• 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

  • Does Nourkrin Hair Nutrient Work to Stop Hair Loss?

    Nourkrin

    Balding men and women considering any hair loss treatment should take caution to believe the many magnificent claims made by today’s advertising. Far too often, a lot of time and money is wasted on questionable treatments with little or no proof of success.
    Nourkrin hair nutrient claims to promote hair growth and strengthen thinning hair in 80% of men and women suffering from almost any hair loss condition other than the self-inflicted trichotillomania (hair pulling) or traction alopecia. Below we evaluate Nourkrin, the "clinical study", and its ingredients to find out whether or not this hair loss treatment lives up to its promises.

    What is Nourkrin?

    Nourkrin recommends using their complete regime of products for at least 6 months for the best results. This includes extra strength, Man, and Maintain oral tablets, a shampoo, a conditioner, and a scalp lotion.  Nourkrin claims their products can promote hair growth in men and women suffering from androgenic alopecia (genetic baldness), alopecia areata, alopecia totalis, alopecia universalis, and telogen effluvium. This is a very bold claim considering each balding condition occurs for varying reasons.

    Ingredients

    The active ingredients in the extra strength tablet include shark cartilage and shellfish extract containing glucosamine.  Other active ingredients include silica kieselguhr (a natural form of silica), horsetail extract, acerola cherry extract with vitamin C, microscyrstaline cellulose, immunogloblin G protein, and fatty acids. In addition to the above, the Man product contains Omega 3 fatty acids and Fenugreek designed to improve scalp circulation. Maintain includes additional marine life proteins, minerals, silica, and vitamin C. The scalp lotion contains marine life protein extract compounds and aloe vera.

    Nourkrin claims that the primary active ingredient glucosamine can rebuild and grow new tissue, including dormant hair follicles - suggesting successful hair regrowth. Though clinical studies prove that glucosamine might be effective in reducing joint pain, increasing joint lubrication, preserving joint space, protecting cartilage breakdown by inhibiting specific enzymes, stimulating cartilage matrix repair, and other anti-inflammatory actions, we couldn't find any evidence to support claims that it can stop hair loss or promote hair regrowth.

    Clinical Study

    Nourkrin conducted a clinical study of 60 people who took their products for 12 months. All subjects were over 18 years of age and suffered from at least some form of hair loss for at least one year prior to the study. During a 6 month double blind clinical study, 30 subjects took Nourkrin while the other 30 took a placebo. After 6 months, the 30 participants taking Nourkrin continued taking it for another 6 months while the 30 on the placebo were switched to Nourkrin for 12 months.

    In the first 6 months, Nourkrin reports that 77% taking their hair loss treatment experienced an increase in hair growth and shaft thickness. After 12 months, 75% reported a decrease in overall thinning hair. 90% of women in the study reported overall hair improvement after 12 months. The hair counting method showed an average increase in hair count of 45 percent during the clinical study.

    Though the above study sounds impressive, we don't know a lot about the participants nor can we be certain of the reliability of the study. All participants suffered from some form of thinning, but its cause for each patient hasn’t been disclosed.  Additionally, clinical studies are considered more credible when they've been conducted or verified by third parties not interested in its financial success.

    Another problem is that none of the active ingredients in Nourkrin are proven to stop hair loss. Therefore, their study is the only one balding men and women have to support such claims.

    Possible Side Effects

    Anyone allergic to shellfish should avoid using Nourkrin. Women who are pregnant or breast feeding should not use Nourkrin hair loss products. Consulting with a doctor before using this treatment is advisable.

    Dosage

    Nourkrin recommends taking 2 tablets daily for at least 6 months. Men and women over 176 lbs or those who smoke are advised to take 3 tablets daily. After 6 months, dosage can be cut down to one a day. Nourkrin also recommends using the shampoo, conditioner, and scalp lotion daily. The scalp lotion may be best applied in the evening and left on overnight.

