• Dr. Bernard Nusbaum

    Dr. Bernard Nusbaum
    Dr. Bernard  Nusbaum
    Dr. Bernard Nusbaum performs highly artistic ultra refined follicular unit hair transplantation with very natural looking results.
  • The Future of Medical Hair Restoration

    Hair Restoration Future

    Today's evolutionary high point - Ultra Refined Follicular Unit Transplantation

    By relocating these carefully prepared bald-resistant follicular units, physicians doing "follicular unit hair transplantation" recreate a natural pattern of hair in the balding areas.

    To do this properly is a very time consuming and exacting process. It requires a team of meticulous medical technicians working hand-in-hand with the hair transplant surgeon in a very lengthy surgical procedure.

    Ultra Refined Grafting - Smaller Blades, Smaller Incisions, Smaller Grafts

    Today's micro surgical blades, like the size of hair grafts, have become ever smaller and now enable hair transplant surgeons to safely make more tiny graft incisions in a given area then ever before. Surgeons are then able to "dense pack" select areas with as many as 40 to 60 follicular unit grafts per square centimeter. This graft density is as much as twice that of the standard follicular unit hair transplant procedure.

    Such high densities of transplanted hair typically produce the appearance of fullness even after only one surgical session. Patients also experience rapid healing and no visible skin distortions due to the tiny size of these incisions.

    Ultra Refined Follicular Unit Grafting - Hard on the clinic but easy on the patient.

    Ultra refined follicular unit grafting raises the bar for physicians and their staff. This delicate and demanding hair transplant procedure requires more skill and careful attention to be performed properly. The smaller and more tightly packed incisions require more closely dissected follicular unit grafts that are carefully trimmed under microscopes. These small and densely packed incisions are also more difficult to place the grafts into.

    This procedure also requires more careful patient selection, as "dense packing" of grafts is not appropriate for all patients.

    Ultra Refined Follicular Unit Transplantation - the new "Gold Standard"

    In the hands of a highly skilled physician and staff the Ultra refined follicular unit hair transplant procedure can achieve excellent new hair growth that is so natural that it is undetectable even under close scrutiny.

    While the standard micro "follicular unit" hair transplant does produce natural looking results, its ability to achieve high density in only one surgical session is limited. Thus patients may have to do subsequent surgical sessions in a transplanted area to achieve a full look.

    The many patient benefits of this new ultra refined procedure are significant and include:

    • The ability to get excellent hair density in only one surgical session.
    • Minimal trauma in the graft recipient area with rapid post surgical healing.
    • Little or no visible pitting or distortions in the transplanted areas.
    • More natural direction and angulation of the transplanted hair.

    All physician members of the Coalition perform Ultra Refined Follicular Unit Hair Transplantation.

    While many hair transplant physicians perform quality follicular unit hair transplants, only some of them are capable of performing large sessions of ultra refined follicular hair transplantation. However, all members of the Coalition of Independent Hair Restoration Physicians perform ultra refined grafting with excellent results.

    The Future of Surgical Hair Restoration

    The amount of hair you can transplant is ultimately limited by the amount of hair follicles you can safely relocate from the bald resistant donor area at the back and sides of your head.

    Some day it may be possible for physicians to create multiple hair follicles from one original follicle. This process typically called Hair Multiplication or more incorrectly Hair Cloning is currently being investigated by several research scientists and hair restoration physicians.

    If and when this process is successfully developed patients would no longer be limited by the finite amount of bald resistant hairs that can be relocated from their donor area. Hair multiplication would result in a virtually limitless supply of hair available for hair transplants.

    This would be especially good news for men or women with extensive baldness and a very limited supply of donor hair. Even those with extensive baldness would theoretically be able achieve thick full heads of hair.

    However, experts believe that we are at least ten years away from hair multiplication being available, if even then. But perhaps some day scientists will be able to use gene therapy to halt the balding process without drugs or surgery.

    Learn about modern hair loss drug treatments that work.

  • Hair Transplant Cost

    Hair Transplant Cost

    Today hair transplant costs are vastly better value, than they did just a few years ago. Increased competition combined with the increased ability of a specialized clinic to produce large sessions of follicular units at reduced hair transplant costs and has resulted in patients getting vastly better results and increased density at lower prices.

    Just a few years ago it was not unusual for a clinic to charge as much as $15 US per graft, while providing patients with only small sessions of a few hundred grafts that achieved limited density and fullness.

    Today hair restoration clinics typically provide free no obligation consultations, with surgical sessions priced either per graft or by the session. Hair transplant costs typically cost between $3.00 to $8.00 per graft, with $5 to $6 per graft being about average.

    It is normal for the price per graft to drop as the size of the surgical session increases. Many clinics will offer a reduced rate per graft once a certain surgical session size (i.e. 1,000 or 2,000 grafts) is exceeded.

