• Menopause and Female Hair Loss

    Many cases of female hair lossare caused by hormonal fluctuations or changes in the body including those who have PCOS (polycystic ovarian syndrome), birth control pillside effects, a recent pregnancy,postmenopausal trauma, or menopause. Women with hair loss experience varying balding patterns These patterns can help determine the type of alopecia you have along with a thorough examination by a physician.

    Because of an imbalance between estrogen and testosterone due to declining estrogen levels, thinning hair and accelerated hair loss is common in women during menopause. Hair on certain areas of the head that is more sensitive to androgen hormones like DHT(associated with male pattern baldness) may thin or fall out. Similarly, declining estrogen levels may result in unwanted facial hair growth.

    In some cases, polycystic ovarian syndrome(PCOS), may accompany menopause and hair loss.

    Be sure to speak with your doctor on the most effective ways to cope with menopause and minimize hair loss during this transitional time.

  • Diffuse Unpatterned Alopecia (DUPA)

    Diffuse Unpatterned Alopecia

    What Is DUPA?

    Diffuse Unpatterned Alopecia (DUPA) is a form of genetic hair loss characterized by diffuse thinning over the entire scalp. Unlike Diffuse Patterned Alopecia (DPA), DUPA lacks the stable permanent zone associated with other forms of alopecia.

    Dr. O'tar Norwood defined DUPA in his 1975 seminole publication "Male Pattern Baldness: Classification and Incidence" as:

    Diffuse, Unpatterened Alopecia (DUPA). In this type, there is a general decrease in the density of hair without any definite pattern, although it is usually more marked over the top and front. This type is common in women.

    Identifying DUPA

    Diffuse Unpatterned Alopecia patients have a similar pattern of hair loss to DPA patients but the balding tends to occur more rapidly. DUPA patients are also more likely to achieve the “horseshoe” pattern commonly associated with Norwood class VII baldness. However, unlike other forms of alopecia hair loss, the DUPA “horseshoe” takes on a thin and transparent appearance.

    It is important that patients suffering from diffuse hair loss are properly diagnosed. While DPA patients are often good candidates for surgical hair restoration, DUPA patients typically make poor hair transplant patients due to the lack of a stable zone in which to harvest donor grafts.

    Treatment for Diffuse Unpatterned Alopecia

    Not a lot is known about the cause and treatment of DUPA. However, about half of males who suffer from this form of balding benefit from Propecia (finasteride). Unfortunately, DUPA is about 10 times more common in females for whom Propecia is not a treatment option.

    Conclusion

    Anyone suffering from diffuse hair loss should consult with a dermatologist or hair restoration physician for a proper diagnosis. This is especially true for balding men and women considering hair transplant surgery.

  • FUE – a new way of doing Follicular Unit Hair Transplantation

    FUE – a new way of doing Follicular Unit Hair Transplantation

    Follicular unit extraction is a minimally invasive procedure for performing follicular unit hair transplantation. However, unlike the predominant follicular unit transplant procedure, in which a strip of donor tissue is removed and dissected under magnification, the FUE procedure uses a small punch to extract each follicular unit one by one.

    Both the strip excision and FUE procedures create 1, 2, 3, and 4 hair follicular unit grafts that are then transplanted into the balding area in the same manner. The primary difference between these two procedures is the technique used to harvest the follicular unit grafts.

    Comparing the Strip Excision procedure to the Extraction (FUE) procedure

    The common strip excision method of performing follicular unit hair transplantation involves surgically excising a thin horizontal strip of bald resistant skin from the donor area.

    Strip Excision Procedure 

    Donor strip being excised
    Donor strip being excised

     

    Incision sutured together
    Incision sutured together

     

    Hair combed down after suturing
    Hair combed down after suturing

     

    This donor area is then sutured together. These sutures (either stitches or staples) are then typically removed about ten days after surgery. Some physicians use dissolvable sutures so that no removal is needed.

     

    Patient’s donor area 2 months after surgery
    Patient’s donor area 2 months after surgery

     

    Once this linear incision is fully healed the patient is left with a thin horizontal scar in the back of the head. This scar is typically hard to detect since the surrounding hair conceals it, even when the hair is cut short.

