The pull test may be used to diagnose hair loss conditions.1 The examiner grasps approximately 40 to 60 hairs at their base using the thumb, index, and middle fingers and applies gentle traction away from the scalp. A positive result is when more than 10% of hairs (four to six) are pulled from the scalp; this implies active hair shedding and suggests a diagnosis of telogen effluvium, anagen effluvium, or alopecia areata. However, a negative test result does not necessarily exclude those conditions. The pull test is difficult to standardize because the pulling force is not distributed uniformly and because it is difficult to approximate the number of hairs grasped, thereby leading to false interpretations.


Certainly a company with a unique background and game plan, HairClone has received some recent media attention. The UK biotech startup was featured in this month’s publication of “Consulting Room” online magazine. In the article both Dr. Bessam Farjo and Paul Kemp of HairClone provided insight as to the company’s current progress and plans for the future. Things seem to be coming along well for HairClone and we should expect to hear from them again within the next several weeks. Full story is on Articles main page.
A clinical researcher who has spent decades researching the fields of pattern hair loss, alopecia areata, endocrinology of the hair follicle and hair follicle morphogenesis, Hoffmann works in his private practice, as a teaching professor in the Department of Dermatology at the University of Marburg and as a researcher on histopathology on hair diseases. He has participated in dozens of clinical hair studies and is the inventor of TrichoScan®, a computerized technique to measure hair growth.
But in November, after 10 years of research, Rogaine introduced a new 5 percent minoxidil formulation for women. It’s a mousse (instead of a liquid) that needs to be applied only once a day instead of twice, which means that it can be more easily incorporated into a woman’s evening skin-care routine. Teal replaces the blue and silver palette of the men’s Rogaine, and the packaging bears a lotus flower. (Also last year, Pantene introduced its Hair Regrowth Treatment for Women, which is 2 percent minoxidil.)
Pura d’or makes a very bold claim with this product: “continued use WILL prevent further hair loss.” While we doubt it will “prevent further hair loss” for everyone, it does have an all-star line up of ingredients. Even if it doesn’t completely stop hair loss, this organic shampoo is certainly the safest for your hair out of our top 5. This shampoo is designed for daily use.

Consider other factors besides color. Color is important - your wig or hair piece should match your natural hair to look natural. However, consider also texture. You wig should feel like real hair; it should have a smooth and silky feel. For those that need full coverage, choose a wig that bounces to give the illusion of volume. A wig that has a lacing that fits your natural hair also helps in making sure that you have a more natural looking hairline.


I must have had about 5 readers email me today about the fascinating research coming out of Yokohama National University in Japan. Professor Junji Fukuda lead the efforts to successfully prepare “hair follicle germs” at large scale simultaneously. Essentially, the researchers prepared a cellular formulation with the right culturing materials to promote successful growth and development of tiny “hair follicle starter kits.” Source article here. 
While some medical practitioners are still on the fence about the effectiveness of laser treatments, studies have found that hair growth using laser therapy increased by 19 normal-size hairs per square centimetre. The regrowth is also observed as thicker, shinier and more manageable. It's a non-invasive, painless procedure that works for both men and women. However, the LLLT is not a stand-alone cure and is thus used in combination with other treatments.
“Once that hair has stopped shedding, it does regrow, at a rate of about a centimeter a month,” said Dr. Senna, who suffered from the condition after each of her pregnancies. She shares photos of herself with patients, to show she can sympathize. In one, her entire frontal hairline clearly is growing back in. “If I’d used a treatment, I would have thought it was a miracle drug,” she said.
For those of you who only check the Updates page, there was a new Brotzu Check-In article published yesterday. Giovanni Brotzu will be presenting data pertaining to his lotion’s use in androgenetic alopecia at an Italian hair research Congress this Saturday, April 14th. We hope to see photo results from the presentation. Check back to the Brotzu article next week for updates.
At the Sanford-Burnham Medical Research Institute, they showed that stem cells derived from human skin to grow hair when grafted onto the skin of mice. A paper describing this research, which was published on January 21st 2015 can be found here in the PLOS One medical journal. Dr. Alexey, a member of the research team made the following written statement: “Our stem cell method provides an unlimited source of cells from the patient for transplantation and isn’t limited by the availability of existing hair follicles.” Once successfully developed, this could transform a fully bald man or woman to the head of hair they had as a teenager. The main challenge now will be replicating their results in large-scale human trials.
The combination of silent suffering, public shame and poorly understood science makes hair loss sufferers easy prey – type “hair loss” into Google and you’ll see what I mean. Kobren tells me that he had to remove the personal messaging function on the Bald Truth message board, as users were being bombarded by scams. Meanwhile, the higher visibility of celebrity transplants means that baldness is at risk of being seen as a sign of poor self-care. Many treat surgery lightly – and enter into punitive financing deals. One of Kobren’s recent guests was The Only Way is Essex star Maria Fowler, who complained that surgery at the controversial KSL Hair in Glasgow left her with an unnatural hairline. “She ended up having a hair transplant because her fiancé was having one. She had always thought her hairline was too high. She went in like she was having her nails painted – and it destroyed her life.”
In 1952, a New York dermatologist named Norman Orentreich invented hair plugs. He removed hair from the back of a patient’s head, where it still grew, and grafted it onto the front. In the decades since, the transplantation process has become more refined. Following the lead of the pioneering dermatologist Robert Bernstein, most doctors perform follicular-unit extraction; instead of crudely ripping up large parts of the scalp, they pluck and move individual follicular units.
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.”

