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.
Re the post 10/17/18 I really liked your response to the request made by one of your readers to email companies asking for information. So I decided to do what you suggested and sent emails to Organ Technologies, Rivertown and Follicum (no particular reason) basically thanking them for their work and wishing them success with their products. Interestingly I received a very nice response from Organ Technologies which really surprised me. Correct me if I’m wrong but I think the sentiment is to be thankful and encouraging to what is being done appose to being negative that we have yet to get what we all want.
After a severe illness, I lost more than half of my formerly beautiful long hair. Since then, I've tried many shampoos claiming to encourage regrowth of healthy hair. Well, I found it! This shampoo really works. It smells great and has resulted in my hair being stronger and shiny; it no longer breaks easily and my hair stays on my head rather than in the hairbrush! Yay! Be sure to follow the instructions for use. A little goes a long way.

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.
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.
“The DHT hormone (dihydrotestosterone) can contribute to thinning in women who are genetically predisposed to female pattern thinning,” Fusco says. For those whose case falls into this category, she advises a prescription shampoo with ketoconazole 2 percent, as it has anti-androgenic properties. “Ketoconazole has been proposed to disrupt the pathway of DHT leading to thinning of follicles.”
During a hair transplant procedure, a dermatologist or cosmetic surgeon removes tiny patches of skin, each containing one to several hairs, from the back or side of your scalp. Sometimes a larger strip of skin containing multiple hair groupings is taken. He or she then implants the hair follicle by follicle into the bald sections. Some doctors recommend using minoxidil after the transplant, to help minimize hair loss. And you may need more than one surgery to get the effect you want. Hereditary hair loss will eventually progress despite surgery.
In the operating room, Bernstein prepped the robot patient for implantation, puncturing the man’s scalp with a long needle. These are the “sites” where the hairs will go. Blood bubbled over his scalp, but the patient didn’t seem to notice. The patient and doctor chatted loosely about summer houses and beers and boats. “Would I be a candidate for a surgery after this surgery?” he asked.

In fact, the Japanese government has recently committed to establish a new approval process for regenerative medicine products focused on accelerating approval timelines. As it turns out, hair loss is a big concern in Asian countries. Buckler said some 21% of adult males and 6% of females in China suffer from hormone-driven hair loss.  And the International Society of Hair Restoration Surgery’s (ISHRS) biennial survey of hair restoration physicians found that the number of hair restoration patients in Asia increased 345% from 2004 to 2010.
Some immediately see a doctor for Rogaine or Propecia, seek out over-the-counter miracle baldness cures, or even look into hair transplants. Others, though, take a more measured approach and begin using shampoos which can help slow hair loss in a safe and natural way. Groom+Style has written about the reasons for hair loss in men previously.  The causes of hair loss in women and children are slightly different. You might also be interested in how to keep your hair healthy in other, natural ways.
Jimenez, J. J., Wikramanayake, T. C., Bergfeld, W., Hordinsky, M., Hickman, J. G., Hamblin, M. R., & Schachner, L. A. (2014). Efficacy and Safety of a Low-level Laser Device in the Treatment of Male and Female Pattern Hair Loss: A Multicenter, Randomized, Sham Device-controlled, Double-blind Study. American Journal of Clinical Dermatology, 15(2), 115–127.
Minoxidil and oral finasteride are the only treatments currently approved by the U.S. Food and Drug Administration for the treatment of androgenetic alopecia. Both of these drugs stimulate hair regrowth in some men, but are more effective in preventing progression of hair loss. Although there are a number of other treatments listed in various texts, there is not good evidence to support their use.8
Over the past year, the Hair Restoration Laboratories’ Professional Strength DHT Blocking Hair Loss Shampoo (and accompanying DHT Blocking Hair Loss Conditioner) has been a top seller on Amazon and many other sites. Combined, the daily use Shampoo and Conditioner has more DHT blockers than any shampoo/conditioner set presently available. Among the key DHT Blockers in this set are: Caffeine, Saw Palmetto, Black Cumin Seed Oil, Cayenne Fruit Extract, Rosemary Leaf Oil, Pumpkin Seed Oil, Green Tea Leaf Extract, Pea Extract and many more. By helping to block DHT, they should be a great asset in helping to halt the miniaturization of the hair follicles and regrow healthier and thicker hair.
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.

