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.
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 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.
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.
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
Men and women who have the impulse to pull their own hair out may be suffering from trichotillomania. Trichotillomania is an impulse control disorder characterized by the repeated urge to and behavior of pulling out one's own hair. Impulse control disorders resemble substance addictions because the patient feels out of control of his or her own behaviors. Men and women with trichotillomania live relatively normal lives but typically show signs of hair loss, thinning, and bald spots all over the scalp and body from pulling it out.
Treating trichotillomaniagoes far beyond trying to stimulate hair regrowth.Even if Rogaineor laser therapy for hair losswere to regrow hair, there is a strong possibility that trichotillomania patients will continue to pull their hair out. Patients with trichotillomania therefore, should be treated at the source of the disorder in conjunction with using proven hair loss treatments.
In addition to medication, Habit Reversal Training (HRT) by a trained counselor has proven to be successful in treating trichotillomania. With Habit Reversal Training, the individual is taught to recognize and redirect their impulse to other more constructive activities. Often times, trichotillomaniapatients are asked to keep a journal of their hair pulling episodes. This can help the counselor and patient to identify and develop strategies to avoid situations that might trigger hair pulling episodes. Journals often include the location of the incident, number of hairs pulled, date, time, and their feelings and thoughts during the episode.
Treating a trichotillomania patient's baldness may be done simultaneously or after proper treatment of the disorder. Rogaine (minoxidil)can be a helpful aid to HRT by stimulating the follicles underneath the scalp, potentially facilitating or expediting hair growth.Treating a patient’s hair loss while they continue to pull their hair out is not constructive. Since this type of balding is not genetic due to the production of DHT, Propecia (finasteride)won't likely help.
Patients who've suffered from trichotillomania for awhile may damage or even remove the hair roots by excessive pulling, making non-surgical hair regrowth next to impossible. Surgicalhair restorationmay be an option for trichotillomania patients whose hair roots are too damaged to produce new hair on their own. Hairrestoration surgeryshould be reserved only for patients who've been successfully treated and no longer suffers from trichotillomania.
Catching and treating trichotillomania early will most likely reduce damage done to the hair follicles and eliminate the need for hair loss treatment, since undamaged hair will return on its own.
One product you used to see quite often in advertising is Avacor. According to Response magazine, Avacor was the third best selling product on the Internet in April, 2002. Avacor was originally manufactured by Global Vision Products. After being taken over by new management, it is now being manufactured by Avacor Products LLC.
Like most products that advertise 'Stop Hair Loss and Regrow Hair!', Avacor contains the only FDA approved topical drug minoxidil. Avacor, like other products with similar claims, mixes FDA approved drugs in their generic form with other ingredients in a multiple regimen of products like shampoo, lotion and vitamins.
Avacor historically cost approximately $239 for a two to three month supply and over $1000 for a year’s worth. New prices are much more reasonable which range from $180 for a 3 month supply to $400 for a year’s supply of the men’s and women’s formula. Note that the ingredients in Avacor can be bought over the counter at your local store at a fraction of the cost for which they are sold in Avacor. However, they do offer 24/7 customer service and a 90 day money back guarantee.
Avacor, like other products with similar claims, has taken a lot of slack over the years for their controversial marketing tactics. Avacor has a checkered past and has previously been the focus of lawsuits and investigative reporting by major media like ABC news. Recently however, new management has taken over and claims they are very serious about selling quality products at more reasonable prices, without the hype and controversial marketing strategies. In looking at their website, while Avacor still uses slick marketing language to promote their products, the vast majority of their claims are much more realistic.
Avacor includes 3 distinct products that claim to provide “total hair care”. This includes a 'Scalp Detoxifying Shampoo', a 'Physicians Topical Formulation' and finally a 'Nutricap'. Avacor's Nutricap ingredients consist mainly of common herbs like saw palmetto, gingko biloba, keratin, resveratrol, and bilberry. While conjectured to inhibit the production of DHT, none of these ingredients are FDA approved or proven to stop hair loss. Avacor’s Physician’s Topical Formulation however, does contain 5% of the FDA approved hair regrowth agent minoxidil.
Other than minoxidil, no other ingredient is proven to regrow hair. A number of studies have been done that suggest saw palmetto inhibits the production of DHT, like Propecia. But, unlike Propecia, it has never been proven to stop or reverse hair loss.
Avacor admits on their website that the only product proven to regrow hair is the Avacor Physician’s formulation which includes the FDA approved ingredient minoxidil (5% for men and 2% for women). The other products claim to provide hair with the essential nutrients for healthy hair growth but are careful not to claim to prevent the progression of male or female pattern baldness (androgenic alopecia). Perhaps this is why the Avacor Physician’s formulation can now be purchased separately. Costs of the Physician’s Formulation are still, but only a little more expensive than Rogaine topical hair loss treatment, one of the first and most popular topical minoxidil products.
At this time, Avacor’s proof comes in the form of the FDA approved study showing that minoxidil can stop and reverse hair loss. No other study is provided with their product. Their website also is much more realistic as to what their product line can accomplish for hair loss suffering consumers.