Therapeutic advanced formula unclogs pores and removes DHT while moisturizing the scalp and stimulating circulation and hair follicles. This Scientific complex shampoo, with olive oil and argan oil, promote manageable hair without the flakes and itchy that comes with dandruff. Our maximum strength anti itch formula clarifies the skin for incredible body in your hair while stopping the thinning of hair. Our formula recipe promotes hair growth and regrowth of strengthened, shiny, thick hair.
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.
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?
A company not previously discussed in online news, SWITCH BIOTECH, has sights on developing a drug for androgenic alopecia. As you will see, the company is still in the very early stages of developing a therapy for AGA, however they are a knowledgeable dermatology-focused company and have a unique method of drug development. Here’s a quote from their website about working on AGA:
“I also reached out to Histogen and Follicum a few weeks ago as well thanking them for all their hard work in bringing a safe and effective treatment to people all over the globe with hairloss issues and expressed how much we all value these companies. I held back from asking about market release as you had suggested. I received a very nice reply from Histogen.”
The pull test may be used to diagnose hair loss conditions.1 The examiner grasps approximately 40 to 60 hairs at their base using the thumb, index, and middle fingers and applies gentle traction away from the scalp. A positive result is when more than 10% of hairs (four to six) are pulled from the scalp; this implies active hair shedding and suggests a diagnosis of telogen effluvium, anagen effluvium, or alopecia areata. However, a negative test result does not necessarily exclude those conditions. The pull test is difficult to standardize because the pulling force is not distributed uniformly and because it is difficult to approximate the number of hairs grasped, thereby leading to false interpretations.
*Photograph used with permission of the Journal of the American Academy of Dermatology. This photograph was published in the Journal of the American Academy of Dermatology, Vol. # 60, Gathers RC, Jankowski M, Eide M, et al. “Hair grooming practices and central centrifugal cicatricial alopecia,” 660-8. Copyright Elsevier (2009). Journal of the American Academy of Dermatology.   
Hair loss is more common than you think and it can happen to anyone. According to Michele J Farber, MD of Schweiger Dermatology Group in NYC, causes range from, “androgenetic or hormone-related hair loss, stress related-hair loss, also called telogen effluvium, and dandruff. Medications, vitamin deficiencies, thyroid disorders, excess styling, and autoimmune disorders can also cause hair loss and thinning.” But the good news is, there are viable solutions, starting with topical growth treatments.
Revivogen’s shampoo is formulated by dermatologists to do three different things: cleanse and revitalize the scalp while fighting dandruff with aloe vera and menthol, moisturize hair and make it look thicker and fuller with proteins and nutrients – and most importantly, prevent hair follicles and the scalp from being saturated with the DHT blamed for causing most cases of pattern baldness.
In this section we take a look at current hair loss cures in 2018. Using one or more of the treatments below is your best shot at keeping your hair around. However, if a cure is defined as a permanent fix to an ailment, these are far from that definition. Each of these treatments have their own limitations. Most are seen more as hair loss management treatments, rather than permanent hair loss cures.
Deionized Water, Sodium Laureth Sulfate, Cocamidopropyl Betaine, Sodium Cocoyl Alaninate, Polyquaternium-7, Sodium PCA, Aloe Barbadensis Leaf Juice, Apigenin, Biotinoyl Tripeptide-1, Butylene Glycol, Camellia Sinensis (Green Tea) Leaf Extract, Fragrance (Parfum), Glycerin, Glycine (Amino Acid), Guar Hydroxypropyltrimonium Chloride, L-Arginine, Larix Europaea (Larch) Wood Extract, Niacinamide, Oleanolic Acid, PEG-150 Pentaerythrityl Tetrastearate, PEG-40 Hydrogenated Castor Oil, PEG-8 Caprylic/Capric Glycerides, PG-26-Buteth-26, Propolis, Sodium Metabisulfite (Antioxidant), Zinc Chloride, Methylchloroisothiazolinone, Methylisothiazolinone, Disodium EDTA, Citric Acid.
Researchers from South Korea have identified a new peptide called PTD-DBM which exhibits wound healing and hair regeneration effects in preclinical studies. The research is being led by Professor Kang-Yell Choi of Yonsei University. Choi’s team identified the peptide PTD-DBM which targets a protein called CXXC5. The interaction of these two proteins leads to stimulation of the Wnt pathway, which then initiates hair follicle neogenesis. Choi hopes to develop this peptide further into a potential hair growth drug candidate. A research paper about these findings was put out by the team earlier this year. Source article about this development here.
In essence, it is widely known as Microneedling, and it has the power to completely revive your head and scalp from within. It will, among other things, help rejuvenate your scalp skin, help remove old skin cells and embedded oils (sebum) that are currently blocking and clogging your hair follicles, and most of all, it will reactivate the hair follicles in your head to make them grow hairs again. How amazing is that?

