As patients, we know that the physician you choose is the most critical decision in restoring your hair is the physician you choose. Hair restoration physicians' skills, experience, and talent vary widely, as do the end results, vary widely.

You must research and choose your physician wisely. After all, who you choose will determine how natural and complete, your new hair will be for the rest of your life. The surgeons selected and approved by our community have been scouted and vetted by the forum's highly esteemed senior valued contributors of the Hair Restoration Network. Our valued contributors have all spent years researching hair transplantation, and they have all had hair transplants. To ensure there is no conflict of interest, none of our valued contributors receive any compensation. They are volunteers who have shared their experiences and contributed for years to our community. Each surgeon has been approved based on their ethics, surgical techniques, results, and reviews. To support the costs of operating and promoting our community, the approved physician contributes a monthly fee to sponsor our community.

Their recommendation is continued as long as they continue to show evidence of excellent patient results and satisfaction. If a patient expresses concerns, physicians are expected to resolve their concerns. We ask that patients first contact a physician with any concerns so that they can resolve them before publicly posting.

Note - The hair restoration physicians recommended on this site are not a definitive list of all excellent hair transplant doctors. Nor do we warrant or guarantee the results of any of the physicians presented on this site. As always, we encourage you to do your due diligence in evaluating these and all hair loss physicians.

We offer the following suggestions for researching a hair restoration physician:

• Does the physician take a holistic approach to hair restoration? Your physician should help you evaluate all your options, surgical and non-surgical.
• Have they invested time and resources in large micro follicular unit hair transplantation sessions? Outstanding work requires a staff dedicated to and trained to use high-powered magnification to produce more than 2,000 carefully trimmed grafts per surgical session.
• Choose a hair restoration clinic that is patient-focused rather than commercially focused. Some clinics emphasize revenue, speed, and volume rather than dedicating the time and individual care needed to produce optimal results. These commercial operations typically rely on heavy advertising rather than satisfied patient or doctor referrals.
• Is hair restoration the primary focus of their practice? Outstanding results require a physician and staff to perform hair restoration surgery regularly. Doing hair restoration as a sideline and other cosmetic procedures may hinder their ability to do large sessions of highly refined follicular unit transplantation.
• How many patients has this physician produced excellent results for? Like any skill, experience over time is critical to acquiring the skill and judgment required to produce excellent results.
• Can the physician provide detailed patient before and after photographs? Do they also have patients who are willing to speak with you and meet with you in person?

What do their hair transplant patients think?

Ultimately, the most critical measure of a hair transplant surgeon's work is their patient's level of satisfaction. Find out what patients think of their physician's work by visiting our discussion forum or viewing hair loss blogs created by patients. View our standards for recommending hair transplant surgeons.

Find an excellent hair restoration physician in your area.

Send a Virtual Consult

This online feature enables you to fill out a hair loss questionnaire and email it to any of the quality hair loss doctors recommended on this site. You can even attach your photos. They will then respond to your questions and concerns.

Click here, to send a Virtual Consult.

Suggest a physician for recommendation on this site.

We are always interested in learning about outstanding hair restoration physicians. Click below to suggest an outstanding physician for recommendation on this site.
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A Viable Alternative to Propecia in Treating Hair Loss?

Folexen S-equol , produced by Australian manufacturer Eclipse Nutraceuticals is considered an "all natural" hair loss treatment that boasts an impressive 87% success rate for preventing and reversing the effects of male pattern baldness with virtually no side effects.  Folexen S-equol has also been a hot topic of discussion on our popular hair loss forum. But, does this self-described "nutraceutical" live up to its hair growth hype?  Is Folexen a viable alternative to Propecia for treating the effects of male pattern baldness?

What is Folexen S-equol?

According to the FAQ on Folexen's website, the active ingredient S-equol is "a metabolite of a natural isoflavone called daidzein, which occurs in soybeans and some other food products".

Isoflavones are an organic compound produced almost exclusively by various bean types. In populations that consume large quantities of soy protein, studies have shown a lower incidence of breast cancer and other common cancers because of its role in influencing sex hormone metabolism and biological activity.

