A 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.

There are a variety of hair loss remedy "concealer" products that are applied to the scalp and/or hair in the thinning areas to mask a person's baldness and increase the look of fullness of thinning hairs. These products such as Toppik, Couvré, and Prothik can work surprisingly well at creating the illusion of fuller hair.

Some of our member physicians advise their hair restoration patients to use such hair loss remedy products to enhance the look of fullness in their transplanted areas. These products can also be used post operatively to hide the immediate surgery.

Toppik - Toppik is an effective, safe, and easy-to-use product that completely covers up the scalp's thinning areas.

Couvre - COUVRe is safe for men and women, easy to use, and is totally undetectable to the world's toughest critics.

Caboki - Caboki is comprised of a series of charged microfibers that, when applied to the scalp, tightly bind hair shafts and create a denser, fuller appearance.

DermMatch - DermMatch is a safe and easy way to cover-up thinning areas and instantly provides the appearance of a natural looking head of hair.

Nanogen - Nanogen is one of the fastest, easiest ways to conceal thinning hair and hair loss.

Prothik - Prothik does an exceptional job of adding thickness and fullness to thinning hair while reducing the contrast between thinning hair and the scalp.

Nizoral 2% is magnificent shampoo and a significant part of what's referred to commonly as the Big 3. The other two are the FDA approved and proven treatments Propecia (finasteride)and Rogaine (minoxidil). To date, Nizoral is the only shampoo on the market that can make the unique claim that it's proven to stop the formation of DHT. Its active ingredient ketoconazoleat 2% concentration has proven to be a moderate DHT inhibitor and has growth stimulating properties about as effective as Rogaine 2%.

This product includes 2%, the highest concentration 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". There is also a less concentrated 1% of Nizoral. To learn more, visit Nizoral regular shampoo.

We strongly suggest using Nizoral shampoo in addition to other proven treatments. Nizoral should be used 2 or 3 times a week to avoid dry hair and a flakey scalp.

On the off days, you may want to consider rotating Nizoral with other excellent shampoos designed specifically for thinning hair. See the recommended treatments section below for other shampoos we recommend.

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 Nizoral in conjunction with other 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 Nizoral has been successful in helping you maintain existing hair.

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.

For many hair loss sufferers, scalp "tinting" solutions are the most effective type of topical concealer. Tinting solutions like COUVRé, also commonly referred to as "masking lotions" or "concealing lotions," eliminate the contrast between thinning hair and the bald scalp by naturally darkening the skin and matching the tone to one's existing hair. By matching bald scalp to an individual's natural hair color, the harsh contrast of thinning hair is eliminated, and a fuller, denser appearance is achieved.

Although several types of masking lotions currently exist, one of the most popular and trusted is COUVRé. However, what makes COUVRé distinct from other masking lotions, or different types of concealers in general? Is COUVRé a quality concealer for both hair loss suffering men and women? Most importantly, what are other concelears users saying, and where can balding individuals purchase their own supply of COUVRé masking lotion?

COUVRé: What is it, and how does it work?

Unlike comparable "shaker" application products (such as Toppik – a popular topical applicator product from the same makers as COUVRé), COUVRé is a tinted lotion, meant to minimize the contrast between dark, thinning hair and the balding scalp. According to the manufacturers, COUVRé is applied to the scalp using a specialized sponge applicator. Once the masking formula is on the scalp and providing sufficient camouflage, users are instructed to simply style hair normally and go about their day.  The manufacturer of COUVRé assert that the application appears subtle, natural, will not appear "greasy or sticky," will not stain clothing or towels, and does not interfere with pores or affect natural hair growth.

The Benefits of COUVRé

According to both the manufacturers and satisfied users, COUVRé offers various benefits over comparable concealer products. First, because the makers of COUVRé are confident in the product, they ensure that, unlike some other concealers, COURVe will create a natural appearance without looking greasy or sticky, and does not clog scalp pores or interfere with existing hair shafts. Because of this, not only is COUVRé useful for those with thinning hair, but also for patients awaiting new growth from hair transplant surgery. What's more, COUVRé does not contain any harmful chemicals, can allegedly withstand perspiration, rain, wind, and even physical contact (such as touching the scalp).  COUVRé comes in 8 different colors/tones (to match all hair types) and is equally effective in both male and female hair loss sufferers.  Although COUVRé will withstand a variety of situations without smearing or smudging, it easily washes completely away with water and shampoo.

COUVRé Color Chart

Why COUVRé has Become Popular and Trusted within the Hair Restoration Community

While COUVRé does offer many benefits above other concealer products, its popularity and reputation within the hair restoration community is likely due to several important factors. First, unlike some other concealing products, COUVRé application is both simple and fast. For many individuals, the ability to naturally conceal thinning hair without spending an excessive amount of time "getting ready," is a huge benefit. Furthermore, because COUVRé contains natural ingredients and does not interfere with native or implanted hairs, it is safe to use with other proven hair loss medications (like Rogaine/minoxidil and Propecia/finasteride) and during the new growth phase of hair restoration surgery. Because of its ease of use, effective nature, and ability to conceal hair loss in a variety of situations, COUVRé has become a reputable hair loss treatment and remains popular within the hair restoration community.

What Real Hair Loss Sufferers are Saying About COUVRé

To read real reviews on COUVRé alopecia masking lotion from other hair loss suffering men and women, visit our hair loss forum and social community.

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.

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.

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.