Over the past several years surgeons have used various techniques to perform follicular unit hair transplantation. One such technique is the Lateral Slit Technique, also known as Coronal or Perpendicular Grafting. This technique’s name is derived from the angle and direction in which the graft incisions are made.

While there are other techniques for performing densely packed and highly refined follicular unit transplantation, the lateral slit technique offers a high degree of control over the angle and direction in which the transplanted hairs will ultimately grow.

The lateral slit technique has been used both intuitively and systematically for years by hair restoration physicians. However, it has recently gained popularity as a systematic and precise way of performing follicular unit hair transplantation.

How our member physicians use the Lateral Slit Technique.

Many of our physician members use the Lateral Slit Technique exclusively or in combination with other techniques for creating graft incisions. The lateral slit technique enables a surgeon to create graft incisions at varying angles (ranging from 10 to 90 degrees to the scalp), including very acute angles that will make the transplanted hair grow out lying flatter to the scalp. The ability to create incisions at very acute angles is particularly useful in areas such as the front temples and sides where the hair normally grows out lying flat on the scalp.

The graft incision determines the direction of the hair growth

The lateral slit technique also helps enable a surgeon to determine the direction of the graft incisions. This then determines the ultimate direction of the transplanted hairs growth. Thus a surgeon can use this technique to control and vary both the direction and angle at which the transplanted hair will grow in order to mimic the subtle changes in hair direction that occur naturally.

Each graft incision is created by analyzing the neighboring hair so the surgeon can reproduce the correct hair pattern. As a result, as each transplanted hair emerges from the scalp it will grow and lay in a similar direction as its neighboring non-transplanted hairs.

Lateral slits can enable denser packing of grafts

Lateral slit incisions also tend to be more parallel to the scalp and thus more superficial and less invasive to the scalp’s underlying vascular structure. This parallel alignment also enables a physician to place more grafts per square centimeter with out the grafts compressing or popping up since the pressure exerted on the grafts does not push them upward from the scalp.

Using blades cut to the size of the grafts

Some of our members use custom blade cutters to create tiny blades to make incisions that match the size and depth of each follicular unit graft being transplanted. This enables a surgeon to safely dense pack more grafts into a given area during a surgical session. Healing time is also more rapid, with minimal scarring.

Typically most clinic’s blades range from 1.5mm to 2mm in size. However, by using the custom blade cutter our physicians can create blades as small as .7mm for a single hair graft and .9mm for a multi hair graft.

In addition, the blades created by the custom cutter are squared off to match the shape of the bulb end of a hair follicle. Non custom cut blades are typically spear pointed which requires them to be inserted deeper thus causing more trauma to the scalps vascular structure.

The ability to control the depth of the incision each blade makes is also critical. Each blade is placed in a blade holder that is set to not allow the blade to go any deeper than required for the graft to being placed in the incision. This minimizes unnecessary trauma to the deep vasculature of the scalp, thus enabling close tight incisions, minimal tissue swelling, and quick healing that leaves no visible scaring, pitting, or cobble stoning of the scalp.

Placing grafts to maximize their aesthetic result and coverage

The plane and direction in which each follicular unit graft is placed on the scalp can also impact the ultimate appearance of density that can be produced with a given number of grafts. This is because hairs within a follicular unit are typically next to each other inline.

Therefore by arranging each multiple hair graft on the scalp in a linear fashion to the line of sight, each follicular unit will provide the maximum appearance of fullness and scalp coverage. This also mimics how hair is normally aligned on the scalp.

Special thanks to Dr. DeYarman, Dr. Sharon Keene, Dr. Jerry Cooley, Dr. Alexander, and Dr. Glenn Charles for contributing their expertise and photos for this section.

Truly a "Full Head of Hair in 30 Seconds?"

Of all the hair loss concealers available, like topical powder applications or "sprinkle solutions," Toppik is amongst the most popular. What's more, of all the "shaker" options currently available to hair loss suffering men and women, Toppik is one of the most recognized and trusted.