Before you consider spending hundreds of dollars for any product or service, do a review. Legitimate products will have legitimate studies and have been reviewed on many quality websites. Doctors with real talent and satisfied patients will be able to show you dozens of photos and allow you to talk with past patients. Proven physicians will make available their resumes along with their formal education and associations they belong to.
It is always best to review a product or doctor for information on their background before you make a decision for something as important as hair loss and hair restoration.
At the very least, the Avacor Physician’s formulation will be as effective as the Rogaine liquid formula or generic minoxidil. However, to date, both Rogaine and generic minoxidil are more cost effective than Avacor. The nutricap, shampoo, conditioner and other products may promote healthy hair and provide it with volume, but make no claims of stopping hair loss or regrowing hair.
Hair has always been an important symbol of status throughout history. Whether it signified social, financial, gender, or professional status, hair has come to be considered a sign of success. And this idea appears to go all the way back to the cavemen.
A few years ago, the frozen body of a man on the Austrian-Italian border was discovered by scientists. Upon examining the clothing and weapons found on the specimen, they were astounded to find that the body was from the Neolithic Age, making him more than 5,000 years old. They had previously thought that the body was only a few years old, based on his trimmed beard and short hairstyle. So even during prehistoric times hair care was in practice.
Even 4,000 years ago, the ancient Egyptians were searching for a hair loss cure. One “cure” used around 1500 B.C. in Egypt called for reciting a magic spell to the sun god and then swallowing a mixture of onions, iron, red lead, honey and alabaster.
Around 1100 B.C. in ancient Egypt it was popular to rub the fats of various animals onto the scalp, including those of the lions, hippopotamuses, crocodiles, ibex, serpents and geese.
Another recipe for growing hair prepared for the King of Upper and Lower Egypt included toes of a dog, refuse of dates, and a hoof of an ass. Of course, these “cures” failed to re-grow hair.
But with baldness regarded as shameful in ancient Egypt, men and women were willing to put such things on their head in the hope they would work. During these times it was believed that baldness stood for the public announcement of a man’s loss of virility.
Yes, hair loss is even mentioned in the Bible. According to this Old Testament passage God does not condone ridiculing the bald.
Kings 2: 23 “From there Elisha went to Bethel. As he was walking along the road, some youths came out of the town and jeered at him. "Go on up, you baldhead!" they said "go on up, you baldhead!" He turned round, looked at them and called down a curse on them in the name of the Lord. Then two bears came out of the woods and mauled forty-two of the youths. And he went on to Mount Carmel and from there returned to Samaria.”
As a hair loss sufferer you can take solace in knowing that today you have treatments for hair loss only dreamed of by the Kings of ancient Egypt and the emperors of Rome.
Hair loss and attempts to stop or reverse it have been around for centuries.
In the 80's hair restoration surgery as a hair loss solution evolved dramatically, as the large punch grafts were gradually replaced with a more refined combination of mini and micrografts. This "combination mini micrografting" hair transplantation procedure no longer used the punch to extract the bald resistant grafts. Rather a strip of bald resistant hair was surgically removed from the back of the head and then trimmed into mini and micrografts.
Typically the minigrafts (4-8 hairs) were used to create fullness and density, while the one, two, and three hair micrografts were used to create a refined and feathered hairline in front. This combination procedure also normally used more grafts, several hundred grafts per session, rather than the approximately 50 to 200 large grafts of the original punch graft procedure.
The 90's saw the gradual introduction of a very refined surgical procedure hair loss solution now known as "follicular unit hair transplantation" or "FUT". This exacting and labor intensive procedure transplants hairs in their naturally occurring one, two, three, and four hair "follicular unit groupings" in which they grow naturally.
To create such natural follicular unit grafts, which mimic the way hair grows naturally, typically requires the use of high powered magnification. Such magnification enables the surgical technicians to properly visualize the follicular units in the donor tissue. They are then able to isolate them and cut them into 1, 2, 3, and some times 4 hair follicular unit grafts.
Critical to the ultimate success of the follicular unit hair transplant procedure was the introduction of the binocular microscope by Dr. Bobby Limmer of San Antonio Texas in the late 1980's. Dr. Limmer found that by using the microscope he and his staff were able to successfully isolate and trim the naturally occurring follicular units into individual grafts.
For his part in pioneering the use the microscope in graft dissection and the follicular unit procedure Dr. Bobby Limmer was awarded the "Platinum Follicle Award" by the International Society of Hair Restoration Surgery in 1996. Many physicians now fondly refer to him as the "Godfather of Follicular Unit Hair Transplantation".
While Dr. Limmer pioneered the use of the microscope in trimming follicular unit grafts, it was Dr. Robert M. Bernstein, in collaboration with Dr. Bill Rassman, who pioneered and advanced the concept of large sessions of all follicular unit grafting. These large follicular unit sessions enabled patients to achieve both naturalness and density.
Dr. Bernstein, who coined the name "follicular unit hair transplantation", tirelessly advocated for its adoption in ground breaking articles and lectures that are today recognized as benchmarks in the advancement of this procedure. Click to read these ground breaking hair restoration articles and papers.
