• How hair loss medication can inhibit DHT and Alopecia Areata

    Propecia or Avodart

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

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

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

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

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

    Women must NOT USE Propecia

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

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

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

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

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

    Get a Prescription for Propecia or Avodart.

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

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

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

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

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

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

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

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

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

    Sticking with the program to see results

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

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

    Other DHT Blockers

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

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

    How hair loss drugs inhibit DHT and Alopecia Areata

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

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

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

    What about side effects?

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

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

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

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

  • Nizoral 2% Shampoo (Extra Strength) for Hair Loss

    Nizoral 2% shampoo

    Nizoral 2% is magnificent shampoo and a significant part of what's referred to commonly as the Big 3. The other two are the FDA approved and proven treatments Propecia (finasteride)and Rogaine (minoxidil). To date, Nizoral is the only shampoo on the market that can make the unique claim that it's proven to stop the formation of DHT. Its active ingredient ketoconazoleat 2% concentration has proven to be a moderate DHT inhibitor and has growth stimulating properties about as effective as Rogaine 2%.

    This product includes 2%, the highest concentration 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". There is also a less concentrated 1% of Nizoral. To learn more, visit Nizoral regular shampoo.

    We strongly suggest using Nizoral shampoo in addition to other proven treatments. Nizoral should be used 2 or 3 times a week to avoid dry hair and a flakey scalp.

    On the off days, you may want to consider rotating Nizoral with other excellent shampoos designed specifically for thinning hair. See the recommended treatments section below for other shampoos we recommend.

    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.

  • Robert J. Dorin, DO, ABHRS

    Dr. Robert Dorin
    Dr. Robert Dorin
    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.
  • 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.
  • Female Hair Loss - Treatment and Restoration

    Female hair loss

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

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

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

    Women with thinning hair compared to Men

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

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

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

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

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

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

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

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

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

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

    David Whiting in Dallas, Texas - 214 824-2087

    Vera Price in San Francisco, California 415 353-4163

    Maria Hordinsky in Minneapolis, Minnesota 612 625-1493

    Wilma Bergfeld in Cleveland, Ohio 216 444-5722

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

  • Nanogen Hair Loss Concealer Review

    Nanogen Hair Loss Concealer

    A Thicker Fuller Head of Hair in 30 Seconds?

    A staggering 50% of men and 30% of women will experience some degree of thinning hair by the age of 50. Along with state of the art hair transplant surgery and credible drug treatments like Propecia (finasteride) and Rogaine (minoxidil), many balding men (and women) have added credible concealers like Nanogen to their daily treatment regimen.

    As the term implies, concealers do not actually regrow hair but rather cosmetically enhance the appearance of balding areas of the scalp by reducing the contrast between scalp and hair color and/or adding fullness to thin, wispy hair follicles.  Nanogen is no exception however, Nanogen is very popular and differs from other topical concealers in several areas.

    How Nanogen Works

    Nanogen is made of microscopic keratin fibers. Keratin is the same material that natural hair is composed of, giving the product a natural look and feel when applied to existing thinning hair. Unlike other fiber-based hair loss concealers, Nanogen’s “nanofibers” have a patent pending, “dipolar” electrostatic charge coating that causes them to cling to existing hairs in a fashion resembling needles on a Christmas tree rather than lying flat against the follicles. It’s this perpendicular binding that gives what some users have described as an immediate “lift” to the hair.  By increasing the diameter of each individual follicle from root to tip, Nanogen is able to enhance the appearance of hair density resulting in the illusion of a full head of hair.

    Applying Nanogen

    Nanogen is available in ten different shades. These colors can even be combined to invisibly blend with your natural hair. The fibers are sprinkled onto the balding scalp from an applicator reminiscent of a large pepper shakerand then blended with the fingertips. Once the desired effect is achieved, there is an optional locking mist available to help the fibers stay in place through inclement weather conditions, intense exercise and perspiration.

    Users should take care when applying Nanogen near the hairline. Over application can result in accumulation and an unnatural appearance.

    Nanogen colors

    Conclusion

    Nanogen’s keratin-based nanofibers are an excellent choice for balding men and women wishing to improve the appearance of thinning hair. Unlike some creams, sprays or make-up type concealers, Nanogen fibers are odor-free, non-itchy, wash out easily and won’t stain your clothing or pillowcase. With practice, the application is clean, quick and simple.

    See what Real Patients are Saying about DermMatch on our Hair Loss Forum

    For an in-depth comparison of Nanogen and similar fiber-based hair loss concealer Toppik, see the discussion topic, Product Review: Nanogen. To see what other members and Nanogen users are saying, you are encouraged to use the "search" feature of our hair restoration discussion forum.

  • Follicular Unit Hair Transplantation - Step by Step

    Follicular Unit Hair Transplantation - Step by Step

    We believe that patients have a right to full disclosure and a complete understanding of exactly what hair restoration surgery involves.

    This step by step presentation shows how today’s state of the art follicular unit hair transplant procedure is typically performed.

    Step 1 - hair transplant donor area

    Patient is prepared for surgery

    During surgery hair follicles from the back of the head that are genetically resistant to going bald will be removed and relocated (transplanted) to the balding areas.

    Step 2 - Patient is prepared for surgery

    Donor area is trimmed

    Prior to surgery, the hair in donor area that will be surgically removed is trimmed.

