Over the past several years surgeons have used various techniques to perform follicular unit hair transplantation. One such technique is the Lateral Slit Technique, also known as Coronal or Perpendicular Grafting. This technique’s name is derived from the angle and direction in which the graft incisions are made.

While there are other techniques for performing densely packed and highly refined follicular unit transplantation, the lateral slit technique offers a high degree of control over the angle and direction in which the transplanted hairs will ultimately grow.

The lateral slit technique has been used both intuitively and systematically for years by hair restoration physicians. However, it has recently gained popularity as a systematic and precise way of performing follicular unit hair transplantation.

How our member physicians use the Lateral Slit Technique.

Many of our physician members use the Lateral Slit Technique exclusively or in combination with other techniques for creating graft incisions. The lateral slit technique enables a surgeon to create graft incisions at varying angles (ranging from 10 to 90 degrees to the scalp), including very acute angles that will make the transplanted hair grow out lying flatter to the scalp. The ability to create incisions at very acute angles is particularly useful in areas such as the front temples and sides where the hair normally grows out lying flat on the scalp.

The graft incision determines the direction of the hair growth

The lateral slit technique also helps enable a surgeon to determine the direction of the graft incisions. This then determines the ultimate direction of the transplanted hairs growth. Thus a surgeon can use this technique to control and vary both the direction and angle at which the transplanted hair will grow in order to mimic the subtle changes in hair direction that occur naturally.

Each graft incision is created by analyzing the neighboring hair so the surgeon can reproduce the correct hair pattern. As a result, as each transplanted hair emerges from the scalp it will grow and lay in a similar direction as its neighboring non-transplanted hairs.

Lateral slits can enable denser packing of grafts

Lateral slit incisions also tend to be more parallel to the scalp and thus more superficial and less invasive to the scalp’s underlying vascular structure. This parallel alignment also enables a physician to place more grafts per square centimeter with out the grafts compressing or popping up since the pressure exerted on the grafts does not push them upward from the scalp.

Using blades cut to the size of the grafts

Some of our members use custom blade cutters to create tiny blades to make incisions that match the size and depth of each follicular unit graft being transplanted. This enables a surgeon to safely dense pack more grafts into a given area during a surgical session. Healing time is also more rapid, with minimal scarring.

Typically most clinic’s blades range from 1.5mm to 2mm in size. However, by using the custom blade cutter our physicians can create blades as small as .7mm for a single hair graft and .9mm for a multi hair graft.

In addition, the blades created by the custom cutter are squared off to match the shape of the bulb end of a hair follicle. Non custom cut blades are typically spear pointed which requires them to be inserted deeper thus causing more trauma to the scalps vascular structure.

The ability to control the depth of the incision each blade makes is also critical. Each blade is placed in a blade holder that is set to not allow the blade to go any deeper than required for the graft to being placed in the incision. This minimizes unnecessary trauma to the deep vasculature of the scalp, thus enabling close tight incisions, minimal tissue swelling, and quick healing that leaves no visible scaring, pitting, or cobble stoning of the scalp.

Placing grafts to maximize their aesthetic result and coverage

The plane and direction in which each follicular unit graft is placed on the scalp can also impact the ultimate appearance of density that can be produced with a given number of grafts. This is because hairs within a follicular unit are typically next to each other inline.

Therefore by arranging each multiple hair graft on the scalp in a linear fashion to the line of sight, each follicular unit will provide the maximum appearance of fullness and scalp coverage. This also mimics how hair is normally aligned on the scalp.

Special thanks to Dr. DeYarman, Dr. Sharon Keene, Dr. Jerry Cooley, Dr. Alexander, and Dr. Glenn Charles for contributing their expertise and photos for this section.

As the field of medical hair restoration continues advancing and evolving, hair loss sufferers look toward new, cutting edge clinics and corporations for faster, more effective, and less invasive hair loss treatments. In various but not all cases, the breakthroughs achieved through oral medications and topical solutions (seen in proven hair loss treatments like Rogaine (minoxidil) and Propecia (finasteride) are fantastic.  Thus, hair restoration entities continue striving to create the next advancement and bring the world closer to a “hair loss cure.” However, for each hair restoration treatment that’s proven safe, effective, and efficient, it seems as if a dozen others are rejected for being unproven, inefficient, or unsafe.

