To us, that meant any product with zero proven ingredients, case studies, or FDA clearance — which shrunk our list by a whopping 180 contenders. That’s right, there are only three treatments that have actually been cleared by the FDA and supported with clinical studies: finasteride (commonly marketed as Propecia), minoxidil, and laser treatments. And, since finasteride is prescription-only, it left us with two.

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.
Anagen effluvium is abnormal diffuse hair loss (usually abrupt) during the anagen phase due to an event that impairs the mitotic or metabolic activity of the hair follicle. The incidence of anagen effluvium after chemotherapy is approximately 65%24; it is most commonly associated with cyclophosphamide, nitrosoureas, and doxorubicin (Adriamycin). Other causative medications include tamoxifen, allopurinol, levodopa, bromocriptine (Parlodel), and toxins such as bismuth, arsenic, and gold. Other medical and inflammatory conditions, such as mycosis fungoides or pemphigus vulgaris, can lead to anagen effluvium.25

Because there are a lot of products in the crowded marketplace that claim they can regrow your hair, it’s a necessity for the legitimate ones to have disclaimers on their websites. Essentially, these disclaimers state that the products haven’t been evaluated by the FDA and so can’t be guaranteed to provide the benefits they claim to provide—at least not from the standpoint of the regulators.
No one wants to deal with premature balding, thinning hair, or outright hair loss, but these conditions affect many people, both men and women. If you’re one of those people, understand that you don’t need to deal with the anxiety and embarrassment of losing your hair. There are many hair loss shampoos on the market that have been proven to work—and they can work for you, too.
Women’s magazine ‘New Beauty’ recently featured several prospective hair growth therapies in a print article. The feature contains several interesting and worthwhile anecdotes. Check the Articles main page to read about Dr. Cotsarelis’ new research on setipiprant for female alopecia, Histogen’s view on the number of injection sessions which may be necessary to get the most out of HSC, and more.
"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.
In our research and our conversations with experts, one name kept popping up repeatedly: Rogaine. As the first topical brand FDA-approved to help regrow hair (all the way back in 1988), Rogaine benefits from more than 20 years of clinical trials and consumer feedback. Rogaine was the first brand to offer a 5 percent minoxidil foam solution when it debuted Men’s Rogaine Unscented Foam in 2006, and virtually every treatment developed since (for both men and women) has been an imitation or derivation of that formula.
"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."

Anagen is the growth phase. This lasts for about 3 - 5 years, where you can observe your hair growing half an inch every month. Full-length hair from this phase is about 18 - 30 inches long. Studies show that this phase may also be affected by other factors. Asian hair, for example, has been found to have a longer anagen phase. Weather is also a factor; hair growth can be faster in summer than in winter.


Hey there, I'm Shawn, the founder of Tools of Men! This site was created to help out other guys by teaching them proper grooming habits and the basics of sensible style. We try to make things here a bit of fun while giving you clear info. If you want to get in touch with us, drop us a line on the contact page or via social media. Thanks for checking out the site - and make sure to come back again!
After the new article featuring Medipost’s hair growth cosmetic was published, Jay Lee PhD of Medipost, began chiming in on the comments section. He first shared that Medipost is currently engaging in a larger clinical trial for the CM3 product which would include higher scale Norwood’s. Then, in a following comment he revealed that Medipost is developing a potentially more advanced hair growth product as well. Here are his words:

Our specially formulated natural remedy for hair loss and shedding is made with natural ingredients. We use high quality products, such as D Panthenol, tea tree oil and evening primrose, to nourish the scalp. This eliminates current hair loss and prevents future problems. It targets the root of falling hair, and penetrates the scalp and hair follicles for itch free, flake free skin that is nourished and ultra hydrated. Our formula rejuvenates and regenerates skin and hair follicles for revitalized, beautiful hair.