    Comparing the costs of various hair loss treatments

    Price options

    Although hair transplant surgery is not inexpensive, it can be the best hair restoration value given that the results are natural and last a life time. The cost of non surgical solutions like a hair system or hair loss medications can exceed the cost of hair restoration surgery when the long term costs are compared.

    For example – A quality custom hair replacement system on average costs $1,200 and needs to be replaced about once a year. In addition, a hair replacement system requires regular upkeep and reattachment each every 5 to 6 weeks at about $75 per visit or $675 per year.

    Hair Piece, or Surgery

     

    Thus the cost of buying and maintaining quality hair replacement systems over 15 years is approximately $28,125.00 ($1,200 plus $675 in annual upkeep = $1,875 x 15 years = $28,125.00). This total cost well exceeds the typical cost of surgical hair restoration.

    Note - Of course the cheapest option is shaving your head with an actual net saving due to no expense for shampoos, conditioners, combs, brushes, or hair stylist.

    Consult a physician for an estimate

    Our member physicians price their procedures independently. So your final cost will depend on who you select and how much hair restoration you will need to be satisfied.

    To do a free consult with one of our quality member physicians to get an estimated cost of restoring your hair visit our member physicians’ area.

  • Does Nourkrin Hair Nutrient Work to Stop Hair Loss?

    Nourkrin

    Balding men and women considering any hair loss treatment should take caution to believe the many magnificent claims made by today’s advertising. Far too often, a lot of time and money is wasted on questionable treatments with little or no proof of success.
    Nourkrin hair nutrient claims to promote hair growth and strengthen thinning hair in 80% of men and women suffering from almost any hair loss condition other than the self-inflicted trichotillomania (hair pulling) or traction alopecia. Below we evaluate Nourkrin, the "clinical study", and its ingredients to find out whether or not this hair loss treatment lives up to its promises.

    What is Nourkrin?

    Nourkrin recommends using their complete regime of products for at least 6 months for the best results. This includes extra strength, Man, and Maintain oral tablets, a shampoo, a conditioner, and a scalp lotion.  Nourkrin claims their products can promote hair growth in men and women suffering from androgenic alopecia (genetic baldness), alopecia areata, alopecia totalis, alopecia universalis, and telogen effluvium. This is a very bold claim considering each balding condition occurs for varying reasons.

    Ingredients

    The active ingredients in the extra strength tablet include shark cartilage and shellfish extract containing glucosamine.  Other active ingredients include silica kieselguhr (a natural form of silica), horsetail extract, acerola cherry extract with vitamin C, microscyrstaline cellulose, immunogloblin G protein, and fatty acids. In addition to the above, the Man product contains Omega 3 fatty acids and Fenugreek designed to improve scalp circulation. Maintain includes additional marine life proteins, minerals, silica, and vitamin C. The scalp lotion contains marine life protein extract compounds and aloe vera.

    Nourkrin claims that the primary active ingredient glucosamine can rebuild and grow new tissue, including dormant hair follicles - suggesting successful hair regrowth. Though clinical studies prove that glucosamine might be effective in reducing joint pain, increasing joint lubrication, preserving joint space, protecting cartilage breakdown by inhibiting specific enzymes, stimulating cartilage matrix repair, and other anti-inflammatory actions, we couldn't find any evidence to support claims that it can stop hair loss or promote hair regrowth.

    Clinical Study

    Nourkrin conducted a clinical study of 60 people who took their products for 12 months. All subjects were over 18 years of age and suffered from at least some form of hair loss for at least one year prior to the study. During a 6 month double blind clinical study, 30 subjects took Nourkrin while the other 30 took a placebo. After 6 months, the 30 participants taking Nourkrin continued taking it for another 6 months while the 30 on the placebo were switched to Nourkrin for 12 months.

    In the first 6 months, Nourkrin reports that 77% taking their hair loss treatment experienced an increase in hair growth and shaft thickness. After 12 months, 75% reported a decrease in overall thinning hair. 90% of women in the study reported overall hair improvement after 12 months. The hair counting method showed an average increase in hair count of 45 percent during the clinical study.

    Though the above study sounds impressive, we don't know a lot about the participants nor can we be certain of the reliability of the study. All participants suffered from some form of thinning, but its cause for each patient hasn’t been disclosed.  Additionally, clinical studies are considered more credible when they've been conducted or verified by third parties not interested in its financial success.

    Another problem is that none of the active ingredients in Nourkrin are proven to stop hair loss. Therefore, their study is the only one balding men and women have to support such claims.

    Possible Side Effects

    Anyone allergic to shellfish should avoid using Nourkrin. Women who are pregnant or breast feeding should not use Nourkrin hair loss products. Consulting with a doctor before using this treatment is advisable.

