• Jerry E. Cooley, MD

    Dr. Jerry Cooley
    Dr. Jerry Cooley
    Dr. Jerry Cooley and his staff were early adapters of using microscopes to do excellent all follicular unit hair transplantation.
  • What are the Different Types of Alopecia?

    What are the Different Types of Alopecia?

    Causes and Treatments

    Alopecia is the medical name for hair loss to the scalp or body.  While Androgenetic Alopecia (genetic hair loss) is the most common, there are many other forms of alopecia related hair loss worth discussing.  Each medically named alopecia comes with distinct symptoms, a unique cause and exclusive treatments. Below, we've compiled a list of and description for the most common types of alopecia related hair loss along with the available treatment options for each.

    While the information on this website can be used as a guide, men and women who believe they are experiencing hair loss should always be properly diagnosed by a qualified hair restoration physician to determine its cause. To learn more about each distinctive alopecia hair loss condition, click the links below.

    Traction Alopecia
    Alopecia Areata
    Diffuse Patterned Alopecia
    Diffuse Unpatterned Alopecia (DUPA)

    Cicatricial alopecia (Scarring Alopecia)

    Alopecia Universalis and Alopecia Totalis

  • Questionable Hair Loss Treatments

    Questionable Hair Loss Treatments

    Balding Has Been Cured

    Try telling that to 80 million men and women who are suffering from hair loss in the United States. They will laugh at you. Yet on a daily basis we are bombarded with ads for hair loss treatments like Avacor, Hair Genesis, Fabao and Procerin that use misleading advertising to sell their products. Thanks to their persuasive messages promising to regrow hair, consumers will spend nearly one billion dollars trying to find an effective hair loss remedy and fall victim to misleading advertising like this.

    Thinning hair is a source of distress for millions of men and women so it is not unusual for them to seek help from anything that sounds like it will work. Most questionable hair loss products use similar, misleading marketing techniques ranging from claims to testimonials and photos.

    Hair Loss Product Claims

    Many hair loss products claim to be able to restore hair through the use of drugs, herbal lotions or other exotic applications like lights, lasers or electrical fields. While many of these products have been around for years, there is little evidence that they can restore hair.

    How are they allowed to make such claims? These products often use small amounts of generic drugs found in Propecia and Rogaine (finasteride and minoxidil) which allows them to make the claim to stop hair loss or they imply hair growth with 'cosmetic' claims.

    Misleading Marketing

    Some hair loss products lead you to believe that they can stop hair loss by parsing their words. They can't come out and claim to regrow hair or stop hair loss, so they advertise vague claims like "thicker, fuller hair". This is a 'cosmetic' claim that any product can make. Be advised that cosmetic claims cannot restore hair or grow hair because they are not proven to do so.

    False Testimonials

    With the anonymous nature of Internet postings, people posing as users will mislead others with false testimonials. Often, positive reviews are produced by people compensated to post these messages. Since there is no real regulation of online postings, consumers are advised to take testimonials with skepticism.

    Phony Photos

    Most product advertising that claim that you can "Regrow Hair!" or make your hair 'thicker and fuller' and show a photo of a balding person with thin hair next to a photo of the same person with thicker hair covering the baldness. Photos don't lie, do they?

    Well, yes they do.

    You can prove it yourself. Take a photo of a head with thinning hair using a flash camera and then photograph the same head without the flash. The photo with the flash will look like a bald head and the photo without the flash will look like more hair.

    Lighting, length of hair and how the hair is arranged on the head determine whether a photo of a head looks bald or not. Most people go through the same routine as balding advances: they push hair from here to there and hair spray it into place in the hope that no one will notice that we are going bald. To the extreme, this becomes the 'comb-over' hair style.

    Review the photos of hair loss products you've seen. In most cases there will be just a few and they will all have misleading elements like lighting, hair style and length of hair in the 'before and after' photographs. If the products or services are really legitimate, there should be dozens of photos, if not hundreds or thousands.

    The FDA and the FCC

    Sadly, we think that the United States Food and Drug Administration and the Federal Communications Commission (agencies who regulate such issues) can stop these scams. Unfortunately, they can't. Since the FDA approved Minoxidil and Finasteride as effective in stopping hair loss, any inclusion of these products in any form enables marketing companies to make hair restoration claims.

