• 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/.

  • Menopause and Female Hair Loss

    Many cases of female hair lossare caused by hormonal fluctuations or changes in the body including those who have PCOS (polycystic ovarian syndrome), birth control pillside effects, a recent pregnancy,postmenopausal trauma, or menopause. Women with hair loss experience varying balding patterns These patterns can help determine the type of alopecia you have along with a thorough examination by a physician.

    Because of an imbalance between estrogen and testosterone due to declining estrogen levels, thinning hair and accelerated hair loss is common in women during menopause. Hair on certain areas of the head that is more sensitive to androgen hormones like DHT(associated with male pattern baldness) may thin or fall out. Similarly, declining estrogen levels may result in unwanted facial hair growth.

    In some cases, polycystic ovarian syndrome(PCOS), may accompany menopause and hair loss.

    Be sure to speak with your doctor on the most effective ways to cope with menopause and minimize hair loss during this transitional time.

  • Patrick Mwamba, MD

    Dr. Patrick Mwamba
    Dr. Patrick Mwamba
    Dr. Patrick Mwamba is one of the early developers of the follicular unit extraction (FUE) method and is the most experienced body hair transplant surgeon in Brussels, Belgium.
  • Dr. Timothy Carman

    Dr. Timothy Carman
    Dr. Timothy Carman
    Dr. Timothy Carman performs large sessions of ultra refined follicular unit transplantation with excellent results
  • Hair transplantation FAQs

    Hair restoration procedure results

    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.

    Learn more about hair transplantation.

    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.

    The state of art hair transplantation procedure that we recommend is called "Follicular Unit Hair Transplantation".

    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.

    View a step by step overview of a typical hair transplant procedure.

    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.

    To compare the long term costs of hair transplantation to other hair loss treatments, visit our hair transplant cost section.

    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.

    View tips on selecting a hair restoration clinic.

    Find an excellent hair restoration physician in your area.

  • Find a Hair Restoration Treatment and Physician

    Find a Hair Restoration Treatment and Physician

    Reviewed by Hundreds of Patients!

    This Learning Center offers in-depth reviews of hair loss treatments and the leading physicians who provide them. Today, there are treatments that can stop or even reverse hair loss. Hair transplant surgery, when done right, can now produce results so natural that even hair stylists cannot spot them.

    But it is critical to choose the right hair loss treatment and hair restoration physician, since the skill, talent, and experience of physicians vary widely, as do their results.

      Find a Coalition Physician
  • Caboki Reviews hair loss breakthrough

    hair loss concealer Caboki

    For many hair loss suffering men and women, topical concealers are a necessary aspect of the "daily routine." Usually composed of hair shaft adhering microfibers or darkening cream, concealers help balding men and women both camouflage areas of noticeable baldness and increase the apparent density of thinning hair. Below, we provide our readers with a product review of the new and popular hair loss concealer Caboki.

    Caboki was released back in 2005 but is only just now receiving more attention, most likely due to increased advertising. Like others before it, Caboki concealer claims to be a "hair loss breakthrough". Despite ambitious promises, Caboki's claims leave several unanswered questions: is Caboki really a breakthrough concealer? How does it compare to other, similar products like Toppik, DermMatch and COUVre? Is Caboki a worthwhile product for purchasing, or will it fall from grace like other alleged "breakthrough" hair loss miracles before it?

    While many products, such as "Toppik" (a popular microfiber-style concealer) and "Couvre" (a concealing cream) are popular and trusted within the hair loss community, new, unproven concealers arrive on the market every day. What's more, many of these new concealers try to "best" the products currently offered and claim to camouflage hair loss in a way "never seen before." However, as with many alleged miracle cures, these products often fail to meet expectations and leave hair loss sufferers disappointed and discouraged. So let's explore how Caboki works to conceal hair loss below.

    Caboki is comprised of a series of charged microfibers that, when applied to the scalp, tightly bind hair shafts and create a denser, fuller appearance. According to the manufacturer, these microfibers are comprised of two different elements: Moroccan Gossypium Herbaceum fiber and iron oxide-based natural (mineral-based) colorants. The makers of Caboki claim these elements allow the product to create a natural, healthy appearance, capable of withstanding harsh lighting conditions, sweat, wind, and rain.

    However, because these elements have been used in other concealer products (Toppik particles, for example, are both charged and made from natural keratin), Caboki still must demonstrate why it's revolutionary. So, what makes Caboki a "hair loss breakthrough?" According to the manufactures, Caboki differs from other concealers in the following ways:

    • Caboki particles, unlike other microfiber concealers, are negatively, not positively charged. Allegedly, positively charged particles (usually made from wool fibers) possess a greater tendency to repel and oppose not only each other, but also the positively charged hair shafts. Because of this, when the particles attach near each other on a hair shaft, they are more likely to repel and detach. According to Caboki creators, negatively charged fibers (made from Moroccan Gossypium Herbaceum fiber) do not experience this intense phenomenon, and create a much greater (200%), electronically attractive (negative to positive), bond. If this is true, Caboki microfibers should bind and adhere to hair shafts with a much stronger, more permanent affinity.
    • Because Caboki particles create a stronger charged bond, the thicker, more volumized hair shafts are likely to stand erect and less non-bonded concealer will collect on the scalp. This combination, according to Caboki, will eliminate the "dull, flat" appearance associated with other concealer products.
    • By only utilizing natural elements (Moroccan Gossypium Herbaceum fibers and iron oxide colorants), Caboki avoids some of the potentially harmful synthetic dyes, fillers, and artificial preservatives used in other concealer products.