    To view a video of an actual strip excision surgery.

    How the FUE Procedure is performed

    With the Follicular Unit Extraction or FUE procedure 1, 2, 3, and 4 hair follicular unit grafts are carefully extracted one at a time using a tiny punch of one millimeter or less. Often the surgeon requires the patient to buzz cut a portion of their donor area so that they are able to see the patient’s scalp.

    The follicular units are extracted
    The follicular units are extracted

     

    The follicular units are extracted by placing the punch around a single follicular unit and cutting a small circle through the skin around that follicular unit. The follicular unit is then gently pulled up and away from the loose tissue underneath the skin.

    The small hole left behind after the follicle is extracted then heals over the following week. Normally this small round incision contracts as it heals making the resulting round scar smaller than the size of the 1mm punch that made the incision. The FUE patient ultimately ends up with hundreds of small round white scars, which are normally not detectable once the patient’s hair grows out.View a video of an actual FUE surgery.

    To Extract or to Excise, that is the question.

    Advocates for the relatively new FUE procedure claim that this procedure produces less noticeable scarring and no tightness or numbness in the donor area since no donor tissue has been pulled together and sutured. Many patients and physicians find the claim that FUE produces less visible scarring to be debatable.

    Some physicians and patients also have concerns about the relatively new FUE procedure, such as the lack of formal studies regarding the percentage of follicles that may or may not be transected during the sight unseen extraction process.

    In addition, since the physician must personally extract all follicles, one by one, the FUE procedure is very physician dependent and thus very expensive. The FUE procedure also requires considerably more time in surgery to move a given amount of hair to the balding area.

    The standard strip excision procedure has the advantage of utilizing a collaborative team to carefully create the grafts once the donor tissue is removed in a strip. This collaborative approach enables a well trained staff to do sessions of 2,000 to 3,000 all follicular unit grafts in a single day. This team approach enables a patient to get a much larger number of grafts/hairs in one sitting at a much lower cost per hair than with the FUE procedure.

    However, some believe that despite being relatively costly the FUE procedure may be appropriate for patients who have very limited elasticity in their donor area or who only need a small number of grafts.

  • 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.
  • 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.

  • Tricomin Follicle Therapy Spray, Shampoo and Conditioner

    Tricomin hair loss treatment

    Tricomin pack

    Tricomin is an all natural hair loss treatment designed for both men and women with thinning hair to stimulate hair regrowth and improve the appearance of thinning hair. It can also be used in conjunction with with Rogainehair regrowth treatment.

    Tricomin Solution Follicle Therapy Spray combines the benefits of the Triamino Copper Nutritional Complex with an exceptional leave-in conditioner. The therapy spray enriches your hair and scalp with a unique blend of mineral and body-building ingredients and essential amino acids. Spraying the therapy spray liberally after shampooing daily will condition and treat your hair and scalp. It's recommended to apply this product to damp or dry hair.

    The Tricomin Revitalizing Shampoo stimulates and restores health, structure, and vitality to thinning, fine, and damaged hair. It's recommended to use the Revitalizing Shampoo daily, gently massaging it into moistened hair scalp, leaving on for 3 to 5 minutes before rinsing. A second application may be made if desired.
    The Restructuring Conditioner uses a unique moisture and nutrient-rich framework to help restore your hair's natural mineral and protein balance. This conditioner helps to add structure and body onto thinning and/or damaged hair.

    For best results, use all three Tricomin products in conjunction with one another. All 3 Tricomin products is called the Tricomin TricoPak.

    How It Works:

    Al three Tricomin products contain the active ingredient copper peptides. Scientific evidence suggests that copper peptides can shorten the shedding (telogen) phase and elongate the growth (anagen) phase of the follicles. Partial FDA trials showed Tricomin products' effectiveness in promoting new hair growth.

    Developing Realistic Expectations:

    Tricomin copper peptide technology may provide marginal benefit to men and women with thinning 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.

    Ingredients

    Tricomin Follicle Therapy Spray:  Purified Water, SD Alcohol 40B, Amodimethicone, Nonoxynol-10, Panthenol, Polyquaternium-11, Polysorbate 60, Tallowtrimonium Chloride, Citric Acid, Dimethyl Lauramine Isostearate, Linoleamidopropyl Ethyl Dimonium Ethosulfate, Triamino Copper Nutritional Complex (Alanine/Histidine/Lysine Polypetide Copper HCl), Methylparaben, Benzethonium Chloride, Menthol, FD&C Blue #1.