Rub the gel-like sap/juice of the aloe vera leaf directly on your scalp. Leave it on for a few hours and then rinse with lukewarm water. Do this three to four times a week. You can also mix a tablespoon of aloe vera gel with wheat grass juice to boost hair growth. Wheatgrass is also rich in protein, vitamins C and E and other minerals. Drink the wheatgrass juice mixed with aloe vera extract for two weeks to stop hair breakage and minimize hair fall.
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.
Approved by the FDA and available in over-the-counter form for both men and women, minoxidil has been found to work in two out of three men. However, and this is a huge problem, if you stop using it, then your hair will actually fall out again and potentially faster than before. Plus, you might not even notice any changes until you’ve been using this medication for at least four months!

When in doubt, read the usage recommendations found on your hair loss shampoo’s container. Those recommendations are there to ensure that you get the best results from your shampoo without causing damage to your scalp or hair. Also, always pay attention to a product’s list of ingredients to make sure that it doesn’t contain something which may cause an allergic reaction.
“Curis (now-dormant company) had performed a lot of studies on targeting the Hedgehog pathway for hair growth with very promising results, however, their compounds caused orthosteric activation of the pathway (turning it on everywhere and robustly which is not safe) vs. Oxy133 which causes a much more regulated and limited allosteric activation of the pathway only in stem cells. This could make Oxy133 a blockbuster. Let’s see what happens.” 

Aclaris Therapeutics has announced on March 9, 2018 that the US Patent and Trademark Office has issued their company U.S. Patent No. 9,895,301, for methods related to  the use and administration of a certain janus kinase (JAK) inhibitor for treating hair loss disorders. This patent covers the treatment of both alopecia areata as well as androgenic alopecia.


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.
Though, it is important to point out that a lot of these companies are developing procedures that involve implanting hair, which means there is a chance they will be expensive — as we mentioned before, traditional hair transplants are costly. But a few companies and products such as Follicum’s FOL-S-005 and Fidia Pharma’s Brotzu Lotion are being designed as topical treatments.
Harklinikken does not advertise, but the 25-year-old multinational company is beginning an aggressive expansion into the $3.6 billion hair-loss market in the United States, meaning you’re likely to hear a lot more about it. A New York clinic opened in June inside the Core Club in Midtown (you don’t need to be a member to get an appointment); and in August, Harklinikken consultations became available at some 70 Women’s Care Florida obstetrics and gynecology clinics. (Roughly 75 percent of the company’s 50,000 active users are female.)
decrease in your blood Prostate Specific Antigen (PSA) levels. Finasteride can affect a blood test called PSA (Prostate-Specific Antigen) for the screening of prostate cancer. If you have a PSA test done you should tell your healthcare provider that you are taking Finasteride because Finasteride decreases PSA levels. Changes in PSA levels will need to be evaluated by your healthcare provider. Any increase in follow-up PSA levels from their lowest point may signal the presence of prostate cancer and should be evaluated, even if the test results are still within the normal range for men not taking Finasteride. You should also tell your healthcare provider if you have not been taking Finasteride as prescribed because this may affect the PSA test results. For more information, talk to your healthcare provider.
If you have something that works for you, don’t change. Search for products that have plenty of positive feedback and don’t just trust Amazon reviews, but dig deeper. Again, most shampoos that claim to halt hair loss and grow new hair are nothing more than snake oil. Stick with ingredients that are clinically proven to work and backed by scientific study.
Finasteride (Propecia). The drug is recommended for male use only, and is in pill form. The drug basically slows down hair loss, while promoting gradual hair growth. The drug works by stopping the enzyme, type II 5-alpha reductas, which is known to produce DHT. The dosage is one pill a day, and has been found to be effective on 80% of men. Like minoxidil, it works best if the bald patches still have tiny, fine hairs. Results are visible within six to three months, and studies of those who have continued its use for two years show longer, thicker hair than those who used it for only for a short time.
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. 