    Cost

    60 tablets of the extra strength tablet costs about $75, the Man $65, the shampoo and scalp cleanser $12, the conditioner $13, and the scalp lotion $30. All in all, the Nourkrin Hair Recovery Program can get pricey after 6 months. FDA approved products like Rogaine (minoxidil)only runs approximately $15 a month or less and male treatment Propecia (finasteride)costs approximately $60 per month, not as expensive as Nourkrin.

    Conclusions

    Nourkrin boasts a big game, claiming high rates of success in reversing hair loss in men and women caused by varying conditions. Their clinical study also confirms its success rate however; the reliability of this study has not been verified by third parties uninterested in its financial success. Additionally, no clinical proof exists that any of the ingredients found in Nourkrin work to treat baldness.

    Whether or not Nourkrin is the "real deal" is hard to determine with little evidence to support its claims. Therefore, those considering this treatment should proceed with caution and may want to consider exhausting proven treatments like Propecia and Rogaine first.

  • 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.
  • Xandrox

    Xandrox

    This hair loss product is a 5% custom solution that combines Minoxidil with Azelaic Acid. Developed by Dr. Richard Lee, a hair loss physician, it’s available by prescription only.

    Xandrox’s two main ingredients tackle hair loss in two ways. The minoxidil stimulates hair growth, while the Azelaic Acid, which contains the 5 Alpha Reductase enzyme, blocks DHT. However, while minoxidil is a proven hair loss treatment, Azelaic Acid is only proven as an acne medication. Many patients feel that Xandrox is preferable to Rogaine because it’s less greasy.

    As of yet, Xandrox has shown few side effects, and may cause less itching and flaking than Rogaine.

    There may be some burning irritation though, due to the Azelaic Acid. But one type of Xandrox counteracts this side effect. It contains a Betamethasone Valerate, a corticosteroid.

    However, you need to know that corticosteroids may cause problems. Short-term use is pretty safe, but if used long-term, they may cause thinning of the skin or skin damage. It may also lead to brittle bones or diabetes. For this reason, it’s recommended that if you have no itching problems that you should use the Betamethasone-free Xandrox. It is available, and it works as well as regular Xandrox.

    There are other types of Xandrox, including the Day Formula, the Night Formula, and Xandrox 12.5%, a cream that’s used for more stubborn areas, such as the frontal hair line, and contains 12.5% Minoxidil. One ml of Xandrox should be applied twice per day, and a routine should be established.

  • PCOS (Polycystic Ovarian Syndrome) and Female Hair Loss

    PCOS (Polycystic Ovarian Syndrome) and Female Hair Loss

    In women with PCOS(polycystic ovarian syndrome), high levels of androgens (male hormones) in the body may cause hair loss. DHT (dihydrotestosterone), more abundant in men, is created from a combination of testosterone and5-alpha-reductase enzymes. DHT can bind to hair follicle sites, accelerate the natural hair growth cycle, and cause hair to go into resting (catagen) sooner causing thinning hair with each cycle.

    Women with PCOS are more susceptible to androgenic alopecia, more commonly referred to as male pattern baldness or genetic female hair loss. Androgenic alopecia is also the number one cause of hair loss and thinning hair in the world.Women with androgenic alopecia typically lose hair in a pattern similar to the ludwig scale,and less commonly the norwood scale.

    If you suspect you have PCOS, you should consult with a physician and get tested for it. Only a physician can diagnose you and recommend a proper treatment.

  • Crinagen Hair Loss Treatment

    Crinagen Hair Loss treatment

    CrinagenCrinagen is an all natural alcohol-free topical scalp spray clinically backed to reduce the amount of DHT (dehydrotestosterone) in the scalp. It contains no alcohol, and has displayed no side effects. Crinagen is also equally safe for men and women and is most effective in men and women with thinning hair. In addition to blocking scalp DHT, they both are reported nourish the scalp’s hair follicles. Crinagen usually displays its effects on average in five months.

