• 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    During the past several decades, superstition, old wives tales, and guess work has gradually been replaced by science.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.

  • Extreme Hair Therapy (EXT)

    Extreme Hair Therapy

    Extreme Hair TherapyIs this hair loss treatment effective?

    Extreme Hair Therapy (EXT) for thinning hair is a 5 "step" hair loss treatment solution created by Hair Club that claims not only to rejuvenate your hair, but "rejuvenate your life".  Making claims to be FDA approved, EXT claims to stimulate hair regrowth in thinning areas by keeping hair in the anagen (hair growth) phase longer.

    Balding men and women seeking hair loss solutions should be careful to do their due diligence in researching all products they are considering.   Is this one of the hair loss products that really works to treat baldness?  Can Extreme Hair Therapy really deliver what it promises?

    Below we take a look at each of the 5 “steps” and separate treatments and analyze whether or not EXT can remedy alopecia in men and women.

    What is the 5 Step Process of Extreme Hair Therapy?

    Step One: Moisturizing or Revitalizing Cleanser
    This moisturizing shampoo is rich with vitamins and works to cleanse the scalp. Though it claims to revitalize and strengthen thinning hair, the ingredients are not listed on their website. Many hair rejuvenators and thickening agents (commonly referred to as volumizing shampoos) help to make hair appear thicker as they take on hydration and swell. Unfortunately, these thickening agents do nothing to stop the progression of male pattern baldness, even if it temporarily makes the hair shaft appear fatter.

    Step Two: Enzyme Scalp Cleanser
    Claiming to be a “new breakthrough”, this organic formula removes sebum oils that can sometimes hinder hair growth. Though sebum buildup, excessive dandruff, and scalp dermatitis are sometimes responsible for certain non-genetic types of balding such as diffuse alopecia or telogen effluvium, it does not promote androgenic alopecia (hereditary male or female hair loss).

    Step Three: Energizing Conditioner
    Adding nutrients such as proteins and wheat amino acids, this conditioner helps to promote a healthy scalp and hair growth. It should be noted that nothing in this step claims to stop hair loss or stimulate hair regrowth.

    Step Four: Hair Revitalizing Complex
    This dietary supplement containing Vitamins B3, D, and E, Biotin, saw palmetto and nettle root is taken twice daily, once in the morning and once at night. Some of these ingredients can also be found in several other hair loss products such as Provillus, Procerin, and Avacor.

    Though some of these ingredients work to treat benign prostatic hyperplasis (BPH) in men by inhibiting DHT (the hormone responsible for female and male pattern baldness), no formal clinical studies have been performed on successful hair loss treatment. It should be noted that tocotrienol molecules in Vitamin E may effectively treat alopecia but its counterpart tocopherol (commonly found in alternative herbal hair loss treatments such as HairMax MD), is not supported.  Additionally, because there are no regulations on herbal medications in the United States, the daily recommended value and dosage in Extreme Hair Therapy is based on something other than FDA regulation.

    Step Five: Minoxidil (2% or 5%)
    Minoxidil (the active ingredient in Rogaine and Xandrox) is an FDA approved hair regrowth formula and is used by many balding men and women with great success. Because Extreme Hair Therapy includes this, they are legally allowed to claim it to be FDA approved.

    Costs:

    Unfortunately, this information is not available on the Hair Club website. Upon calling the toll free number for this information, we are told that we must schedule a consultation with a Hair Club specialist. Customer service representatives are apparently not provided with this information.

    Side Effects and Warnings:

    No EXT side effects are reported on the Hair Club website however, Minoxidil may cause scalp irritation or redness, chest pain, a rapid heartbeat, faintness, swelling of the hands and/or feet, and unwanted facial hair growth.  Be sure to discuss the use of herbal medication with your physician before taking them. Saw Palmetto should be avoided by pregnant women with hair loss.

    Conclusions:

    The only FDA proven ingredient in Hair Club’s Extreme Hair Therapy hair loss treatment is Minoxidil.  Though Saw Palmettoand nettle root may be effective in treating men with an enlarged prostate by inhibiting DHT, no formal tests have been performed on them.

  • Folexen (S-equol)

    Folexen S-equol

    Folexen S-equolA Viable Alternative to Propecia in Treating Hair Loss?

    Folexen S-equol , produced by Australian manufacturer Eclipse Nutraceuticals is considered an "all natural" hair loss treatment that boasts an impressive 87% success rate for preventing and reversing the effects of male pattern baldness with virtually no side effects.  Folexen S-equol has also been a hot topic of discussion on our popular hair loss forum. But, does this self-described "nutraceutical" live up to its hair growth hype?  Is Folexen a viable alternative to Propecia for treating the effects of male pattern baldness?