It is called the vampire treatment because blood is taken from the patient that removes the platelet rich plasma. Then, the PRP is injected back into the scalp. This energizes the scalp with new active blood flow. Treatment is available at select clinics but widespread adoption may become the norm. It is less invasive than hair transplants but costs more if you count the cost of doing many sessions.
“Regenerative medicine is a game-changing area of medicine with the potential to fully heal damaged tissues and organs, offering solutions and hope for people who have conditions that today are beyond repair,” Buckler said. “RepliCel is one of the most promising biotech companies to watch in the field of developing medical innovations that are life-changing.”
While thinning generally worsens after menopause, doctors said hormone treatments typically do not improve hair growth. Minoxidil lotion or foam, which can be purchased over the counter, is the first line of treatment. About half of women who use it have not lost more hair a year later, Cotsarelis said. Spironolactone, a blood-pressure drug, can also help, doctors said. Some may also try finasteride — approved to treat baldness in men — off-label. The evidence that it works in women is weak, Patel said.
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).
Hey Frederique, I removed it because it was no longer available for some reason. I’m not sure how well can these shampoos work if you are going through chemo. How you consulted your doctor about it? Ask if minoxidil is safe for your situation. It may be the best solution for your case since your cause for hair loss is not due to DHT. But please don’t take my word for it, consult with a doctor first.

You always hear these stories about people who take a homeopathic approach to fighting baldness. It’s always some off-the-wall remedy like smearing a paste of ginger and cayenne pepper on your scalp three times a day or eating a special type of ginseng farmed only in a rural village in Tibet. We'll go on the record to say that it's highly unlikely that these remedies work at any level.


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.

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).


Keranique is another line of products targeted towards women. They offer a complete system consisting of shampoos, conditioners, and topicals. Our testers found that it was one of the harshest shampoos and was not always color safe. Their topical foam contains Minoxidil which can irritate some scalps. Keranique hair products are safe to use and highly effective.  They also have an anti-dandruff shampoo that has received amazing reviews.
Follica is developing a wounding device that when coupled with a hair stimulant like minoxidil, is found to be more effective at triggering new growth. They like to call this wounding process ‘skin disruption’. The idea behind this treatment is that after the skin is wounded, cells migrate to that area to repair. They then must choose between two paths: healing the skin (making epidermis) or making hair. It is there where Follica sees the window of opportunity, where they can encourage the cells to do the latter and regenerate new and more hair.
SOURCES: George Cotsarelis, MD, director, Hair and Scalp Clinic, University of Pennsylvania School of Medicine, Philadelphia. Andrew Kaufman, MD, assistant professor, department of dermatology, University of California, Los Angeles; medical director, Center for Dermatology Care, Thousand Oaks, Calif. Tom Barrows, PhD, director of product development, Aderans Research Institute Inc., Atlanta. Cotsarelis, G. and Millar, S.E. Trends in Molecular Medicine, July 2001; vol 7: pp 293-301. American Society for Dermatologic Surgery web site. American Academy of Facial and Reconstructive Plastic Surgery web site. American Hair Loss Council web site. Springer, K. American Family Physician, July 1, 2003; vol 68: pp 93-102. Hair Loss Help web site, "Interview with Dr. Ken Washenik from Bosley." Fuchs, E. Developmental Cell, July 2001: vol 1: pp 13-25.

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.” 

