• 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

  • FUE – a new way of doing Follicular Unit Hair Transplantation

    FUE – a new way of doing Follicular Unit Hair Transplantation

    Follicular unit extraction is a minimally invasive procedure for performing follicular unit hair transplantation. However, unlike the predominant follicular unit transplant procedure, in which a strip of donor tissue is removed and dissected under magnification, the FUE procedure uses a small punch to extract each follicular unit one by one.

    Both the strip excision and FUE procedures create 1, 2, 3, and 4 hair follicular unit grafts that are then transplanted into the balding area in the same manner. The primary difference between these two procedures is the technique used to harvest the follicular unit grafts.

    Comparing the Strip Excision procedure to the Extraction (FUE) procedure

    The common strip excision method of performing follicular unit hair transplantation involves surgically excising a thin horizontal strip of bald resistant skin from the donor area.

    Strip Excision Procedure 

    Donor strip being excised
    Donor strip being excised

     

    Incision sutured together
    Incision sutured together

     

    Hair combed down after suturing
    Hair combed down after suturing

     

    This donor area is then sutured together. These sutures (either stitches or staples) are then typically removed about ten days after surgery. Some physicians use dissolvable sutures so that no removal is needed.

     

    Patient’s donor area 2 months after surgery
    Patient’s donor area 2 months after surgery

     

    Once this linear incision is fully healed the patient is left with a thin horizontal scar in the back of the head. This scar is typically hard to detect since the surrounding hair conceals it, even when the hair is cut short.

    To view a video of an actual strip excision surgery.

    How the FUE Procedure is performed

    With the Follicular Unit Extraction or FUE procedure 1, 2, 3, and 4 hair follicular unit grafts are carefully extracted one at a time using a tiny punch of one millimeter or less. Often the surgeon requires the patient to buzz cut a portion of their donor area so that they are able to see the patient’s scalp.

    The follicular units are extracted
    The follicular units are extracted

     

    The follicular units are extracted by placing the punch around a single follicular unit and cutting a small circle through the skin around that follicular unit. The follicular unit is then gently pulled up and away from the loose tissue underneath the skin.

    The small hole left behind after the follicle is extracted then heals over the following week. Normally this small round incision contracts as it heals making the resulting round scar smaller than the size of the 1mm punch that made the incision. The FUE patient ultimately ends up with hundreds of small round white scars, which are normally not detectable once the patient’s hair grows out.View a video of an actual FUE surgery.

    To Extract or to Excise, that is the question.

    Advocates for the relatively new FUE procedure claim that this procedure produces less noticeable scarring and no tightness or numbness in the donor area since no donor tissue has been pulled together and sutured. Many patients and physicians find the claim that FUE produces less visible scarring to be debatable.

    Some physicians and patients also have concerns about the relatively new FUE procedure, such as the lack of formal studies regarding the percentage of follicles that may or may not be transected during the sight unseen extraction process.

    In addition, since the physician must personally extract all follicles, one by one, the FUE procedure is very physician dependent and thus very expensive. The FUE procedure also requires considerably more time in surgery to move a given amount of hair to the balding area.

    The standard strip excision procedure has the advantage of utilizing a collaborative team to carefully create the grafts once the donor tissue is removed in a strip. This collaborative approach enables a well trained staff to do sessions of 2,000 to 3,000 all follicular unit grafts in a single day. This team approach enables a patient to get a much larger number of grafts/hairs in one sitting at a much lower cost per hair than with the FUE procedure.

    However, some believe that despite being relatively costly the FUE procedure may be appropriate for patients who have very limited elasticity in their donor area or who only need a small number of grafts.

  • DHT Blockers - Inhibiting Hair Loss at its Roots

    DHT Blockers

    There are several topical treatments like Revivogen, Crinagen, Progesterone Creams, Kevis 8 and Xandrox that claim to minimize or block the amount of dyhydrotestosterone (DHT) present in the scalp.

    DHT acts as a catalyst for the hair loss process as it binds with the receptor sites in hair follicles that are genetically vulnerable to hair loss. Over time, this process of DHT acting on the genetically vulnerable hair follicles hurts their ability to grow healthy hair.

    The success of these topical treatments in reducing DHT levels in the scalp has not been clinically proven. However, the possibility of reducing DHT only in the scalp region rather than through out the entire body as with Propecia or Avodart is appealing.

    Click to learn more about how to stop hair loss with Hair Growth Stimulators

  • Dr. Bessam Farjo

    Dr. Bessam Farjo
    Dr. Bessam Farjo
    The Farjo Hair Institute is a family run clinic solely devoted to performing excellent follicular unit hair transplantation in Manchester and London.
  • 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.

  • Carlos K. Wesley, M.D.

