To date, the only two FDA approved hair loss treatments include Propecia (finasteride) and Rogaine (minoxidil). However, a number of alternative oral and topical products are marketed daily as effective hair regrowth solutions.  Though there is no question that marketing often over-reaches in order to sell a product, the real question balding men and women ask is, is there any proof that these products are effective in treating baldness?  What is the chance of regrowing hair?

Topical Hair Loss Products, Treatments and Cover Ups (Concealers)

For centuries men and women have been rubbing hair loss products including solutions, ointments, treatments and concoctions on their thinning hair in the hope of stimulating hair regrowth. In ancient Egypt it was popular to rub the fats of various animals, including lions, hippopotamuses, crocodiles, ibex, serpents and geese, onto the scalp as a hair loss cure.

Hippocrates had a personal interest in finding a treatment for baldness as he suffered from hair loss. He developed a number of different treatments, including a mixture of horseradish, cumin, pigeon droppings, and nettles to the scalp. These concoctions failed miserably and he became prominently bald. These and other treatments failures have continued to disappoint balding men and women.

Today’s Topicals - Snake Oils or Legitimate Hair Loss Products?

Today topical hair loss products such as special shampoos, conditioners, Rogaine, various scalp treatments, and cover up products can offer a potentially helpful adjunct to more effective and proven treatments such as Propecia (finasteride), Avodart (dutasteride), and or surgical hair restoration. However, many of the claims made by these topical treatments are unproven and even false.

What About Oral Hair Loss Treatments – Do They Work?

In addition to a multitude of topical hair loss treatments available, there’s an abundance of oral supplements that are conjectured to treat baldness.  Most oral solutions include ingredients that attempt to stop hair loss by inhibiting the production of DHT, the hormone responsible for androgenic alopecia (male pattern baldness).  However, much like topical treatments, very little proof exists for the majority of these claims.

Many products such as Provillus, Procerin, and Extreme Hair Therapy include both an oral and topical solution that attempt to stop hair loss at its source while working to stimulate hair follicles.  But how effective are these topical, oral and all-in-one solutions?

To learn more about various Topical Hair Loss Products, click below

DHT Blockers– These topical such as Revivogen, Crinagen, Progesterone Creams, and Xandrox claim to minimize the amount of dihydrotestosterone (DHT) present in the balding scalp. They are applied directly to the scalp.

Growth Stimulators- These topical solutions claim to work by stimulating hair growth. They include Rogaine, Tricomin, Folligen, Proxiphen (along with Prox-N and Nano Shampoo) and Retin-A.

Azelaic Acid– An active ingredient found in popular topical hair loss treatments such as Xandrox and Provillus conjectured to inhibit the production of DHT.

Superoxide Dismutase– These topicals such as Tricomin, Proxiphen, Proxiphen-N and Folligen, claim to stop hair loss by reducing Super Oxide and also stimulating hair growth and reducing tissue inflammation.

Anti-Inflammatories- These anti-inflammatory treatments claim to reduce itching, flaking, redness, and inflammation that may increase hair loss. These topical treatment options include Tricomin, Folligen, Proxiphen and Proxiphen-N, Betadine and T-Gel and Nizoral Shampoo.

Cover Ups / Concealers- Topically applied scalp/hair cover ups like Toppik, Prothik, and Couvré can do a surprisingly good job of masking and minimizing a person’s appearance of being bald. These topical concealers and “cover ups” act by reducing the contrast between a hair loss sufferer’s thinning hair and balding scalp, while increasing the volume and fullness of the thinning hair.

Rogaine (Minoxidil)) – Applied twice daily to the balding areas, this treatment has only been shown to work in the crown (back of the head). It is the only topical treatment for hair loss that is FDA approved.

Propecia (Finasteride)– An FDA approved oral hair loss solution proven to inhibit the production of DHT, the hormone responsible for genetic male pattern baldness (MPB).