Choosing where and who will perform your hair transplant is as important a consideration as to what kind of hair transplant to get. Of utmost consideration is that this should be done by the dermatologist /surgeon, and not his/her technician. The surgeon himself/herself should also oversee the design of your hairline and how the extraction of the graft will be done.
Indian gooseberry. Also known as amla, Indian gooseberry is one of the most popular natural ingredients that can induce fast hair growth. It is also a known antibacterial that can help maintain a healthy scalp. Mix a tablespoon of Indian gooseberry pulp and lemon juice. Use it to massage your scalp, and cover with a shower cap after. Leave on for the night and wash with shampoo in the morning.
Researchers continue to strive for the holy grail of hair loss cures by trying to gain a better understanding of how the hair growth cycle is controlled. Rather than treating the symptoms of hair loss, scientists aim to target the cause, which, in turn, may yield fewer side effects. Recently, there have been numerous discoveries in the hair loss arena that may lead to new promising treatments.
When you're investing considerable time and money on a mix of hair treatments and cures, the last things you should be doing are those that will only aggravate your condition. Likewise, when your hair has finally grown back, the last thing you would want is for you to go through another horrific episode of hair loss. Preventing further - or another case of hair loss, and stopping it before it actually happens should be your goal.
Side effects and concerns: Minoxidil is safe, but it can have unpleasant side effects even apart from the alcohol-related skin irritation. Sometimes the new hair differs in color and texture from surrounding hair. Another risk is hypertrichosis — excessive hair growth in the wrong places, such as the cheeks or forehead. (This problem is more likely with the stronger 5% solution.)
Women with androgenic alopecia may consider trying prescription ketoconazole at a strength of 2 percent. This drug comes in the form of a shampoo and also goes by the name Nizoral. It’s an antifungal agent and may help reduce the body’s production of testosterone and other androgens that lead to hair loss. You can also find 1 percent strength at your local pharmacy, but it may not be as effective.
Approved by the FDA and available in over-the-counter form for both men and women, minoxidil has been found to work in two out of three men. However, and this is a huge problem, if you stop using it, then your hair will actually fall out again and potentially faster than before. Plus, you might not even notice any changes until you’ve been using this medication for at least four months!
Regarding the RCH news, is your source more reliable than Lee Buckler since he seems to know more about RCH than Lee buckler himself. Recently, Lee Buckler tweeted “We anticipate seeing data from the RCH-01 study in Japan sometime before year-end but the real answer is whenever the investigators/hospitals in charge of the trial (not us) decide to release the data once it ready”
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.
Lipogaine is a complete hair care system to treat most hair loss issues. The Big 5 Shampoo is a blend of Biotin, caffeine, Argan oil, Castor oil, and other powerful ingredients. They use only premium organic and natural DHT blocking ingredients with no sulfates or parabens. Lipogaine is for both men and women and all hair types, including color-treated hair. They also have a Minoxidil product and a fantastic 90-day money-back guarantee, including shipping, which is pretty rare.
Thanks so much for the guidance! After further research I have to agree with you 100%. Lipogaine Big 3 does containe ketoconazole, which would eliminate the need for Nizoral, however the shampoo only contains a few hair loss/thinning related ingredients. The Big 5 contains 17 and just seems like a better overall product. That plus Nizoral twice weekly seems pretty solid to me.
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.

SOURCES: George Cotsarelis, MD, director, Hair and Scalp Clinic, University of Pennsylvania School of Medicine, Philadelphia. Andrew Kaufman, MD, assistant professor, department of dermatology, University of California, Los Angeles; medical director, Center for Dermatology Care, Thousand Oaks, Calif. Tom Barrows, PhD, director of product development, Aderans Research Institute Inc., Atlanta. Cotsarelis, G. and Millar, S.E. Trends in Molecular Medicine, July 2001; vol 7: pp 293-301. American Society for Dermatologic Surgery web site. American Academy of Facial and Reconstructive Plastic Surgery web site. American Hair Loss Council web site. Springer, K. American Family Physician, July 1, 2003; vol 68: pp 93-102. Hair Loss Help web site, "Interview with Dr. Ken Washenik from Bosley." Fuchs, E. Developmental Cell, July 2001: vol 1: pp 13-25.
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.
This is a bestselling shampoo on Amazon. The list of ingredients is extremely lengthy. The product contain a number of natural organic DHT blockers (including saw palmetto) and various nourishing hair vitamins. Additional beneficial ingredients include amla oil, argan oil, pumpkin seed oil, rosemary oil, tea tree oil, green tea extract, niacin and biotin.
Rub the gel-like sap/juice of the aloe vera leaf directly on your scalp. Leave it on for a few hours and then rinse with lukewarm water. Do this three to four times a week. You can also mix a tablespoon of aloe vera gel with wheat grass juice to boost hair growth. Wheatgrass is also rich in protein, vitamins C and E and other minerals. Drink the wheatgrass juice mixed with aloe vera extract for two weeks to stop hair breakage and minimize hair fall. 

I have only used this twice, but in that short time of use, I believe my hair shedding has increased. In fact, immediately following the last use my hair seemed to be coming out more than I had seen prior to ordering the shampoo at all. Experiencing hair loss, thinning, or excessive shedding (especially for a woman) can be very distressing, and to purchase a product in hopes that it will help to curb or even reverse the issue only to find it exacerbates the problem is INCREDIBLY stressful. I was hopeful about this product, given the overall reviews, but I'm afraid to use this product even one more time, for fear of making my hair loss worse.