Since its inception, Toppik has been featured in various media outlets, including Time magazine, the Oprah Winfrey show, Fox News, NBC, and Eyewitness news. Throughout this media exposure and positive word of mouth, this hair loss product has been utilized by an estimated 3 million balding men and women worldwide.  So what makes Toppik so popular? How does it work? How does it compare to other types of concealers? Most importantly, what are real consumers saying about Toppik and where can interested parties purchase this popular concealer?

Toppik Hair Loss Concealer: What is it, and how does it work?

Toppik, like many other concealers available today, is a topical powder application. The powder formula is comprised of a series of charged, keratin-based, "hair binding fibers" that, when sprinkled on thinning hair, tightly adhere to individual hair strands. With each "shake" of the Toppik product, thousands of these particles are applied to the head and bind to hair shafts via opposing electrical activity (much like the way magnetized material attracts metal).

By tightly binding to hair shafts in such significant numbers, Toppik naturally recreates the appearance of a thick, dense head of hair.  According to the makers of Toppik, the bond created by the hair shaft and keratin particle is so strong that it will withstand wind, rain and perspiration, and will continue to naturally thicken and volumize the hair until "washed out" by shampoo. Additionally, because Toppik is available in a variety of different tones, the product is able to precisely match any hair color/texture and still remain completely undetectable.

What Benefits Does Toppik Offer Over Other Concealers?

Although Toppik is popular and well known within the hair restoration community, hair loss sufferers should still ask one crucial question: what benefits does Toppik offer over other, similar concealers? According to the manufactures, Toppik offers a variety of benefits that other, comparable products simply cannot match. First, Toppik's keratin fibers are completely safe, organic, all natural, and utilize electric energy to adhere to hair fibers with unmatched efficacy.

Next, not only is Toppik available in a variety of colors, but these tones can also be "mixed" to match any color and can even cover gray hair and new growth from hair transplant surgery.  Toppik colors include black, dark brown, medium brown, light brown, medium blonde, blonde, auburn, gray and white.

Furthermore, Toppik can be used in conjunction with other hair styling products (though the powder needs to be applied to dry scalp, and styling products should be applied before usage), will not "rub off" on clothing or pillows, can be safely utilized with other hair restoration products and medications,  will not clog pores or dry out the scalp, is equally effective in balding men and women, and is easily applied via the shaking method or by applying the popular "spray applicator" to the shaker apparatus.

Why is Toppik so Popular in the Hair Loss Community?

Because of its innovative design, positive "track record," ease of use, and effective nature, Toppik has developed a trusted reputation and large fan base in the hair restoration community. Hair loss sufferers not only trust the history behind the Toppik brand, but appreciate the product's single use longevity and lasting strength of the fiber-hair shaft bond. The fact that the product is effective for male and female hair loss sufferers and can be easily used with other styling and hair restoration products makes Toppik an even better option for any individual considering a topical concealer.

What Real Consumers are Saying About Toppik?

To see what real hair loss suffering men and women are saying and to read helpful tips about applying Toppik in a variety of situations and in conjunction with other hair loss treatments, visit our Hair Loss Forum and Social Community.  You can also read our product review by visiting "Product Review: Nanogen Versus Toppik".

Alopecia areata (sometimes referred to as“spot baldness”) is a medical condition that typically results in patchy hairloss or bald spots on the scalp, beard, arms and legs. Though the exact cause of alopecia areata is unknown, it is thought to be an autoimmune disorder causing the body’s immune system to attack its own hair follicles, resulting in hair loss.

Roughly 2% of the world’s population suffers from alopecia areata and approximately 5% of these have a family history of "alopecia", the medical term for hair loss.

Diagnosing Alopecia Areata

Alopecia areata is normally diagnosed through the observation of symptoms. However, occasionally a scalp biopsy or blood tests may be performed.