    Dr. Carlos Wesley
    Dr. Carlos Wesley
    Dr. Carlos Wesley is a board certified diplomat of the ABHRS and performs high quality follicular unit hair transplants with excellent results in NYC.
  • The Psychology of Hair Loss

    Hair transplants - Are they right for you?

    Long ago, a full head of hair was valued as a means of protection, heat retention, and camouflage.

    Today we value hair for other reasons. Whether we admit it or not, good hair still is associated with power, virility and youth.

    Such associations date back to ancient times. Remember the story of Samson and Delilah? When Delilah cut Samson’s long hair he lost his power.

    Samson

     "And Delilah made him sleep on her knees; and she called for a man, and she caused him to shave off the seven locks of Samson’s head. . . and his strength went from him."(Judges 16:19)

    As “enlightened” as we are today, stereotypes associated with hair loss persist. The bald or balding are sometimes passed over and teased at work, in the media, and in the social scene. The media idolizes the young and the attractive and often lampoons the bald or balding.Of course, it’s not fair. But at least losing your hair is not health threatening. However, it can result in various psychological and emotional issues. These include insecurity, isolation, panic, a sense of loss, and even depression. But let’s first look at the role of hair (and the lack of it) in our society.How is Hair Loss seen by Society? So why does something as superficial as hair seem so important to so many men and women? Studies have shown that hair is a symbol of social, professional, cultural, and/or religious affiliations. Good hair implies power, virility, strength and youth.

    Studies reveal how baldness is perceived.In a study done in 1971, a picture of one person was distributed to 60 people. But each picture had been altered by a commercial artist to reflect a non bald, balding, or bald condition. The results revealed some negative stereotypes.

    1971 Hair loss study

    When the person was shown with a balding head of hair he was rated as weak, dull, and inactive. This same person with a bald head of hair was rated as unkind, bad, and ugly. Yet this same person with a full head of hair was rated as handsome, virile, strong, active, and sharp.

    Today, more than 30 years later, it is hard to know if things have really changed. But maybe some of these tired negative stereotypes about being bald are starting to change, at least in the media.

    NYPD

    Today, bald NYPD Blue's -Dennis Franz, a multiple Emmy Award-winner, is considered a sex symbol.

    Sopranos

    As is Tony Soprano of the popular HBO TV show the Sopranos.

    Kojak

    And, of course, let’s not forget Telly Savalas of the 70’s TV show Kojak who was once voted by People magazine as the “sexiest man alive.”

    Studies about Baldness and Self Esteem

    Those who are bald or balding are generally thought of as older, weaker, and more ineffectual, both in the work world and on the social scene.

    According to a 1995 article in the “British Journal of Psychology,” balding men have been found to have lower levels of self-esteem than their peers, are less sociable, suffer more from depression,and are less likely to succeed in life.

    Hair loss, especially when first occurring, can lead to rash decisions. So it is important to slow down and look at the many viable options that are available for dealing successfully with hair loss.

    Our Hair Treatments section offers in-depth information on many viable treatments.

    1992, researchers from the Old Dominion University in Norfolk, Virginia surveyed 145 balding men and found that 84% were preoccupied with baldness.

    Their responses showed that they were filled with self-consciousness and helplessness. They were also envious of men with full heads of hair.

    Additional research indicated that single men and woman who had begun losing hair in their early twenties were more likely to suffer from extremely low self-esteem.

    Hair loss often creates emotional distress.

    Loosing your hair can be disturbing, especially if you're a young man or woman. This unwanted loss forces those afflicted to face new issues, such as the perceived loss of youth and sexual attractiveness.

    It's common for young people who are balding to have feelings of isolation. They may feel uncomfortable among their peers and in public. Young people with hair loss often lose their confidence and may also become less productive at work.

    For older people hair loss is often just one more sign that they're reaching middle or old age. It may prompt them to question the direction of their lives or fear that their lives are closer to the end than the beginning. This can result in a sense of loss, insecurity, or even depression.

    And as bad as men have it, hair loss can be even worse for women. Balding women must deal not only with the thought of aging, but also that they may not be considered attractive.

    Coming to terms with hair loss.

    Yes, hair loss can be disturbing. But there are many effective options available to you, ranging from hair loss drugs that often halt thinning to restoring the hair you’ve lost with surgical hair restoration.

    However, prior to choosing a hair loss treatment, it is wise to deal with the psychological effects of hair loss.

    Hair loss at any age, while not painful or dangerous, can cause emotional damage and distress.

    Finding support and advice to cope with hair loss.

    You can find support and share ideas and advice privately with other hair loss sufferers by reading and posting on our popular hair loss discussion forum.

    By sharing with others you will realize that others share your same concerns and feelings about going bald. You will also learn about what hair loss treatments actually work or not from those who have already tried them.

    Find a "Hair Loss Mentor" for - one on one - support and guidance.

