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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.

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.

A few weeks after the Air Force One incident, while addressing a crowd at the annual meeting of the Conservative Political Action Conference, Trump caught himself on a giant monitor. Immediately, he checked his hair. What secrets were these camera angles exposing? Then—as far as I can tell, for the first time ever—he admitted to hair loss. “Oh, I try like hell to hide that bald spot, folks,” he said. “I work hard at it. Hey, we are hanging in, we are hanging in, we are hanging in there. Right? Together, we are hanging in.”


OK, we know what’s on your mind at this point, and the answer is no. Drinking massive quantities of coffee or other caffeine-laden drinks will not help make hair grow. As one scientist pointed out, you’d have to drink 40 to 50 cups of coffee for caffeine to have any kind of therapeutic benefit for your hair roots because caffeine is easily diluted and quickly excreted by the body. Besides, that amount of coffee would be toxic because caffeine is, well, kind of a drug.
Joseph and his readership, he said, are convinced that we are at a “peak moment” for the industry. He ticked off “platelet-rich plasma” and “injectable cell therapies” and other high-level technologies that are being developed by companies from New York to San Diego, Tokyo, and Stockholm. He won’t make bets on who’s going to win the arms race. But, he says, “if you were the first, that’d be fun for the trillion dollars that you’d make. Over the next few years? It’s prime time.”
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.”
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.
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.
2. Volumizing shampoos and treatments. Typically, these work by depositing ingredients, like wheat protein and keratin, that adhere to the hair shaft to a) thicken it and b) create spaces between hairs so you look like you have more of it. Try Kiehl’s Rice & Wheat Volumizing Shampoo ($18) with hydrolyzed wheat protein; Rogers likes Redken Cerafill Defy Shampoo and Conditioner ($20 each) with ceramides that bulk up hair.
That said, hair loss isn't as bad or as hopeless as it sounds. It shouldn't be cause for added personal stress or social stigma, nor should it be something that should make us feel more self-conscious and less confident as individuals. With the advances in technology, you don't have to be saddled anymore with the uncomfortable choice of wearing an ill-fitting, unnatural-looking hairpiece. There is now a wide array of options available to treat and cure hair loss, whether temporary or permanent.
I’ve just come across the official press release from Organ Technologies (the biotech company which is developing Tsuji’s methods) regarding their recent advancements in hair follicle cloning. It contains the important information which has already been listed on Follicle Thought, though it  also includes many more details. The press release is titled Organ Technologies and RIKEN Launch Preclinical Tests in Hair Follicle Regenerative Medicine. 
Always shampoo and condition your hair regularly. Let your hair breath by avoiding wigs that are made with cotton and nylon caps that absorb moisture and lead to drier and more damaged hair. Instead, choose those with netted caps. Make sure your wig isn't too tight. Secure it with hypoallergenic double-sided tapes. Do not put your wig on over wet hair to avoid the growth of mildew and bacteria.
“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.
Our runner-up Clinical Effects Hair Therapy was a very close second to our top pick and our Best Value choice. Several of our testers felt that this was the overall best shampoo both in how their hair felt as well as the light scent.  We feel that it is the best overall value in this category as you can buy it at a price significantly less than the competition.  Clinical Effects is for both men and women and comes with an amazing 90 Day guarantee that is also the best in this category. We highly recommend it if you’re looking for a less expensive option to Shapiro MD.  They have fantastic customer service and stand behind all of their products.
However, the high incidence of androgenic alopecia is caused by the male hormones. Testosterone in the scalp is converted into dihydrotestosterone (DHT) that causes the follicles to shrink in size, therefore inhibiting the growth of hair, which eventually leads to baldness. However, hair follicles on the sides and back of the head do not have as much DHT compared to the top, hence why hair loss is concentrated on the crown of the head. Interestingly, DHT is known to help in the growth of the beard and hair on the chest, a reason why most bald men have hairy chests and grow their beards much faster.
The Rogaine rep we spoke to explained that the different packaging (and therefore different prices) has to do with the FDA-approval process: “We discovered in clinical trials that the hair loss patterns between men and women are different,” she said by way of explanation. “Men typically have that bald spot on the crown of their head, where women generally have a general thinning throughout, but concentrated more on the top of the head. So for FDA approval, we had to come up with two different, gender-specific products, so the directions were more explanatory.”

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.