    Even the studies done for Rogaine and Propecia are not that encouraging. When Rogaine was studied (active ingredient is minoxidil), 16% of the placebo group had measurable new hair growth. Four out of twenty-five people had real, measurable hair growth when they believed they were using something that worked. Both studies were limited in time and scope. To read the studies that were done achieve FDA approval, visit the FDA web site and scroll down to Propecia and Rogaine. (http://www.fda.gov/cder/foi/nda/index97.htm )

    Hair Loss and Hair Restoration

    If a person is genetically prone to hair loss and balding, FDA proven hair loss treatments may help slow the process if they are used early and often. If you are like many and have already lost more hair than you're happy with, there is only one option to restoring your own natural hair: hair transplants. Hair transplants have become an art in the restoration of natural hair which is genetically resistant to the causes of balding.

    Like any surgical solution, your success depends upon the quality of the doctor you choose. Doctors who are successful in restoring a natural looking head of hair are carefully reviewed by the Coalition of Hair Restoration Physicians for membership in this exclusive organization. They must allow access to past patients, confirm their training and provide photos and videos of their patients.

    While hair transplants are not possible for everyone, they are now more natural and affordable than ever before.

    View hundreds of real hair transplant photos done by the world's top hair loss specialists who are members of the Coalition of Hair Restoration Physicians.

  • Dr. Matt Egan

    Dr. Matt Egan
    Dr. Egan
    Dr. Matt Egan is a distinguished hair restoration surgeon based in the UK. Dr. Matt Egan's combination of surgical expertise, dedication to natural aesthetics, and personalized patient care make him a highly regarded choice for individuals seeking hair transplant procedures.
  • 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.

  • TRX2 Molecular Hair Loss Treatment from Europe

    TRX2 Molecular Hair Loss Treatment from Europe

    Revolutionary Hair Growth Formula?

    Anyone suffering the effects of an incurable and debilitating medical condition yearns for the promise of new and revolutionary treatment options and hair loss sufferers are no exception. Though often dismissed as insignificant by those who are unaffected by it, baldness and thinning hair can devastate the lives of millions of men and women susceptible to the effects of androgenic alopecia. The desperation to restore the flowing locks of youth make this demographic particularly susceptible to slick marketing campaigns promising to halt balding and regrow hair. One such product marketed in this fashion is Europe’s TRX2 Molecular Hair Loss Treatment. But, will hair loss sufferers find follicles behind the flash?

    TRX2 Ingredients

    TRX2 Molecular Hair Loss Treatment is not a drug or medication. It is an herbal, dietary supplement taken orally. A glance at its ingredients list reveals nothing new or revolutionary. Each component is readily available at your local nutritional supplement shop, though you may not find the same concentrations of each in a single product.  It's ingredients are listed below:

    Ingredients: L-carnitine tartrate (800 mg), potassium chloride (191 mg), L-leucine (150 mg), isoleucine (75 mg), valine (75 mg), nicotinic acid (40 mg), and biotin (150 µg).

    TRX2 Scientific Studies?

    With these ingredients so readily available, one might wonder if the significant cost savings of purchasing them individually and mixing your own TRX2 at home is just as effective for hair growth. The official website’s FAQ addresses this notion with the following response.

    “The benefit of taking TRX2™ Molecular Hair Growth Supplement singularly, as opposed to buying each ingredient separately, is based on several facts:

    The precise amount and ratio of ingredients in our supplement are carefully chosen and engineered based on credible scientific studies. The ingredients in our capsule were specifically formulated to work in concert with one another and are manufactured in accordance with strict European quality controls. For the consumer, the convenience of taking all compounds at the optimum ratio in one capsule and delivered via our proprietary potassium channel stimulating complex is crucially important.”

    Perhaps this is true. However, at a hefty €54.95 (about $72) for a one month supply, those seeking to save some money may want to give the home brew option a shot first.

    Additionally, referencing scientific studies is an effective way to add legitimacy to a product but one must always consider the source. While the TRX2 website provides detailed data gathered from a “randomized, double-blind, placebo-controlled study”, it is unclear who conducted the study and there is no mention of publication in a peer reviewed journal.  Peer review is the industry standard for evaluation of clinical trial results and its absence is cause for concern.

    Does TRX2 Work?

    TRX2 claims to stop hair loss and regrow hair through the “rejuvenation of potassium ion channels within hair follicles”. This theory is based on research suggesting that the opening of potassium channels is an important regulatory mechanism for hair growth.

    A bold statement at the top of the TRX2 website states that it has been shown to regrow hair in nearly 9 out of 10 men and women. But, does TRX2 really do what it claims? The bottom of the company’s website provides a very important disclaimer.

    These statements have not been evaluated by the medicines regulatory agencies. This product is not a drug or medicine, and is therefore not intended to diagnose, treat, cure or prevent any disease. This patent-pending food supplement contains nutrients that help promote and sustain healthy hair growth. Results may vary and are subject to your individual metabolism. Regarding risks and side-effects please see the package insert and ask your physician or healthcare specialist.”