    How It Works:

    The product's main ingredients are Saw Palmetto, Zinc, and Azelaic Acid. All 3 ingredients are reported to reduce the production of scalp DHT and nourish the scalp's hair follicles.

    Developing Realistic Expectations:

    Crinagen has not been clinically proven nor approved by the FDA. Thus, like Revivogen and Tricomin, Crinagen should be used only after seriously considering proven treatments like Propecia (finasteride) and Rogaine (minoxidil).

    Don't expect immediate results. It's recommended to use Crinagen 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 Crinagen is working for you.

    Hair shedding is a common symptom the first few months and a sign that the medication 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.

  • Trichotillomania and Treating Hair Loss

    Trichotillomania and Treating Hair Loss

    Men and women who have the impulse to pull their own hair out may be suffering from trichotillomania. Trichotillomania is an impulse control disorder characterized by the repeated urge to and behavior of pulling out one's own hair. Impulse control disorders resemble substance addictions because the patient feels out of control of his or her own behaviors. Men and women with trichotillomania live relatively normal lives but typically show signs of hair loss, thinning, and bald spots all over the scalp and body from pulling it out.

    Treating trichotillomaniagoes far beyond trying to stimulate hair regrowth.Even if Rogaineor laser therapy for hair losswere to regrow hair, there is a strong possibility that trichotillomania patients will continue to pull their hair out. Patients with trichotillomania therefore, should be treated at the source of the disorder in conjunction with using proven hair loss treatments.

    In addition to medication, Habit Reversal Training (HRT) by a trained counselor has proven to be successful in treating trichotillomania. With Habit Reversal Training, the individual is taught to recognize and redirect their impulse to other more constructive activities. Often times, trichotillomaniapatients are asked to keep a journal of their hair pulling episodes. This can help the counselor and patient to identify and develop strategies to avoid situations that might trigger hair pulling episodes. Journals often include the location of the incident, number of hairs pulled, date, time, and their feelings and thoughts during the episode.

    Treating a trichotillomania patient's baldness may be done simultaneously or after proper treatment of the disorder. Rogaine (minoxidil)can be a helpful aid to HRT by stimulating the follicles underneath the scalp, potentially facilitating or expediting hair growth.Treating a patient’s hair loss while they continue to pull their hair out is not constructive. Since this type of balding is not genetic due to the production of DHT, Propecia (finasteride)won't likely help.

    Patients who've suffered from trichotillomania for awhile may damage or even remove the hair roots by excessive pulling, making non-surgical hair regrowth next to impossible. Surgicalhair restorationmay be an option for trichotillomania patients whose hair roots are too damaged to produce new hair on their own. Hairrestoration surgeryshould be reserved only for patients who've been successfully treated and no longer suffers from trichotillomania.

    Catching and treating trichotillomania early will most likely reduce damage done to the hair follicles and eliminate the need for hair loss treatment, since undamaged hair will return on its own.

  • Alopecia Areata: Patchy Hair Loss and How to Treat It

    Alopecia Areata

    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.

  • Scalp Micropigmentation (SMP)

     micro pigmentation

    A Cosmetic Tattooing Procedure to Conceal Hair Loss

    Scalp Micropigmentation, the process of tattooing thinning or bald areas of the scalp to resemble shortly cropped hair, has been met with high amounts of enthusiasm from patients seeking alternative ways to mask and conceal their hair loss. This artistic and minimally invasive procedure, also referred to as SMP, provides men and women suffering from hair loss with an illusion of fullness or the appearance of thick, shortly cropped hair. SMP results (not the procedure) are often compared to topical concealers such as Toppik, DermMatch and Nanogen, because they also help conceal baldness and make thinning hair appear thicker and fuller.

    Although scalp micropigmentation is increasing in popularity, it is still a new and evolving practice and its mystique may leave interested patients asking several important questions.

