal the discomfort from the surgical procedure is.
Today hair restoration clinics typically provide free no obligation consultations, with surgical sessions priced either per graft or by the session. Prices typically average around $5 to $6 per graft.
It is normal for the price per graft to drop as the size of the surgical session increases. Many clinics will offer a reduced rate per graft once a certain surgical session size (i.e. 1,000 or 2,000 grafts) is exceeded.
The amount of grafts you will need ultimately depends on your degree of hair loss, now and in the future, and on how full you desire your hair to be.
For help estimating the amount of grafts/hairs you may need, click here.
To use our interactive graft calculator, click here
With today’s very refined micro hair transplantation procedure the incisions are very small and less invasive than past procedures. This results in more rapid healing. Most patients feel fine within a day or two following surgery, although some numbness and mild soreness can be expected for several days following surgery.
Immediately following surgery a patient’s recipient area is typically pink with scabs forming around the micro incisions. These hundreds of tiny incisions will heal rapidly within a week to ten days.
During the first few days after the surgery a person’s hair transplants will be noticeable if there is no previous hair to mask these temporary scabs. However, most patients feel comfortable being in public without wearing a hat within 5 to 7 days following surgery.
Once the transplanted hair grows out the results should look entirely natural, even under close examination.
Normally it takes between three to five months following surgery before the transplanted hair follicles begin to grow new hair. The transplanted hair grows in very thin initially and gradually grows thicker and fuller over time. After one year a patient’s transplanted hair will be fully mature and will continue to grow for a life time.
Since the hair follicles that are transplanted to the balding areas are genetically resistant to going bald, they will continue to grow for a life time – just as if they had been left in the bald resistant donor area.
To understand why some hair follicles are genetically resistant to going bald, while other are not, click here.
The most important decision in restoring your hair is the physician you choose. The skill, talent, and experience of hair restoration physicians vary widely, as do the end results. Who you choose will determine how natural and full your new hair will be for the rest of your life.
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
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/.
Robert J. Dorin, DO has been a specialist in hair restoration since 2002 and a member of our network since 2006. He offers advanced FUE and FUT procedures as well as PRP therapy. Prospective patients seek out Dr. Dorin for his personalized care and ultra-refined results.
While Nizoral 2% shampoo is more effective at inhibiting DHT production and its binding to hair follicles, Nizoral regular strength offers a smoother, gentler approach to treating hair loss while minimizing scalp irritating effects from other topical treatments such as Rogaine 5% liquid.
This product includes 1% of the active ingredient ketoconazole. To view the clinical abstract proving the effectiveness of ketoconazole in the treatment of androgenetic alopecia, view "Ketoconazole as a hair loss treatment". Alternatively, you can obtain a prescription from your medical practitioner for the more concentrated 2%.
Developing Realistic Expectations:
Men and women sometimes suffer from hair loss for different reasons. Thus, diagnosing its cause is necessary to facilitate and promote proper treatment.
Don't expect immediate results. It's recommended to use Nizoral in conjunction with other proven treatments for at least 6 to 12 months before determining its effectiveness. Documenting your progress with bi-monthly photos can help you determine whether or not Nizoral has been successful in helping you maintain existing hair.
To date, only surgical hair restoration is proven to grow hair in completely bald areas. You are invited to have a free virtual consultation with one of our prescreened hair restoration physicians.
Birth control pills can be a great way of preventing conception however;all medication comes with potential side effects. In addition to the many serious possible side effects associated with birth control pills, some come with a risk of female hair loss. By suppressing ovulation due to the combined actions of hormones progestin or estrogen, women who are predisposed to hormonal related hair loss may experience varying degrees of balding while on the pill, or even more likely, a few weeks to months after coming off of it.
