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

Female hair loss, otherwise known as Female Pattern Baldness (FPB), affects 1 out of every 4 women in the United States. Recent findings have found that the incidence of FPB has been reported to be as low as 8% and as high as 87%. And, it does appear to be as common for women as for men. Most often, menopause is the most frequent time for hair loss in women to become apparent.

For a woman to lose her hair can be even more troubling than for men. A woman with thinning hair is not generally accepted as part of the normal aging process. Society has come to expect a thick, luxurious head of hair as part of the attractiveness in women.

While males and females can both experience thinning hair, they typically do not lose their hair in the same order or appearance.

Women with thinning hair compared to Men

Typically men observe their hair loss earlier, whereas women will first notice it in their late 20's through their early 40's. Female Pattern Baldness (FPB) is often seen during hormonal changes. These include the use of birth control pills, following childbirth, or during or after the time of menopause.

Top view of patient, showing excellent growth of transplanted hair.

In addition, men typically have localized areas (patterns) of thinning, whilein women this usually occurs as thinning across the top, or over an even wider area. When women have very diffuse thinning over much of their scalp they are generally not good candidates for hair restoration surgery. However, women with localized hair loss, similar to the typical male pattern baldness, can successfully undergo hair restoration surgery.

Thinning hair in females is also characterized by an increase in the combination of normal thick hairs mixed in with finer, smaller hairs. This results in decreased density, and not total hair loss.

A woman's hair has also been proven to be more sensitive to the effects of stress than men's hair. Stress can result in hair loss in women and men. But this type of loss is not female pattern baldness. Rather, it is known as “telogen effluvium.” This type of hair loss is the shedding of hair in the resting phase when the body senses that it needs to divert its energies elsewhere. Therefore stress can temporarily changes the amount of hair that is shed. But the lost hair is likely to grow back.

The production of the hair loss-inducing androgens is also different among men and women. A woman produces a small quantity of androgens in the adrenal glands and the ovaries. The ovaries also produce pre-hormones, which are then converted to androgens on the outside of the ovaries or adrenal glands.

Generally speaking, a woman with hair loss will probably not experience total balding in a given area. But if there is total hair loss, this is most likely a sign of a previously hidden disease. For this reason, it’s important for females to have their hormone levels checked by a physician if they are experiencing heavy hair loss.

Finally, men and women react differently to various hair loss treatment options. In men, hair loss may be halted or even reversed by finasteride (brand named "Propecia"). However, Propecia is not safe for females or children. Minoxidil (Rogaine) can be effective for both men and women in treating hair loss.

However, for some women the causes of their hair loss are much more complex than the classic "male pattern baldness". Thus proper diagnosis of the underlying cause is vital before any hair loss treatments are attempted.

The following physicians are nationally well known experts in female hair loss. Feel free to contact them.

David Whiting in Dallas, Texas - 214 824-2087

Vera Price in San Francisco, California 415 353-4163

Maria Hordinsky in Minneapolis, Minnesota 612 625-1493

Wilma Bergfeld in Cleveland, Ohio 216 444-5722

For a web community that is dedicated to female hair loss visit HerAlopecia.com

Nizoral 2% is magnificent shampoo and a significant part of what's referred to commonly as the Big 3. The other two are the FDA approved and proven treatments Propecia (finasteride)and Rogaine (minoxidil). To date, Nizoral is the only shampoo on the market that can make the unique claim that it's proven to stop the formation of DHT. Its active ingredient ketoconazoleat 2% concentration has proven to be a moderate DHT inhibitor and has growth stimulating properties about as effective as Rogaine 2%.

This product includes 2%, the highest concentration 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". There is also a less concentrated 1% of Nizoral. To learn more, visit Nizoral regular shampoo.

We strongly suggest using Nizoral shampoo in addition to other proven treatments. Nizoral should be used 2 or 3 times a week to avoid dry hair and a flakey scalp.

On the off days, you may want to consider rotating Nizoral with other excellent shampoos designed specifically for thinning hair. See the recommended treatments section below for other shampoos we recommend.

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.

As patients, we know that the physician you choose is the most critical decision in restoring your hair is the physician you choose. Hair restoration physicians' skills, experience, and talent vary widely, as do the end results, vary widely.

You must research and choose your physician wisely. After all, who you choose will determine how natural and complete, your new hair will be for the rest of your life. The surgeons selected and approved by our community have been scouted and vetted by the forum's highly esteemed senior valued contributors of the Hair Restoration Network. Our valued contributors have all spent years researching hair transplantation, and they have all had hair transplants. To ensure there is no conflict of interest, none of our valued contributors receive any compensation. They are volunteers who have shared their experiences and contributed for years to our community. Each surgeon has been approved based on their ethics, surgical techniques, results, and reviews. To support the costs of operating and promoting our community, the approved physician contributes a monthly fee to sponsor our community.

