Once male-pattern baldness starts, it’s not going to stop until every last hair on your head has shrunk or shed, though the rate at which this happens differs from person to person and depends on genetics. And since the grind of hair loss is unending, it’s important to start treatment as soon as your hairline starts bothering you. If you’re looking for a more quantitative metric, Dr. Paul McAndrews, clinical professor of dermatology at the USC School of Medicine and member of the International Society of Hair Restoration Surgery, assures me that “you have to lose half your hair before the human eye can tell.” (Of course, if you don’t care about losing your hair and are fine with going full Prince William and shaving your head, go for it. We’ve got some recommendations for razors and hair trimmers to help you out on that front.)
A little farther up the follicle is the mysterious feature called the bulge. That's where follicle stem cells live. When they get the right set of chemical signals, these self-renewing cells divide. They don't divide like normal cells, in which both halves become new cells that keep splitting and developing. Only one half of the follicle stem cell does that. The other half becomes a new stem cell, and stays put for future regeneration.
When you notice one or more of these problems, you might be experiencing hair loss. For more information on the different stages of balding, have a look at the Norwood Scale. There, you can see the seven different stages of male pattern baldness. As hair loss progresses higher on the scale it becomes more difficult to keep your hair and potentially regrow lost hair.
P.R.P., considered a nonsurgical treatment, is not covered by insurance, and clinical studies about its effectiveness (and longevity of results) are not conclusive because different doctors use different mixes. But P.R.P. has a long (though also inconclusive) history of use elsewhere in the body. Athletes like Kobe Bryant have received the treatment in an attempt to heal injuries.
Since PhytoCayne Revitalizing shampoo is so watery, it’s easy to overpour and waste a good amount of this expensive product. That’s one reason we rank it below Revivogen and Nioxin. The more important reason for the #3 ranking is that this shampoo doesn’t do everything that the other two products do. It’s still effective for most users, however, and worth a try.
I’ve been updating the Ultimate Guide to Hair Regeneration 2018 a bit over the last several weeks. There are two new companies who made the list, although you’ve most likely heard of them before, and some positions have changed. Position changes usually happen when pivotal news gets reported or progress is made by a particular company. I’ve been meaning to work on the Guide for a while now and only recently found time for it in between writing new articles and other activities.
"This is an oral, prescription-only medication with the brand name Propecia that’s also FDA approved to treat hair loss," says Spencer. Male pattern hair loss occurs when a hormone called dihydrotestosterone (DHT) prevents hair follicles from getting the nutrients they need. Finasteride works by blocking the production of DHT, which protects the follicles.
Hair loss is often distressing and can have a significant effect on the patient's quality of life. Patients may present to their family physician first with diffuse or patchy hair loss. Scarring alopecia is best evaluated by a dermatologist. Nonscarring alopecias can be readily diagnosed and treated in the family physician's office. Androgenetic alopecia can be diagnosed clinically and treated with minoxidil. Alopecia areata is diagnosed by typical patches of hair loss and is self-limited. Tinea capitis causes patches of alopecia that may be erythematous and scaly and must be treated systemically. Telogen effluvium is a nonscarring, noninflammatory alopecia of relatively sudden onset caused by physiologic or emotional stress. Once the precipitating cause is removed, the hair typically will regrow. Trichotillomania is an impulse-control disorder; treatment is aimed at controlling the underlying psychiatric condition. Trichorrhexis nodosa occurs when hairs break secondary to trauma and is often a result of hair styling or overuse of hair products. Anagen effluvium is the abnormal diffuse loss of hair during the growth phase caused by an event that impairs the mitotic activity of the hair follicle, most commonly chemotherapy. Physician support is especially important for patients in this situation.
There have also been studies on the effects of 1% pyrithione zinc shampoo and a 5% minoxidil solution. In one study, 200 men between the ages of 18 to 49 who experienced baldness between type III and type IV on the Norwood scale were given this treatment for a six-month period. They found that minoxidil, when used on its own, was approximately twice as powerful as pyrithione zinc at stimulating hair growth, but that both products were successful at increasing the amount of visible hair when used over a 26-week period.
It wasn’t quite the “accident” it was portrayed to be. He worked out that the drug targeted a protein called SFRP1, which affects follicle growth. He looked into the literature and discovered there was a pre-existing osteoporosis drug, WAY-316606, designed to target this protein with much more precision. So he applied that to leftover slabs of scalp donated by hair transplant clinics. “We usually do experiments for over a week. We put the hair follicles in a dish and this drug enhanced hair shaft elongation within two days. But it also kept the hairs healthier. When you look at them, they’re larger, thicker hair follicles. So, it’s quite promising.”