Treating Alopecia Areata

There is no cure for alopecia areata and current treatments, while sometimes effective, offer limited success.  Current treatments for alopecia areata include; steroid injections, topical corticosteroids (steroid hormonesnaturally produced in the adrenal cortex of vertebrates), topical immunotherapy, Rogaine(minoxidil) and ultraviolet light therapy.

Although permanent hair loss is a possibility, the course of the disease is unpredictable and varies from patient to patient. The good news is that, even without treatment and after many years,the hair follicles do remain viable and ready to resume normal hair production if and when they receive the appropriate signal. Hair regrowth may, and often does, occur in time.

Are Alopecia Areata Patients Good Candidates for Hair Transplantation?

Patients suffering from alopecia areata are rarely considered good candidates for hair transplant surgery because donor hair grafts harvested from the “safe” zone at the rear and sides of the scalp are still vulnerable to the effects of the body’s immune system once transplanted to the recipient sites. However, if the affected area is small, has remained unchanged for an extended period of time and if there is no sign of inflammation below the scalp, hair transplantation may be an option. This would require a thorough consultation with a skilled and experienced hair restoration surgeon and the patient would need to fully understand and accept the risks of such a procedure.

Adapting to and Living with Alopecia Areata

Depending upon the severity of the condition, hair loss concealers like Toppik, Nanogen and DermMatch may help disguise bald patches. In more severe cases, a hair replacement system or full wig may be necessary.

Aswith all forms of hair loss, patients suffering from alopecia areata may experience emotional and psychological trauma. It’s important to reach out to family and friends, join an alopecia support group and/or seek the services of a mental health professional if you are experiencing intense, prolonged and overwhelming psychological effects.

Contained in Several Popular Hair Loss Treatments for Men

Nettle root extract can be found in a number of popular hair loss treatments, such as Provillus and Procerin, and at your local health food store as a standalone product. Conjectured to effectively inhibit the production of DHT, below we examine whether or not nettles are as effective as Propecia (finasteride) in blocking DHT and stopping the progression of male or female pattern hair loss.

Description

“Nettles” is the common name for Urtica Dioica, an herbal plant also known as the Stinging Nettle. This perennial herb is often eaten in many parts of the world and is often added to soups, salads or cooked as greens, though less frequently. Nettle leaves are long and pointy, but only the shoots and top of the plant are eaten. Nettle plants have dark green leaves and typically grow about 2 or 3 feet tall and its flowers are covered with tiny stinging hairs that contain an irritant. Allergic reactions are common if they come in contact with human skin.

Use of Nettles

Nettle root extract was found to partially block 2 enzymes by researchers such as R. Hartmann.  The first is 5-alpha-reductase that when combined with testosterone, produces DHT (dihydrotestosterone). DHT is the hormone responsible for androgenic alopecia hair loss. The second enzyme is aromatase, which makes estrogen.  Combining nettle root extract with another herbal agent pygeum has been found to inhibit these two enzymes more effectively than either one alon It was shown that nettle root extract had to be used at high dosages in order to effective whereas lower doses of pygeum worked well.  Prostatonin, the combination product of nettles and pygeum have been used to treat BPH (benign prostatic hypertrophy).

Studies by researchers JJ Lichius and others have shown a reduction in prostate growth in mice when large doses of nettle extract were taken orally. Combining nettle root extracts with saw palmetto berries in BPH patients reduced the amount of testosterone and estrogen. Conversely, it has been conjectured that nettles can block testosterone from binding to the sex hormone globulin, a carrier protein that binds testosterone and limits its bioavailability in the body. As a result, nettles have been called an aphrodisiac since it may help maintain testosterone levels.

Other uses of Nettles include treatment for arthritis, asthma, kidney, urinary tract infections, and last but not least, baldness.