Their recommendation is continued as long as they continue to show evidence of excellent patient results and satisfaction. If a patient expresses concerns, physicians are expected to resolve their concerns. We ask that patients first contact a physician with any concerns so that they can resolve them before publicly posting.

Note - The hair restoration physicians recommended on this site are not a definitive list of all excellent hair transplant doctors. Nor do we warrant or guarantee the results of any of the physicians presented on this site. As always, we encourage you to do your due diligence in evaluating these and all hair loss physicians.

We offer the following suggestions for researching a hair restoration physician:

• Does the physician take a holistic approach to hair restoration? Your physician should help you evaluate all your options, surgical and non-surgical.
• Have they invested time and resources in large micro follicular unit hair transplantation sessions? Outstanding work requires a staff dedicated to and trained to use high-powered magnification to produce more than 2,000 carefully trimmed grafts per surgical session.
• Choose a hair restoration clinic that is patient-focused rather than commercially focused. Some clinics emphasize revenue, speed, and volume rather than dedicating the time and individual care needed to produce optimal results. These commercial operations typically rely on heavy advertising rather than satisfied patient or doctor referrals.
• Is hair restoration the primary focus of their practice? Outstanding results require a physician and staff to perform hair restoration surgery regularly. Doing hair restoration as a sideline and other cosmetic procedures may hinder their ability to do large sessions of highly refined follicular unit transplantation.
• How many patients has this physician produced excellent results for? Like any skill, experience over time is critical to acquiring the skill and judgment required to produce excellent results.
• Can the physician provide detailed patient before and after photographs? Do they also have patients who are willing to speak with you and meet with you in person?

What do their hair transplant patients think?

Ultimately, the most critical measure of a hair transplant surgeon's work is their patient's level of satisfaction. Find out what patients think of their physician's work by visiting our discussion forum or viewing hair loss blogs created by patients. View our standards for recommending hair transplant surgeons.

Find an excellent hair restoration physician in your area.

Send a Virtual Consult

This online feature enables you to fill out a hair loss questionnaire and email it to any of the quality hair loss doctors recommended on this site. You can even attach your photos. They will then respond to your questions and concerns.

Click here, to send a Virtual Consult.

Suggest a physician for recommendation on this site.

We are always interested in learning about outstanding hair restoration physicians. Click below to suggest an outstanding physician for recommendation on this site.
Click here if you are with a hair restoration clinic.
Click here if you are a hair transplant patient.

Is this hair loss treatment effective?

Extreme Hair Therapy (EXT) for thinning hair is a 5 "step" hair loss treatment solution created by Hair Club that claims not only to rejuvenate your hair, but "rejuvenate your life".  Making claims to be FDA approved, EXT claims to stimulate hair regrowth in thinning areas by keeping hair in the anagen (hair growth) phase longer.

Balding men and women seeking hair loss solutions should be careful to do their due diligence in researching all products they are considering.   Is this one of the hair loss products that really works to treat baldness?  Can Extreme Hair Therapy really deliver what it promises?

Below we take a look at each of the 5 “steps” and separate treatments and analyze whether or not EXT can remedy alopecia in men and women.

What is the 5 Step Process of Extreme Hair Therapy?

Step One: Moisturizing or Revitalizing Cleanser
This moisturizing shampoo is rich with vitamins and works to cleanse the scalp. Though it claims to revitalize and strengthen thinning hair, the ingredients are not listed on their website. Many hair rejuvenators and thickening agents (commonly referred to as volumizing shampoos) help to make hair appear thicker as they take on hydration and swell. Unfortunately, these thickening agents do nothing to stop the progression of male pattern baldness, even if it temporarily makes the hair shaft appear fatter.

Step Two: Enzyme Scalp Cleanser
Claiming to be a “new breakthrough”, this organic formula removes sebum oils that can sometimes hinder hair growth. Though sebum buildup, excessive dandruff, and scalp dermatitis are sometimes responsible for certain non-genetic types of balding such as diffuse alopecia or telogen effluvium, it does not promote androgenic alopecia (hereditary male or female hair loss).

Step Three: Energizing Conditioner
Adding nutrients such as proteins and wheat amino acids, this conditioner helps to promote a healthy scalp and hair growth. It should be noted that nothing in this step claims to stop hair loss or stimulate hair regrowth.

Step Four: Hair Revitalizing Complex
This dietary supplement containing Vitamins B3, D, and E, Biotin, saw palmetto and nettle root is taken twice daily, once in the morning and once at night. Some of these ingredients can also be found in several other hair loss products such as Provillus, Procerin, and Avacor.