    Donor area is prepared for surgery

    Once the donor area has been prepared it is given local anesthesia.

    Donor tissue is removed

    Donor tissue is removed

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

    Donor area is sutured

    Donor area is sutured

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

    Hair combed over sutures

    Hair combed over sutures

    When patient’s hair is combed over the donor area the sutures are not visible. These sutures are typically removed approximately ten days after surgery.

    Donor tissue is trimmed into follicular unit grafts

    Donor tissue is trimmed into follicular unit grafts

    Surgical technicians then use microscopes to view the donor tissue in order to dissect and prepare follicular units hair grafts.

    Bald recipient area is prepared

    Bald recipient area is prepared

    After being given local anesthesia, the balding recipient area is ready for surgery. No trimming or shaving of hair is needed in the top recipient area.

    Incisions are made in the balding areas

    Incisions are made in the balding areas

    Tiny incisions are made in the recipient areas in irregular patterns that mimic nature. The follicular unit grafts will then be placed carefully into these tiny incisions.

    Grafts are placed into the incisions

    Grafts are placed into the incisions

    Follicular unit grafts are gently placed into the recipient incisions.

    Grafts are placed in varying densities

    Grafts are placed in varying densities

    Typically the smallest one and two hair grafts are placed in the very front of the hairline, with three and four hair grafts placed behind them.

    Patient immediately following surgery

    Patient immediately following surgery

    Following surgery a patient will have hundreds of tiny incisions with short hair stubble showing from the new grafts.

    Close up of recipient area after surgery

    Close up of recipient area after surgery

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

  • Hair Transplant Surgery

    Hair Transplant Surgery

    Currently the only solution for regrowing hair, particularly in the hairline area, is hair transplant surgery, an advanced surgical hair restoration technique.

    Done right, a hair transplant is so natural that even a hair stylist cannot detect that a person has had hair transplants.

    The days of the "corn row" or "Barbie Doll" hair transplants are long gone.

    To achieve such truly natural results requires a dedicated and highly skilled staff doing a state of the art hair transplant procedure. The state of the art micro hair transplant procedure that our member physicians perform is called "Ultra Refined Follicular Unit Hair Transplantation".

    Hair transplant surgery involves relocating (transplanting) the bald resistant hair follicles from the back of the head to the balding areas on the top and front of the head.

    This process is effective and will last a lifetime because the hair follicles taken from the back of the head are genetically resistant to baldness, no matter where they are transplanted.

    This procedure is regarded by most hair restoration physicians to be the "gold standard in hair transplants". Learn more about this hair transplant procedure.

    Because this very refined procedure is difficult to perform at the highest quality level only a minority of all hair restoration surgeons perform it successfully. Our member physicians have extensive experience performing this advanced and very refined procedure with excellent proven results.

    Today, hair transplant surgical hair restoration is an out-patient procedure requiring only local anesthesia. Most patients are surprised by how little discomfort they experience during and after their surgery. Many patients watch TV or sleep during their procedure.

    Hair transplant surgery is the only certain way of restoring significant amounts of hair in balding areas. View hair transplant photos of actual hair loss patients.

    Sharing information in the Hair Loss Learning Center forum with patients who have successfully restored their hair is a good way to begin the process of selecting a hair transplant surgeon with a proven record of restoring a natural hairline. Online consultation can put you directly in touch with one of the world's top hair restoration physicians in your area who can help you assess your options.

  • Surgical Hair Restoration - View our procedures in detail

    Surgical Hair Restoration

    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.

  • Diffuse Unpatterned Alopecia (DUPA)

    Diffuse Unpatterned Alopecia

    What Is DUPA?

    Diffuse Unpatterned Alopecia (DUPA) is a form of genetic hair loss characterized by diffuse thinning over the entire scalp. Unlike Diffuse Patterned Alopecia (DPA), DUPA lacks the stable permanent zone associated with other forms of alopecia.

    Dr. O'tar Norwood defined DUPA in his 1975 seminole publication "Male Pattern Baldness: Classification and Incidence" as:

    Diffuse, Unpatterened Alopecia (DUPA). In this type, there is a general decrease in the density of hair without any definite pattern, although it is usually more marked over the top and front. This type is common in women.

    Identifying DUPA

    Diffuse Unpatterned Alopecia patients have a similar pattern of hair loss to DPA patients but the balding tends to occur more rapidly. DUPA patients are also more likely to achieve the “horseshoe” pattern commonly associated with Norwood class VII baldness. However, unlike other forms of alopecia hair loss, the DUPA “horseshoe” takes on a thin and transparent appearance.

    It is important that patients suffering from diffuse hair loss are properly diagnosed. While DPA patients are often good candidates for surgical hair restoration, DUPA patients typically make poor hair transplant patients due to the lack of a stable zone in which to harvest donor grafts.

    Treatment for Diffuse Unpatterned Alopecia

    Not a lot is known about the cause and treatment of DUPA. However, about half of males who suffer from this form of balding benefit from Propecia (finasteride). Unfortunately, DUPA is about 10 times more common in females for whom Propecia is not a treatment option.

    Conclusion

    Anyone suffering from diffuse hair loss should consult with a dermatologist or hair restoration physician for a proper diagnosis. This is especially true for balding men and women considering hair transplant surgery.