    How does scalp micropigmentation work? What are the benefits, limitations and potential risks associated with the procedure? Who is a suitable candidate? What are the costs associated with SMP? What happens if consumers don't like the results? Is the ink associated with scalp micropigmentation permanent? Are all SMP practitioners equal or do some produce better, more natural looking results?

    How Scalp Micropigmentation Works

    Scalp Micropigmentation is the artistic application of tattoo-like ink or pigmentation "dots" to bald or thinning areas of the scalp to recreate the appearance of shortly cropped hair (or "stubble") by a trained practitioner. SMP practitioners are typically experienced in the art but often aren't medical professionals or hair restoration physicians. Scalp micropigmentation is typically used for one of three purposes. These include:

    • Creating the illusion of fullness or density to thinning hair by applying cropped, hair-like tattoos in between and around thinning hair.
    • Creating the appearance of closely cropped or shaved hair on an otherwise bald scalp.
    • Camouflaging a pre-existing hair transplant scar. Typically, this is a rare, but stretched, linear scars from follicular unit hair transplantation procedures via strip harvesting (FUT) can sometimes require revision.

    Scalp micropigmentation ink is normally placed in the superficial dermis, a layer of skin between the epidermis (the outer layer of the skin) and subcutaneous tissues that consists of connective tissue and cushions the body from stress and strain. However, SMP practitioners often place ink at varying depths. Some practitioners are now beginning to use a “sweeping” technique when tattooing, in order to create a more three-dimensional appearance on the scalp.

    Depending on the size of the balding/thinning area and the desired appearance, the procedure can take anywhere from 1-8 hours, and can now be completed with both permanent and temporary SMP ink.

    According to Coalition hair transplant surgeon Dr. Robert Bernstein, the key to further achieving a natural result with SMP lies in holding the inking tool at an appropriate angle, controlling the depth at which the ink is placed, monitoring the amount of ink deposited at each site, and selecting appropriate ink tones.

    To read more of Dr. Bernstein's input and discussion related to SMP at the 2012 annual ISHRS Scientific Meeting for hair restoration physicians, visit "Scalp Micropigmentation (Scalp Tattooing)at the 2012 ISHRS (International Society of Hair Restoration Surgery) Scientific Meeting".

    Permanent Versus Temporary Scalp Micropigmentation (Advantages and Disadvantages)

    Defining and understanding the difference between permanent and temporary ink is important for any consumer considering the procedure.

    Permanent scalp micropigmentation is performed with micropigmentation ink that is not designed to fade or change over time. The ink is placed slightly deeper in the scalp tissue, and the procedure can be performed with ink containing both colored and black pigment.

    Advantages of permanent SMP include the ability to undergo a single SMP treatment without frequent “touch ups" and potentially lower long-term costs.

    Disadvantages include the possibility that the ink will eventually fade to a green or blue hue (due mainly to the black pigment used in permanent SMP ink) and the inability to reverse the procedure without laser pigment removal (i.e. “laser tattoo removal”) if the work is unsatisfactory.

    Temporary scalp micropigmentation is performed with ink that is specially designed to gradually fade and disappear within 6 to 24 months after the procedure. The ink is placed into a superficial layer of the scalp, which allegedly helps to define the pigmentation and decrease the probability of “blurring” ink. Temporary SMP is performed with ink containing no black pigment. Because black pigmentation can eventually fade into a blue or green tone, it would inevitably produce an unnatural looking result as it gradually fades and disappears, and should be avoided.

    Advantages of temporary SMP include: the ability to redesign or discontinue the process (when the ink fades after 6-24 months) if the results are not satisfactory; the decreased rates of ink blurring, running, and definition loss with the superficial placement into the scalp; and the ability to use the three-dimension technique (which was designed by Beauty Medical in Milan, Italy, and is now utilized by several leading clinics recommended by this patient community).