Though some of these ingredients work to treat benign prostatic hyperplasis (BPH) in men by inhibiting DHT (the hormone responsible for female and male pattern baldness), no formal clinical studies have been performed on successful hair loss treatment. It should be noted that tocotrienol molecules in Vitamin E may effectively treat alopecia but its counterpart tocopherol (commonly found in alternative herbal hair loss treatments such as HairMax MD), is not supported.  Additionally, because there are no regulations on herbal medications in the United States, the daily recommended value and dosage in Extreme Hair Therapy is based on something other than FDA regulation.

Step Five: Minoxidil (2% or 5%)
Minoxidil (the active ingredient in Rogaine and Xandrox) is an FDA approved hair regrowth formula and is used by many balding men and women with great success. Because Extreme Hair Therapy includes this, they are legally allowed to claim it to be FDA approved.

Costs:

Unfortunately, this information is not available on the Hair Club website. Upon calling the toll free number for this information, we are told that we must schedule a consultation with a Hair Club specialist. Customer service representatives are apparently not provided with this information.

Side Effects and Warnings:

No EXT side effects are reported on the Hair Club website however, Minoxidil may cause scalp irritation or redness, chest pain, a rapid heartbeat, faintness, swelling of the hands and/or feet, and unwanted facial hair growth.  Be sure to discuss the use of herbal medication with your physician before taking them. Saw Palmetto should be avoided by pregnant women with hair loss.

Conclusions:

The only FDA proven ingredient in Hair Club’s Extreme Hair Therapy hair loss treatment is Minoxidil.  Though Saw Palmettoand nettle root may be effective in treating men with an enlarged prostate by inhibiting DHT, no formal tests have been performed on them.

Hair loss Myths - What is or isn’t true?

Maybe you’ve heard that wearing a tight baseball cap too often will make you bald or that if you wash your hair too much you’ll suffer hair loss. Well, they’re both old wives’ tales.

So what really causes hair loss and what’s myth?

Brushing to Grow Hair?

The idea of brushing the hair 100 times a day to stimulate the scalp circulation is a fantasy. In fact, if you brush your hair too much, you may end up injuring and losing hair.

This myth stems from the thought that hair loss was due to poor circulation and that brushing or massaging would improve blood flow and nutrition to the follicles. The truth is, bald or not, there’s no major difference in scalp circulation.

Styling and Hair Loss?

There’s some truth and some fiction when it comes to hair styling and Hair Loss.

It is true that certain hair styles, such as corn-rows or tight ponytails, can cause hair loss. These styles put undue tension on the hairs. But as for hair sprays, perm solutions, or coloring resulting in hair loss there’s no truth to that idea. These applications may cause some damage to the hair strands. But the all-important follicles, located under the skin, stay safe.

And what about the idea that haircuts will make your hair grow back thicker and faster? That’s wishful thinking. Everyone’s hair growth and length depends on their own unique hair cycle, which is based on both nutrition and heredity. The longer your growth phase the longer your hair growth.

Blowing away your hair?

What about hair dryers? Are these follicular incinerators?

The good news is there is no evidence that hair dryers cause thinning hair. However, too hot or too much drying may lead to brittle and breakable hair. Let common sense guide you and hold the hair dryer at a normal distance from your scalp and dry to your heart’s content.

Vitamins and Steroids?

Think about this – if you were losing hair because of a lack of vitamins or minerals in your diet, why wouldn’t the back and sides of your head be affected? In actuality, vitamin deficiency results in an even distribution of hair loss all over the head. Of course, it doesn’t hurt to take vitamins on a regular basis for your overall health.

Your follicles width and amount are based on heredity. So claims of hair growing miracle drugs or natural hair loss treatments are untrue.

However, steroids use can cause hair loss. Research has proven that anabolic steroids raise the levels of baldness-inducing male hormones. For those who are genetically prone to hair loss, this can speed up the loss in as little as 3 to 6 months. While this loss may be reversed, it can be permanent.

Sexual Activity to Grow Hair?

Unfortunately, there is no truth to the idea that the more sex you have, the less hair you’ll lose! And the same goes for the rumors that the chemicals released during sex can affect hair loss. Science has yet to uncover any proof to this fantasy. But that doesn’t mean you shouldn’t keep experimenting.

The Hair Loss Family Tree

Many men believe that if their father has a full head of hair, they’ll keep a good head of hair. But hair loss or hair growth is set by a genetic combination determined by both sides of your family.Of course, if your family tree is filled with balding scalps, you do have a better chance of losing hair.

Treatments that work

While hair loss sufferers spend small fortunes on treatments based on myths, there are several proven treatments, non-surgical and surgical.

Currently there are only two non-surgical hair loss treatments that are FDA approved for Hair loss. These two are Propecia (Finasteride) and Rogaine (minoxidil).

Other treatments may or may not help stop or reverse hair loss, but they are not formally approved by the FDA

To learn about proven treatments visit our Hair Loss Solutions section.