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.
From the top of my head, I don’t remember if the Lipogaine’s Big 3 Shampoo contains ketoconazole but if it does, then that’s a definite plus. Another thing you can do is buy Nizoral and use it in conjunction with The Big 5 Shampoo. So for example, use Nizoral on Mondays and Thursdays and The Big 5 in all the days in between. That way you’d get all the benefits.
Farrell makes what he calls “hair systems.” They’re not quite wigs or toupees—you can keep them on for weeks at a time. They cost more than a thousand dollars. Farrell was in New York for a week, holding meetings with clients in his hotel room. Now his rolling suitcases were packed. Malaysia, Singapore, South Africa, Russia: he’s almost always on the road, satiating international demand for high-end hair pieces.
Hollywood has made movies about it. Industries have made billions from it. And if the volume of scripture is any indication, the Almighty God must have placed great value on his creation of the head of human hair. After all, He gave Samson—the strongest man of whom the Bible tells—his immense strength through his hair and declared a woman’s hair "a glory unto" her in the 11th chapter of 1 Chorinthians.
Traction alopecia. Unlike the other two that are caused by genetic or natural factors, this condition is self-caused and occurs most in women. Hair loss happens because of the continuous and constant pulling on the hair that puts pressure on the follicles. Pressure on the hair, brought about by wearing tight hair styles, braiding, weaving, or even hair treatments like bleaching, causes the follicles to loosen their grip on the shaft and eventually cause hair to fall out, leaving bald spots on the scalp or very thin hair strands.
Hair loss can have a devastating effect on people's self-esteem. It's a condition that affects approximately 60 percent of women and 85 percent of men at some time in their lives. In The Hair-Loss Cure, author Dr. David H. Kingsley helps you find out why you are losing hair, helps you choose the right treatments, and helps you cope with the psychological and lifestyle problems often caused by losing your hair.
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.
Over the past year, the Hair Restoration Laboratories’ Professional Strength DHT Blocking Hair Loss Shampoo (and accompanying DHT Blocking Hair Loss Conditioner) has been a top seller on Amazon and many other sites. Combined, the daily use Shampoo and Conditioner has more DHT blockers than any shampoo/conditioner set presently available. Among the key DHT Blockers in this set are: Caffeine, Saw Palmetto, Black Cumin Seed Oil, Cayenne Fruit Extract, Rosemary Leaf Oil, Pumpkin Seed Oil, Green Tea Leaf Extract, Pea Extract and many more. By helping to block DHT, they should be a great asset in helping to halt the miniaturization of the hair follicles and regrow healthier and thicker hair.
Weinstein has big dark eyebrows and a kind face. Kind of an Elliott Gould vibe. I looked at his head. There was a spotty, thatchy outcropping of gray-black hair. Not exactly an overflowing abundance, but hair, to be sure. “I had nothing on top,” Weinstein said. “You can see—I grew my hair back! And it grew back more or less the color I had when I was young.”
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.
Rogaine’s foam squirts out just like hair mousse and is applied with “cool, dry hands.” Applying means working the foam down to the scalp where you want to see thicker growth — for it to work, “it has to get into your scalp,” Dr. Wolfeld explains. “If it sits on your hair, it’s not really as effective.” Once massaged, it dissolves into a watery liquid that leaves a tingly sensation, “but no burning!” one of our balding testers was happy to discover.
Finasteride comes in the form of a tablet and works by inhibiting the formation of DHT, a hormone which permanently damages hair follicles. They are only appropriate for use as a male pattern baldness treatment and must be taken once a day for 3-6 months for the effects to be seen. In one study, 90% of men with mild to moderate hair loss saw positive effects after taking finasteride for six months, with hair loss stopping and in some cases even reversing. Finasteride is therefore very effective while it is being taken, but will not continue to have an effect after treatment has ceased. Around a year after you have finished taking Propecia or finasteride, you can expect your hair loss to have resumed and any hair regrowth to have fallen out. For this reason, they are not cures so much as effective ongoing treatments.
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.
Central centrifugal cicatricial (scarring) alopecia: This type of hair loss occurs most often in women of African descent. It begins in the center of the scalp. As it progresses, the hair loss radiates out from the center of the scalp. The affected scalp becomes smooth and shiny. The hair loss can be very slow or rapid. When hair loss occurs quickly, the person may have tingling, burning, pain, or itching on the scalp. Treatment may help the hair re-grow if scarring has not occurred.
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.
Another type of hair loss is alopecia areata, in which hair on the head (and sometimes on the body) falls out in patches. In most cases this type of hair loss resolves itself within a few months, however in some cases it can lead to more severe forms of hair loss such as alopecia totalis (loss of all hair on the scalp) or alopecia universalis (loss of all hair on the body). Alopecia areata is most common in people aged 15-29 and there are various treatments for it: minoxidil, corticosteroid injections, topical corticosteroid creams or lotions, dithranol cream, immunotherapy and light therapy. However none of these can be thought of as a cure for alopecia areata, as they are only temporary solutions.
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.
“It all started with a particular drug, Cyclosporine A, which is an immunosuppressant,” Hawkshaw explains. “It’s typically given to transplant patients to stop them rejecting new organs post-surgery and it’s been observed that it enhances hair growth. But the thing is, you don’t really want to give this to patients normally because you don’t want to suppress their immune system. So, I used that drug to treat human hair follicles in the lab to try and identify how it actually worked.”
Dr. Carlos Wesley, a hair restoration surgeon in Manhattan, said that women in his practice respond better to P.R.P. than men do, which may have something to do with the fact that women with genetic hair loss tend to have more inflammatory cells around the follicles. From 2013 to 2014, he said, he had an 83 percent increase in female patients, in part because of P.R.P.
Even though modern folklore, and even some limited scientific studies, have suggested that the mother's side of the family is largely responsible for a genetic predisposition toward baldness, the truth is balding is not all our mothers' fault. In fact, doctors now say baldness patterns are inherited from a combination of many genes on both sides of the family. There are some environmental factors that come into play, too.
Happy Friday from Follicle Thought and I hope you are enjoying March Madness basketball. That being said, please also enjoy this video of Deion Sanders, NFL Hall of Famer who recently had a 5,000+ FUE hair transplant, showing off his new grown-in hairline. Video was posted by his barber. With all the technical details and the day-in, day-out watch for new hair growth technology it is important we take a moment to enjoy the lighter side of things. Sit back and “get a side shot of that thing.” 😂

