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Super DoctorsThe Super Doctors 2013 list, which appears in New York Times Magazine, has included Dr. Bernstein for the second year in a row. The list, published by Key Professional Media as a special insert in the magazine, ranks Dr. Bernstein as one of New York City’s best dermatologists.

Super Doctors 2013 is a directory of the best physicians in the New York City area, as determined by a thorough peer selection and evaluation process.

Dr. Bernstein has also been included in the annual ‘Best Doctors‘ list, published by Castle Connolly in New York Magazine, for 13 consecutive years. Dr. Bernstein is honored to be recognized by the people who best know medicine and medical practice, his colleagues in the New York area.

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Super Doctors - Key Professional Media - 2008 Edition CoverDr. Bernstein has been nominated by his colleagues as one of the best doctors in New York in Castle Connolly’s Top Doctors list for 13 consecutive years.

The Super Doctors 2012 list, published by Key Professional Media as a special section in the May 20, 2012 issue of New York Times Magazine, has now also included Dr. Bernstein as one of New York City’s best dermatologists.

The list is a directory of the area’s top physicians that is derived from a thorough selection process. First, doctors complete a survey and nominate peers from whom they would seek medical care. Research staff at the company adds to the peer-nominated list any doctors who have achieved certain credentials or honors, usually physicians in highly specialized areas of medical treatment. All candidates are then evaluated using a set of 10 criteria, including: years of experience, hospital appointments and fellowships, professional activities, leadership positions, academic achievements/positions, board certifications, publications and presentations, honors and awards, and other outstanding achievements in medicine. Based on this evaluation, doctors with the highest scores form a “blue ribbon panel” where they evaluate physicians within their own area of expertise. Once the highest-scoring doctors are contacted and independently verified to be clear of any other outstanding disciplinary issues, the list is ready to go to press.

As with the Castle Connolly ‘Best Doctors‘ list, which appears annually in a special issue of New York Magazine, Dr. Bernstein is honored to be recognized by the people who best know medicine and medical practice, his colleagues in the New York area.

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Eyebrow transplant and restoration article - New York TimesThe New York Times, once again, has recognized Dr. Bernstein’s pioneering hair restoration techniques. The NYT Fashion and Style section noted that he is, “the first hair transplant surgeon on the east coast,” to use the ARTAS robotic system for Follicular Unit Extraction.

This precision, image-guided robot is unique in its, “use of digital mapping and tracking to extract and harvest ‘follicular units.'”

For more information about the ARTAS System see our Robotic Hair Transplantation section of our website.

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NYT - New Stratagems in the Quest for HairFred R. Conrad/The New York Times

Dr. Bernstein is featured in Douglas Quenqua’s article in the New York Times — “New Stratagems in the Quest for Hair” — about the latest advances in hair restoration. The article mentions Dr. Bernstein’s pioneering research on hair cloning, including his studies on hair multiplication using the breakthrough biotechnology of ACell’s MatriStem® extracellular matrix.

On hair cloning:

Dr. Robert M. Bernstein, clinical professor of dermatology at Columbia University, is now one of several researchers experimenting with [ACell MatriStem].

“It’s just a question of time now” before hair cloning becomes a reality, Dr. Bernstein said. “We keep on moving back that time, but I think there’s absolutely no doubt that it’s going to be done.”

He believes hair cloning will be commercially available within 10 years. This may sound like a long time to wait, but “it’s important to remember that baldness is unlike other conditions where you can progress past the point of being helped,” Dr. Bernstein said. “Once we have a cure for hair loss, everyone will be able to benefit.”

On male pattern baldness:

“Hair has been an evolutionary sign of health and sexuality and youth, and that doesn’t change,” Dr. Bernstein said. “Shaved heads look cool, but not everyone wants one, and not everyone looks good with one.”

The article also discusses interest among hair restoration physicians in researching the use of the eyelash growth medication Latisse for hair regrowth on the scalp.

Go here to read the article at the NYT.

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Sometimes an “accident” in the laboratory can lead to a remarkable breakthrough. Penicillin, Botox, Viagra, and Minoxidil — the active ingredient in Rogaine — were all unintended discoveries that led to treatments for a variety of conditions.

A similar twist of fate, this time by researchers at UCLA, could lead scientists to a new hair loss treatment.

Mice had been bred to overproduce a stress hormone that causes them to lose their hair. The scientists’ intention was to study the effects of a chemical compound, called astressin-B, on blocking the effects of stress on the mouse colon.