Provillus– A popular oral and topical solution containing FDA approved hair regrowth solution minoxidil and a number of all-natural ingredients that supposedly inhibit the production of DHT

Saw Palmetto– A popular herbal treatment contained in many marketed hair loss products including but not limited to Provillus, Procerin, and Extreme Hair Therapy (EXT)

Extreme Hair Therapy (EXT) – A nonsurgical 5 step hair loss treatment process provided by Hair Club

Xandrox– Topical hair loss solution containing azelaic acid and FDA approved hair regrowth solution minoxidil

Revivogen– Topical hair loss solution containing a number of all natural ingredients said to inhibit the production of DHT

Crinagen – A topical spray containing ingredients said to inhibit the production of DHT

Progesterone– A synthetic form of the female hormone progesterone that has been used to treat female hair loss

TRX2- TRX2 is marketed to hair loss suffering men and women and claims to help promote and sustain healthy hair growth through potassium channels.

To learn more about these and other treatments, see what real patients are saying about them on our hair loss forum.

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

Diffuse Hair Loss and How to Treat It

Unlike male pattern baldness (MPB) and female pattern hair loss (FPHL), which tends to follow one of the hair loss patterns defined by the NorwoodScale and the LudwigScale, Diffuse Patterned Alopecia (DPA) is characterized by diffuse thinning throughout the front, crown and vertex(crown) with no distinct pattern evident. However, like male and female pattern balding,Diffuse Patterned Alopecia patients typically preserve the stable "permanent zone" on the sides and back of the scalp and may sometimes retain a well-defined hairline. DPA is also a type of hereditary balding condition like and rogenetic alopecia (genetic hair loss).

Diffuse Patterned Alopecia (DPA) can be difficult to diagnose and, particularly in its early stages, may be confused with a similar condition known as Diffused Unpatterned Alopecia (DUPA). While both conditions are characterized by diffuse thinning, DUPA sufferers lack the stable permanent zone necessary for surgical hair restoration.

Treatment for Diffuse Patterned Alopecia

DPA often responds well to medical hair loss treatments like Propecia (finasteride) and Rogaine(minoxidil) and, due to the preservation of the permanent donor region, many DPA sufferers are candidates for hairrestoration surgery.

Conclusion

It’s essential that hair loss suffering men and women seeking medical and/or surgical treatment for diffuse thinning consult with a skilled and experienced hair restoration physician. Differentiating between DPA and DUPA is critical because Diffuse Patterned Alopecia patients frequently make good hair transplant candidates, whereas DUPA patients rarely do.

Most hair loss sufferers can benefit from hair transplants. However, some are better candidates than others and will achieve more dramatic results.

Different Patients Achieve Different End Results

Two Hair Transplant Sessions one totaling 1860 grafts the other 2995 grafts

It is important to have realistic expectations and to find a hair transplant surgeon who can meet or exceed your expectations.

Surgical hair restoration is largely a matter of "Supply and Demand".

The look you can and will achieve with hair transplants is determined by several factors. But the most critical factor is really a question of "supply and demand".

The supply of hair is how much viable bald resistant donor hair you have. The demand is how much bald area you want to cover and to what degree of thickness.

Your “Donor Hair” determines what you can achieve.

For virtually all hair loss sufferers, even those with severe baldness, there is typically hair that grows for life on the sides and back of the head. This is because the hair in this "donor area" is genetically different from the hair on the top of the head in people who go bald.

The hair follicles in the "donor area" are genetically resistant to the effects of such baldness causing hormones as (DHT) dihydrotestosterone. That's why they continue to grow, while the hair on the top (in the male pattern baldness area) thins and goes bald over time.

How much viable donor hair you have will largely determine how much you can accomplish with hair transplants. Most people have enough viable donor hair to do at least one or two hair transplant procedures.

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.

The Gospel on hair loss

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.

How mankind has treated hair loss over time.

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.

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