    Tricomin Revitalizing Shampoo: Purified Water, Sodium Laureth Sulfate, Disodium Cocoamphodiacetate, Cocomidopropyl Betaine, Ceteth-16, Glycerin, Laneth-16, Oleth-16, Steareth-16, PEG-75 Lanolin, Sodium Chloride, Triamino Copper Nutritional Complex (Alanine/Histidine/Lysine Polypetide Copper HCl), Citric Acid, Diazolidinyl Urea, Hydrolyzed Keratin, Panthenol, Methylparaben, Fragrance, Propylparaben, Peppermint Oil, D&C Red #33, FD&C Blue #1.

    Tricomin Restructuring Conditioner: Purified Water, Glyceryl Stearate, PEG-100 Stearate, Stearamidopropyl Dimethylamine, Cetyl Alcohol, Propylene Glycol, Stearyl Alcohol, Dimethylamine, Triamino Copper Nutritional Complex (Alanine/Histidine/Lysine Polypetide Copper HCl), Hydroxyethylcellulose, Panthenol, Aloe Vera Gel, Soydimonium Hydroxypropyl Hydroxylyzed Wheat Protein, Hydroxylyzed Keratin, Citric Acid, Methylparaben, Fragrance, Disodium EDTA, Propylparaben, Peppermint Oil, Tocopheryl Acetate, Cholecalciferol, Retinyl Palmitate, Vegetable Oil, FD&C Blue #1, D&C Red #33.

  • Hair Growth Stimulators

    Hair Loss

    Reviving Thinning Hair

    These types of treatments work by stimulating hair growth. However, they can't stop hair loss completely as they don't address the root causes of hair loss. Products that act to stimulate hair growth include Rogaine, Tricomin, Folligen, Proxiphen (along with Prox-N and Nano Shampoo) and Retin-A.

    Tricomin

    Tricomin pack

    Tricomin, which is used by men and women, is a topical spray that has undergone a wide variety of scientific testing. The spray’s main ingredient is copper, which has been proven to be beneficial for hair.

    The FDA has conducted some clinical studies, with the subjects applying the treatment twice per day for 24 weeks. These results were shown to be very positive. However, the product’s parent company, ProCyte Corporation, chose to release Tricomin as a cosmetic. They wanted to avoid the FDA approval process, which tends to be very lengthy.

    Tricomin may be an effective option for those who want a treatment that’s undergone scientific testing, yet isn’t drug-based.

    The product can be used safely by men, women and children. It’s also non-irritating and has no known side effects. Tricomin can be used for any type of hair loss

    The product should be sprayed to damp or dry hair twice each day. But if you’re using another topical treatment, such as Rogaine, you should wait a few hours before applying Tricomin. This is because the scalp may turn a greenish color when mixed with other products. However, this discoloration isn’t permanent and washes out. And like other treatments, Tricomin needs to be used regularly to maintain its results.

    Besides the spray, Tricomin is available as a shampoo and conditioner. They should be used as an addition and not as a replacement, though.

    For more detailed information of Tricomin Follicle Therapy Spray, Shampoo and Conditioner, click here.

    Folligen

    Folligen

    The makers of Tricomin make this product, available as a cream, lotion and spray. It was originally designed as a skin repair cream in the Dermatology Department at the University of California at San Francisco.

    However, a 41-year-old woman with severe hair loss re-grew lost hair in two and one-half months with the cream. The company, Skin Biology, has since marketed this cream, which also contains copper-peptide as a hair loss treatment. The blue-colored copper-peptide complexes are meant to improve hair vitality and the health of the scalp and hair follicles.

    Folligen products are meant for both men and women. They feature a cream for hairline application, spray for overall use, and lotion for bald spots. While Folligen may work on its own, its best results may be seen when it’s used with products like Rogaine.

    Essentially, Folligen’s products soothe irritated scalps. They also relieve the itching and burning associated with Rogaine. However, the Folligen spray may cause itching or burning. Also, because the cream and lotion are bright green, it’s better to use them at night, while covering your pillow.