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.
The Brotzu lotion has been back in Italian headlines over the past week. It’s not clear what has prompted this wave of Brotzu news, but we know there has been significant interest surrounding the lotion since it first spread across the international hair-ternet. Recently, enthusiasts have also gone as far to start an online petition advocating for Fidia Pharma and Brotzu to release the heralded lotion. 
One of the downsides to the product is that you pay hand over foot for all those special ingredients DS packed into this bottle. It’s not the cheap crap that most manufacturers throw into your standard shampoos. It is expensive stuff, and using it daily means there’s no real way of making it last a long time either. The bottom line is you have to bite the bullet but with all the ingredients in this bottle, you’re getting your money’s worth.

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
You might be surprised to know that some of those shampoos, conditioners, and styling agents have harsh chemicals that do a number on your hair. You may want to consider switching to softer hair care products that are designed to slow down hair thinning in men. DHT-blocking shampoos and conditioners containing ingredients such as ketoconazole and pyrithione zinc have shown some promise in helping reverse hair loss by potentially disrupting the production of DHT, the hormone linked to male pattern baldness. These

The optimal treatment for this condition is not known, and psychiatric referral may be indicated. Treatment options include cognitive behavior therapy19 and selective serotonin reuptake inhibitors, although strong evidence of a treatment effect has not been demonstrated. Preliminary evidence suggests positive treatment effects with acetylcysteine, olanzapine (Zyprexa), and clomipramine (Anafranil).19 A combination of cognitive behavior therapy and medications may be more effective than either approach alone.19
Again, you’ll want to visit your doctor to get a blood test to check your levels in these vitamins. For example, women who have iron levels lower than 70 nanograms per milliliter are considered deficient. From there, work with your doctor to find an appropriate dose according to your deficiency level. Excessive or unnecessary supplementation can be dangerous.
I’ve been updating the Ultimate Guide to Hair Regeneration 2018 a bit over the last several weeks. There are two new companies who made the list, although you’ve most likely heard of them before, and some positions have changed. Position changes usually happen when pivotal news gets reported or progress is made by a particular company. I’ve been meaning to work on the Guide for a while now and only recently found time for it in between writing new articles and other activities. 
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