For this reason, it’s always advantageous to thoroughly research the newest hair loss solutions and determine whether they are safe and effective, or if they fail to live up to the high expectations set by the current gold standard treatments such as proven solutions Propecia and Rogaine.   Below, we evaluate whether Spectral.DNC, a topical solution created by Divine Skin Laboratories (DS Laboratories) can help stop hair loss and regrow hair.

Spectral.DNC is a topical treatment formulated by DS Laboratories which claims its “the world’s most effective topical hair loss treatment.” But can Spectral.DNC live up to these lofty claims and offer a more effective solution, or will it suffer the fate of many therapies before it and fail to gain the approval of the hair restoration patient community?

According to DS Laboratories, Spectral.DNC is applied (as an atomized mist or liquid) to the balding scalp twice daily, once in the morning and once at night. Along with a series of vitamins and herbal supplements (herbal extracts, copper peptides, and a vitamin complex), the active ingredients in Spectral. DNC are 5% minoxidil, Aminexil (SP94), and Retinol. Since minoxidil is also the proven, active ingredient in topical Rogaine, Divine Skin utilizes a frequently asked questions feature on its website to explain how Spectral.DNC is different and more effective than minoxidil. According to Divine Skin, it’s the two other active ingredients – Aminexil and Retinol that make Spectral.DNC more effective than Rogaine.

Aminexil (or Aminexil SP94) is a compound currently featured as an active ingredient in a line of healthy hair shampoos by L’Oreal. Aminexil is allegedly helpful in the treatment of perifollicular fibrosis – a pre-mature aging of hair shafts caused by inflammation and an overproduction of collagen proteins. It’s worth noting that while some reputable sources have researched its connection to perifollicular fibrosis, it hasn’t been conclusively linked to hair loss (especially androgenic alopecia hair loss), nor is Aminexil proven to treat perifollicular fibrosis. Furthermore, Aminexil is not recognized or approved by the United States Food and Drug Administration (FDA) as a treatment for any type of hair loss.

DS Laboratories indirectly counters these statements by sharing the results of a “worldwide” study which demonstrated an 8% increase in hair growth and a 6% increase in hair shaft diameter in hair loss sufferers using Aminexil (compared to a placebo group). This study however, is not without its limitations.  This study was conducted in 1994, only contained 130 participants, lasted for 42 days, and doesn’t appear to be published in any sort of peer reviewed publication. Because of this, it’s difficult to evaluate whether or not the addition of Aminexil as an improvement over simple 5% minoxidil. But what about the Retinol?

Retinol (and its derivatives) is a form of Vitamin A, often used in medical dermatology for maintaining healthy skin and treating specific types of acne. Allegedly, certain forms of Retinol act as hair restoration drugs (after periods of long term usage) by preventing hair loss hormones from binding to target receptors and killing healthy hair follicles. While evidence of these claims was difficult to find, many Retinol users claim that the drug is harsh on skin and utilizing it in the scalp would cause irritation and require small, likely ineffective dosages. Much like Aminexil, there’s no solid evidence to suggest that Retinol makes Spectral.DNC a more effective hair loss solution than Rogaine or other minoxidil related products. Interestingly enough, while copper peptidesare listed as in inactive ingredient, research supports that copper peptides may play a role in transforming thin vellus hairs into thicker terminal hairs, increasing follicular size, and regenerating healthy scalp skin.  However, because copper peptides aren’t listed as an official “active ingredient” by DS Laboratories nor do we know its concentration, it’s difficult to gauge its efficacy within Spectral.DNC.

The only proven and FDA approved ingredient in Spectral.DNC is 5% minoxidil. While minoxidil is safe and efficient, it’s unclear what the additional ingredients in Spectral.DNC may actually accomplish. Furthermore, the cost of Spectral.DNC runs between $35.00 and $45.00 for a month supply, compared to around $ 25.00 for a three month supply of generic 5% minoxidil.  According to DS Laboratories, the only known side effects revolve around minoxidil (which are no different than those associated with Rogaine).  Although minoxidil is relatively safe and effective, it’s been used as a hair loss treatment for decades.

Those hair loss sufferers considering using Spectral.DNC as a treatment for thinning hair can feel confident knowing that they will, at the very least, obtain similar results to using minoxidil 5%.  Until the other active ingredients are peer reviewed, whether or not Spectral.DNC is more effective than Rogaine 5% is mostly conjecture.

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.

Hair loss is a universal condition, affecting all ages, races, genders and nationalities. It’s estimated that “androgenetic alopecia,” or male and female pattern baldness affects 35 million men and 21 million women in the United States alone. This section examines how race, age and gender affect hair loss.