    Dosage

    Nourkrin recommends taking 2 tablets daily for at least 6 months. Men and women over 176 lbs or those who smoke are advised to take 3 tablets daily. After 6 months, dosage can be cut down to one a day. Nourkrin also recommends using the shampoo, conditioner, and scalp lotion daily. The scalp lotion may be best applied in the evening and left on overnight.

    Cost

    60 tablets of the extra strength tablet costs about $75, the Man $65, the shampoo and scalp cleanser $12, the conditioner $13, and the scalp lotion $30. All in all, the Nourkrin Hair Recovery Program can get pricey after 6 months. FDA approved products like Rogaine (minoxidil)only runs approximately $15 a month or less and male treatment Propecia (finasteride)costs approximately $60 per month, not as expensive as Nourkrin.

    Conclusions

    Nourkrin boasts a big game, claiming high rates of success in reversing hair loss in men and women caused by varying conditions. Their clinical study also confirms its success rate however; the reliability of this study has not been verified by third parties uninterested in its financial success. Additionally, no clinical proof exists that any of the ingredients found in Nourkrin work to treat baldness.

    Whether or not Nourkrin is the "real deal" is hard to determine with little evidence to support its claims. Therefore, those considering this treatment should proceed with caution and may want to consider exhausting proven treatments like Propecia and Rogaine first.

  • Azelaic Acid

    Azelic Acid

    Azelic AcidAn Active Ingredient in Several Topical Hair Loss Treatments

    Azelaic acid is a naturally occurring substance found in whole grains that contains a mild antibiotic designed to “clean” skin.  It is also said to be a potential inhibitor of 5-alpha-reductase in human skin.  A reduction of this enzyme may reduce the amount DHT (dihydrotestosterone) in the body and therefore, have a similar effect to finasteride; the active ingredient in FDA approved oral hair loss solution Propecia (finasteride). In theory, applying azelaic acid to the scalp may prevent or eliminate the binding of DHT to the hair follicle receptor, preventing hair loss and potentially stimulating hair regrowth.  Azelaic acid can be found in many prescription acne medication and topical hair loss products like Xandrox and Provillus

    Combining azelaic acid with FDA approved hair regrowth solution minoxidil in a single topical product in theory, may prove to be a more powerful hair loss treatment for androgenic alopecia than minoxidil alone.  This is why some conjecture that Xandrox may be a more effective treatment than Rogaine (minoxidil)

    Azelaic acid has not been clinically proven effective as a standalone treatment for treating genetic female hair loss and male pattern baldness. It has also been known to irritate the scalp when applied topically.  Though there is a low percentage, azelaic acid may interact with other medications.  Be sure to consult your physician before using azelaic acid while on other medications.

  • Nioxin Shampoo and Conditioner for Men and Women with Thinning Hair

    Nioxin Kit

    Nioxin is an excellent product including both a shampoo and conditioner formulated specifically for men and women with thinning hair."> While neither the shampoo nor conditioner hasn't been proven to have any effects on DHT (the hormone responsible for male pattern baldness); Nioxin's ability to strengthen follicles and energize cellular activity can improve the overall health of your scalp and hair. Nioxin therefore may have the ability to delay the effects of hair loss. For best results, use both the shampoo (refered to as Nioxxin Shampoo Scalp Cleanser) and conditioner (referred to as Nioxin Scalp Therapy) in conjunction with one another.

    Nioxin Scalp Cleanser's cooling properties refreshes and cools the scalp promoting maximum cleanliness and freshness. Because of this, Nioxin shampoo, especially when combined with the conditioner also significantly reduces scalp itchiness and tenderness after hair transplant surgeryin both the recipient and donor areas.

    Nioxin Scalp Therapy is an excellent volumizing scalp and hair conditioner that moisturizes and improves your hairs' natural resilience, while promoting a healthy scalp environment for optimal hair growth. Nioxin Conditioner is the perfect conclusion to the Nioxin Shampoo Scalp Cleanser.

    Nioxin Scalp Therapy's minty fresh cooling sensation literally refreshes and cools the scalp promoting maximum cleanliness and freshness. Because of this, Nioxin also significantly reduces scalp itchiness and tenderness after hair transplant surgery in both the recipient and donor areas.

    We strongly recommend using Nizoral shampooevery 2 or 3 days in conjunction with Nioxin. Its active ingredient ketoconazoleat 2% concentration has proven to be a moderate DHT inhibitor and has growth properties approximately as effective as Rogaine2%.

    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.

    The Nioxin product line is an excellent scalp and hair cleansing shampoo and conditioning therapy but is not proven to stop hair loss. Thus, we strongly recommend using Nioxin in conjunction with the "Big 3" (Propecia, Rogaine, and Nizoral.

    To date, only surgical hair restoration is proven to grow hair in completely bald areas. You are invited to have a

    free virtual consultation 
    Consult Now
    with one of our prescreened hair restoration physicians.

