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.
The physical examination should focus on the hair and scalp, but attention should be given to physical signs of any comorbid disease indicated by the review of systems. If only the scalp is involved, the physician should look for typical male or female pattern to determine the presence of androgenetic alopecia. Whole body hair loss is consistent with alopecia totalis. Dry, broken hair suggests trichorrhexis nodosa, whereas scaling, pustules, crusts, erosions, or erythema and local adenopathy suggest infection.
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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.
“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.” 

While diet alone won’t save your hair, there may be some truth to the old adage that you are what you eat. “You’re not going to have the healthiest hair if you’re living off doughnuts, because being nutrient-deficient weakens strands and makes them more prone to breakage,” says Denise Kernan, owner of DK Hair Techs, Inc., a member of the International Society for Hair Restoration Surgery, and a hair transplant technician who has worked on everyone from senators to sports stars to actors to mafia guys (she won’t name names to protect the privacy of her clients).
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.
“Smelling” Receptor Keeps Hair Growing – Many of you may have noticed the headlines regarding sandalwood and hair growth over the past week. The research everyone is talking about comes from Ralf Paus and his team at the Monasterium Laboratory GmbH. For the record, Paus is also the main researcher behind the WAY-316606 hair growth discovery. This time Paus et al identified an olfactory receptor in hair follicles, OR2AT4,  which plays a role in regulating hair growth or inhibition. Olfacory receptors are responsible for detecting odors in cell membranes and provide the basis for our sense of smell, they do carry out additional functions though, as demonstrated by Paus.  

Kerastem, a company developing an autologous fat-derived stem cell therapy for hair growth, has reported positive data from their phase 2 trial. The results have come from a 6 month clinical trial involving 70 patients. In this study, the patients received a one-time injection of fat-derived stem cells, and purified fat, into their scalp. Kerastem reports an average increase of 29 hairs per cm2 from the treatment, or an increase of 17% from baseline. The press release does mention that the treatment “successfully stimulates hair growth in people with early stage hair loss”, so that is something to take into consideration when evaluating the results. For more info visit Kerastem’s website. 
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.

What’s got less evidence supporting its efficacy are the hair-growth shampoos that claim to block DHT (like those sold by Hims in their Rx Hair Kit). Rieder is skeptical that you’re going to see any tangible benefits by rubbing DHT blockers into your scalp. “I find it very difficult to believe that something that’s applied to the scalp and rinsed off is going to have any appreciable effect.” All four doctors also shut down any suggestions that hair-growth supplements or vitamins, like biotin, could help promote hair growth or stop hair loss — though a couple hypothesized that vitamins or supplements could lead to hair regrowth if your hair loss was a result of a nutritional deficiency. But otherwise, if you’re dealing with regular old male-pattern baldness, “There is no such thing as a ‘hair vitamin,’” says McMichael.


Trichotillomania may be difficult to diagnose if the patient is not forthcoming about pulling at his or her hair. Patients typically present with frontoparietal patches of alopecia that progress posteriorly and may include the eyelashes and eyebrows. Bare patches are typical, and the hair may appear uneven, with twisted or broken off hairs. Trichotillomania may lead to problems with self-esteem and social avoidance. Complications include infection, skin damage, and permanent scarring.18
"The majority of men lose their hair not through stress, or bad diet, or lack of sleep, but through the genetic trait of male pattern baldness which is hard to treat through shampoos or supplements alone. Women lose their hair for very different reasons, but the argument still stands that a lot of the hair loss products on the market are just offering false hope. That said, there are a few that really work."
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.
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.
"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."
Our panel of five people was unanimous in their choice – Shapiro MD. Developed by two leading dermatologists this patented formula has been proven to fight and even reverses hair loss in both men and women.  While some testers found the smell a bit herbal the overall consensus was that it was a fantastic color-safe shampoo and a moisturizing conditioner. In addition, we found their customer service was excellent and they honored their 60-day guarantee.  Shapiro MD designed their shampoo and conditioner with pharmaceutical-grade ingredients.  Shapiro MD’s mission is to develop health and beauty products using only clinically tested ingredients.
Pura d’or also have a hair loss conditioner compliment to this shampoo but we think it’s a bit overkill to use both(as a bottle of this stuff runs on the pricey side)—but if you love the shampoo the conditioner is also a very popular product that couldn’t hurt. Leave it in for about 3 minutes and let your scalp absorb all those vitamins and minerals.
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 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.