    What is Folexen S-equol?

    According to the FAQ on Folexen's website, the active ingredient S-equol is "a metabolite of a natural isoflavone called daidzein, which occurs in soybeans and some other food products".

    Isoflavones are an organic compound produced almost exclusively by various bean types. In populations that consume large quantities of soy protein, studies have shown a lower incidence of breast cancer and other common cancers because of its role in influencing sex hormone metabolism and biological activity.

    As a metabolite, S-equol is the product that remains after the isoflavone is broken down or "metabolized" by the body.

    In addition to its active ingredient, Folexen contains the following GRAS (generally recognized as safe) inactive ingredients: starch, maltodextrin, allantoin, propionic acid. It may also contain hypromellose (vegetarian capsule).

    But is there any evidence that S-equol  works to treat hair loss?

    How Folexen S-equol Allegedly Works to Treat Baldness

    In the body, testosterone is converted to the hormone dihydrotestosterone (DHT) via the enzyme 5-alpha-reductase (5AR). It's widely known that androgenic alopecia (genetic hair loss) results when genetically vulnerable hair follicles are exposed to DHT which then binds to the receptor sites of these follicles causing them to weaken and shrink over time. This shrinking process is known as miniaturization.

    The recognized leader in the battle against the balding effects of DHT is the clinically proven and FDA approved drug Propecia (finasteride). Propecia works by inhibiting the conversion of testosterone to DHT, potentially slowing or even reversing the effects of androgenic alopecia. However, approximately 2% of males who take Propecia experience debilitating sexual side effects.

    Unlike finasteride, Folexen's rumored ability to suppress hair loss and potentially regrow hair is based on the theory that S-equol can bind strongly to free DHT molecules, prohibiting them from binding to the hair follicles' receptor sites. Because Folexen does not suppress the conversion of testosterone to DHT, there is no resulting increase of testosterone in the body and therefore, no sexual side effects. But are there any clinical studies supporting that S-equol can truly prevent DHT from binding to hair follicle receptor sites and prevent hair loss?

    Clinical Studies

    Folexen's website references four articles in peer reviewed journals. Two of these studies center on S-equol's effect on prostate health while the other two don't appear to reference S-equol at all.

    At this time, there appears to be no scientific data presented supporting Folexen's efficacy as a hair loss treatment.

    Side Effects

    The company claims that the product is virtually side effect free: specifically noting that it does not cause gynecomastia (enlarged breasts), erectile dysfunction or any of the other side effects that are experienced with some other treatments.

    Some users however, did report mild diarrhea that dissipated within one week of commencing treatment.

    What is the Recommended Dosage?

    The recommended dosage of Folexen is 4 capsules per day (two every 12 hours), totaling 10mg of the active ingredient. Eclipse claims that the product has been tested safe at much higher concentrations (up to hundreds of milligrams) and there is some speculation based on available data that it may, in fact, require a dose as high as 100mg to match the Propecia's hair growth results.

    Where to Buy Folexen S-equol

    Folexen is only available by mail order from Australia. A bottle of 100 2.5mg capsules (25 day supply) costs approximately $40 USD + shipping but there is a discount for purchases exceeding 4 bottles and again for 9+ bottles. However, it's easy to see that even in bulk this treatment is several times more expensive than purchasing generic 5mg finasteride and quartering the tablet, as many finasteride users do.

    As a natural product and not a drug, there are no shipping restrictions. Estimated delivery time is two weeks.

    Conclusion

    Time will tell if Folexen S-equol proves to be an effective weapon in the fight against androgenic alopecia or simply another product in a long line of expensive disappointments.

  • Stemcelex – A Revolutionary Stem Cell Hair Loss Treatment?

    Stemcelex – A Revolutionary Stem Cell

    Stemcelex is the newest product in a long line of hair restoration therapies claiming to “cure” hair loss via stem cell therapy. Given the recent onslaught of news regarding stem cell based hair loss treatments, injectable baldness cures, and research breakthroughs, it’s not surprising to see new therapies claiming to aggressively fight hair loss through these same mechanisms. However, is Stemcelex truly a stem cell based, regenerative hair loss cure, or is it another therapy simply riding the recent wave of interest in these types of non-invasive, revolutionary treatments?