    Ingredients (Full List)

    Nioxin Shampoo Scalp Cleanser: AQUA/EAU/WATER, TEA-LAURYL SULFATE, SODIUM LAURETH SULFATE, COCAMIDOPROPYL BETAINE, HYDROXYPROPYLTRIMONIUM HONEY, COCAMIDE MEA, PEG-150 DISTEARATE, PANTHENOL, GLYCOPROTEINS, POLY-SORBATE-60, POLYSORBATE-80, CYSTINE BIS-PG-PROPYL SILANETRIOL, HYDROLYZED KERATIN, ACETAMIDE MEA, PROPYLENE GLYCOL, ETHOXYDIGLYCOL, DIMETHYL ISOSORBIDE, COENZYME A, PANTOTHENIC ACID, PYRIDOXINE, CYANOCOBALAMIN, BIOTIN, FOLIC ACID, NIACIN, THIAMINE HCl, UBIQUINONE, ACHILLEA MILLEFOLIUM, ANTHEMIS NOBILIS, CAMELLIA SINENSIS, CITRUS GRANDIS, EQUISETUM ARVENSE, HUMULUS LUPULUS, MELISSA OFFICINALIS, MENTHA PIPERITA, PRUNUS AFRICANA, ROSMARINUS OFFICINALIS, SALVIA OFFICINALIS, SERENOA SERRULATA, SYMPHYTUM OFFICINALE, TARAXACUM OFFICINALE, THYMUS VULGARIS, URTICA DIOICA, SACCHAROMYCES LYSATE EXTRACT, PHOSPHOLIPIDS, SACCHAROMYCES/COPPER FERMENT, SACCHAROMYCES/IRON FERMENT, SACCHAROMYCES/MAGNESIUM FERMENT, SACCHAROMYCES/SILICON FERMENT, SACCHAROMYCES/ZINC FERMENT, PEG-23M, MELANIN, CITRIC ACID, SODIUM CHLORIDE, TETRASODIUM EDTA, DISODIUM EDTA-COPPER, SUPEROXIDE DISMUTASE, CI 42090/BLUE 1, PHENOXYETHANOL, METHYLPARABEN, PROPYLPARABEN, METHYLISOTHIAZOLINONE.
    Nioxin Scalp Therapy: AQUA/EAU/WATER, CETRIMONIUM CHLORIDE, CETYL ALCOHOL, DICETYLDIMONIUM CHLORIDE, AMODI-METHICONE, TRIDECETH-12, LAURAMINE OXIDE, GLYCOPROTEINS, DIMETHICONE, SODIUM PCA, CYSTINE BIS-PG-PROPYL SILANETRIOL, PANTHENOL, POLYQUATERNIUM-11, ACHILLEA MILLEFOLIUM, ANTHEMIS NOBILIS, ARCTIUM MAJUS, CALEN-DULA OFFICINALIS, CAMELLIA SINENSIS, EQUISETUM ARVENSE, FRANGULA ALNUS, GERANIUM MACULATUM, HUMULUSLUPULUS, JUGLANS REGIA, LARREA DIVARICATA, MELISSA OFFICINALIS, MENTHA PIPERITA, PRUNUS AFRICANA, QUASSIA AMARA, ROSMARINUS OFFICINALIS, SALVIA OFFICINALIS, SERENOA SERRULATA, SYMPHYTUM OFFICINALE, TARAXACUM OFFICINALE, THYMUS VULGARIS, URTICA DIOICA, YUCCA FILAMENTOSA, PHOSPHOLIPIDS, DIMETHYL ISOSORBIDE, CETEARYL ALCOHOL, ETHOXYDIGLYCOL, CETEARETH-20, PROPYLENE GLYCOL, SACCHAROMYCES LYSATE EXTRACT, COENZYME A, PANTOTHENIC ACID, PYRIDOXINE, CYANOCOBALAMIN, BIOTIN, FOLIC ACID, NIACIN, THIAMINE HCl, UBIQUINONE, SACCHAROMYCES/COPPER FERMENT, SACCHAROMYCES/IRON FERMENT, SACCHAROMYCES/MAGNESIUM FERMENT, SACCHARO-MYCES/SILICON FERMENT, SACCHAROMYCES/ZINC FERMENT, MELANIN, TRIETHANOLAMINE, SUPEROXIDE DISMUTASE, CI 42090/BLUE 1, PHENOXYETHANOL, METHYLPARABEN, PROPYLPARABEN, METHYLISOTHIAZOLINONE.

  • Laser Treatment

    Laser Treatment

    Is it Effective in Stopping Hair Loss?

    Use of low level laser therapy (LLLT) devices for treating hair loss has been heavily debated for some time by reputable hair restoration physicians and patients on our hair loss forum. While some physicians reject its use entirely, others use laser hair treatment as a regular part of their practice. Additionally, some physicians believe that laser light therapy can assist with postoperative healing after hair transplant surgery.