    So, it's now clear why the manufacturers of Caboki believe it is a superior product, but does this mean Caboki is a legitimate hair loss concealer? Does it truly outshine other concealer product currently on the market?

    While the product is still fairly new, most anecdotal experiences and testimonials from real hair loss suffering men and women are positive. Most individuals believe the negatively charged Caboki particles bind strongly to the positively charged hair shafts and create a longer-lasting increase in density. Furthermore, the particles seem to be more resistant to potentially damaging elements like water, sweat, and wind. Having said that, many individuals report some common problems experienced with other concealer products – concealer wiping off on pillows and clothes, some smearing with sweat, and difficultly creating a natural appearance in the hairline. However, these same individuals claim the problems occur less frequently with Caboki. Altogether, it's likely that Caboki is both a helpful hair loss concealer and equivalent to other products currently on the market. While it is clear that Caboki does possess some advantages and interesting claims, it could be difficult to quantify whether it truly exceeds or simply meets the standard set by other available hair loss concealers. Truthfully, only time and the opinion of hair loss sufferers will determine whether Caboki lives up to its claims and defines itself as a legitimate concealer breakthrough.

  • Future Hair Loss Treatments

     medical hair loss treatment

    Some day, perhaps in the distant future, baldness may become a curable aliment. Scientists are currently researching gene therapies to alter a person's genetic vulnerability to hair loss. However, the actual implementation of such hair loss treatments may be decades away.

    In the near future, drug treatments which inhibit the balding process seem more promising. The hair loss drug Propecia (finasteride) has been proven successful in slowing and/or stopping hair loss by blocking the conversion of testosterone into dihydrotestosterone (DHT) in the scalp.

    Another promising drug that inhibits the development of hair loss causing DHT hormones is Dutasteride.

    Like Propecia, it also inhibits the creation of DHT. And based on preliminary clinical studies, dutasteride promises to be even more successful than Propecia in inhibiting the production of DHT.

    In addition, Dutasteride inhibits the activities of two types of 5-alpha-reductase enzymes. In contrast, Propecia (Finasteride) only inhibits one type. 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, it is being marketed as Avodart by GlaxoSmithKline as a hair loss treatment. Some hair restoration physicians also prescribe it for the treatment of hair loss. Like Propecia, Avodart is not safe for women and children.

    In time, perhaps even more effective hair loss drugs will be developed to inhibit the hair loss process.

    Future Hair Transplants - an endless supply of bald resistant donor hairs?

    The amount of hair you can transplant is ultimately limited by the amount of hair follicles you can safely relocate from the bald resistant donor area at the back and sides of your head.

    Some day it may be possible for physicians to create multiple hair follicles from one original follicle. This process typically called "hair cloning" or more correctly "Hair Multiplication" is currently being investigated by several research scientists and hair restoration physicians.

    If and when this process is successfully developed patients would no longer be limited by the finite amount of bald resistant hairs that can be relocated from their donor area. Hair multiplication would result in a virtually limitless supply of hair available for hair transplantation.

    This would be especially good news for men or women with extensive baldness and a very limited supply of donor hair. Even those with extensive baldness would theoretically be able achieve thick full heads of hair.

    However, experts believe that we are at least ten years away from hair multiplication being available, if even then.

    For most men and women, hair loss can be effectively halted or even reversed with current hair loss treatments. But the future holds the promise of even more effective treatments and perhaps some day even a "hair loss cure".

  • Thomas Chung Wai Nakatsui, MD

    Dr. Thomas Nakatsui
    Dr. Thomas Nakatsui
    Dr. Nakatsui performs large sessions of ultra refined follicular units using the lateral slit technique with extremely natural results.
  • Azelaic Acid

    Azelic Acid

    Azelic AcidAn Active Ingredient in Several Topical Hair Loss Treatments

    Azelaic acid is a naturally occurring substance found in whole grains that contains a mild antibiotic designed to “clean” skin.  It is also said to be a potential inhibitor of 5-alpha-reductase in human skin.  A reduction of this enzyme may reduce the amount DHT (dihydrotestosterone) in the body and therefore, have a similar effect to finasteride; the active ingredient in FDA approved oral hair loss solution Propecia (finasteride). In theory, applying azelaic acid to the scalp may prevent or eliminate the binding of DHT to the hair follicle receptor, preventing hair loss and potentially stimulating hair regrowth.  Azelaic acid can be found in many prescription acne medication and topical hair loss products like Xandrox and Provillus

    Combining azelaic acid with FDA approved hair regrowth solution minoxidil in a single topical product in theory, may prove to be a more powerful hair loss treatment for androgenic alopecia than minoxidil alone.  This is why some conjecture that Xandrox may be a more effective treatment than Rogaine (minoxidil)

    Azelaic acid has not been clinically proven effective as a standalone treatment for treating genetic female hair loss and male pattern baldness. It has also been known to irritate the scalp when applied topically.  Though there is a low percentage, azelaic acid may interact with other medications.  Be sure to consult your physician before using azelaic acid while on other medications.