Race and Hair Loss

In physiological terms, human beings are all composed of the same bones, muscles, and everything else down to the cellular level. But there are specific differences.

Hair, in all of its variations, is one area in which human beings display their differences. Hair follicles can widely vary in terms of color, length, shape, thickness, strength and various other factors.

There are many ethnic groups to consider. But we will focus on the special considerations of Asians, Blacks (of African descent) and Caucasians.

Asian Hair Loss Considerations

Asian people typically have very straight hair. Their scalps contain fewer hairs per square centimeter, they actually have a lower hair density than that of Caucasian hair follicles. But because the individual hair follicles of East Asians are thicker, this gives the look and impression of greater hair density.

For these reasons, hair restoration techniques for East Asians, much like other races, must be sensitive to a variety of anatomic and cultural differences. For instance, East Asian females often have an increased likelihood of developing “diffuse alopecia,” or hair that thins evenly over the entire head than Caucasian females.

Even though it’s not a definite requirement, it’s very helpful for Asian patients to seek out doctors with experience in Asian hair.

Another consideration for East Asians considering hair restoration surgery is the increased chance of developing keloid scars. A keloid is a thick, irregularly shaped and elevated scar with uncontrolled growth that results from excess fibrous skin tissue. East Asians typically have a greater likelihood of keloid development than Caucasians, but less than that of people of African descent. Therefore, before undergoing surgery, East Asians may want to consider being medically evaluated for keloids.

African Hair Loss Considerations

People of African descent usually possess naturally curly hair. This curly hair gives the visual impression of increased hair density for a given amount of hair, which is beneficial in hair restoration surgery.

The hair follicles beneath the skin of people of African decent also typically curve more than Caucasians. This can make harvesting the donor hairs, without severing or transecting the hair follicles beneath the scalp, more difficult. A hair restoration physician needs to be very aware of this difference and adjust to its requirements.

As in the case of East Asians, people of African descent possess some unique hair and skin characteristics. Some of these medical conditions are more common in black skin than in white skin. This may increase the risk for post-surgical complications.

Those of African descent have a higher chance of developing keloid scarring when injured. This in turn leads to a greater chance of noticeable donor scars. Keloids aren’t a widespread problem. But those with a history of them are carefully evaluated in regard to their existing scars. The evaluation usually involves a small "test procedure" to determine if there’s a normal healing rate.

Another issue is that of postoperative skin discoloration. With darker skin, there’s often a greater risk of both increased and decreased skin color after injury or surgery. These risks can be determined by the patient’s medical and family history.

Ingrown hairs are also a more common problem in darker skin. If a patient has a history of ingrown hairs or other minor skin infections, this may signal a higher risk for ingrown hairs post-hair restoration surgery. Again, this risk can be determined by a small test procedure.

Caucasian Hair Considerations

Caucasians (white people) may have a wide range of hair and skin types. However, if someone has dense and or coarse hair, as well as skin color similar to their hair color, they will generally achieve the best results for a given amount of restored hair.

Learn more about aging and gender hair loss

The new and revolutionary Revita Shampoo has all the right stuff to stop DHT and promote healthy hair growth. Revita contains the proven DHT inhibitor ketoconazoleand vitamins and minerals essential for nourishing and cleansing the scalp and hair, including the same copper peptide technology included in Tricominproducts.

This product includes a 6 ounces or 180ML bottle with 1% of the active ingredient ketoconazole. To view the clinical abstract proving the effectiveness of ketoconazole in the treatment of androgenetic alopecia, view Ketoconazole as a hair loss treatment.

Unlike Nizoral, the revolutionary Revita shampoo can and should be used daily. Revita leaves your scalp and hair feeling great daily with no signs of dryness or flakiness. It's also a magnificent volumizing shampoo, promoting maximum fullness.

Developing Realistic Expectations:

Men and women sometimes suffer from hair loss for different reasons. Thus, diagnosing its cause is necessary to facilitate and promote proper treatment.

Don't expect immediate results. It's recommended to use Revita in conjunction with proven treatments 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 Revita has been successful in helping you maintain existing hair.

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

Ingredients (Full List)

Apple PolyphenolProcyanidin B2 & C1
Copper Peptides
Spin Traps
Ketoconazole
Rooibos
MSM
Caffeine 4%
Carnitine Tartrate
Amino Acids
Emu Oil
Biotin