Finasteride inhibits an enzyme that converts testosterone to DHT, or dihydrotestosterone, the hormone that causes hair loss in men, and unlike minoxidil, this drug can actually help hair grow back, as well as prevent further loss. All you have to do is take one pill a day, and according to Dr. Evan Rieder, dermatologist in the Ronald O. Perelman Department of Dermatology at NYU Langone Health, two-thirds of men taking this treatment will see improvements in hair density over time.
“If you don’t want a scar because you like to wear your hair short, you might opt for a “scarless” hair transplant,” says Dr. Joyce. Also known as follicular unit extraction (FUE), grafts are harvested one at a time with tiny punches that heal virtually undetected so you can still buzz your head. “If you’ve gone so bald that you don’t have a lot of donor hair on your head, we can do FUE extractions with body hair such as on your chest, stomach, back, and sometimes even the pubic area,” says Dr. Joyce.
“Regenerative medicine is a game-changing area of medicine with the potential to fully heal damaged tissues and organs, offering solutions and hope for people who have conditions that today are beyond repair,” Buckler said. “RepliCel is one of the most promising biotech companies to watch in the field of developing medical innovations that are life-changing.”
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.
The earlier you begin treating hair loss, the more effective the treatment will be. Androgenetic alopecia is a condition that gradually worsens over time, so the general rule is that the earlier you seek treatment, the better. “If you’re losing your hair and you have genetic hair loss, using medication such as Propecia or minoxidil is most effective when started early,” says Dr. Robert M. Bernstein, Dr. Wolfeld’s colleague at Bernstein Medical – Center for Hair Restoration. Because not everyone loses hair on the same timeline, you can’t rely on statistics to tell you when you should start treatment. Some men start to notice thinning in their early 20s, while others maintain a thick head of hair well into their 50s. If you suspect that you’re starting to lose your hair and want it to stop, act quickly.
It's for this reason that grocery stores have shelves stocked full with hair care and hair grooming products of all forms and kinds, for different purposes, and even specialized and customized for use of men and women. In one study, it was found that more than half of the men in the UK use about six to ten hair grooming products alone, from the staple shampoos and conditioners to hair gels and other styling products.

As with the Nioxin shampoo, the PhytoCayne shampoo is meant to be used in conjunction with another product, the company’s revitalizing treatment serum. The shampoo is designed to “prepare” the scalp to absorb the serum. For that reason, you’ll find that this shampoo doesn’t really moisturize your scalp in the way the first two entries on our hair loss shampoo list do. What it does, though, is thicken hair for a fuller appearance, and many users say that it also significantly slows additional hair loss and breakage.


If you’re looking for an au naturel option, look no further. This shampoo has been an Amazon best seller since 2012. It smells great, lathers well, and has no harsh chemicals mixed in. Pura d’or has elimated all the bad stuff from this shampoo—no Parabens or SLS. It does have a ton of good stuff too! Practically every clinically proven natural ingredient that aids against hair loss is packed into this shampoo. Nettles extract, he shou wu (fo-ti), argan oil, B vitamins, biotin, and saw palmetto.
Now known as RCH-01, RepliCel’s procedure is a patented cellular replication and implantation technology designed to rejuvenate damaged and miniaturized hair follicles in a balding scalp. According to Buckler, the technology involves the extraction of as few as 20 hair follicles from the back of a patient’s scalp where healthy cycling hair follicles reside.  Specific cells are isolated from hair follicles and are cultured using the company’s proprietary cellular replication process.  The cultured cells are reintroduced or injected back into balding areas on a patient’s scalp and are expected to rejuvenate damaged hair follicles leading to the growth of new healthy hair fibers.
Treatment for adults with less than 50% of scalp involvement is intralesional triamcinolone acetonide injected intradermally using a 0.5-inch, 30-gauge needle. Maximal volume is 3 mL per session.11 Treatment may be repeated every four to six weeks until resolution or for a maximum of six months. Local adverse effects include transient atrophy and telangiectasia.
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