2. Oil-rich conditioner. “Oils improve hair’s tensile strength,” says Paradi Mirmirani, a hair-loss specialist and dermatologist in Vallejo, California. In other words, oils make hair less likely to break under pressure, which is especially important for thinning hair that’s prone to snapping when brushed or styled. Mirmirani recommends using a conditioner fortified with natural oils, like Burt’s Bees Very Volumizing Pomegranate Conditioner, which contains avocado oil ($8), or Honest Company Conditioner with coconut oil ($10). That one’s got an added benefit: “Coconut oil has been shown to penetrate hair,” says cosmetic chemist Randy Schueller, so it makes your hair stronger from the inside out. (Just don’t load up on pure coconut oil. “You might overshampoo your hair to get it out, and then you’ll end up drying your hair and undoing any benefit,” says Fusco.)
While techniques have advanced, the bald are no better served, says Spencer Kobren, who runs Bald Truth, a website and podcast in the lustrous world of the alt-bald media. He has learned to be highly suspicious of anything announcing itself as a cure; indeed, he resolutely fails to get excited about RT1640 or the Manchester findings. “I have been doing this for 20 years,” he tells me from his home in Beverly Hills. “When I wrote my book in 1998, they had just found the hair loss gene. There was talk of hair clones. There was a cell-based solution coming out of Japan. It was like: ‘This is it! We’re going to cure this in five years!’” He’ll believe it when he sees it.
Try balayam yoga. Balayam yoga (also called balam yoga) is an ancient acupressure exercise associated with hair growth. It comes from the Hindu words, Bal, which means hair, and Vyayam meaning exercise. The exercise involves rubbing the fingernails on both hands together to stimulate activity in the scalp. It has been known to help cure pattern baldness in men and women if done correctly and frequently over a long period of time.
Would there be any harm/benefit in combining the use of two hair-loss prevention shampoos, to take advantage of different ingredients and functions? Mainly Nizoral, at the twice a week recommendation, plus the Argan Oil Shampoo twice a week? I have somewhat oily hair and do get dandruff from time to time, but I do feel after washing my hair, it can feel dry and stiff. Just wondering if a combination of the two (one for dandruff, and one for healthy, thicker hair) might prove effective. Also, would you have any recommendations on a combo? Thanks!
Dr. Melissa Piliang, a dermatologist at the Cleveland Clinic, said that Rogaine works better on the top and crown (for reasons not fully understood, the frontal hairline tends to be more resistant to treatment) and ideally should be started as soon as women notice thinning. “Any regrowth you get is a minimal amount,” Dr. Piliang said. “So the more density when you start, the better results you get.”
With those pinned down, it wasn’t hard to determine which don’t actually work. Pretty much all the “active” ingredients listed in ineffective treatments — from biotin and zinc to emu oil and saw palmetto — have never been proven, and are instead marketed based on logical-seeming correlations. It would make sense that biotin, a B vitamin readily found in hair, skin, and nails, could help hair grow more quickly. And caffeine is a stimulant that works in coffee, so rubbing some on your scalp might wake some of those sleepy follicles… right?
The dermatologist also will carefully look at your scalp and hair. During an exam, the dermatologist may pull on your hair. Sometimes a dermatologist needs to pull out a hair to get the necessary evidence. And sometimes a dermatologist needs to look at the hair on the rest of your body to see whether there is too little or too much hair in other areas.
NFL Hall of Fame player Deion Sanders has recently undergone a hair transplant. He has not been shy about discussing it publicly and over the last several weeks has actually continued to put out a slew of hilarious and outrageous posts pertaining to his renewed follicles. For his first announcement to social media, he posted this jubilant and priceless video to his Instagram:
This video is equally hilarious. Once again, there is inspiration here. Deion had a 5,000+ FUE last year and received good results from it. But he’s not done yet, he has the resources to have another procedure and get as close as he can to the result that he really wants, so he did. Surely, he’s just about maxing-out his donor area now. Once again, congratulations to Deion for pursuing his hair growth goals. Enjoy the video and have a big laugh. OOOOeeee.
“Everyone wants to try it,” Altman told me. “We get inundated with e-mails saying, ‘Tell me what the price is, I really don’t care, I’ll buy it.’ ” Weinstein looked at me. “You have your hair,” he said. “I don’t know why you’re interested in this,” Altman chimed in, with wildly unrealistic but much appreciated enthusiasm for my reporting. “ ’Cause eighty million people don’t! There’ll be eighty million people reading this article!”
Recent update: “Breakthrough” in South Korea (11/21/17). We don’t want to get anyone’s hopes up prematurely, and we definitely hope this is not just another false alarm, but this recent discovery does seem to hold some promise. At best it would probably be 3-5 years out for wide availability, we think it’s still worth checking out. Professor Kang-Yell Choi of South Korean University Yonsei lead research indicating that they may have discovered a new protein that controls hair growth. The study in the Journal of Investigative Dermatology as well as a news article in the Korea Herald are good places to start reading about this new development.