    At first glance, Stemcelex seems quite impressive. The product website is filled with scientific explanations, graphs, charts, and diagrams explaining the science behind stem cell based hair restoration. Stemcelex even states its affiliation with Dr. George Cotsarelis, a researcher at the University of Pennsylvania Medical Center who, along with a talented research team, recently discovered that the bald scalp does not suffer from a lack of stem cells, but rather a dysfunction in the pathway to properly activating stem cells to produce hair. The finding was significant and Dr. Cotsarelis’ involvement and the seemingly detailed science look promising, but what about Stemcelex itself? Does it utilize these scientific breakthroughs and offer an effective treatment for hair loss?

    Unfortunately, despite the impressive name recognition and detailed explanations, Stemcelex doesn’t appear to live up to its lofty hair restoration claims. Despite claiming to “activate” the dormant stem cells described by Dr. Cotsarelis, Stemcelex does not offer any sort of feasible molecular/stem cell based therapy. The website cleverly explains the science behind stem cell inactivation and the promise of reversing the dysfunctional pathway, but instead of reinforcing Dr. Cotsarelis’ view that cures for reversing the inactivation pathway are not yet understood, Stemcelex claims to actually fix the stem cell inactivation through a series of unproven homeopathic and herbal treatments for hair loss.

    So, what is actually inStemcelex? The treatment involves a three day cycle of different lotions and topical treatments for baldness applied twice a day.

    Day1: On the first day of the hair restoration cycle, a topical lotion made from Jaborandi Pilocarpus is applied twice after washing and thoroughly drying one’s hair. According to Stemcelex, Jaborandi Pilocarpus is a parasympathetic activator (it excites the nerves that cause the body to “rest and digest” during periods of relaxation) that rids the scalp of excess oils and dandruff that impede healthy follicular hair growth. Furthermore, Stemcelex claims that Pilocarpus naturally darkens and thickens existing, native hairs. According to the experts, Pilocarpus has no reproducible pharmacological applications and any evidence that it actually thickens and darkens hair is anecdotal.

    Day 2: The second day of the cycle involves Veratrum Lobelianum, a family of herbs commonly used in Chinese medicine.  Stemcelex claims these herbs can penetrate the scalp and activate the necessary molecular signaling to “regenerate” the hair follicle stem cells. Furthermore, Veratrum allegedly down-regulates or prevents the production of Dihydrotestosterone (DHT), the hormone directly responsible for male pattern baldness. According to the research, members of the Veratrum family have been used in everything from a Native American poison to a drug researched in human blood pressure.  Currently, they are used in cancer treatments. Although the science behind cancer therapies indicates that the drug could have some molecular benefit in signaling cell activation and inactivation, there has been no research or evidence suggesting that Veratrum is useful in fighting, reversing, or preventing the effects of male or female hair loss.

    Day 3: During the third day of the Stemcelex cycle, a kelp based topical extract is applied twice daily to provide nutrients to the “new hair growth” and also ensure that the scalp remains clean and healthy. This step of the treatment doesn’t claim to be more than a simple dose of nutrients useful in good scalp hygiene.

    After reviewing the active ingredients behind Stemcelex, there is no evidence to suggest that Stemcelex is an effective hair loss treatment at this point in time. The idea of activating the dormant stem cells is important to finding a molecular cure to hair loss, but despite understanding this importance, Stemcelex doesn’t offer any concrete stem cell reactivation agents. It’s possible that Veratrum may prove useful in cell signaling and reactivating dormant cells, but the current research and evidence simply don’t support its use at this time.  Furthermore, Stemcelex charges a hefty $99.85 for a month supply of the treatment which may keep even the most curious and enthusiastic hair loss suffering men and women away.

    Altogether, the idea of reversing dormant hair follicle stem cells is important, but therapies for effectively stopping and rewiring this pathway do not seem to exist at this point in time. Unfortunately, this seems to nullify the claims made by Stemcelex and prevent it from becoming a stem cell hair loss cure.

  • Dr. Rukshan Senanayake

    Dr. Ruk
    Dr. Ruk
    Dr. Ruk has years of experience with FUE. He tailors each procedure to individual needs, hair type, and desired outcomes. Dr. Ruk has raving reviews and high-quality before-and-after photos that showcase his exceptional results.
  • Rogaine 2% Liquid for Women

    Rogaine for womenRogaine for women is the most recommended treatment for hair loss on the market for women today, and the only FDA approved and clinically proven treatment available for female hair loss sufferers.

    Note: Despite what the insert says, Rogaine works just as well for frontal hair loss, recession, and thinning hair.

