The patient, a small, vaguely European man in his late forties, had rings on his fingers and a bloody, rectangular gash on the back of his head. It looked like a chunk of missing carpet. Bernstein pointed at the white opening of exposed scalp, and explained how easy it would be to stitch skin together over the gap. This was a traditional process for follicular-unit transplantation. Then Bernstein led me into a second room, where another patient was seated with his face in a massage-table-like padded hole. A portion of the back of his head was marked off. To his right was a boxy gray machine, roughly four feet by four feet, with a jutting mechanical arm. This was the ARTAS Robotic Hair Transplant.
Niacin, also known as vitamin B3, is another vitamin that you can find in a lot of men’s hair loss shampoos. Like biotin, niacin and its derivatives are scientifically proven to increase hair growth when topically applied to hair growth areas over the course of several months. However, it's important to call out that this pilot study used female participants.
Some factors that are thought to play a role in female hair loss include high androgen birth control pills, menopause, pregnancy, ovarian cysts, and other factors tied to the actions of hormones. The American Hair Loss Association said it’s important that women who have a history of hair loss in their family to be made aware of the potential effects of birth control pills on normal hair growth.
Some treatments in development hold particular promise for women. Angela Christiano, a hair geneticist and Columbia University professor of dermatology, is hoping to begin clinical trials in a year or two on a procedure in which she dissects hair-follicle stem cells, grows them in the lab until she has several million, then injects them into the scalp, where, a very small study done with a human skin model has shown, they induce new hairs.
HairMax is known for their lasercomb products — an FDA approved hair loss treatment. They’ve started to branch out and now they offer a supplement, topical, and this shampoo (as well as a matching conditioner). One of the standout ingredients in this shampoo is the gotu kola. We have a full write up about gotu kola and its relationship to hair loss here.
"Despite some of the claims, a shampoo or conditioner won’t be able to stop or slow hair loss, nor help with a receding hairline or thicken hair that’s becoming thinner," says trichologist Anabel Kingsley from The Philip Kingsley Trichology Clinic in London. "At best, a thickening shampoo will make hair temporarily thicker for a short period of time, but they certainly won’t help with hair loss or thinning."
Testosterone replacement is becoming popular for men. Cotsarelis warns that this may accelerate hair loss. Propecia might help -- but because it prevents testosterone breakdown, it might affect the dose of male hormone replacement therapy. Cotsarelis warns men taking both Propecia and testosterone replacement to make sure their doctor carefully monitors their testosterone levels.
But Buckler said hair growth isn’t the only perk to his company’s discovery. It turns out that use in skin repair and tendon regeneration are also possibilities of the technology. “While we were delving deep into the hair follicle, we discovered another cell population,” he said. The hair follicle is actually a minor organ. There are two different cell groupings. One grows hair fibers. Another grows the tissue that the hair follicle fiber grows in.” And it is within this latter cell grouping that the magical main structural protein found in skin and other connective tissues—collagen—is found.
I’d come to think that the simplest answer was the right one: this was regular male-pattern baldness, elaborately covered up. But the Air Force One incident only deepened the mystery. What kind of hair afflicted by male-pattern baldness rises in the back? I suddenly had no idea which parts of his head contained which hairs. Watching the flaps on the back of his head shoot up again and again, I became unmoored in my beliefs.
Hair transplant surgery – which works by painstakingly moving grafts of hair (typically two to four follicles at a time) from the back of the head to the temples and crown, the first parts to drop – is becoming mainstream. Wayne Rooney was frank about his 48-hour, £30,000 follicular unit extraction at Harley Street Hair Clinic in 2011, and is widely credited with changing attitudes towards the procedure. Actor James Nesbitt had one as he feared he’d lose out on roles as a bald man. “It was something I struggled with,” he said, “and that was probably the vanity in me.”