    History of Laser Light Therapy

    Shortly after the first working laser was invented in 1964, a researcher from Semmelweis University of Budapest named Andre Mester developed a theory that exposure to cold laser light (similar to UV radiation emitted by the sun) may eventually lead to cancer. To test his theory, Mester shaved a group of mice and trapped some of them in a cage with constant cold laser light exposure leaving the other half unexposed as a control group. To his surprise, the light didn’t cause cancer in any of his animal subjects. Instead, mice that were exposed to the laser light therapy grew back their shaved fur much faster than the control group. Mester named his discovery photo-biostimulation. His theory was that somehow, the laser light had stimulated the hair cells into an accelerated state of hair growth.

    Laser Therapy as a Hair Loss Treatment

    Today, low level laser therapy is being used as a hair loss treatment. To treat baldness with laser light therapy, laser rays are directly applied to the scalp by a mechanical device so that red blood cells are stimulated. Lasers are said to work by converting ATP (Adenosine Triphosphate) to ADP (Adenosine Diphosphate), releasing energy and causing cellular metabolic changes. During this process, additional nutrients and oxygen are provided to the scalp assisting the normal chemical processes performed by those cells, increasing overall blood circulation. Lasers, when applied to the scalp and hair, have been said to improve overall hair quality, promote hair growth, and increase hair shaft diameter.

    laser comb

    Laser treatment devices have a similar appearance to a hood hair dryer which is placed over top of your head. The low level laser toll will rotate allowing laser rays, usually red in color, to be discharged into your scalp. Hand held devices such as the Hairmax comb have also been developed and resemble a brush in appearance.

    Promoting healthy hair growth however, is not the same as the regrowth of miniaturized hairs brought on by genetic female hair loss or male pattern baldness (MPB). So what clinical evidence exists, if any, that laser therapy is an effective treatment? Below we take a closer look at the available data including exclusive interviews of leading hair restoration physicians.

    Varying Opinions of Well Respected Physicians

    Physicians have long shared varying views on whether or not laser treatment is viable. While some well respected physicians reject its use entirely, some believe that LLLT can provide marginal benefit for men and women suffering from androgenic alopecia (genetic baldness). Additionally, some physicians believe that laser hair treatment can assist a hair transplant patient’s postoperative wound healing process and expedite hair growth.

    Dr. Charles (one of our well respected members of the Coalition of Independent Hair Restoration Physicians) believes it may provide similar hair loss prevention benefit to Rogaine in the mid vertex area and crown. Benefits in the frontal area include an increase in overall hair quality rather than hair loss prevention.

    Dr. Charles believes LLLT works better when combined with Propecia (finasteride) and Rogaine (minoxidil). Like Propecia and Rogaine, he believes low level laser therapy may help some patients more than others and works better in patients with only minimal thinning hair.

    Dr. Charles believes in helping balding men and women develop and maintain realistic expectations and he doesn’t oversell its benefits. Because lasers are free from side effects, he always tells his patients that the biggest risk is the money. Dr. Charles believes more research on laser hair treatment is needed.;

    Dr. Williams of the Coalition has been using laser hair treatment as a regular part of his practice for over 2 years and feels quite confident in its success in some patients. In his experience, LLLT promotes healthy hair growth and can increase hair shaft diameter of miniaturized hair affected by genetic female hair loss and male pattern baldness in some patients.

    Dr. Williams offers 16 free laser therapy sessions to local males following hair transplant procedures and encourages his female transplant patients to undergo laser light therapy for one full year at a highly discounted rate. Dr. Williams usually notices faster transplanted hair regrowth and a quicker resolution of postoperative telogen effluvium or “shock loss”, if it occurs.

    Because androgenic alopecia is a progressive condition, Dr. Williams encourages male patients to use Propecia while encouraging out of town females to use the Hairmax laser comb to help maintain their existing hair. Dr. Williams would like to see more formal studies defining the benefits of lasers as a hair loss treatment, but he is encouraged by his experience with it to date.

    Dr. Alan Feller (also a member of the Coalition) is one doctor who remains skeptical. "Medical lasers work in only one way, and that is to deliver energy to a target. When it strikes the target the energy is absorbed and converted to heat. That's it". Dr. Feller believes that more compelling evidence is needed to promote low level laser therapy (LLLT) as a hair regrowth solution or to stop hair loss.

    Recent Scientific Studies

    study presented at the last International Society of Hair Restoration Surgery (ISHRS) meeting in Las Vegas (2007) by Maria A Muricy, MD, confirms increase in hair shaft diameter, fullness, and overall quality with laser hair treatment alone. Additionally, some statistically significant evidence reveals that low level laser therapy when combined with 5% minoxidil (the active ingredient in FDA approved Rogaine) provided noticeable cosmetic benefits for women in particular. However, this study also showed that laser hair loss treatment alone produced no statistically significant new hair growth in both men and women.