Nettle Root as a Hair Loss Treatment

Like many other herbal supplements with some clinical evidence suggesting efficacy in treating enlarged prostates (BPH), some have claimed that nettle root extract may stop hair loss and maybe even aid hair regrowth.  Because Propecia (finasteride) works to stop the progression of male pattern baldness by inhibiting the production of DHT, it is conjectured that nettle root extract may be of similar benefit.

Nettle root is a popular ingredient taken orally in a couple big name hair loss products such as Provillus and Procerin.  Some have also conjectured that applying nettle root extract topically to the scalp may also facilitate new hair growth. Because many topical irritant type products are used to treat alopecia areata hair loss, some suggest nettle root extract applied topically may be effective in treating it. Those who conjecture its efficacy to treat baldness recommend doses of 500mg or more daily.

Though some have declared that nettle root extract may be an effective hair loss treatment, no clinical controlled studies have been performed proving its efficacy for androgenic alopecia (genetic female hair loss and male pattern baldness) or alopecia areata. 

Possible Side Effects of Nettles

Despite claims made that “all natural” herbal supplements are free from side effects, nettle root has its share of warnings. When topically applied, irritation of the scalp or an allergic reaction can occur. When taken orally, it can cause upset stomach, burning, difficulty with urination, bloating and edema.  Nettle root extract should not be used in patients with heart or kidney problems, due to fluid retention properties.
Those who want to try nettle root extract as a hair loss treatment should proceed with caution and consult their doctor before using it.

In fighting hair loss, there may be certain unwelcome side effects produced. These side effects are the results of the body's natural immune response. These effects can increase hair loss, if not controlled.

But with anti-inflammatory hair loss cure products, such side effects as itching, flaking, redness, and naturally, inflammation, are reduced. These topical treatment options include Tricomin, Folligen, Proxiphen and Proxiphen-N, Betadine and T-Gel and Nizoral Shampoos.

Nizoral

Here’s one shampoo that fits in with any treatment option.

Nizoral, made for men and women, is available in any grocery store. Nizoral is effective at reducing itching, inflammation and other side effects of other treatments, such as Propecia. The shampoo also maintains scalp health. Plus, research has shown that using Nizoral for an extended period may help to treat male pattern baldness (MPB) and female pattern baldness (FPB).

It’s advised that you apply Nizoral once every three days, in rotation with your normal shampoo. However, as Nizoral’s effects can last for several days, it is a very inexpensive treatment option. After one month of use, you should then use Nizoral once every 1-2 weeks. The shampoo should be applied to wet hair and scalps. You should then leave it in for 3-5 minutes before rinsing thoroughly.

T/Gel Shampoos

T/Gel is the brand name for a variety of shampoos and hair loss cure treatments. Primarily, these products are designed to treat such scalp problems as dandruff, itching, flakiness, and excess oil.

The Original Formula shampoo contains 2% Neutar ®, which is essentially 0.5% Coal Tar. There’s also T/Gel’s Fine/Oily Hair Formula, Extra Strength Formula, and Stubborn Itch Control Formula. These varieties all feature Neutar, a patented product, which dissolves into the scalp as it treats the previously mentioned symptoms.

T/Sal® Maximum Strength Therapeutic Shampoo features 3% Salicylic Acid. This effectively treats the crusty scalp build-up of psoriasis, as well as problems caused by excessively oily skin. This product should be used at least three times a week, unless other wise directed by your physician. T/Gel’s Healthy Scalp Anti-Dandruff Shampoo also contains Salicylic Acid, specifically 1.8%. There’s also T/Scalp® Therapeutic Anti-Itch Liquid, which features 1% Hydrocortisone. This is meant for treating severe dandruff.

The prices for these products vary, but generally, a 16oz. bottle of the Original formula retails for about $13.00.

Nioxin shampoo and conditioners

If you have fine or thinning hair, you may want to consider the Nioxin family of hair products. These all-natural cleansers, conditioners, treatments and styling products are free of any drugs.