In the operating room, Bernstein prepped the robot patient for implantation, puncturing the man’s scalp with a long needle. These are the “sites” where the hairs will go. Blood bubbled over his scalp, but the patient didn’t seem to notice. The patient and doctor chatted loosely about summer houses and beers and boats. “Would I be a candidate for a surgery after this surgery?” he asked.
Hair pieces and wigs. One of the most traditional answers to hair loss, wigs and toupees are perfect for severe cases where full coverage is needed. Wigs can be made either from real human hair, animal hair or synthetic fiber. The materials are sewn together into certain hair styles and are worn on top of the real hair. For those who want to cover up only bald spots or add volume to thinning hair, hair pieces and hair extensions are also available. These are balls of hair that can be attached at the base or clipped to portions of the head.
This medication goes by the name Avodart. It is used for the treatment of BPH also known as enlarged prostate. However, there are a large number of users using it for the off label purpose of treating hair loss. Remember the 5 alpha reductase we mentioned that Propecia blocks? Well there are two types of 5 alpha reductase. Type I and Type II. Whereas Propecia has only been shown to block type II, Avodart blocks both types. This effect overall lowers DHT levels even more, further reducing the risk of damaged hair follicles. However, it faces the same limitations as Propecia. It must be taken daily and may lose its effectiveness overtime.
RepliCel is a regenerative medicine company focused on developing autologous cell therapies (or therapies that involve one individual as both donor and recipient) that address conditions linked to a deficit of healthy cells required for normal healing and function. Located in Vancouver, British Columbia, the company has developed first-of-their-kind cell therapies that will, they hope, treat conditions that now affect 1 in 3 Americans: pattern baldness, aging and sun-damaged skin, and chronic tendon degeneration.
A study led by Dr. Noha Doghaim of Tanta University in Egypt showed that carboxytherapy may be a promising treatment option for both alopecia areata and androgenic alopecia. The study comprised 80 subjects who were treated over the period of three months with either placebo or carboxytherapy. Both groups found favorable results from the carboxytherapy, however during a follow-up examination the improvements in androgenic alopecia subjects had decreased over time. The researchers noted that continual treatments would be necessary to maintain and bolster the benefits for AGA.
It’s also possible that some of Harklinikken’s users are women whose hair would have grown back even if they’d done nothing. Many women who arrive in a dermatologist’s office with prior diagnoses of female pattern hair loss actually have what’s called telogen effluvium. That’s a period of acute shedding of hair — meaning up to 60 percent of hair — three months after a triggering event like pregnancy, significant weight loss or starting or stopping hormone medications.
In Michael Wolff’s “Fire and Fury,” Kuntzman’s theory is bolstered. Wolff writes that Ivanka Trump “often described the mechanics behind it to friends: an absolutely clean pate—a contained island after scalp-reduction surgery—surrounded by a furry circle of hair around the sides and front, from which all ends are drawn up to meet in the center and then swept back and secured by a stiffening spray.”
Giovanni Mele, a stylist who owns Giovanni and Pileggi in Center City, said many women with thinning hair try to wear their hair long. He thinks they're much better off with short, pixie-like styles with light layering on top. He recommends that lighter-skinned women choose colors that are a little darker than blond or gray. He is a fan of a hair-thickening product made by Nioxin.
I just received an email sharing a new Trinov website: TrinovAnticaduta.com. This one does appear to be an official website for Trinov. The page is in Italian and can be translated, it mainly features a sign up form to download the “Trinov ebook” for either the men or women’s version. I downloaded the men’s Trinov ebook, however it is a pdf in the Italian language and cannot be translated. There is also a short YouTube video for Trinov featured on the page. Fidia Pharma’s logo is at the bottom of the TrinovAnticaduta page and for good measure I looked up the domain on Whois and saw that the page is registered to Fidia. Things will just keep getting more interesting from here.
The best hair loss shampoos are gentle enough so that you can use them multiple times a week. Nizoral, however, is most effective when used only a few times a week (and should be left on the hair for three to five minutes before rinsing). But you can also alternate Nizoral with another type of hair loss shampoo – such as the Lipogaine products or Alpecin’s Caffeine shampoo – for an effective one-two hair loss fighting punch. Use Nizoral twice a week while using your other hair loss shampoo on the other days.
Patients with tinea capitis typically present with patchy alopecia with or without scaling, although the entire scalp may be involved. Other findings include adenopathy and pruritus. Children may have an associated kerion, a painful erythematous boggy plaque, often with purulent drainage and regional lymphadenopathy. Posterior auricular lymphadenopathy may help differentiate tinea capitis from other inflammatory causes of alopecia. If the diagnosis is not clear from the history and physical examination, a skin scraping taken from the active border of the inflamed patch in a potassium hydroxide preparation can be examined microscopically for the presence of hyphae. Skin scrapings can also be sent for fungal culture, but this is less helpful because the fungi can take up to six weeks to grow.