Jerry Wong, MD
Dr. Jerry Wong
Dr. Jerry Wong exclusively performs Ultra Refined Follicular Unit Hair Transplantation with outstanding results.
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Victor Hasson MD
Dr. Victor Hasson
Dr. Victor Hasson exclusively performs Ultra Refined Follicular Unit Hair Transplantation with outstanding results. -
What is Rogaine and how does it work?
Along with Propecia, Rogaine is one of the only proven hair loss medication options approved by the FDA for treating hair loss. Minoxidil, (Rogaine’s active ingredient), was originally created as a drug for treating hypertension (high blood pressure). It was then discovered that one of its side affects was growing hair. Minoxidil was then tested for use a topical application for regrowing hair. The results were sufficiently impressive that the FDA approved it as a treatment for hair loss.
Rogaine works by revitalizing shrunken hair follicles, thus increasing their size. When you use Rogaine every day, your follicles may increase in size, and the growing phase may become longer. This may then produce longer, thicker hairs.
Rogaine is a clear alcohol-based solution and should be applied to a person’s thinning area with its supplied dropper or spray twice a day.
The solution is approved and available in two strengths -- Regular (2%) and Extra Strength (5%). Individual users of Regular strength Rogaine have claimed success rates of 30-40%. Meanwhile, users of Extra Strength Rogaine have claimed success rates of 50-60%. Currently, the average price for a 2oz. bottle of Rogaine is about $20-30 per month. Minoxidil is also available as a generic and can be purchased over the counter without prescription.
It’s important to note that Rogaine (minoxidil) does not cure baldness and scientists have been unable to determine just how it works. What is known is that Rogaine increases the blood flow to the areas of the scalp that surround these balding areas. Currently some researchers believe that Rogaine (minoxidil) works by opening the follicle’s potassium channels located in the cells. It’s theorized that these channels, when opened, may regulate hair growth.
Rogaine can’t grow hair on completely bald scalps or in the frontal hairline areas. It has been found to be somewhat effective in maintaining or growing hair in the crown area (the top back of the head). However, Rogaine is only effective at delaying hair loss. It is also more effective in women than in men. And again, the reasons for this are not understood.
What can I expect with Rogaine?
Rogaine (minoxidil) generally only regrows hair in a minority of men and women. In most cases, the best case scenario for hair growth with these treatments is a thin coverage of thin hair.
The real benefits of Rogaine (minoxidil) is keeping what hair you have or slowing your thinning. Rogaine’s success depends on how advanced your hair loss has become.
You must apply it to your scalp twice a day for life to get and maintain any benefits. Research shows that using Rogaine (minoxidil) only once a day is ineffective. If you stop taking Rogaine (minoxidil) you will loose whatever hair you preserved or regrew within 2 to 4 months. And while Rogaine may stimulate hair growth, it may not prevent the hair follicles from their eventual deterioration.
It's also true that Rogaine's effects may diminish over time. Some doctors believe that patients can build up a tolerance after many years of use. But it's possible to fight this tolerance by taking a week or two off from the treatment every 3-4 months. However, it's not advised to take this break unless you've taken the hair loss medication consistently for at least 12 months.
Are there side effects from Rogaine?
There are only minor side effects with Rogaine. But some users do experience certain problems such as scalp irritation, itching, and dandruff. However, this can be treated with a good shampoo like Nizoral or Neutrogena T-Gel. There may also be an increase in hair shedding at the start of the treatment. You shouldn’t panic, as this may actually be a signal that the treatment is working.
Due to the medication’s alcohol content, some users may develop a contact rash or irritated skin. And with excessive doses, some users may experience dizziness or a rapid heartbeat. However, with normal use these effects are uncommon.
Rogaine users with severe, refractory high blood pressure experienced some problems. One such problem was “hypertrichosis,” hair growth on the face or other bodily areas. This side effect appears in about 3-5 % of women who use the 2% solution, and higher among women using the 5% solution.