    And while you can wash Folligen off easily, it’s not advisable for people with very light blonde hair to use the product. They may develop a greenish tinge to their hair.

    Proxiphen, Proxiphen-N, NANO Shampoo

    Proxiphen is a prescription formula topical cream that has not yet received FDA approval. It combines the power of minoxidil and other chemicals. The cream should be applied everyday for the first 8 - 12 months, and after that, every other day. Proxiphen is dispensed only when a physician gives a diagnosis of hair loss.

    Proxiphen-N, the non-prescription Proxiphen is less expensive and is also not as strong. It’s advisable for patients to use minoxidil with Proxiphen-N.

    NANO (nicotinic acid N-Oxide) shampoos and conditioners are an excellent compliment to your existing minoxidil treatment. They contain NANO, which is a minoxidil-like hair growth stimulator. They also have agents that stimulate hair growth. These products are beneficial when used with Proxiphen and Proxiphen-N.

    In order to see some results, Proxiphen-N and the NANO products need to be diligently used for at least 8-10 months at the very least.

    A one-month supply at prescription strength is about $100. A 2-month supply of Proxiphen - N will cost $59.95. A 90-day supply of NANO Shampoo and Conditioner will cost $39.95 and $29.95, respectively.

    Retin-A

    Retin-A (also known by its scientific name, tretinoin gel 0.1%), is a topical treatment that’s primarily used as an acne medication. However, research has shown that Retin-A, either by itself or with Rogaine, may grow some hair in those with male pattern baldness or female pattern baldness.

    To use Retin-A, you should apply a thin layer with a gauze pad or cotton swab to the affected areas at bedtime. Remember to wash your hands immediately after using the product! You should also take care not to get any Retin-A near the eyes, mouth, or open cuts. The medication may irritate sensitive skin.

    It should also be mentioned that if Retin-A is used more often, the results will not improve. Rather, the side effects may increase. These effects include an immediate warming of the skin. Other skin problems may include peeling, itching, scaling, redness and maybe mild stinging. Luckily, once your skin adjusts to the medication, these effects should subside.

    Retin-A may also cause increased sensitivity to sunlight as well as wind and cold. For these reasons, you should avoid prolonged exposure to the sun and sunlamps. You should also use effective sunscreens, and wear protective clothing.

    In regards to pregnant mothers, research hasn’t shown any risk of birth defects, as of yet. Nevertheless, physicians recommend using Retin-A during pregnancy only if necessary. You should also consult your doctor before breast-feeding. One tube of Retin-A Cream can be purchased for about $28.00.

    Click to learn more about Superoxide Dismutase (SOD's)

  • Hair Loss Shampoos & Conditioners

    Hair Loss shampoos and conditioners

    There are a variety of shampoos and conditioners that can be used to slow down the progression of male and female pattern baldness. It should be noted that no shampoo nor conditioner is proven to regrow hair.  Thus, for best results, any shampoo and conditioner product should be used in conjunction with other proven hair loss treatments such as Propecia (finasteride)and Rogaine (minoxidil).

    Shampoo and conditioner can also help to "volumize" the hair, making hair appear thicker and fuller.  Ingredients found in many of these treatments are designed to promote healthy hair growth and nourish the follicles.  Thus, for a healthy scalp and hair, using one or more of these dedicated shampoos and conditioners can be the perfect addition to any hair loss treatment regimen.  To learn more about each product, click a link below:

    Nioxin
    Nizoral 2% Shampoo - Extra Strength
    Nizoral Shampoo - Regular
    Revita Shampoo
    Revivogen
    Tricomin

    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.

  • Thomas Chung Wai Nakatsui, MD

    Dr. Thomas Nakatsui
    Dr. Thomas Nakatsui
    Dr. Nakatsui performs large sessions of ultra refined follicular units using the lateral slit technique with extremely natural results.
  • Damkerng Pathomvanich, MD

    Dr. Damkerng Pathomvanich
    Dr. Damkerng Pathomvanich
    Dr. Damkerng Pathomvanich and his experienced staff regularly perform large densely packed megasessions with outstanding results.