    Careful wording in the above statement may give consumers the wrong idea. Helping to “promote and sustain healthy hair growth” is not the same as stopping hair loss or regrowing hair lost due to the effects of androgenic alopecia. A quality shampoo and condition can make hair more manageable and appear fuller.

    TRX2 Side Effects

    While TRX2 contains "drug-free" ingredients that are all natural or synthesized as normal metabolites in the human body, there is a potential for certain side effects.

    Some consumers of TRX2 have reported transitory gastrointestinal effects including an upset stomach.  Thus, it is recommended to take TRX2 after eating.  Additional side effects include the possibility of allergic reactions such as skin flushes.  If any of these conditions occur, it is recommended to consult a physician.

     It is also recommended that any potential customers suffering from digestive system disorders, diabetes or those who are glucose-intolerant consult with their physician before taking TRX2.

    Moreover, pregnant women and nursing mothers should avoid taking TRX2 due to its lack of long term safety data.

    Conclusion

    The role of potassium channels in hair growth is still being investigated and it’s unclear if TRX2 truly has the potential to significantly affect these channels. However, there is a clinically proven and FDA approved medical hair loss treatment that is known to do so. Rogaine (minoxidil) has been used successfully by balding men and women for more than 20 years. The exact mechanisms by which minoxidil affects hair growth are not fully understood but it is a known vasodilator and has also been shown to enhance the flow of potassium ions. Given that minoxidil is relatively inexpensive, clinically proven and comes with very little risk of side effects, it may be a better option for hair loss suffering men and women.

    Additionally, balding men should seriously consider adding Propecia (finasteride) to their hair growth regimen. Propecia stops hair loss  at its core by inhibiting the production of DHT (the hormone responsible for genetic baldness) and is arguably the most effective treatment for male pattern balding currently available.

    When it comes to “new and revolutionary” hair loss treatments, proceed with caution. There is nothing wrong with trying a new treatment provided it is safe and purchased from a reliable source. However, forgoing tried and true medical treatment s in favor of experimental products may result in further loss of precious and irreplaceable hair.

    To share your thoughts and experience with TRX2 on our hair loss forum, join the discussion “TRX2: Any Feedback?”.

  • Diffuse Patterned Alopecia (DPA)

    Diffuse Patterned Alopecia (DPA)

    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.

  • Revita Shampoo for Hair Loss

    Revita Hair Loss Treatment

    Revita ShampooThe new and revolutionary Revita Shampoo has all the right stuff to stop DHT and promote healthy hair growth. Revita contains the proven DHT inhibitor ketoconazoleand vitamins and minerals essential for nourishing and cleansing the scalp and hair, including the same copper peptide technology included in Tricominproducts.

    This product includes a 6 ounces or 180ML bottle with 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.

    Unlike Nizoral, the revolutionary Revita shampoo can and should be used daily. Revita leaves your scalp and hair feeling great daily with no signs of dryness or flakiness. It's also a magnificent volumizing shampoo, promoting maximum fullness.

    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 Revita in conjunction with 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 Revita has been successful in helping you maintain existing hair.

    Hair shedding is a common symptom the first few months and a sign that Revita may be working for you. It's crucial to push past this stage with continued use for the recommended period of time.

    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.

    Ingredients (Full List)

    Apple PolyphenolProcyanidin B2 & C1
    Copper Peptides
    Spin Traps
    Ketoconazole
    Rooibos
    MSM
    Caffeine 4%
    Carnitine Tartrate
    Amino Acids
    Emu Oil
    Biotin

  • Alternative Hair Loss Treatment Options

    alternative hair loss treatment

    ancient hair loss

    To date, the only two FDA approved hair loss treatments include Propecia (finasteride) and Rogaine (minoxidil). However, a number of alternative oral and topical products are marketed daily as effective hair regrowth solutions.  Though there is no question that marketing often over-reaches in order to sell a product, the real question balding men and women ask is, is there any proof that these products are effective in treating baldness?  What is the chance of regrowing hair?

    Topical Hair Loss Products, Treatments and Cover Ups (Concealers)

    For centuries men and women have been rubbing hair loss products including solutions, ointments, treatments and concoctions on their thinning hair in the hope of stimulating hair regrowth. In ancient Egypt it was popular to rub the fats of various animals, including lions, hippopotamuses, crocodiles, ibex, serpents and geese, onto the scalp as a hair loss cure.