Nizoral is the gold-standard in hair loss prevention. Its main ingredient is ketoconazole. The nice thing about Nizoral is that you only need to use it twice a week (because ketoconazole binds to the proteins in your hair so it will keep working many days after use). If you were to use it daily your scalp would be drier than a desert and itchy as all heck.


Unfortunately, as with the aforementioned minoxidil, you’ll begin to lose your hair again if you ever stop taking Finasteride. Additionally, it may cause erectile dysfunction and other sexual problems in men although that’s uncommon. Men who experience these side effects from taking this pill can reverse them; however, that can take up to three months to occur.

Hair transplantation involves harvesting follicles from the back of the head that are DHT resistant and transplanting them to bald areas. A surgeon will remove minuscule plugs of skin that contain a few hairs and implant the plugs where the follicles are inactive. Around 15 percent of hairs emerge from the follicle as a single hair, and 15 percent grow in groups of four or five hairs.
You’ll find ketoconazole in Nizoral anti-dandruff shampoo, and preliminary research indicates that it may be effective in treating hair loss. Researchers found that both 2% ketoconazole and minoxidil regimens improved hair density, size, and proportion of anagen follicles. Ketoconazole also is effective in treating a fungus called Pityriasis that often inhabits the scalp.
Acupuncture is a form of Chinese medicine that has been practiced for thousands of years. Its applications are many, and some researchers believe that it may help with hair loss from alopecia areata. How? The needles inserted into the scalp may help stimulate hair follicles and promote regrowth. More research needs to be done in this area, but consider asking your doctor for a referral to a licensed acupuncturist if this treatment sounds appealing to you. (Learn more about acupuncture for hair loss.)
In II Kings 2:23-24, the prophet Elisha is mocked by a gang of surly kids. The kids “said unto him, ‘Go up, you bald head! Go up, you bald head!’ ” Elisha “cursed them in the name of the Lord.” Promptly “two she-bears came out of the wood and tore forty-two of them.” Sometime later—in 2013—German researchers published a study indicating that men experienced hair loss as an “enormous emotional burden” that could lead to an “impaired quality of life” and “psychological disorders.” Inversely, one study has shown that people perceive men with bountiful hair as likely having big penises.
The Holy Grail remains a drug that will promote regrowth, but this might not be so far away. Earlier this year, Manchester University announced that an osteoporosis drug had been found to have “dramatic results” promoting hair growth when applied to tissue samples in pre-clinical trials. The resultant frenzy left the PhD student responsible, Dr Nathan Hawkshaw, a little dazed. “Every other week, something comes out about hair loss and it doesn’t generate as much media coverage as what I experienced,” he grumbles. He’s in this for the science – there aren’t many fields where you get to mess around with real human tissue – but such is the distress caused by hair loss and such is the potential customer base that interest is always high.
