• 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.

  • PABA – Popular Ingredient in Several Herbal Hair Loss Treatments

    Para-Aminobenzoic Acid (PABA)Para-Aminobenzoic Acid (PABA) has been called the anti-gray hair vitamin and is considered one of the lesser known members of the vitamin B complex family (despite the fact that it’s not really a vitamin at all).  PABA is a non-protein amino acid and isn’t essential in the human body.  It can be found in foods such as liver, whole grain, yeast, and kidney and is listed as an active ingredient in several popular herbal hair loss treatments such as Provillusfor women and Procerin

    The potassium salt in PABA called POTABA is available on prescription. POTABA is indicated for Peyronie’s Disease and scleroderma. The dose for Peyronie’s disease and scleroderma is very high (12 grams daily in 4 to 5 distributions) and must only be used under medical supervision. Because of the high doses needed to achieve clinical efficacy, patient compliance is typically poor.

    But can PABA actually treat male pattern baldnessor genetic female hair loss?

    Some tests conclude that PABA when combined with other elements such as folate, biotin, and pantothenic acid, may restore pre-maturely graying hair to its natural color.  Some anecdotal reports suggest it might also stop hair loss, however; there are at least as many reports that contradict this.  Moreover, we haven’t seen any evidence to suggest it can stimulate new hair growth or hair regrowth.

    PABA comes in doses of 100mg, 250mg, and 500mg as a standalone product.  However, since no formal clinical studies have been performed on PABA for hair loss, a suitable dosage is mostly speculation.  Additionally, since no regulations have been placed on herbal medication, one should proceed with extreme caution before taking any herbal supplement.  Consulting with a doctor is advised.

    Side Effects and warnings:

    Some manufacturers of herbal replacements to medication would have you believe that herbal treatments come without potential side effects.  However, this is a farce. 

    The following side effects have been reported from consumers of PABA: Anorexia, vomiting, nausea, hypersensitivity, fever and rash (particularly with larger doses). These symptoms went away when PABA is stopped.

    Ironically, Provillusonly includes PABA in the woman’s formula.  However, women should know that pregnant women, nursing mothers, and children should avoid using PABA.


    For those with renal disease, PABA should be used with caution.  PABA should be stopped if hypersensitivity develops. Those taking pharmaceutical doses of PABA must be under medical supervision.

  • 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.

  • Bijan Feriduni, MD

    Dr. Bijan Feriduni
    Dr. Bijan Feriduni
    Dr. Bijan Feriduni has been dedicated exclusively to advanced hair restoration since 1995 and now performs large sessions of ultra refined strip and FUE hair transplantation with outstanding results.
  • 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.
  • ElectroTrichoGenesis (ETG)

    Electro Tricho Genesis

    Brilliant Hair Loss Treatment, or is it a Scam?

    ElectroTrichoGenesis (ETG), also known as Cosmetic TrichoGenesis (CTG), is a little known hair loss treatment that makes some very lofty hair growth claims. How does ETG work and is it really clinically proven to treat androgenic alopecia(genetic balding)?

    How ElectroTrichoGenesis (ETG) Works

    ETG is promoted as a safe, painless and non-intrusive. Treatment is administered via an “ergonomically shaped couch with a semi spherical hood” manufactured by Current Technology Corporation in Vancouver, Canada.

    The patient reclines on the chair and the hood (with disposable liner) is placed over the head but does not make contact with the scalp. This special hood contains electrodes that deliver “specified pulsed electrostatic energy” delivered passively to the scalp by the low-level electric field generated within it.Electro Tricho Genesis

    ETG is believed to stimulate the regrowth of hair through the positive influence of the pulsed electrostatic field it generates. This field is said to stimulate “changes within the hair bulge and the follicle, stabilizing hair loss and stimulating new hair growth”. Patients receive a single 12 minute session weekly.

    Is ETG Clinically Proven?

    The following three studies on the efficacy of ElectroTrichoGenesis (ETG) as a treatment for thinning hair have been published in peer-reviewed journals:

    Maddin, W. Stuart; Bell, Peter W.; James, John H. M. (1990).
    "The Biological Effects of a Pulsed Electrostatic Field with Specific Reference to Hair Electrotrichogenesis". International Journal of Dermatology29(6): 446–450.

    Benjamin, Benji; Ziginskas, Danute; Harman, John; Meakin, Timothy (2002).
    "Pulsed electrostatic fields (ETG) to reduce hair loss in women undergoing chemotherapy for breast carcinoma: A pilot study". Psycho-Oncology11(3): 244–248

    Maddin, WS; Amara, I; Sollecito, WA (1992).
    "Electrotrichogenesis: further evidence of efficacy and safety on extended use". International Journal of Dermatology31(12): 878–80

    According to the 36-week comparative, controlled study conducted on male subjects at the University of British Columbia and published in The International Journal of Dermatology, 96.7% of those treated experienced cessation of hair loss and/or hair regrowth. Decreased hair loss was seen as early as 4 to 6 weeks but many patients required more time for results.

    The pilot study conducted on women undergoing chemotherapy for breast carcinoma and published in  Psycho-Oncology,showed that twelve out of 13 participants had good hair retention throughout the chemotherapy period and afterwards with no reported side effects.

    As with the clinically proven medical hair loss treatments Rogaine (minoxidil) and Propecia (finasteride), ETG is said to be most effective in the early stages of balding.