Yasmin is a birth control pill that combine sethinyl estradiol and drospirenone Because Yasmin may induce hair follicles into the telogen phase (hair shedding) of the hair growth cycle, hair loss is a reported side effect
We recommend women to use only low-androgenindex birth control pills. For women with a strong predisposition for genetic hair lossin their family, we recommend use of other non-hormonal birth control pills or other forms of contraceptives for the prevention of conception.
For your reference, here is a list of birth control pills ranging from the lowest androgen index to the highest: Desogen,Ortho-Cept, Ortho-Cyclen, Ortho Tri-Cyclen, Micronor, Nor-Q D, Ovcon-35,Brevicon/Modicon, Ortho Norvum 7/7/7, Ortho Novum 10-11, Tri-Norinyl, Norinyland Ortho 1/35, Demulen 1/35, Triphasil/Tri-Levien, Nordette, Lo/Ovral,Ovrette, Ovral, Loestrin1/20, Loestrin 1.5/30.
Hair loss suffering men and women are always seeking new and credible treatments and with good reason. Medical science is still years from producing a true hair loss cure and current treatment options are vastly limited. Women with hair loss have even fewer options than their balding male counterparts when it comes to proven, non-surgical hair loss treatments. Additionally, there is no shortage of cunning charlatans waiting to take advantage of the unwary consumer. Thus, when a new product like Kevis Hair Rejuvenation Formula comes along claiming to be a “permanent” solution and “the most successful and potent hair loss treatment on the planet”, potential customers would be wise to remain skeptical.
Kevis hair loss treatment is not an entirely new solution. In fact, their website states that it has been sold throughout Europe and Asia for over 25 years but has only been available in the United States for 15 years. This is simply the 8th generation of the formula; hence their new name Kevis 8. But how can such an impressive treatment exist for 10 years yet remain virtually unknown to roughly 70 million balding American men and women? What’s even more surprising is that Kevis claims that published clinical studies give this solution for baldness an average success rate of 92%. So why are so many people still seeking viable hair loss treatments today?
Kevis 8 is a drug-free topical lotion developed and manufactured by Italian pharmaceutical company, Farmaka, and distributed by Kevis Rejuvenation Programs in North and South America and by Pfizer in Europe and Asia. As such, it does not come under the regulatory supervision of the United States Food and Drug Administration (FDA). It is applied directly to the scalp and can be used by both men and women. Ingredients are listed as:
H.U.C.P is a high concentrate of pharmaceutical grade hyaluronic acid which purportedly aids in the breakdown of accumulated DHT in the follicle and creates a binding effect in the follicle's receptor sites preventing further DHT buildup. Kevis also lists the ingredient Tricozyme™. Tricozyme is a protein enzyme that they claim attaches itself to free-floating DHT molecules rendering them “inactive and inoperable”.
Kevis claims that results from using their product are “permanent”. Once hair follicles are protected from the effects of DHT they will remain DHT resistant for life. Thus, their claim is that once the desired result is reached, there is no need to continue using Kevis. This is a hefty claim considering all other non-surgical balding solutions are required to be used for life in order to experienced continued benefits.
In an effort to demonstrate its efficacy, Kevis provides complete, downloadable copies of seven clinical studies conducted by various institutions in France and Italy and provides summaries of each. They also offer several before and after photos (including those of company founder and President Brian Reichenberg) and written testimonials. What seem to be conspicuously missing are references to third-party studies and publications in peer reviewed journals. Without these critical components it’s impossible to verify the company’s hair growth claims.
Balding men and women may want to stick with clinically proven and FDA approved medical hair loss treatments. For men those treatments are Rogaine (minoxidil) and Propecia (finasteride). Rogaine is also approved for use by females. However, women should not ingest or even come in contact with finasteride due to the risk of specific birth defects. Men and women who are unable or unwilling to use these drugs can find credible alternatives.
When it comes to purchasing and using hair loss treatments, there is much more at stake than your hard earned money. Dedicating months or years to ineffective treatments may result in the unnecessary loss of valuable and irreplaceable hair follicles.
Is it Effective in Treating Baldness?