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

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, 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

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)

We believe that patients have a right to full disclosure and a complete understanding of exactly what hair restoration surgery involves.

This step by step presentation shows how today’s state of the art follicular unit hair transplant procedure is typically performed.

Patient is prepared for surgery

During surgery hair follicles from the back of the head that are genetically resistant to going bald will be removed and relocated (transplanted) to the balding areas.

Donor area is trimmed

Prior to surgery, the hair in donor area that will be surgically removed is trimmed.

Donor area is prepared for surgery

Once the donor area has been prepared it is given local anesthesia.

Donor tissue is removed

The donor tissue containing the bald resistant hair follicles is then surgically removed.

Donor area is sutured

The donor tissue containing the bald resistant hair follicles is then surgically removed.

Hair combed over sutures

When patient’s hair is combed over the donor area the sutures are not visible. These sutures are typically removed approximately ten days after surgery.

Donor tissue is trimmed into follicular unit grafts

Surgical technicians then use microscopes to view the donor tissue in order to dissect and prepare follicular units hair grafts.

Bald recipient area is prepared

After being given local anesthesia, the balding recipient area is ready for surgery. No trimming or shaving of hair is needed in the top recipient area.

Incisions are made in the balding areas

Tiny incisions are made in the recipient areas in irregular patterns that mimic nature. The follicular unit grafts will then be placed carefully into these tiny incisions.

Grafts are placed into the incisions

Follicular unit grafts are gently placed into the recipient incisions.

Grafts are placed in varying densities

Typically the smallest one and two hair grafts are placed in the very front of the hairline, with three and four hair grafts placed behind them.

Patient immediately following surgery

Following surgery a patient will have hundreds of tiny incisions with short hair stubble showing from the new grafts.

Close up of recipient area after surgery

The tiny graft incisions heal rapidly. The redness and scabbing in the recipient area normally clears up within about one week.

It was Hippocrates, the “Father of Modern Medicine”, who first recognized a connection between hair loss and the sexual organs. Hippocrates’ studies of eunuchs (men castrated before puberty) observed that these men did not suffer from hair loss.

We know today that this is due to the absence of testosterone, which is normally converted into dyhydrotestosterone or DHT – the active ingredient in baldness. In March 1995, Duke University researchers came to the conclusion that " . . . while castration may be a cure, it is not commercially acceptable."

Hippocrates had a personal interest in finding a cure 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. This and other treatments failed to work and he lost the rest of his hair. The area of permanent hair on the back and sides of the head (from which donor hair is taken for hair transplants) is also known as the “Hippocratic wreath.”

Ancient Rome and Hair Loss

Moving from Greece to the Roman Empire, we find that Julius Caesar employed a variety of methods to hide his thinning hair. In addition to the laurel wreath that he wore, he first grew his hair long in the back, and then combed it forward over his bald spot. Yes, the “Comb Over” is ancient.
Learn how man has treated hair loss up to modern times.
Being a Eunuch – the sure way to stop baldness

In the 1940’s, the studies of Hippocrates and Aristotle were continued. Both men had concluded that eunuchs always kept all their hair.

This finding was backed up by the work of Dr. James Hamilton.

He discovered that certain male hormones (missing in eunuchs) were critical to the development of male pattern baldness.