A popular skin care drug—which is intended to target eczema—was just found to have an unusual side effect: hair growth. According to an article on Newsweek, the FDA-approved drug dupilumab was given to a 13-year-old alopecia sufferer to treat her eczema. The patient, who hadn’t grown hair on her scalp since she was two, suddenly grew a significant amount of hair on her head after continual use of the drug, a study in the journal JAMA Dermatology reports.
*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.   
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.
3. Hair fibers. The best (and easiest) way to hide a widening part or sparse patch is with hair fibers. They’re tiny, charged fibers that adhere to your scalp (until your next shampoo). Toppik Hair Building Fibers ($25) come in a range of colors so you can easily find one that matches your own hair. (In a pinch, you can also brush a powdered eye shadow that matches your hair color along your part.)

It can be safe provided you use registered, regulated healthcare or pharmaceutical services. LloydsPharmacy Online Doctor offers both Propecia and finasteride for men suffering from male pattern baldness through a safe and discreet online prescription service, and you will be able to order minoxidil or Regaine through our online shop or in one of our pharmacy stores.


Take in natural supplements. If you aren't getting enough nutrients from the foods you eat, you can also try taking natural supplements to address your nutritional deficiencies. Multivitamins that especially contain vitamins A, C, and the B-complex vitamins can be taken once a day. Fish oil capsules that contain omega-3 fatty acids are also recommended.
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.
Biotin – Naturally found in many of the rich protein foods you eat including nuts, meats, eggs, etc. Biotin (or simply known as Vitamin B7) has been found in many studies to be linked directly to hair growth. Not only are men using this same vitamin to growth thicker beards, but Biotin is also prevalent in many of the leading natural hair loss shampoos on the market as you will see in just a minute. If you are going all-natural root, this ingredient should most definitely be included in the product you select. 

More good research coming from the University of Alabama at Birmingham shows that a certain gene affecting mitochondrial function can dramatically reverse signs of aging in mice. The aging factors which were shown to be reversible include skin wrinkles, gray hair, and hair loss. Next comes the important phase where the researchers continue forward to translate this discovery to human use. Full article on the front page.

Lund, Sweden, March 7, 2018: Follicum AB (“Follicum” or “the company”) today announced that the first patient has been treated in the Phase IIa clinical trial in Germany with its lead candidate FOL-005 on 60 patients with hair loss. The study is conducted at Clinical Research Center for Hair and Skin Science (“CRC”) in Berlin and bioskin, Hamburg, Germany. The global market for pharmaceutical hair loss products for both men and women is estimated to be worth $3 billion. The available drug products have unwanted side-effects that limit their use.

“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.
One is how much emphasis the company places on compliance, the major stumbling block in the efficacy of any treatment, said Dr. Senna, an author of studies on the subject. Prospective users are questioned about their ability to stick to a regimen because the extract must be applied every day, and they are told that the more conscientious they are, the better. Users are also reminded and encouraged with regular check-ins.
In my opinion this shampoo has a "manly" smell. No flowers or sweet smells which is ok. Maybe it's an herb smell. Its not too overpowering and its a scent that is acceptable to both of us which is nice since my husband and I are both using this shampoo. He is real impressed with it and says his hair feels softer. He also thinks it is getting thicker on the top. I see him every day so I'm not sure I notice it. We have only been using it for a month or two so I don't really think that's enough time to see drastic improvement. I did notice the other day that he needs a hair cut so it may be that his is growing faster. I also noticed that I have little short hair sticking up all over my head so I obviously have new growth! I haven't really noticed a reduction in the amount of hair that I am losing but I am so excited to know that I have new hair coming in. I will be 50 this year and my husband is 51 so I know that our hair loss is a normal aging thing but neither of us like it and have tried several different shampoos looking for something that will stop the hair loss. I guess if we can't stop it we'll settle for new growth! Our first bottle of Biotin Shampoo is almost empty and I have decided to get another bottle instead of moving on to something else. This stuff is definitely worth staying with for a while to see how much the hair growth and reduction will improve.
Kuntzman described the “snake oil” era of hair restoration, in the early twentieth century, when salesmen offered nonsense treatments, often with horrific results. One involved “cylinders of skin taken from the abdomen and sewn into your scalp to function as a sort of belt loop” for new hairs, Kuntzman said; another used paraffin injections that left some customers with lifelong horn-like head bumps. Most of the really ugly stuff ended in 1938, when the Food and Drug Administration began regulating the industry.

“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.” 
What's to know about alopecia areata? Alopecia areata is an autoimmune disorder that usually results in unpredictable, patchy hair loss. Approximately 7 million people in the U.S. have alopecia areata, and it can affect anyone of any age or gender. There is no cure for alopecia areata although some treatments are available to help hair regrow more quickly. Read now
Taking hair supplements can be helpful for anyone who is experiencing hair loss or hair thinning. Dendy Engelman, MD, a board-certified dermatologic surgeon at Medical Dermatology & Cosmetic Surgery in New York City, previously recommended Nutrafol, a research-backed hair supplement, to Prevention. "This uses highly concentrated botanicals to address every stage of the growth cycle," she says. Nutrafol's hair supplements include vitamin E and ashwagandha (an adaptogen that helps balance cortisol levels in the body), among others.
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.