In recognition of his many contributions in both conceptualizing, pioneering and advocating "follicular unit hair transplantation", Dr. Bob Bernstein was awarded the "Platinum Follicle Award" by the International Society of Hair Restoration Surgery.
Over time the merits of this refined but difficult to perform procedure became accepted and the follicular unit hair transplant procedure has become acknowledged by most hair restoration physicians to be the "Gold Standard" for surgical hair restoration. Click here to see video of a Follicular Unit Hair Transplant procedure.
Some feel that hair restoration surgery has evolved to its highest degree now that it relocates hair exactly as it grows naturally. However, even the "Gold Standard" in hair transplantation has continued to evolve by becoming even more "ultra refined".
Today some leading hair restoration surgeons, including all members of the Coalition of Independent Hair Restoration Physicians, perform an ultra refined follicular unit hair transplant procedure using very tiny incisions that enable them to safely "dense pack" tiny grafts when appropriate. This ultra refined follicular unit procedure is a hair loss solution that enables patients to achieve cosmetic density in a given area after only one surgical session.
We know that and rogenetic alopecia or male pattern baldness is by far the most common cause of hair loss, accounting for 95% of hair loss in men and women. But there are a variety of other causes for hair loss in men and women. These include disease, aging, improper hair care, poor nutrition, and stress.
It's a proven fact that medical conditions, as well as treatments and procedures, may lead to hair loss. Many people have experienced sudden and large amounts of hair loss about 3 or 4 months after an illness or a major surgery. Fortunately, this hair loss is usually temporary, and is related to the stress of the illness.
Hair loss may also signal a previously hidden disease,including lupus, thyroid disease or diabetes. Because hair loss may be an early sign, it's a good idea to identify the problem and begin treating it at this time.
Psychological disorders such as Trichotillomaniamay be responsible for self-inflicted hair loss Men and women suffering from this condition pull their own hair out by the roots.
Hair loss may stem from taking certain medicines, but this normally stops once the medication is no longer taken.
Another cause of medical hair loss is hormonal problems. Essentially, having an overactive or under active thyroid gland may cause your hair to fall out. Treating the thyroid disease will usually help this hair loss. Hormones can also cause hair loss if male hormones (androgens), or female hormones (estrogens), are out of balance. However, if the hormone imbalance is corrected, the hair loss should stop.
Did you know that 40% of men have noticeable hair loss by age 35, and 65% by age 60?
Aging is one of the factors necessary for and rogenetic alopecia to occur, along with a genetic predisposition and the presence of hair loss-inducing hormones. Hair loss is dependent on exposing the vulnerable hair follicles to the proper hormones over time.
Isn't it frustrating to see people with thick, full heads of hair treat it so badly? Dyes, bleaching, pigtails -- it all takes its toll on hair.
The chemicals used for dying, tinting, bleaching, straightening or any other hair-altering procedures can lead to hair becoming strained or damaged. Eventually, this hair may even break off.
But it's not any better in the hair salon, as excessive styling that pulls the hair too tightly may also lead to a type of hair loss, called "traction alopecia." As long as this pulling is stopped before the scalp scars, the hair will grow back normally. But be warned, scarring can cause permanent hair loss.
It's also not a good idea to subject your hair to hot oil treatments or the chemicals used in permanents. These may cause inflammation of the hair follicle. This too, may lead to scarring and hair loss.
Researchers have found that some hair loss may be due to insufficient protein or iron in your diet, as well as malnutrition, in general. As effective as "miracle" or "fad" diets sound, they may cause damage. Vitamin deficiencies, as well as certain illnesses related to eating, such as bowel disease or eating disorders, can also cause poor nutrition. These may all cause hair loss.
Stress can be harmful to the entire body, and the hair on our heads is no exception. Regardless of the cause - illness, a traumatic experience, nutritional deficiency - our rate of hair loss may increase.
However, it should be noted that stress-induced hair loss is not a cause of male-pattern baldness. Rather, this type of balding is known as "telogen effluvium." Telogen effluvium is caused when the body senses a problem and diverts its energies there. This results in hair being shed, although it's usually reversible.
Stress affects the hair of men and women differently. It's been foundthat women's hair is more sensitive to stress' effects than men's hair. One possibility is that stress (along with DHT and other things) may facilitate hair loss for women who are genetically predisposed towards it While the cause of genetic female hair lossis a bit of a mystery, women experiencing hair loss are advised to consult a dermatologist or hair restoration specialist to determine its cause Many causes of thinning hair in females are non-genetic and hair loss is often reversible by treating whatever condition is promoting it.
Excessive DHT in the hair follicle causes specific immune responses. These responses cause the cells to release a substance known as Superoxide. This substance combats against any viruses, cells, or foreign tissues. SOD's claim to fight hair loss by reducing the presence of Superoxide.
As a result, the body is less prone to reject any offending hair follicles, which helps to ward off hair loss. SOD's actually treat hair loss in more than one way. Besides reducing Superoxide, they also stimulate growth and they have anti-inflammatory properties. SOD’s are topical, as well. They include Tricomin, Proxiphen, Proxiphen-N and Folligen.
Click to learn more about Anti Inflammatories
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.