Nioxin can improve the hair’s health by cleansing the scalp’s skin, strengthening the hair follicle and energizing the cellular activity. In addition, Nioxin is supposed to restore the scalp’s proper moisture balance. On average, the Nioxin products take about 45 days to show their effects.

Nioxin has not been found to have any effect on DHT. However, by keeping the follicles healthy, these products may help delay hair loss. Because there are no side effects, the products can be used everyday. Nioxin typically costs $30-$125 per month.

Click to learn more about Hair Cover Ups

Viviscal's hair growth vitamin and dietary supplement taken twice daily promises to "reverse hair loss" and grow thicker hair in both men and women experiencing balding and thinning hair.  Its primary activeingredient, AminoMar C™ Marine Complex, is said to be a proprietary blend of ingredients and proteins that "provides the essential nutrients needed to nourish thinning hair and promote existing hair growth".

The entire Viviscal product line includes an "all natural" dietary supplement, a shampoo and conditioner, and a scalp lotion.  Viviscal is promoted as being 100% natural, drug-free, gluten-free and safe from harmful side effects. But can Viviscal deliver on its promises to reverse hair loss and grow new hair?

In 2011, Viviscal advertisement was banned in the United Kingdom by the Advertising Standard Authority (ASA) who deemed that its claims to maintain optimum hair health were unproven. The ASA concluded:

"Because the evidence sent did not show that the ingredients in Viviscal had been shown to have a positive effect on hair health, we concluded the claims that the product could 'nourish hair follicles' had not been substantiated' and ruled the advert cannot be broadcast until it is changed."

However, as with many similar products promising to grow hair, substantiating their hair growth claims may not be a simple task.

Viviscal’s manufacturer does reference a number of studies that seem to support their claims of growing thicker hair. For example, the results of "Scientific Pilot Study #1" on 40 hair loss suffering females with an average age of 35 concluded, "Viviscal was well received by test subjects and the analysis of hair counts showed a mean reduction in hair loss of 46% in only 10 weeks." Additional studies are cited on Viviscal’s website.

Recently, we learned that Dr. Glenn Charleshas publicly endorsed Viviscal.  Dr. Charles has an outstanding reputation for performing state of the art hair transplant surgery and is a highly esteemed member of the Coalition of Independent Hair Restoration Physicians.When asked to comment on his public endorsement of Viviscal, Dr. Charles stated:

"I have never had any hair loss patients display any negative effects. I describe it to my patients as a natural supplement that can promote a healthier scalp and hair. It may also, in turn, slow down the hair loss process. I tell all my patients that there are no guarantees with this product.  Although most patients believe that they did have improvement after using this product, I admit that some patients do not see any noticeable changes that either they or I can identify."

Other hair loss experts are not as optimistic regarding Viviscal’s hair growth potential. Coalition member Dr. Bill Rassmanof Los Angeles states:

"I am skeptical of the photographs (results) and the changes shown make me doubt what the Viviscal marketing department wants me to see. Viviscal reportedly contains ‘special marine extracts and a silica compound’ - and yet I’m to believe this will regrow hair? If these photos were real, the product would have taken over the market years ago."

It's also important to note that Viviscal does notmake any claims on their website that their products can reverse the effects of genetic hair loss.  Instead, it simply states, "Viviscal works to reverse hair loss due to stress, poor nutrition, and many health related ailments".

So is Viviscal an effective hair loss treatment? More research may be needed before this question can be effectively answered. 

While there may be no harm (potential side effects) in trying it, at an average cost of $600 per year there are certainly more affordable and proven treatments available. The only clinically proven and FDA approved medical hair loss treatments currently available are Rogaine (minoxidil) and Propecia (finasteride). While Rogaine may be used by both male and female patients, Propecia is safe and approved only for male hair loss sufferers. Always consult your physician before adding any treatment to your hair loss regimen.

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.