Finasteride has limitations though, such as the requirement of daily treatment, a limit to how many damaged hair follicles it can revive, and that it may lose its effectiveness overtime for some people. This drug has shown to be better at preventing further hair loss than reversing it (regrowth). Just keep in mind that some side effects might make the hair loss seem more appealing.
The Rogaine rep we spoke to explained that the different packaging (and therefore different prices) has to do with the FDA-approval process: “We discovered in clinical trials that the hair loss patterns between men and women are different,” she said by way of explanation. “Men typically have that bald spot on the crown of their head, where women generally have a general thinning throughout, but concentrated more on the top of the head. So for FDA approval, we had to come up with two different, gender-specific products, so the directions were more explanatory.”
And, for all of these collective efforts, Christiano reminded me, the only things that have really worked were discovered accidentally. Soon to join minoxidil and finasteride will be Xeljanz, or tofacitinib: originally developed for rheumatoid arthritis, it has remarkable effects on hair growth for patients with alopecia areata, an autoimmune disorder that causes patients to lose hair in big patches over their entire bodies.

What fans say: One user, who has an 11-year-old daughter with severe dandruff, said " I tried multiple OTC shampoos, home remedies, and two prescription scalp treatments. Nothing worked. I really panicked when I noticed a bald spot on her head! A friend suggested Ducray. After two or three shampoos, my daughter’s head was almost clear. I could not believe it. After several weeks of using this shampoo three or four times a week, the chunky flakes are completely gone and her scalp is no longer itchy and red."

Minoxidil (Rogaine). Minoxidil is one of the most common and popular forms of medication for hair loss, particularly pattern baldness, but also generally used in cases of alopecia areata. It is an over-the-counter drug that comes in either liquid or foam form and is applied on the scalp, particularly on the bald patches, to promote hair growth and stop further hair loss.
Minoxidil (Rogaine). Minoxidil is one of the most common and popular forms of medication for hair loss, particularly pattern baldness, but also generally used in cases of alopecia areata. It is an over-the-counter drug that comes in either liquid or foam form and is applied on the scalp, particularly on the bald patches, to promote hair growth and stop further hair loss.
“I like to know if one of the things that Follicle can do is to right an e-mail or letter, in our as a community (people who are visiting FT website) name, to the first four companies to let them know that they are lots of people who are waiting for their products, and a cure for hair regrowth and hair loss and ask them to give as the update as soon as they can, and release their products asap.”
4. Tinted dry shampoo. Camouflage spots where you’re seeing more scalp than you want to (your hairline, a widening part, a thinning crown) and add volume with a colored dry shampoo (try Orlando Pita Color Boost Dry Shampoo in Light or Dark Tones, $22). But be sure to give your scalp a vigorous shampoo during your next shower — dermatologists recommend keeping your scalp free of styling products so you’re not clogging already taxed pores.
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.
I hope you’re all having a good Friday and feeling good out there. Two weeks ago I posted my first “Feel Good Friday” update which contained a hilarious video of Deion Sanders showing off his new hairline from a 5,000+ FUE procedure he had in 2017. That video is now unable to embed because its owner changed his account to private. Coincidentally, a week after I shared that video I noticed that Deion posted a new video to his own Instagram account of him going back to his clinic for another FUE hair transplant to “comeplete his comeback”, in his own words.
Due to the concern of several readers, I’ve removed the link to the new Trinov website that has popped up on the net. For now, the website only contains an email address subscription box which really poses no issue to anyone who subscribed. At this time, it’s not confirmed who the actual owner of the new Trinov site is, so use your discretion until we find out more regarding this matter. Until more information is known the website will not be shared on Follicle Thought.
Dupilumab is FDA approved for treating eczema aka atopic dermatitis and sold under the brand name Dupixent.  As the story goes, a patient with alopecia totalis (a form of areata which leaves a person’s head completely bald) was being treated for eczema by the drug Dupixent. After 6 weeks the patient first began to notice progress in terms of hair growth and at 7 months she had noticeable pigmented hair growth on her scalp. Notably, the patient stopped taking the dupilumab for a period of time and noticed her growth subsided; when she began taking the drug again the hair improved once more. This provides another useful therapy option for patients seeking treatment for AA. One would imagine a topical version would be worthwhile to investigate.
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