    Laser Hair Therapy and FDA Approval

    Another important issue to consider is the significance and meaning of the FDA clearance (not approval) of the Hairmax laser comb. Though some have proposed the Hairmax laser comb was only approved for safety, apparently the FDA did require Lexington International (who funded the study) to provide it with a study on its efficacy (effectiveness) in treating baldness. But this study and its results have not been released to the public since Lexington International had the option of submitting the study to the FDA privately. The obvious question then is – why would Lexington hide their study from the public if it proved the efficacy of laser hair regrowth?

    While the Hairmax laser comb device was found by the FDA to be safe based on its “substantial equivalence” to previously approved laser light therapy devices and thus “cleared” (not “approved”), it was unclear to what extend the FDA reviewed or cleared it based on its effectiveness in treating hair loss. To learn more about the FDA standards for “approving” food and drugs and for “clearing” medical devices visit www.fda.gov

    It appears that much of the laser hair treatment industry is now promoting their devices as “FDA Approved for Hair Loss” as if they are on par with the two only FDA approved hair loss solutions Propecia (finasteride) and Rogaine (minoxidil). However, until laser hair treatment provides compelling public evidence of its effectiveness in treating hair loss, it is quite possible that the effectiveness of low level laser therapy may be oversold by some companies. We expect that time will tell.

  • Dr. Özlem Biçer MD

    Dr. Ozlem Bicer
    Dr. Ozlem Bicer
    Dr. Biçer provides ultra-refined follicular unit extraction (FUE) at an exceptionally low-price. Dr. Biçer's practice combines quality with affordability with a patient-centered focus and attention to detail.
  • Scalp Micropigmentation (SMP)

     micro pigmentation

    A Cosmetic Tattooing Procedure to Conceal Hair Loss

    Scalp Micropigmentation, the process of tattooing thinning or bald areas of the scalp to resemble shortly cropped hair, has been met with high amounts of enthusiasm from patients seeking alternative ways to mask and conceal their hair loss. This artistic and minimally invasive procedure, also referred to as SMP, provides men and women suffering from hair loss with an illusion of fullness or the appearance of thick, shortly cropped hair. SMP results (not the procedure) are often compared to topical concealers such as Toppik, DermMatch and Nanogen, because they also help conceal baldness and make thinning hair appear thicker and fuller.

    Although scalp micropigmentation is increasing in popularity, it is still a new and evolving practice and its mystique may leave interested patients asking several important questions.

    How does scalp micropigmentation work? What are the benefits, limitations and potential risks associated with the procedure? Who is a suitable candidate? What are the costs associated with SMP? What happens if consumers don't like the results? Is the ink associated with scalp micropigmentation permanent? Are all SMP practitioners equal or do some produce better, more natural looking results?

    How Scalp Micropigmentation Works

    Scalp Micropigmentation is the artistic application of tattoo-like ink or pigmentation "dots" to bald or thinning areas of the scalp to recreate the appearance of shortly cropped hair (or "stubble") by a trained practitioner. SMP practitioners are typically experienced in the art but often aren't medical professionals or hair restoration physicians. Scalp micropigmentation is typically used for one of three purposes. These include:

    • Creating the illusion of fullness or density to thinning hair by applying cropped, hair-like tattoos in between and around thinning hair.
    • Creating the appearance of closely cropped or shaved hair on an otherwise bald scalp.
    • Camouflaging a pre-existing hair transplant scar. Typically, this is a rare, but stretched, linear scars from follicular unit hair transplantation procedures via strip harvesting (FUT) can sometimes require revision.

    Scalp micropigmentation ink is normally placed in the superficial dermis, a layer of skin between the epidermis (the outer layer of the skin) and subcutaneous tissues that consists of connective tissue and cushions the body from stress and strain. However, SMP practitioners often place ink at varying depths. Some practitioners are now beginning to use a “sweeping” technique when tattooing, in order to create a more three-dimensional appearance on the scalp.

    Depending on the size of the balding/thinning area and the desired appearance, the procedure can take anywhere from 1-8 hours, and can now be completed with both permanent and temporary SMP ink.

    According to Coalition hair transplant surgeon Dr. Robert Bernstein, the key to further achieving a natural result with SMP lies in holding the inking tool at an appropriate angle, controlling the depth at which the ink is placed, monitoring the amount of ink deposited at each site, and selecting appropriate ink tones.

    To read more of Dr. Bernstein's input and discussion related to SMP at the 2012 annual ISHRS Scientific Meeting for hair restoration physicians, visit "Scalp Micropigmentation (Scalp Tattooing)at the 2012 ISHRS (International Society of Hair Restoration Surgery) Scientific Meeting".