However, ketoconazole is still not FDA approved for hair loss treatment, which means it cannot be endorsed or marketed as such. Put simply, ketoconazole likely curbs hair loss, but additional research is needed for the FDA to give it approval. While it is safe to use as a supplement to our top picks, we wanted to recommend products with as much scientific backing as possible. So, we stuck with FDA approved minoxidil or FDA cleared laser treatments. But we’ll keep a close eye on products like ketoconazole shampoos and update as new research appears.
A clinician diagnoses female pattern hair loss by taking a medical history and examining the scalp. She or he will observe the pattern of hair loss, check for signs of inflammation or infection, and possibly order blood tests to investigate other possible causes of hair loss, including hyperthyroidism, hypothyroidism, and iron deficiency. Unless there are signs of excess androgen activity (such as menstrual irregularities, acne, and unwanted hair growth), a hormonal evaluation is usually unnecessary.
A little something for you all to nibble on. I’ve recently discovered a stem cell therapeutic company who has an interest in putting out cosmetic hair growth products. The company, Stemedica, is working on treating a wide range of diseases through clinical stem cell therapies. I counted 6 clinical trials in progress on their pipeline page. Perhaps more interesting for this audience, the company is also developing skin and hair growth cosmetic products from their core stem cell technology. Stemedica has a specific subsidiary in place to roll out dermatology cosmetics called StemCutis. Their website mentions the use of stem cell-derived growth factors to to be used in the products. It’s not clear what stage of development the hair growth product is at, but it’s good to have it listed in Stemedica’s sights. 
The most permanent solution for those who have lost or are losing their hair is hair transplants. Follicles are harvested from the back of the head and seeded into bald areas. Techniques have vastly improved and no longer do these look like fake “plugs”. Skilled surgeons can provide the patient we a very natural looking head of hair. A recent technological innovation is robotic assisted hair transplantation which help the surgeon be more precise and keep scalp scarring minimal. The limitations?

Minoxidil, popularly known as brand name Rogaine, works much differently than Propecia. It does not inhibit DHT, but it increases blood flow and therefore nutrition to the scalp and hair follicles. This has been shown to revive dormant follicles to a healthy state of growth in some users. Whereas Propecia has much more consistent results, minoxidil is more dependent on the user. Dramatic results such as new regrowth can be seen in individuals who respond well, but they are the minority. Minoxidil, like Propecia, is much better at hair maintenance. It will help you keep the hair you do have for longer, but only if you use it daily.
Some 30 million women in the United States have hereditary hair loss (compared with 50 million men), according to the American Academy of Dermatology, though that figure does not include the millions more who struggle with thinning hair because of pregnancy, menopause, stress and other health conditions. Barely 5 percent of women are said to be good candidates for hair transplant surgery because women lose hair everywhere, meaning that, unlike with men, there is rarely a luxuriant spot on the back of the head from which to harvest hairs unobtrusively.

“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.”
Disruptions in the normal length of each phase, which can cause hair loss and hair thinning, may be the result of a number of internal and external stimuli. These are also what we call the triggers and causes of your hair loss. As a quick example, dieting can leave the body stressed and in need of important nutrients. Because of this stress, hair growth may be cut shorter than usual and there is an early onset of telogen or shedding of hair.

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Certain foods have also been found to aggravate or worsen hair fall, such as sugar, which triggers the overproduction of the male hormone, androgen, which in turn causes the hair follicles to shrink in size and for hair to fall out or stop growing. Fish products that are known to contain high levels of mercury like tuna, mackerel and swordfish can also cause hair weakening and excessive hair fall. Studies have also found that fried foods are associated with the production of high levels of DHT.
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