    This product includes the original 2% minoxidil solution manufactured over 15 years ago. While it only reports a 46% success rate as opposed to the 5% liquid solution's 64% and the foam's impressive 85%, Rogaine for women reduces the possibility of unwanted side effects, including the unpopular unwanted facial and body hair growth.

    How It Works:

    Rogaine works by stimulating the hair follicles and revitalizing them. This sometimes stimulates the regrowth of miniaturizing hairs, promoting a thicker and fuller appearance of hair.

    Developing Realistic Expectations:

    Rogaine for women is a good starting point for women with thinning hair. While it's not as effective as the 5% liquid solution or Rogaine foam, the possibility of side effects are reduced. Thus, women may want to start small and work their way up to the more advanced Rogaine solutions.

    Don't expect immediate results. Just as hair loss is a slow process, regrowing it is too. Thus, it's recommended to use Rogaine for approximately 6 to 12 months before determining its effectiveness. Documenting your progress with bi-monthly photos can help you better evaluate the results.

    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 consultationwith one of our prescreened hair restoration physicians.

  • 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.
  • Viviscal Hair Loss Treatment Product Review - Can it Really Promote New Hair Growth?

    Viviscal Hair Loss Treatment

    Viviscal's hair growth vitamin and dietary supplement taken twice daily promises to "reverse hair loss" and grow thicker hair in both men and women experiencing balding and thinning hair.  Its primary activeingredient, AminoMar C™ Marine Complex, is said to be a proprietary blend of ingredients and proteins that "provides the essential nutrients needed to nourish thinning hair and promote existing hair growth".

    The entire Viviscal product line includes an "all natural" dietary supplement, a shampoo and conditioner, and a scalp lotion.  Viviscal is promoted as being 100% natural, drug-free, gluten-free and safe from harmful side effects. But can Viviscal deliver on its promises to reverse hair loss and grow new hair?

    In 2011, Viviscal advertisement was banned in the United Kingdom by the Advertising Standard Authority (ASA) who deemed that its claims to maintain optimum hair health were unproven. The ASA concluded:

    "Because the evidence sent did not show that the ingredients in Viviscal had been shown to have a positive effect on hair health, we concluded the claims that the product could 'nourish hair follicles' had not been substantiated' and ruled the advert cannot be broadcast until it is changed."

    However, as with many similar products promising to grow hair, substantiating their hair growth claims may not be a simple task.

    Viviscal’s manufacturer does reference a number of studies that seem to support their claims of growing thicker hair. For example, the results of "Scientific Pilot Study #1" on 40 hair loss suffering females with an average age of 35 concluded, "Viviscal was well received by test subjects and the analysis of hair counts showed a mean reduction in hair loss of 46% in only 10 weeks." Additional studies are cited on Viviscal’s website.

    Recently, we learned that Dr. Glenn Charleshas publicly endorsed Viviscal.  Dr. Charles has an outstanding reputation for performing state of the art hair transplant surgery and is a highly esteemed member of the Coalition of Independent Hair Restoration Physicians.When asked to comment on his public endorsement of Viviscal, Dr. Charles stated:

    "I have never had any hair loss patients display any negative effects. I describe it to my patients as a natural supplement that can promote a healthier scalp and hair. It may also, in turn, slow down the hair loss process. I tell all my patients that there are no guarantees with this product.  Although most patients believe that they did have improvement after using this product, I admit that some patients do not see any noticeable changes that either they or I can identify."

    Other hair loss experts are not as optimistic regarding Viviscal’s hair growth potential. Coalition member Dr. Bill Rassmanof Los Angeles states:

    "I am skeptical of the photographs (results) and the changes shown make me doubt what the Viviscal marketing department wants me to see. Viviscal reportedly contains ‘special marine extracts and a silica compound’ - and yet I’m to believe this will regrow hair? If these photos were real, the product would have taken over the market years ago."

    It's also important to note that Viviscal does notmake any claims on their website that their products can reverse the effects of genetic hair loss.  Instead, it simply states, "Viviscal works to reverse hair loss due to stress, poor nutrition, and many health related ailments".

    So is Viviscal an effective hair loss treatment? More research may be needed before this question can be effectively answered. 

    While there may be no harm (potential side effects) in trying it, at an average cost of $600 per year there are certainly more affordable and proven treatments available. The only clinically proven and FDA approved medical hair loss treatments currently available are Rogaine (minoxidil) and Propecia (finasteride). While Rogaine may be used by both male and female patients, Propecia is safe and approved only for male hair loss sufferers. Always consult your physician before adding any treatment to your hair loss regimen.

  • 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.