Rogaine and Hair Transplants
Some hair restoration physicians have come to consider Rogaine to be instrumental right after surgery. This is especially true when grafts have been placed in and around existing hair.
The shock of surgery can result in temporary hair loss. Rogaine is thought to possibly help prevent this temporary loss of healthy preexisting hair. The 5% solution has been found to be more effective for men and women. However, some physicians believe that the hair loss medication should be stopped a week or two before surgery. They feel that Rogaine may increase bleeding, while dilating blood vessels.
After surgery, most patients wait a week or two before restarting Rogaine. This gives the graft areas time to heal. However, taking Propecia is not interrupted by surgery.
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Folexen (S-equol)
A Viable Alternative to Propecia in Treating Hair Loss?Folexen S-equol , produced by Australian manufacturer Eclipse Nutraceuticals is considered an "all natural" hair loss treatment that boasts an impressive 87% success rate for preventing and reversing the effects of male pattern baldness with virtually no side effects. Folexen S-equol has also been a hot topic of discussion on our popular hair loss forum. But, does this self-described "nutraceutical" live up to its hair growth hype? Is Folexen a viable alternative to Propecia for treating the effects of male pattern baldness?
What is Folexen S-equol?
According to the FAQ on Folexen's website, the active ingredient S-equol is "a metabolite of a natural isoflavone called daidzein, which occurs in soybeans and some other food products".
Isoflavones are an organic compound produced almost exclusively by various bean types. In populations that consume large quantities of soy protein, studies have shown a lower incidence of breast cancer and other common cancers because of its role in influencing sex hormone metabolism and biological activity.
As a metabolite, S-equol is the product that remains after the isoflavone is broken down or "metabolized" by the body.
In addition to its active ingredient, Folexen contains the following GRAS (generally recognized as safe) inactive ingredients: starch, maltodextrin, allantoin, propionic acid. It may also contain hypromellose (vegetarian capsule).
But is there any evidence that S-equol works to treat hair loss?
How Folexen S-equol Allegedly Works to Treat Baldness
In the body, testosterone is converted to the hormone dihydrotestosterone (DHT) via the enzyme 5-alpha-reductase (5AR). It's widely known that androgenic alopecia (genetic hair loss) results when genetically vulnerable hair follicles are exposed to DHT which then binds to the receptor sites of these follicles causing them to weaken and shrink over time. This shrinking process is known as miniaturization.
The recognized leader in the battle against the balding effects of DHT is the clinically proven and FDA approved drug Propecia (finasteride). Propecia works by inhibiting the conversion of testosterone to DHT, potentially slowing or even reversing the effects of androgenic alopecia. However, approximately 2% of males who take Propecia experience debilitating sexual side effects.
Unlike finasteride, Folexen's rumored ability to suppress hair loss and potentially regrow hair is based on the theory that S-equol can bind strongly to free DHT molecules, prohibiting them from binding to the hair follicles' receptor sites. Because Folexen does not suppress the conversion of testosterone to DHT, there is no resulting increase of testosterone in the body and therefore, no sexual side effects. But are there any clinical studies supporting that S-equol can truly prevent DHT from binding to hair follicle receptor sites and prevent hair loss?
Clinical Studies
Folexen's website references four articles in peer reviewed journals. Two of these studies center on S-equol's effect on prostate health while the other two don't appear to reference S-equol at all.
At this time, there appears to be no scientific data presented supporting Folexen's efficacy as a hair loss treatment.
Side Effects
The company claims that the product is virtually side effect free: specifically noting that it does not cause gynecomastia (enlarged breasts), erectile dysfunction or any of the other side effects that are experienced with some other treatments.
Some users however, did report mild diarrhea that dissipated within one week of commencing treatment.
What is the Recommended Dosage?
The recommended dosage of Folexen is 4 capsules per day (two every 12 hours), totaling 10mg of the active ingredient. Eclipse claims that the product has been tested safe at much higher concentrations (up to hundreds of milligrams) and there is some speculation based on available data that it may, in fact, require a dose as high as 100mg to match the Propecia's hair growth results.