    In addition to our discussion forum, you can also view Hair Loss Weblogs created by actual hair restoration patients. These blogs contain photos journals documenting the person's hair restoration. Often you can correspond with these blog authors by email.

    If you have a hair loss question please post it on our Hair Loss Q & A Blog. This blog can also be searched for dozens of answers on many hair restoration topics.

    Empowering yourself with information and sharing your feelings and concerns will also make you feel much more in control of your hair loss. Then, if and when you finally do choose a hair loss treatment option, you will feel much more confident in your decision.

    Many who once were preoccupied by their hair loss find a solution and move on in life, sometimes with a "new lease on life". While others choose to remain bald and simply accept it.

    The choice is yours to make. This site is dedicated to helping you successfully resolve your hair loss issue on the inside as well as on the outside.

    The disturbing truth about hair loss

    In 1999, the psychological impact of hair loss, as well as its leading treatments, was the subject of the American Academy of Dermatology's summer scientific meeting in New York. At this meeting it was revealed that there were direct links between androgenetic alopecia (male and female pattern baldness) and personality disorders in those afflicted.

    In one study of 116 subjects with hair loss it was determined that 76.3% of the participants had at least one actual personality disorder. This was an extremely high rate of disorder compared to the much lower rate of 10% of the general public suffering from personality disorders.

    Another study showed that twice as many women than men with hair loss rated themselves as “very” or “extremely” upset about their hair loss.

  • Suneet Soni, (M.S), (M.Ch)

    Dr. Suneet Soni
    Dr. Suneet Soni
    Dr. Suneet Soni provides state of the art FUT and FUE surgery and uses all the latest tools and techniques providing his patients with excellent results.
  • Dr. Ted Miln

    Dr. Ted Miln
    Dr. Ted Miln
    Dr. Ted Miln is performing refined follicular unit grafting with incredible density, with results that are undetectable from his patient's native hair.
  • Ultra Refined Follicular Unit Hair Transplantation

    Ultra Refined Follicular Unit Hair Transplantation

    The Ultimate in fullness and naturalness in one surgery session.

    We’ve all seen the “pluggy” hair transplants of the past. But we don’t see today’s state of the art hair transplants because they go unnoticed.

    Corn RowsMini MicroFollicular units
    Plugs Mini Micros Follicular Units

    Follicular Evolution - from plugs to micro grafts to ultra refined grafts

    Surgical hair restoration has dramatically evolved from the big round “plug” grafts of the 1960 ’s and 70’s, to the “mini micrografts” of the 80’s and early 90’s, to modern hair transplant procedures using entirely follicular unit grafts .

    Now hair restoration surgery is going through another important evolution that is improving both the naturalness and fullness that can be achieved from any one surgical hair transplant session.

    Ultra Refined Grafting - Smaller Blades, Incisions and Grafts

    Today ’s micro surgical blades, like the size of hair grafts, have become ever smaller and now enable hair transplant surgeons to safely make more tiny graft incisions in a given area then ever before. Surgeons are then able to “dense pack” select areas with as many as 40 to 60 follicular unit grafts per square centimeter. This graft density is as much as twice that of the standard follicular unit hair transplant procedure.

    FUT result

    FUT Result

    Such high densities of transplanted hair typically produce the appearance of fullness even after only one surgical session. Patients also experience rapid healing and no visible skin distortions due to the tiny size of these incisions.

    Ultra Refined Follicular Unit Grafting - Hard on the clinic but easy on the patient.

    Ultra refined follicular unit grafting raises the bar for physicians and their staff. This delicate and demanding hair transplant procedure requires more skill and careful attention to be performed properly. The smaller and more tightly packed incisions require more closely dissected follicular unit grafts that are carefully trimmed under microscopes. These small and densely packed incisions are also more difficult to place the grafts into.

    This procedure also requires more careful patient selection, as “dense packing” of grafts is not appropriate for all patients.

    Ultra Refined Follicular Unit Transplantation – the new “Gold Standard”

    Natural hair hair transplant hair line

    In the hands of a highly skilled physician and staff the Ultra refined follicular unit hair transplant procedure can achieve excellent new hair growth that is so natural that it is undetectable even under close scrutiny.

    While the standard micro “follicular unit” hair transplant does produce natural looking results, its ability to achieve high density in only one surgical session is limited. Thus patients may have to do subsequent surgical sessions in a transplanted area to achieve a full look.

    The many patient benefits of this new procedure are significant and include:

    • The ability to get excellent hair density in only one surgical session.
    • Minimal trauma in the graft recipient area with rapid post surgical healing.
    • Little or no visible pitting or distortions in the transplanted areas.
    • More natural direction and angulation of the transplanted hair.

    Coalition of Independent Hair Restoration Physicians All members of the Coalition of Independent Hair Restoration Physiciansare required to perform ultra refined grafting with excellent results. Learn more about the membership standards.