As a metabolite, S-equol is the product that remains after the isoflavone is broken down or "metabolized" by the body.

In addition to its active ingredient, Folexen contains the following GRAS (generally recognized as safe) inactive ingredients: starch, maltodextrin, allantoin, propionic acid. It may also contain hypromellose (vegetarian capsule).

But is there any evidence that S-equol  works to treat hair loss?

How Folexen S-equol Allegedly Works to Treat Baldness

In the body, testosterone is converted to the hormone dihydrotestosterone (DHT) via the enzyme 5-alpha-reductase (5AR). It's widely known that androgenic alopecia (genetic hair loss) results when genetically vulnerable hair follicles are exposed to DHT which then binds to the receptor sites of these follicles causing them to weaken and shrink over time. This shrinking process is known as miniaturization.

The recognized leader in the battle against the balding effects of DHT is the clinically proven and FDA approved drug Propecia (finasteride). Propecia works by inhibiting the conversion of testosterone to DHT, potentially slowing or even reversing the effects of androgenic alopecia. However, approximately 2% of males who take Propecia experience debilitating sexual side effects.

Unlike finasteride, Folexen's rumored ability to suppress hair loss and potentially regrow hair is based on the theory that S-equol can bind strongly to free DHT molecules, prohibiting them from binding to the hair follicles' receptor sites. Because Folexen does not suppress the conversion of testosterone to DHT, there is no resulting increase of testosterone in the body and therefore, no sexual side effects. But are there any clinical studies supporting that S-equol can truly prevent DHT from binding to hair follicle receptor sites and prevent hair loss?

Clinical Studies

Folexen's website references four articles in peer reviewed journals. Two of these studies center on S-equol's effect on prostate health while the other two don't appear to reference S-equol at all.

At this time, there appears to be no scientific data presented supporting Folexen's efficacy as a hair loss treatment.

Side Effects

The company claims that the product is virtually side effect free: specifically noting that it does not cause gynecomastia (enlarged breasts), erectile dysfunction or any of the other side effects that are experienced with some other treatments.

Some users however, did report mild diarrhea that dissipated within one week of commencing treatment.

What is the Recommended Dosage?

The recommended dosage of Folexen is 4 capsules per day (two every 12 hours), totaling 10mg of the active ingredient. Eclipse claims that the product has been tested safe at much higher concentrations (up to hundreds of milligrams) and there is some speculation based on available data that it may, in fact, require a dose as high as 100mg to match the Propecia's hair growth results.

Where to Buy Folexen S-equol

Folexen is only available by mail order from Australia. A bottle of 100 2.5mg capsules (25 day supply) costs approximately $40 USD + shipping but there is a discount for purchases exceeding 4 bottles and again for 9+ bottles. However, it's easy to see that even in bulk this treatment is several times more expensive than purchasing generic 5mg finasteride and quartering the tablet, as many finasteride users do.

As a natural product and not a drug, there are no shipping restrictions. Estimated delivery time is two weeks.

Conclusion

Time will tell if Folexen S-equol proves to be an effective weapon in the fight against androgenic alopecia or simply another product in a long line of expensive disappointments.

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.

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.

Alopecia areata (sometimes referred to as“spot baldness”) is a medical condition that typically results in patchy hairloss or bald spots on the scalp, beard, arms and legs. Though the exact cause of alopecia areata is unknown, it is thought to be an autoimmune disorder causing the body’s immune system to attack its own hair follicles, resulting in hair loss.

Roughly 2% of the world’s population suffers from alopecia areata and approximately 5% of these have a family history of "alopecia", the medical term for hair loss.

Diagnosing Alopecia Areata

Alopecia areata is normally diagnosed through the observation of symptoms. However, occasionally a scalp biopsy or blood tests may be performed.

Treating Alopecia Areata

There is no cure for alopecia areata and current treatments, while sometimes effective, offer limited success.  Current treatments for alopecia areata include; steroid injections, topical corticosteroids (steroid hormonesnaturally produced in the adrenal cortex of vertebrates), topical immunotherapy, Rogaine(minoxidil) and ultraviolet light therapy.