    Disadvantages of temporary SMP include ongoing maintenance and costs associated with undergoing subsequent SMP applications every 6 to 24 months, and the possibility of discoloration as the ink fades (though the temporary ink is purposely designed to fade evenly and without discoloration).

    To learn more about the advantages and disadvantages of permanent and temporary SMP, visit "Temporary Scalp Micropigmentation: Advantages, Disadvantages, and Clinics Currently Offering the Procedure".

    Scalp Micropigmentation Costs

    The cost of SMP is variable and depends upon the type of procedure (temporary versus permanent), size of the procedure, and the practitioner/clinic performing the micropigmentation. While rates typically vary and change, permanent SMP can cost anywhere from $800 for a small procedure and $6000 for a large one. The cost of temporary SMP is approximately half the cost of permanent SMP and typically ranges from $500 to $2500 depending on the size of the procedure. Subsequent procedures, which are needed 6 to 24 months after the initial results fade are typically 50% of the original costs.

    What Makes a Good SMP Candidate?

    Although a wide variety of men and women are interested in scalp micropigmentation, the procedure is actually only ideally suited for a small, select number of hair loss consumers.
    SMP is likely best suited for individuals interested in aiding the appearance of density in shortly cropped, diffusely thinned hair, and for patients trying to camouflage a hair transplant scar. It may also be suitable in creating a greater illusion of fullness in those who've already undergone surgical hair restoration.

    SMP consumers should also consider a naturally asymmetrical hairline design and “fading” effect (from decreased pigmentation in the hairline to denser, increased pigmentation in the middle scalp) if hairline restoration is performed. This approach will likely create a more natural result in eligible candidates.

    Creating Realistic Expectations

    While scalp micropigmentation may be a useful adjunct therapy for a select group of consumers interested in concealing their hair loss, it should be approached with realistic expectations and performed by a trusted clinic. Individuals considering the procedure must remember that SMP is a two-dimensional process and cannot provide the texture and growth of real hair. Undergoing SMP without respecting its limitations may create unrealistic expectations and disappointing results.

    Evolving Procedure or Just a Fad?

    Is SMP just a fad or will it continue to evolve and cultivate additional interest from hair loss sufferers and hair restoration physicians?

    While some hair loss experts are quickly embracing the procedure, others are more resistant, and liken scalp micropigmentation to less popular "niche" treatments like hair systems, laser caps, and topical concealers. Whether or not it will continue increasing in popularity and retain its momentum is not yet clear.

    Hair restoration is a rapidly changing field and new and evolving therapies may eventually render scalp micropigmentation and other hair loss treatments obsolete.  Altogether, only time will tell whether SMP is a lasting adjunct therapy or a passing fad.

    Clinics Currently Offering Scalp Micropigmentation

    As of January 2013, the following hair restoration clinics recommended by this website are offering some form of Scalp Micropigmentation: Hasson and Wong (Drs. Victor Hasson and Jerry Wong), and Shapiro Medical Group (Drs. Ron and Paul Shapiro).

    Dr. Feller, Dr. Lindsey, Hasson and Wong, and Shapiro Medical Group trained with Beauty Medical and offer the temporary SMP procedure; Dr. William Rassman performs his own variation of Scalp Micropigmentation with permanent ink.

    Note that in many cases, a trained technician and not the physician will be performing scalp micropigmentation.

    This website does not currently recommend one SMP clinic over another. Those considering scalp micropigmentation as a tool to conceal hair loss and create an illusion of hair are encouraged to do their own diligence in researching each technique, practitioner and clinic.

    To discuss scalp micropigmentation with hair loss sufferers and other interested parties and to view results showing before and after pictures, visit the Scalp Micropigmentation Forum.

  • Victor Hasson MD

    Dr. Victor Hasson
    Dr. Victor Hasson
    Dr. Victor Hasson exclusively performs Ultra Refined Follicular Unit Hair Transplantation with outstanding results.