    Hippocrates had a personal interest in finding a treatment for baldness as he suffered from hair loss. He developed a number of different treatments, including a mixture of horseradish, cumin, pigeon droppings, and nettles to the scalp. These concoctions failed miserably and he became prominently bald. These and other treatments failures have continued to disappoint balding men and women.

    Today’s Topicals - Snake Oils or Legitimate Hair Loss Products?

    topical hair loss treatments

    Today topical hair loss products such as special shampoos, conditioners, Rogaine, various scalp treatments, and cover up products can offer a potentially helpful adjunct to more effective and proven treatments such as Propecia (finasteride), Avodart (dutasteride), and or surgical hair restoration. However, many of the claims made by these topical treatments are unproven and even false.

    What About Oral Hair Loss Treatments – Do They Work?

    In addition to a multitude of topical hair loss treatments available, there’s an abundance of oral supplements that are conjectured to treat baldness.  Most oral solutions include ingredients that attempt to stop hair loss by inhibiting the production of DHT, the hormone responsible for androgenic alopecia (male pattern baldness).  However, much like topical treatments, very little proof exists for the majority of these claims.

    Many products such as Provillus, Procerin, and Extreme Hair Therapy include both an oral and topical solution that attempt to stop hair loss at its source while working to stimulate hair follicles.  But how effective are these topical, oral and all-in-one solutions?

    To learn more about various Topical Hair Loss Products, click below

    DHT Blockers– These topical such as Revivogen, Crinagen, Progesterone Creams, and Xandrox claim to minimize the amount of dihydrotestosterone (DHT) present in the balding scalp. They are applied directly to the scalp.

    Growth Stimulators- These topical solutions claim to work by stimulating hair growth. They include Rogaine, Tricomin, Folligen, Proxiphen (along with Prox-N and Nano Shampoo) and Retin-A.

    Azelaic Acid– An active ingredient found in popular topical hair loss treatments such as Xandrox and Provillus conjectured to inhibit the production of DHT.

    Superoxide Dismutase– These topicals such as Tricomin, Proxiphen, Proxiphen-N and Folligen, claim to stop hair loss by reducing Super Oxide and also stimulating hair growth and reducing tissue inflammation.

    Anti-Inflammatories- These anti-inflammatory treatments claim to reduce itching, flaking, redness, and inflammation that may increase hair loss. These topical treatment options include Tricomin, Folligen, Proxiphen and Proxiphen-N, Betadine and T-Gel and Nizoral Shampoo.

    Cover Ups / Concealers- Topically applied scalp/hair cover ups like Toppik, Prothik, and Couvré can do a surprisingly good job of masking and minimizing a person’s appearance of being bald. These topical concealers and “cover ups” act by reducing the contrast between a hair loss sufferer’s thinning hair and balding scalp, while increasing the volume and fullness of the thinning hair.

    Rogaine (Minoxidil)) – Applied twice daily to the balding areas, this treatment has only been shown to work in the crown (back of the head). It is the only topical treatment for hair loss that is FDA approved.

    Propecia (Finasteride)– An FDA approved oral hair loss solution proven to inhibit the production of DHT, the hormone responsible for genetic male pattern baldness (MPB).

    Provillus– A popular oral and topical solution containing FDA approved hair regrowth solution minoxidil and a number of all-natural ingredients that supposedly inhibit the production of DHT

    Saw Palmetto– A popular herbal treatment contained in many marketed hair loss products including but not limited to Provillus, Procerin, and Extreme Hair Therapy (EXT)

    Extreme Hair Therapy (EXT) – A nonsurgical 5 step hair loss treatment process provided by Hair Club

    Xandrox– Topical hair loss solution containing azelaic acid and FDA approved hair regrowth solution minoxidil

    Revivogen– Topical hair loss solution containing a number of all natural ingredients said to inhibit the production of DHT

    Crinagen – A topical spray containing ingredients said to inhibit the production of DHT

    Progesterone– A synthetic form of the female hormone progesterone that has been used to treat female hair loss

    TRX2- TRX2 is marketed to hair loss suffering men and women and claims to help promote and sustain healthy hair growth through potassium channels.

    To learn more about these and other treatments, see what real patients are saying about them on our hair loss forum.

  • What Causes Hair Loss?

    Causes of hair loss

    As you see yourself balding, while others retain their hair, you may ask - why me?

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

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

    So what are the specific causes of hair loss?

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

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

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

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

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

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

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

    Androgenetic Alopecia

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

    For baldness to occur three factors need to be present:

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

    2. A genetic pre-disposition to balding.

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

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

    There are also several categories of treatments for hair loss which include drugs, topical lotions, hair care products, hair replacement systems and hair restoration surgery. To learn more about each, please visit our Hair Loss Treatment section.