Although permanent hair loss is a possibility, the course of the disease is unpredictable and varies from patient to patient. The good news is that, even without treatment and after many years,the hair follicles do remain viable and ready to resume normal hair production if and when they receive the appropriate signal. Hair regrowth may, and often does, occur in time.

Are Alopecia Areata Patients Good Candidates for Hair Transplantation?

Patients suffering from alopecia areata are rarely considered good candidates for hair transplant surgery because donor hair grafts harvested from the “safe” zone at the rear and sides of the scalp are still vulnerable to the effects of the body’s immune system once transplanted to the recipient sites. However, if the affected area is small, has remained unchanged for an extended period of time and if there is no sign of inflammation below the scalp, hair transplantation may be an option. This would require a thorough consultation with a skilled and experienced hair restoration surgeon and the patient would need to fully understand and accept the risks of such a procedure.

Adapting to and Living with Alopecia Areata

Depending upon the severity of the condition, hair loss concealers like Toppik, Nanogen and DermMatch may help disguise bald patches. In more severe cases, a hair replacement system or full wig may be necessary.

Aswith all forms of hair loss, patients suffering from alopecia areata may experience emotional and psychological trauma. It’s important to reach out to family and friends, join an alopecia support group and/or seek the services of a mental health professional if you are experiencing intense, prolonged and overwhelming psychological effects.

Is this hair loss treatment effective?

Extreme Hair Therapy (EXT) for thinning hair is a 5 "step" hair loss treatment solution created by Hair Club that claims not only to rejuvenate your hair, but "rejuvenate your life".  Making claims to be FDA approved, EXT claims to stimulate hair regrowth in thinning areas by keeping hair in the anagen (hair growth) phase longer.

Balding men and women seeking hair loss solutions should be careful to do their due diligence in researching all products they are considering.   Is this one of the hair loss products that really works to treat baldness?  Can Extreme Hair Therapy really deliver what it promises?

Below we take a look at each of the 5 “steps” and separate treatments and analyze whether or not EXT can remedy alopecia in men and women.

What is the 5 Step Process of Extreme Hair Therapy?

Step One: Moisturizing or Revitalizing Cleanser
This moisturizing shampoo is rich with vitamins and works to cleanse the scalp. Though it claims to revitalize and strengthen thinning hair, the ingredients are not listed on their website. Many hair rejuvenators and thickening agents (commonly referred to as volumizing shampoos) help to make hair appear thicker as they take on hydration and swell. Unfortunately, these thickening agents do nothing to stop the progression of male pattern baldness, even if it temporarily makes the hair shaft appear fatter.

Step Two: Enzyme Scalp Cleanser
Claiming to be a “new breakthrough”, this organic formula removes sebum oils that can sometimes hinder hair growth. Though sebum buildup, excessive dandruff, and scalp dermatitis are sometimes responsible for certain non-genetic types of balding such as diffuse alopecia or telogen effluvium, it does not promote androgenic alopecia (hereditary male or female hair loss).

Step Three: Energizing Conditioner
Adding nutrients such as proteins and wheat amino acids, this conditioner helps to promote a healthy scalp and hair growth. It should be noted that nothing in this step claims to stop hair loss or stimulate hair regrowth.

Step Four: Hair Revitalizing Complex
This dietary supplement containing Vitamins B3, D, and E, Biotin, saw palmetto and nettle root is taken twice daily, once in the morning and once at night. Some of these ingredients can also be found in several other hair loss products such as Provillus, Procerin, and Avacor.

Though some of these ingredients work to treat benign prostatic hyperplasis (BPH) in men by inhibiting DHT (the hormone responsible for female and male pattern baldness), no formal clinical studies have been performed on successful hair loss treatment. It should be noted that tocotrienol molecules in Vitamin E may effectively treat alopecia but its counterpart tocopherol (commonly found in alternative herbal hair loss treatments such as HairMax MD), is not supported.  Additionally, because there are no regulations on herbal medications in the United States, the daily recommended value and dosage in Extreme Hair Therapy is based on something other than FDA regulation.

Step Five: Minoxidil (2% or 5%)
Minoxidil (the active ingredient in Rogaine and Xandrox) is an FDA approved hair regrowth formula and is used by many balding men and women with great success. Because Extreme Hair Therapy includes this, they are legally allowed to claim it to be FDA approved.