Where to Buy Folexen S-equol
Folexen is only available by mail order from Australia. A bottle of 100 2.5mg capsules (25 day supply) costs approximately $40 USD + shipping but there is a discount for purchases exceeding 4 bottles and again for 9+ bottles. However, it's easy to see that even in bulk this treatment is several times more expensive than purchasing generic 5mg finasteride and quartering the tablet, as many finasteride users do.
As a natural product and not a drug, there are no shipping restrictions. Estimated delivery time is two weeks.
Conclusion
Time will tell if Folexen S-equol proves to be an effective weapon in the fight against androgenic alopecia or simply another product in a long line of expensive disappointments.
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Hair Loss - It’s more than skin deep
Hair loss suffers often don’t want to admit that going bald bothers them. But there's nothing wrong or vain about being concerned with hair loss.No matter what people say, having hair or not does matter. We are judged by our appearance. And hair loss, also known as alopecia, is generally seen as a sign of weakness and aging.
Does hair loss matter? You be the judge...
"At first I just didn't feel comfortable admitting that I wanted my hair back."– Dean, restored his hair with Propecia and hair restoration surgery.
Hair loss Statistics – Hair loss affects about 35 million men and 21 million women in the United States alone.40% of men have noticeable hair loss by age 35 and 65% by age 60.
So how can you remedy hair loss and its effects?
First you need to understand why hair loss occurs. In Cause of Thinning Hair and Baldness you'll learn that your hair loss has little or nothing to do with shampooing, hats, or any other practices. Alopecia is largely genetic.
It's also important to deal with the psychological and emotional effects of hair loss. In the Psychology of hair loss these personal issues and how society views hair loss are uncovered.
Regardless of our differences, hair loss can affect anyone. However,there are a variety of gender and racial differences to consider.Age is also a prime factor. In Race, Age and Hair Loss these differences are explored.
Hair loss is not a new phenomenon, as our Ancient Hair Loss "Cures" section reveals. Whether it's Julius Caesar using wreaths to hide his thinning, or French King Louis XIV's elaborate 15-20 pound wigs -- history's filled with interesting tales of balding cover-ups. This section also explores the reality behind many Hair Loss Myths and “cures”, from electro-shock treatments to headstands.
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Thomas Chung Wai Nakatsui, MD
Dr. Thomas Nakatsui
Dr. Nakatsui performs large sessions of ultra refined follicular units using the lateral slit technique with extremely natural results. -
Parsa Mohebi, M.D
Dr. Parsa Mohebi
Dr. Parsa Mohebi provides large sessions of high quality follicular unit transplantation with excellent results -
Surgical Hair Restoration - View our procedures in detail
Our physician members perform a very refined hair transplant procedure called "Follicular Unit Hair Transplantation". Today there are two methods for doing this procedure. They differ only in the methods used to harvest and prepare the grafts.
Follicular Unit Extraction Video is provided courtesy of Dr. Alan Bauman.
How the follicular unit extraction (FUE) hair transplant procedure is different than standard strip excision hair transplant surgery.
How the minimally invasive hair transplant procedure known as Follicular Unit Extraction or FUE is performed.
How follicular unit grafts are created under microscopic dissection and then placed into tiny incisions in the balding areas.
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Nizoral Shampoo (Regular Strength) for Hair Loss
While Nizoral 2% shampoo is more effective at inhibiting DHT production and its binding to hair follicles, Nizoral regular strength offers a smoother, gentler approach to treating hair loss while minimizing scalp irritating effects from other topical treatments such as Rogaine 5% liquid.
This product includes 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". Alternatively, you can obtain a prescription from your medical practitioner for the more concentrated 2%.
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 Nizoral in conjunction with other 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 Nizoral has been successful in helping you maintain existing 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.
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Follicular Unit Hair Transplantation - Step by Step
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.