Baldness is not caused by excess testosterone as is commonly thought; nor is it inherited from your maternal grandfather. It’s caused by sensitivity to testosterone: an enzyme converts testosterone into a substance called dihydrotestosterone – which then causes the follicle to shrink and fall out. Male pattern baldness is inherited, but from both or either side of your genetic line. Why men go bald, we’re not sure – though there is a hypothesis that baldness was once a genetic advantage. People tend to associate baldness with virility and wisdom. The bald hunter-gatherer would have been a natural choice for a chieftain back when life expectancies were shorter and bald heads rarer. In our age of appearances not so much. Of 17 male members of Cabinet, two are bald (Chris Grayling and Sajid Javid). Studies correlate baldness with depression; the term “psycho-trichological” is used to describe the feelings of disfigurement, social avoidance and anxiety disorders that often arrive with premature baldness.
He now enjoys full scalp coverage, which he credits to modern transplant techniques combined with Propecia – but when he embarked on what he refers to as his “hair-loss journey”, there weren’t so many options. One trichologist advised him to dunk his head in freezing cold water six times per day; another zapped his scalp with infra-red light; finally, he opted for surgery. “The techniques were far less refined – 450 grafts,” he says. “Now, we can move 4,500 grafts in a single session. It left me with scars at the back of my head. And I committed to more and more procedures. Each time, they were taking another strip of tissue from the back of my head, leaving another scar.” He was eventually “fixed” at a surgery in Vancouver, but in his present role he talks people out of surgery as much as talking them into it. “I wish I could turn back the clock so I never had surgery,” he says.

Researchers from South Korea have identified a new peptide called PTD-DBM which exhibits wound healing and hair regeneration effects in preclinical studies. The research is being led by Professor Kang-Yell Choi of Yonsei University. Choi’s team identified the peptide PTD-DBM which targets a protein called CXXC5. The interaction of these two proteins leads to stimulation of the Wnt pathway, which then initiates hair follicle neogenesis. Choi hopes to develop this peptide further into a potential hair growth drug candidate. A research paper about these findings was put out by the team earlier this year. Source article about this development here.


Contact immunotherapy. Another drug that can be administered for cases of alopecia areata is contact immunotherapy and is recommended for severe cases. Diphenylcyclopropenon (DPCP) is applied on the scalp every week, and the dosage of the drug is increased over time until a mild allergic reaction is observed, which signals that the drug is taking effect. Regrowth may be observed within three months from the beginning of treatment.
This shampoo has one of the top ratings of any shampoo sold online. KIMI Naturals must be doing something right! Saw palmetto, biotin, argan oil, and keratin are some of the highlight ingredients in this shampoo. They offer a 60 day money back guarantee, so if you’re not happy with the results after you give it a go, get you’re money back. On their KIMI Naturals website, they also sell a vitamin supplement and scalp treatment which they sell together with this shampoo as a 3-pack system.
The history and physical examination are often sufficient to determine a specific etiology for hair loss. It is convenient to divide the various causes into focal (patchy) and diffuse etiologies, and proceed accordingly. Patchy hair loss is often due to alopecia areata, tinea capitis, and trichotillomania. Diffuse hair loss is commonly due to telogen or anagen effluvium. Androgenetic alopecia may be diffuse or in a specific pattern, and may progress to complete baldness.