    Permanent Versus Temporary Scalp Micropigmentation (Advantages and Disadvantages)

    Defining and understanding the difference between permanent and temporary ink is important for any consumer considering the procedure.

    Permanent scalp micropigmentation is performed with micropigmentation ink that is not designed to fade or change over time. The ink is placed slightly deeper in the scalp tissue, and the procedure can be performed with ink containing both colored and black pigment.

    Advantages of permanent SMP include the ability to undergo a single SMP treatment without frequent “touch ups" and potentially lower long-term costs.

    Disadvantages include the possibility that the ink will eventually fade to a green or blue hue (due mainly to the black pigment used in permanent SMP ink) and the inability to reverse the procedure without laser pigment removal (i.e. “laser tattoo removal”) if the work is unsatisfactory.

    Temporary scalp micropigmentation is performed with ink that is specially designed to gradually fade and disappear within 6 to 24 months after the procedure. The ink is placed into a superficial layer of the scalp, which allegedly helps to define the pigmentation and decrease the probability of “blurring” ink. Temporary SMP is performed with ink containing no black pigment. Because black pigmentation can eventually fade into a blue or green tone, it would inevitably produce an unnatural looking result as it gradually fades and disappears, and should be avoided.

    Advantages of temporary SMP include: the ability to redesign or discontinue the process (when the ink fades after 6-24 months) if the results are not satisfactory; the decreased rates of ink blurring, running, and definition loss with the superficial placement into the scalp; and the ability to use the three-dimension technique (which was designed by Beauty Medical in Milan, Italy, and is now utilized by several leading clinics recommended by this patient community).

    Disadvantages of temporary SMP include ongoing maintenance and costs associated with undergoing subsequent SMP applications every 6 to 24 months, and the possibility of discoloration as the ink fades (though the temporary ink is purposely designed to fade evenly and without discoloration).

    To learn more about the advantages and disadvantages of permanent and temporary SMP, visit "Temporary Scalp Micropigmentation: Advantages, Disadvantages, and Clinics Currently Offering the Procedure".

    Scalp Micropigmentation Costs

    The cost of SMP is variable and depends upon the type of procedure (temporary versus permanent), size of the procedure, and the practitioner/clinic performing the micropigmentation. While rates typically vary and change, permanent SMP can cost anywhere from $800 for a small procedure and $6000 for a large one. The cost of temporary SMP is approximately half the cost of permanent SMP and typically ranges from $500 to $2500 depending on the size of the procedure. Subsequent procedures, which are needed 6 to 24 months after the initial results fade are typically 50% of the original costs.

    What Makes a Good SMP Candidate?

    Although a wide variety of men and women are interested in scalp micropigmentation, the procedure is actually only ideally suited for a small, select number of hair loss consumers.
    SMP is likely best suited for individuals interested in aiding the appearance of density in shortly cropped, diffusely thinned hair, and for patients trying to camouflage a hair transplant scar. It may also be suitable in creating a greater illusion of fullness in those who've already undergone surgical hair restoration.

    SMP consumers should also consider a naturally asymmetrical hairline design and “fading” effect (from decreased pigmentation in the hairline to denser, increased pigmentation in the middle scalp) if hairline restoration is performed. This approach will likely create a more natural result in eligible candidates.

    Creating Realistic Expectations

    While scalp micropigmentation may be a useful adjunct therapy for a select group of consumers interested in concealing their hair loss, it should be approached with realistic expectations and performed by a trusted clinic. Individuals considering the procedure must remember that SMP is a two-dimensional process and cannot provide the texture and growth of real hair. Undergoing SMP without respecting its limitations may create unrealistic expectations and disappointing results.

    Evolving Procedure or Just a Fad?

    Is SMP just a fad or will it continue to evolve and cultivate additional interest from hair loss sufferers and hair restoration physicians?

    While some hair loss experts are quickly embracing the procedure, others are more resistant, and liken scalp micropigmentation to less popular "niche" treatments like hair systems, laser caps, and topical concealers. Whether or not it will continue increasing in popularity and retain its momentum is not yet clear.

    Hair restoration is a rapidly changing field and new and evolving therapies may eventually render scalp micropigmentation and other hair loss treatments obsolete.  Altogether, only time will tell whether SMP is a lasting adjunct therapy or a passing fad.

    Clinics Currently Offering Scalp Micropigmentation

    As of January 2013, the following hair restoration clinics recommended by this website are offering some form of Scalp Micropigmentation: Hasson and Wong (Drs. Victor Hasson and Jerry Wong), and Shapiro Medical Group (Drs. Ron and Paul Shapiro).

    Dr. Feller, Dr. Lindsey, Hasson and Wong, and Shapiro Medical Group trained with Beauty Medical and offer the temporary SMP procedure; Dr. William Rassman performs his own variation of Scalp Micropigmentation with permanent ink.