What they saw, however, surprised them. The mice that were treated with the chemical had fully regrown their hair. After repeating the results, the researchers injected the chemical into young mice, which were similarly genetically altered but had yet to lose their hair. Those mice never lost their hair despite the fact that they, too, were bred to overproduce the stress hormone.

Whether this discovery will lead to a drug that cures common baldness in human beings, or whether such a cure will only affect hair loss due to stress, is unknown at this early stage.

For further reading on this discovery, see articles in Dermatology Times and the New York Times, as well as the primary scientific publication in the journal PLoS ONE.

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Dr. Christiano Interviewed on Alopecia, Hair Loss by New York TimesDr. Angela Christiano, a colleague of Dr. Bernstein’s at Columbia University, has been studying the causes of alopecia areata and genetic hair loss for many years. She, in fact, suffers from the disease as well.

The New York Times has published a question and answer interview with Dr. Christiano which covers her own struggle with alopecia, her research into the causes of genetic hair loss, and where she sees the field going in the future. Here is one exchange that offers a window into how her research is breaking new ground in the field of hair loss genetics:

Q. When were you able to actually do the study?

A. In 2008. We published our findings this past July. Ours was the first study of alopecia to use a genome-wide approach. By checking the DNA of 1,000 alopecia patients against a control group of 1,000 without it, we identified 139 markers for the disease across the genome.

We also found a big surprise. For years, people thought that alopecia was probably the stepchild of autoimmune skin diseases like psoriasis and vitiligo. The astonishing news is that it shares virtually no genes with those. It’s actually linked to rheumatoid arthritis, diabetes 1 and celiac disease.

Continued discovery by Dr. Christiano and others in the field of hair loss genetics will lead to clues like these, which will shape the future of hair loss treatment. The hope for hair loss sufferers around the world is that a medical treatment can be developed which will effectively cure androgenetic alopecia, or common baldness. There is a lot of ground to be covered and there are many studies yet to be conducted, but progress is being made.

You can read more about Dr. Christiano’s research on our Hair Loss Genetics News page.

Read the article and listen to a two minute audio stream of the interview at the NYT.

Photo c/o Ruth Fremson/The New York Times

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She turned me into a newt! I got better…

~ John Cleese, Monty Python and the Holy Grail

Have you ever thought that you want to be more like a newt? You might not have thought about it in those terms, but these tiny amphibians have a physical capability that human beings have dreamed about for eons: the capability of regenerating tissue. If we could tap into this capability, the possibilities for medical treatment are limitless. We could regrow an arm, a leg, a hand, repair a heart after a heart attack, or even regrow hair. Two new avenues of scientific research, discussed in an article in the New York Times, might just help us enable human beings regenerate tissue.

The Stanford Approach

For ages, it has been well known that humans do not possess the regenerative powers of lower vertebrates, such as newts and fish, but the reason has been a mystery. The researchers at Stanford University in California, working with mouse muscle cells, have begun to understand the mechanism behind the capability for certain animals to regenerate tissue.

It seems that lower vertebrates have a genetic makeup that allows their cells to multiply when tissue regeneration is needed. Since unchecked cell multiplication can also lead to tumor (cancer) formation, they also have a tumor suppressor gene known as Rb. This gene is naturally inactivated in newts and fish when they start regenerating tissue.

Mammals possess both the Rb gene and a backup, called the Arf gene, which will close down a cancer-prone cell if Rb fails to do so. […]

The Stanford team shut off both Rb and Arf with a chemical called silencing-RNA and found that the mouse muscle cells started dividing. When injected into a mouse’s leg, the cells fused into the existing muscle fibers, just as they are meant to.

It would appear then, that mammals, including humans, have regenerative capabilities normally programmed into their DNA, but over hundreds of millions of years these capabilities have been suppressed so that the more important function -– that of cancer prevention -– could operate. To clone human tissue, one would theoretically just need to deactivate the suppressor genes, but in a way that would not put the person at an increased risk of developing cancer. Of course, these genes have not yet been identified in man, nor is it known if they even exist.

The UCSF Approach

A second, but very different, approach to tissue regeneration has been taken up by Dr. Deepak Srivastava and his team at the University of California, San Francisco. Based on work by Japanese scientist Shinya Yamanaka, Dr. Srivastava successfully converted ordinary tissue cells (fibroblasts) of the mouse heart into heart muscle cells:

[Dr. Yamanaka] showed three years ago that skin cells could be converted to embryonic stem cells simply by adding four proteins known to regulate genes. Inspired by Dr. Yamanaka’s method, Dr. Srivastava and his colleagues selected 14 such proteins and eventually found that with only three of them they could convert heart fibroblast cells into heart muscle cells.