If you do decide to start treatment to save your hair, a good place to start is with minoxidil, more commonly known as Rogaine. Don’t expect this hair-loss treatment to create luscious locks; minoxidil is better at slowing down or preventing more loss rather than promoting hair growth. But, according to Dr. Amy McMichael, professor and chair of Wake Forest Baptist Medical Center’s Department of Dermatology, it is effective “if used as recommended, with evidence of improvement seen around six to nine months.” Simply massage the foam or solution into your scalp once or twice daily, and for best results, use a formula with 5 percent concentration.
Tissue expansion. In this procedure, a material called a tissue expander is inserted under portions of the scalp with hair. Saline water is injected for six to eight weeks in order to expand or stretch this portion of hair-bearing skin. The bags are eventually removed and the expanded hair-bearing skin is cut away and moved to the adjacent bald area. This is typically used to address hair loss as a result of burns or injuries on the scalp.
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.
"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."
Cloning has seen many false starts and wrong turns, Christiano told me. Now her team is building “an artificial skin with a dermis and an epidermis, with molds made to mimic the dimensions of hair density,” she explained. “When the artificial skin matures we pull out the pre-formed hairs and insert them into the skin.” Bernstein is convinced that, in the next ten years, cloned hair will happen. “And then the supply and demand problem is solved,” Bernstein said. “Without Bernanke!”
Of course, there are plenty of men who wish desperately to restore their youthful locks, and a few — we can think of one powerful one — who cling to elaborate comb-overs, but many balding men simply clip their hair short and go on with their lives. Dermatologists say hair loss is emotionally harder for women, who are often deeply embarrassed by thinning hair even though it's quite common. By the time they reach 50, about 40 percent of women are experiencing what's known as female-pattern hair loss, said Gopal Patel, a dermatologist with Aesthetic Dermatology Associates in Media. Women of African descent struggle with even more conditions that can damage hair follicles and cause bald spots.
Caffeine – Quickly finding its way in to many skincare products for both men and women, caffeine is a natural antioxidant that not only fights free radicals that accelerate the signs of aging, but also help to stimulate the growth of hair. In fact, in a recent study published on the National Institute of Health (NIH) website, it was discovered that there were ‘growth-promoting effects’ to the hair with regular application (source).
“While nutritious eating isn’t going to bring your hair back by any means, eating plenty of protein-rich foods and healthy fats can make the hair that you still have look thicker and shinier.” Skimping on the B vitamins in particular can interfere with the formation of hair cells and, therefore, hair growth. The best sources of Bs are protein-packed foods like chicken, fish, eggs, and pork, as well as leafy greens such as spinach. (These foods are also good for melting belly fat, so it’s a win win).
“The most common cause of hair loss in both men and women is androgenetic alopecia, which is genetic pattern hair loss,” explains Dr. Michael B. Wolfeld, a board-certified plastic surgeon and an assistant clinical professor of plastic surgery at the Icahn School of Medicine at Mount Sinai Hospital in New York. The root cause of this type of hair loss is dihydrotestosterone (DHT), a byproduct of testosterone that shrinks certain hair follicles until they eventually stop producing hair.
The key ingredient in Nizoral is ketoconazole, which reduces hair follicle inflammation that contributes to hair loss. Ketoconazole also kills fungi that cause dandruff, but there’s not so much of it as to be toxic (which large amounts of ketoconazole can be). It has been argued that dandruff may contribute to hair loss; while there’s no direct link, it’s certainly worth noting here.
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.
7/26/18 Update: After positive early data, various trials of JAK inhibitors such as Ruxolitinib and Xeljanz are underway. Columbia researchers have had positive results with Xeljanz in 11 out of 12 subjects achieving some regrowth with no adverse side effects over 16 months of treatment. Investigators at Stanford and Yale are conducting three trials of oral and topical tofacitnib and Locks of Love Foundation is fuding another ruxolitinib study. At this time, there are about 15 publications looking at JAK inhibitors and their relationship to alopecia and its variants.
Beyond that, things get more controversial, with some doctors saying there's inadequate evidence for other treatments. Saxena thinks there is enough scientific evidence to support some of the alternatives and recommends them to patients. But they are not for women on tight budgets. There's Nutrafol, a "nutraceutical" that costs about $80 a month. Women can also get injections in the scalp of platelet-rich plasma made from their own blood. The first four treatments cost about $2,000 at Saxena's practice in Fort Washington or Lansdale. Maintenance injections, done every three to six months, cost $515 each. Women can also buy Theradome, a light-emitting helmet, for $895 online.  Saxena, who has hair loss herself, said she has had the injections and currently uses minoxidil, spironolactone, and Nutrafol.

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.”
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