    Note that in many cases, a trained technician and not the physician will be performing scalp micropigmentation.

    This website does not currently recommend one SMP clinic over another. Those considering scalp micropigmentation as a tool to conceal hair loss and create an illusion of hair are encouraged to do their own diligence in researching each technique, practitioner and clinic.

    To discuss scalp micropigmentation with hair loss sufferers and other interested parties and to view results showing before and after pictures, visit the Scalp Micropigmentation Forum.

  • Questionable Hair Loss Treatments

    Questionable Hair Loss Treatments

    Balding Has Been Cured

    Try telling that to 80 million men and women who are suffering from hair loss in the United States. They will laugh at you. Yet on a daily basis we are bombarded with ads for hair loss treatments like Avacor, Hair Genesis, Fabao and Procerin that use misleading advertising to sell their products. Thanks to their persuasive messages promising to regrow hair, consumers will spend nearly one billion dollars trying to find an effective hair loss remedy and fall victim to misleading advertising like this.

    Thinning hair is a source of distress for millions of men and women so it is not unusual for them to seek help from anything that sounds like it will work. Most questionable hair loss products use similar, misleading marketing techniques ranging from claims to testimonials and photos.

    Hair Loss Product Claims

    Many hair loss products claim to be able to restore hair through the use of drugs, herbal lotions or other exotic applications like lights, lasers or electrical fields. While many of these products have been around for years, there is little evidence that they can restore hair.

    How are they allowed to make such claims? These products often use small amounts of generic drugs found in Propecia and Rogaine (finasteride and minoxidil) which allows them to make the claim to stop hair loss or they imply hair growth with 'cosmetic' claims.

    Misleading Marketing

    Some hair loss products lead you to believe that they can stop hair loss by parsing their words. They can't come out and claim to regrow hair or stop hair loss, so they advertise vague claims like "thicker, fuller hair". This is a 'cosmetic' claim that any product can make. Be advised that cosmetic claims cannot restore hair or grow hair because they are not proven to do so.

    False Testimonials

    With the anonymous nature of Internet postings, people posing as users will mislead others with false testimonials. Often, positive reviews are produced by people compensated to post these messages. Since there is no real regulation of online postings, consumers are advised to take testimonials with skepticism.

    Phony Photos

    Most product advertising that claim that you can "Regrow Hair!" or make your hair 'thicker and fuller' and show a photo of a balding person with thin hair next to a photo of the same person with thicker hair covering the baldness. Photos don't lie, do they?

    Well, yes they do.

    You can prove it yourself. Take a photo of a head with thinning hair using a flash camera and then photograph the same head without the flash. The photo with the flash will look like a bald head and the photo without the flash will look like more hair.

    Lighting, length of hair and how the hair is arranged on the head determine whether a photo of a head looks bald or not. Most people go through the same routine as balding advances: they push hair from here to there and hair spray it into place in the hope that no one will notice that we are going bald. To the extreme, this becomes the 'comb-over' hair style.

    Review the photos of hair loss products you've seen. In most cases there will be just a few and they will all have misleading elements like lighting, hair style and length of hair in the 'before and after' photographs. If the products or services are really legitimate, there should be dozens of photos, if not hundreds or thousands.

    The FDA and the FCC

    Sadly, we think that the United States Food and Drug Administration and the Federal Communications Commission (agencies who regulate such issues) can stop these scams. Unfortunately, they can't. Since the FDA approved Minoxidil and Finasteride as effective in stopping hair loss, any inclusion of these products in any form enables marketing companies to make hair restoration claims.

    Even the studies done for Rogaine and Propecia are not that encouraging. When Rogaine was studied (active ingredient is minoxidil), 16% of the placebo group had measurable new hair growth. Four out of twenty-five people had real, measurable hair growth when they believed they were using something that worked. Both studies were limited in time and scope. To read the studies that were done achieve FDA approval, visit the FDA web site and scroll down to Propecia and Rogaine. (http://www.fda.gov/cder/foi/nda/index97.htm )

    Hair Loss and Hair Restoration

    If a person is genetically prone to hair loss and balding, FDA proven hair loss treatments may help slow the process if they are used early and often. If you are like many and have already lost more hair than you're happy with, there is only one option to restoring your own natural hair: hair transplants. Hair transplants have become an art in the restoration of natural hair which is genetically resistant to the causes of balding.

    Like any surgical solution, your success depends upon the quality of the doctor you choose. Doctors who are successful in restoring a natural looking head of hair are carefully reviewed by the Coalition of Hair Restoration Physicians for membership in this exclusive organization. They must allow access to past patients, confirm their training and provide photos and videos of their patients.

    While hair transplants are not possible for everyone, they are now more natural and affordable than ever before.

    View hundreds of real hair transplant photos done by the world's top hair loss specialists who are members of the Coalition of Hair Restoration Physicians.