Iron supplements. Iron deficiency could be a cause of hair loss in some women . Your doctor may test your blood iron level, particularly if you're a vegetarian, have a history of anemia, or have heavy menstrual bleeding. If you do have iron deficiency, you will need to take a supplement and it may stop your hair loss. However, if your iron level is normal, taking extra iron will only cause side effects, such as stomach upset and constipation.
That said, there are products that don’t have FDA approval or clearance, but may help prevent hair loss. For example, shampoos with ketoconazole, a chemical with anti-DHT properties, is widely used to treat fungal infections but has become popular among consumers as a hair loss treatment. It makes sense — research shows that ketoconazole actually has beneficial effects on hair growth (especially for those with seborrheic dermatitis).
"Others are taking hair follicles out of human scalp and growing them with dermal papilla cells," Cotsarelis says. "If they grow in culture, you might be able to recombine them with skin cells and form new follicles. This would let you expand the number of follicles you get for a hair transplant. This may not be that far off -- five to 10 years, maybe. There's very good evidence you will be able to do that."
Licorice root. Licorice is an herb that is also used to treat and prevent hair loss and hair damage. It soothes the scalp and helps with dry flakes, dandruff and other forms of scalp irritation. Mix a tablespoon of ground licorice root with a cup of milk and a quarter teaspoon of saffron. Apply the paste on the bald patches and leave it on overnight. Rinse in the morning. You can do this two to three times a week.
Alopecia areata. This condition, called patchy hair loss, is the opposite of pattern baldness. Whereas in the former, thinning hair follows a pattern, alopecia areata is marked by smooth and bald patches anywhere on the scalp. The bald patches are circular, and can be as small as a pencil eraser or as big as a quarter. It begins with one or two spots that multiply on other parts of the head. The condition is caused by an autoimmune disease where the antibodies mistake the hair as the "enemy" and start attacking it, resulting into hair loss.
The only nonchemical option offered up by the dermatologists I spoke with — short of a surgical hair transplant or platelet-rich plasma therapy, which is like Kim Kardashian’s vampire facial but for your scalp — was the laser comb. First cleared by the FDA in 2009, the HairMax LaserComb is a handheld laser device that is designed to promote hair growth. As the manufacturer explains in a letter to the FDA, “The device provides distributed laser light to the scalp while the comb teeth simultaneously part the user’s hair to ensure the laser light reaches the user’s scalp,” which, in turn, stimulates the hair follicles.
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.
And just like that, more fascinating hair-related research was published in PLOS Biology. A team of researchers lead by Dr. Nathan Hawkshaw of the University of Manchester have identified the drug ‘WAY-316606’ as a potential candidate for hair regrowth. WAY-316606 is an existing drug used to treat osteoporosis. It’s not clear at this time whether WAY-316606 is approved and on the market, or if it was partially developed to treat the bone disease.
Managing hair loss is just as important as treating it. Now that we've talked about the different treatment options and cures available to reverse hair loss and promote increased growth, let's talk about how you can manage your condition and at the same time prevent further hair loss. The first is more psychological, while the second is more practical.
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.
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.
But there is a Canadian company who has been working diligently to change that. And if they’re right—and so far the research indicates they are—baldness may become a thing of the past for those who choose not to tolerate hair loss anymore. And they're not only attacking baldness, Aging skin and tendon degeneration are on the cutting block as well. It's great news for the tens of millions of older Americans who suffer from these malladies. But the most fascinating part lies in the source of the cure. It’s you. The company focuses on the development of cell therapies using a patient's own cells.
Christiano is more of a skeptic. Lab results are nice, she said, but “you can grow mouse or rat hair sixteen ways till Sunday. They grow beautifully!” She laughed. “Humans, not so much.” She points out that there’s so much we still don’t understand. For one: Why does the hair on the back of men’s heads stick around, even when all the rest drops? She also counsels caution when playing God with hair loss. Some companies are seeking hair-restoration cures by attempting to modify developmental-cell pathways. Those pathways, Christiano says, “are potent, and so it’s tempting, but you have to make sure it’s well enough controlled that you don’t initiate a cancer signal.”