Costs:

Unfortunately, this information is not available on the Hair Club website. Upon calling the toll free number for this information, we are told that we must schedule a consultation with a Hair Club specialist. Customer service representatives are apparently not provided with this information.

Side Effects and Warnings:

No EXT side effects are reported on the Hair Club website however, Minoxidil may cause scalp irritation or redness, chest pain, a rapid heartbeat, faintness, swelling of the hands and/or feet, and unwanted facial hair growth.  Be sure to discuss the use of herbal medication with your physician before taking them. Saw Palmetto should be avoided by pregnant women with hair loss.

Conclusions:

The only FDA proven ingredient in Hair Club’s Extreme Hair Therapy hair loss treatment is Minoxidil.  Though Saw Palmettoand nettle root may be effective in treating men with an enlarged prostate by inhibiting DHT, no formal tests have been performed on them.

For many hair loss sufferers, scalp "tinting" solutions are the most effective type of topical concealer. Tinting solutions like COUVRé, also commonly referred to as "masking lotions" or "concealing lotions," eliminate the contrast between thinning hair and the bald scalp by naturally darkening the skin and matching the tone to one's existing hair. By matching bald scalp to an individual's natural hair color, the harsh contrast of thinning hair is eliminated, and a fuller, denser appearance is achieved.

Although several types of masking lotions currently exist, one of the most popular and trusted is COUVRé. However, what makes COUVRé distinct from other masking lotions, or different types of concealers in general? Is COUVRé a quality concealer for both hair loss suffering men and women? Most importantly, what are other concelears users saying, and where can balding individuals purchase their own supply of COUVRé masking lotion?

COUVRé: What is it, and how does it work?

Unlike comparable "shaker" application products (such as Toppik – a popular topical applicator product from the same makers as COUVRé), COUVRé is a tinted lotion, meant to minimize the contrast between dark, thinning hair and the balding scalp. According to the manufacturers, COUVRé is applied to the scalp using a specialized sponge applicator. Once the masking formula is on the scalp and providing sufficient camouflage, users are instructed to simply style hair normally and go about their day.  The manufacturer of COUVRé assert that the application appears subtle, natural, will not appear "greasy or sticky," will not stain clothing or towels, and does not interfere with pores or affect natural hair growth.

The Benefits of COUVRé

According to both the manufacturers and satisfied users, COUVRé offers various benefits over comparable concealer products. First, because the makers of COUVRé are confident in the product, they ensure that, unlike some other concealers, COURVe will create a natural appearance without looking greasy or sticky, and does not clog scalp pores or interfere with existing hair shafts. Because of this, not only is COUVRé useful for those with thinning hair, but also for patients awaiting new growth from hair transplant surgery. What's more, COUVRé does not contain any harmful chemicals, can allegedly withstand perspiration, rain, wind, and even physical contact (such as touching the scalp).  COUVRé comes in 8 different colors/tones (to match all hair types) and is equally effective in both male and female hair loss sufferers.  Although COUVRé will withstand a variety of situations without smearing or smudging, it easily washes completely away with water and shampoo.

COUVRé Color Chart

Why COUVRé has Become Popular and Trusted within the Hair Restoration Community

While COUVRé does offer many benefits above other concealer products, its popularity and reputation within the hair restoration community is likely due to several important factors. First, unlike some other concealing products, COUVRé application is both simple and fast. For many individuals, the ability to naturally conceal thinning hair without spending an excessive amount of time "getting ready," is a huge benefit. Furthermore, because COUVRé contains natural ingredients and does not interfere with native or implanted hairs, it is safe to use with other proven hair loss medications (like Rogaine/minoxidil and Propecia/finasteride) and during the new growth phase of hair restoration surgery. Because of its ease of use, effective nature, and ability to conceal hair loss in a variety of situations, COUVRé has become a reputable hair loss treatment and remains popular within the hair restoration community.

What Real Hair Loss Sufferers are Saying About COUVRé

To read real reviews on COUVRé alopecia masking lotion from other hair loss suffering men and women, visit our hair loss forum and social community.