    Conclusion

    Although the data put forth in this article seems to paint ETG as a clinically proven and highly effective hair loss treatment, it’s important to note that the procedure is not new. The studies referenced above were published more than 13 years ago. If ETG truly works to stimulate hair growth and suppress the advancement of hair loss, why has it not become a fixture in the world’s leading hair restoration clinics? Where are all the glowing, unbiased reviews?

    With no reported side effects, there may be no harm in giving ETG a try if there is a provider in your area and the fees are reasonable. However, balding men and women are encouraged to consult with an experienced and reputable hair restoration physicianin order to diagnose the cause of their thinning hair and learn about the outstanding medical and surgical options available today.

  • Revita Shampoo for Hair Loss

    Revita Hair Loss Treatment

    Revita ShampooThe new and revolutionary Revita Shampoo has all the right stuff to stop DHT and promote healthy hair growth. Revita contains the proven DHT inhibitor ketoconazoleand vitamins and minerals essential for nourishing and cleansing the scalp and hair, including the same copper peptide technology included in Tricominproducts.

    This product includes a 6 ounces or 180ML bottle with 1% of the active ingredient ketoconazole. To view the clinical abstract proving the effectiveness of ketoconazole in the treatment of androgenetic alopecia, view Ketoconazole as a hair loss treatment.

    Unlike Nizoral, the revolutionary Revita shampoo can and should be used daily. Revita leaves your scalp and hair feeling great daily with no signs of dryness or flakiness. It's also a magnificent volumizing shampoo, promoting maximum fullness.

    Developing Realistic Expectations:

    Men and women sometimes suffer from hair loss for different reasons. Thus, diagnosing its cause is necessary to facilitate and promote proper treatment.

    Don't expect immediate results. It's recommended to use Revita in conjunction with proven treatments for at least 6 to 12 months before determining its effectiveness. Documenting your progress with bi-monthly photos can help you determine whether or not Revita has been successful in helping you maintain existing hair.

    Hair shedding is a common symptom the first few months and a sign that Revita may be working for you. It's crucial to push past this stage with continued use for the recommended period of time.

    To date, only surgical hair restoration is proven to grow hair in completely bald areas. You are invited to have a free virtual consultation with one of our prescreened hair restoration physicians.

    Ingredients (Full List)

    Apple PolyphenolProcyanidin B2 & C1
    Copper Peptides
    Spin Traps
    Ketoconazole
    Rooibos
    MSM
    Caffeine 4%
    Carnitine Tartrate
    Amino Acids
    Emu Oil
    Biotin

  • Rogaine Foam for Men and Women

    The exciting new Rogaine foam has undergone its own extensive FDA trials and can rightfully boast an impressive 85% hair regrowth success rate in people who use it twice daily. This is more than 20% higher than the liquid 5% minoxidil solution at 64%. Rogaine foam also comes without the inconveniences of its liquid counterpart such as scalp irritation, flaking, and messy application. The foam dries almost instantly as opposed to the liquid's 15 minute waiting period.

    Note: Despite what the insert says, Rogaine works just as well for frontal hair loss, recession, and thinning hair.

    How It Works:

    Rogaine foam uses versafoam technology to aid the delivery of the minoxidil to the hair follicles. As the minoxidil absorbs into the scalp, it stimulates follicles, revitalizing them, promoting thicker and healthier hair growth. This promotes a thicker and fuller appearance of hair.

    Developing Realistic Expectations:

    While Rogaine foam is supreme in many ways, it's unlikely to regrow thick terminal hair in completely bald areas. For best results, men ought to consider combining Rogaine with Propecia (finasteride), the only FDA approved and clinically proven DHT inhibitor to stop hair loss. See the "recommended treatments" section below for more details.

    Don't expect immediate results. Just as hair loss is a slow process, regrowing it is too. Thus, it's recommended to use Rogaine for approximately 6 to 12 months before determining its effectiveness. Documenting your progress with bi-monthly photos can help you better evaluate the results.

    Hair shedding is a common symptom the first few months and a sign that the medication may be working for you. It's crucial to push past this stage with continued use for the recommended period of time.

    To date, only surgical hair restoration is proven to grow hair in completely bald areas. You are invited to have a free virtual consultation with one of our prescreened hair restoration physicians.

  • Crinagen Hair Loss Treatment

    Crinagen Hair Loss treatment

    CrinagenCrinagen is an all natural alcohol-free topical scalp spray clinically backed to reduce the amount of DHT (dehydrotestosterone) in the scalp. It contains no alcohol, and has displayed no side effects. Crinagen is also equally safe for men and women and is most effective in men and women with thinning hair. In addition to blocking scalp DHT, they both are reported nourish the scalp’s hair follicles. Crinagen usually displays its effects on average in five months.

    How It Works:

    The product's main ingredients are Saw Palmetto, Zinc, and Azelaic Acid. All 3 ingredients are reported to reduce the production of scalp DHT and nourish the scalp's hair follicles.

    Developing Realistic Expectations:

    Crinagen has not been clinically proven nor approved by the FDA. Thus, like Revivogen and Tricomin, Crinagen should be used only after seriously considering proven treatments like Propecia (finasteride) and Rogaine (minoxidil).

    Don't expect immediate results. It's recommended to use Crinagen 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 Crinagen is working for you.

    Hair shedding is a common symptom the first few months and a sign that the medication may be working for you. It's crucial to push past this stage with continued use for the recommended period of time.

    To date, only surgical hair restoration is proven to grow hair in completely bald areas. You are invited to have a free virtual consultation with one of our prescreened hair restoration physicians.

  • 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.