• 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.

  • 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.

  • Parsa Mohebi, M.D

    Dr. Parsa Mohebi
    Dr. Parsa Mohebi
    Dr. Parsa Mohebi provides large sessions of high quality follicular unit transplantation with excellent results
  • Dr. Rafael De Freitas

    Dr. Rafael De Freitas
    Dr. Rafael De Freitas
    Dr. De Freitas is an expert in performing Follicular Unit Extraction (FUE). He's regarded as one of the world's best FUE surgeons. He performs dense-packed ultra-refined follicular unit grafting at an affordable price.
  • ProTHIK Hair Loss Concealer

    ProTHIK Hair Loss Concealer

    Truly "Personal Care Luxury?"

    Of all the types of concealers available today, one of the longest lasting may be the "spray on," color-matching aerosol topical. Although many brands and differing types of spray on concealers currently exist, ProTHIK is considered by many to be one of the most trusted. What makes this product so popular in the hair loss community? How does ProTHIK work to conceal hair loss? Is ProTHIK truly a "personal care luxury for men" like their website indicates?

    ProTHIK: What is it, and how does it Work?

    ProTHIK belongs to the popular "aerosol" variety of spray applications. It is applied properly by spraying an appropriate amount of the aerosolized solution onto balding areas of the scalp. Due to its resin technology and variety of natural color choices, spraying ProTHIK onto areas of the balding scalp or thinning hair eliminates unsightly "bald spots" and reportedly leaves the patient with a realistic looking and undetectable appearance. But what does ProTHIK offer that similar hair loss products do not?

    The Benefits of ProTHIK

    According to the manufacturers, ProTHIK is superior to similar products for a number of important reasons.

    First, ProTHIK allegedly possesses superior rub-resistance, a single component formulation (meaning multiple applications during one sitting is not necessary), superior water resistance, and a greater overall durability.

    Second, when applied to the scalp, ProTHIK supposedly creates a natural, undetectable appearance (to both visual and physical inspection) that is resistant to excessive amounts of sweat. What’s more, ProTHIK is proposed to last overnight or between showers, and washes off easily with basic shampoo.

    Third, ProTHIK is designed to provide adequate coverage in a variety of hair loss scenarios. For example, ProTHIK is reportedly able to conceal scalp regions with only 10 to 15% remaining hair and "bald patches" as large as 3-4 centimeters in diameter.

    ProTHIK Product Reviews

    Like other aerosol products, ProTHIK is only recommended for areas of hair loss 1.5 - 1 inches posterior to the frontal hairline however, it's considered especially effective in the vertex (crown) region.  Despite the more specific application, ProTHIK remains popular with many consumers because of its overall effective nature, natural appearance, and lasting durability.  On the flip side, some ProTHIK users have expressed concerns about messy application and clogging.

    Unlike similar products, ProTHIK reports that it requires fewer applications and its resin technology does not create a shiny, thickened, or "sticky" appearance when applied to areas of balding scalp.

    Additionally, manufacturers of ProTHIK report that it remains effective in hair thinned up to 85 – 90% of its original density and bald patches as large as 3-4 centimetres in diameter. For these, and many other reasons, ProTHIK remains a popular, trusted choice for individuals seeking a quality aerosol concealer.

    What Real Hair Loss Sufferers are Saying About ProTHIK

    To learn what hair loss suffering men and women who've used ProTHIK are saying, visit our popular hair loss forum and social community.

  • Dr. Munib Ahmad MD

    Dr. Munib Ahmad
    Dr. Munib Ahmad
    Dr. Munib Ahmad in the Netherlands, performs every part of the hair transplant procedure to ensure his patients receive the highest quality. He is the first point of contact from the consultation to the aftercare. His results show aesthetic artistry with keen attention to detail.
  • Dr. Tsvetalin Zarev

    Dr. Tsvetalin Zarev
    Dr. Zarev
    Dr. Zarev performs gigasession hair transplant surgery with an extremely high yield and density. He can restore extreme cases of baldness with density and coverage.
  • 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.

  • From big wigs to surgical hair restoration

    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.

    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.

  • Toppik Hair Loss Concealer

    Toppik Hair Loss Concealer

    Truly a "Full Head of Hair in 30 Seconds?"

    Of all the hair loss concealers available, like topical powder applications or "sprinkle solutions," Toppik is amongst the most popular. What's more, of all the "shaker" options currently available to hair loss suffering men and women, Toppik is one of the most recognized and trusted.

    Since its inception, Toppik has been featured in various media outlets, including Time magazine, the Oprah Winfrey show, Fox News, NBC, and Eyewitness news. Throughout this media exposure and positive word of mouth, this hair loss product has been utilized by an estimated 3 million balding men and women worldwide.  So what makes Toppik so popular? How does it work? How does it compare to other types of concealers? Most importantly, what are real consumers saying about Toppik and where can interested parties purchase this popular concealer?

    Toppik Hair Loss Concealer: What is it, and how does it work?

    Toppik, like many other concealers available today, is a topical powder application. The powder formula is comprised of a series of charged, keratin-based, "hair binding fibers" that, when sprinkled on thinning hair, tightly adhere to individual hair strands. With each "shake" of the Toppik product, thousands of these particles are applied to the head and bind to hair shafts via opposing electrical activity (much like the way magnetized material attracts metal).

    By tightly binding to hair shafts in such significant numbers, Toppik naturally recreates the appearance of a thick, dense head of hair.  According to the makers of Toppik, the bond created by the hair shaft and keratin particle is so strong that it will withstand wind, rain and perspiration, and will continue to naturally thicken and volumize the hair until "washed out" by shampoo. Additionally, because Toppik is available in a variety of different tones, the product is able to precisely match any hair color/texture and still remain completely undetectable.

    What Benefits Does Toppik Offer Over Other Concealers?

    Although Toppik is popular and well known within the hair restoration community, hair loss sufferers should still ask one crucial question: what benefits does Toppik offer over other, similar concealers? According to the manufactures, Toppik offers a variety of benefits that other, comparable products simply cannot match. First, Toppik's keratin fibers are completely safe, organic, all natural, and utilize electric energy to adhere to hair fibers with unmatched efficacy.

    Next, not only is Toppik available in a variety of colors, but these tones can also be "mixed" to match any color and can even cover gray hair and new growth from hair transplant surgery.  Toppik colors include black, dark brown, medium brown, light brown, medium blonde, blonde, auburn, gray and white.

    Toppik Color

    Furthermore, Toppik can be used in conjunction with other hair styling products (though the powder needs to be applied to dry scalp, and styling products should be applied before usage), will not "rub off" on clothing or pillows, can be safely utilized with other hair restoration products and medications,  will not clog pores or dry out the scalp, is equally effective in balding men and women, and is easily applied via the shaking method or by applying the popular "spray applicator" to the shaker apparatus.

    Why is Toppik so Popular in the Hair Loss Community?

    Because of its innovative design, positive "track record," ease of use, and effective nature, Toppik has developed a trusted reputation and large fan base in the hair restoration community. Hair loss sufferers not only trust the history behind the Toppik brand, but appreciate the product's single use longevity and lasting strength of the fiber-hair shaft bond. The fact that the product is effective for male and female hair loss sufferers and can be easily used with other styling and hair restoration products makes Toppik an even better option for any individual considering a topical concealer.

    What Real Consumers are Saying About Toppik?

    To see what real hair loss suffering men and women are saying and to read helpful tips about applying Toppik in a variety of situations and in conjunction with other hair loss treatments, visit our Hair Loss Forum and Social Community.  You can also read our product review by visiting "Product Review: Nanogen Versus Toppik".