To make clinical use of the discovery, Dr. Srivastava said he would need first to duplicate the process with human cells, and then develop three drugs that could substitute for the three proteins used in the conversion process.

The drugs could then be injected into damaged areas of the heart to repair the cardiac muscle cells following a heart attack. By using heart fibroblasts to produce cardiac muscle cells, rather than using embryonic stem cells, it is possible that risk of unwanted tumor formation, often noted with stem cell therapies, can be avoided.

It is not a stretch to assume that if scientists can undo the inability of animals to grow heart muscle or limbs, we might someday be able to genetically reverse the inability of a bald person to grow hair.

View more information on hair cloning and hair cloning methods. Also view our hair cloning news and hair cloning glossary pages.

View Nicholas Wade’s NYT article, “Two New Paths to the Dream: Regeneration.” Also take a look at the diagram that accompanies the article.

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Eyebrow transplant and restoration article - New York TimesEyebrow transplant procedures are growing in popularity. More women are realizing how much damage they can cause to their appearance by overplucking, shaping, and over-styling their eyebrows. Today, the New York Times reports on the trend of repairing eyebrows with hair transplant techniques and the use of camouflage products to cover up eyebrows that have been “tamed into oblivion.”

As the article’s headline declares, it is time to call in the professionals. The author of the article, Ms. Catherine St. Louis, turns to hair transplant pioneer Dr. Robert M. Bernstein for guidelines on performing a cosmetically-pleasing eyebrow transplant.

Here is a portion of the article:

Chronic repeated plucking is now a common reason why women have eyebrow transplants, which entail using hair from the scalp, arms or pubic area. A more timeless reason that spans the sexes is the gradual thinning, especially on the outer parts, as we age.

AND the number of such transplants is growing. In 2008, 3,484 eyebrow transplants were performed nationwide, up from 2,544 in 2004, the International Society of Hair Restoration Surgery says.

Dr. Robert M. Bernstein, a hair restoration specialist in Manhattan, said that the most natural-looking transplants for eyebrows followed a few rules. Hair has to lie flat; single-hair transplants, not units of multiple hairs, are used; hairs should follow a curve and be planted to account for changes in direction. (In general, Dr. Bernstein said, the upper hairs point down and lower ones face up slightly to create an interlocking ridge that gives brows their body.)

Visit our eyebrow transplant page for more information on eyebrow transplant and restoration procedures.

See another article by Ms. St. Louis on the topic of hair restoration and hair loss in women.

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New York Times - Hair TransplantThe New York Times interviewed Dr. Bernstein for a full-length article on hair loss and hair transplant options for women interested in hair restoration. The article – titled, “Tricks and Transplants for Women’s Hair Loss” – covered modern hair transplantation techniques, hair transplant costs, camouflage techniques, and more.

Read below for some excerpts of the article:

Exploring Your Options:

Hairstylists, impressed with how realistic the “new” transplanted hair looks, recommend doctors to clients who are tired of hiding their hair loss with layers or high- and lowlights. “I’ve seen bad jobs,” said Seiji Kitazato, the creative director at Frédéric Fekkai on Fifth Avenue, who refers clients to a few surgeons. “But now you can’t even tell.”

Still, not every woman of the millions who suffer from hair loss is a candidate. Underlying conditions, including anemia and thyroid problems, that are temporary, treatable or affect the scalp rather than the hair, must be dealt with before a transplant can be considered. If a transplant is ruled out, sufferers must rely on wigs, hairpieces or styling tricks.

What’s more, “most medications can cause hair loss, some more frequently than others,” said Dr. Robert M. Bernstein, a clinical professor of dermatology at Columbia University who has a restoration center in Manhattan.

A transplant is an option only for a woman who has a thick enough area of hair from the back and sides to “donate” to a more paltry part of her scalp. But many women don’t experience this kind of localized balding; instead their entire head of hair thins out during menopause or as they age.

Buyer Beware:

So the incentive to treat any and all comers is high. “It’s a big problem,” Dr. Bernstein said. “You shouldn’t go to someone who will give a transplant to anyone who walks in the door.” If your condition is not properly assessed, you could permanently shed more hair after surgery than you gained, he warned, or if the hair transplanted wasn’t stable, “it would disappear.”

Before Hair Transplant Surgery:

If you’re suffering hair loss, see a dermatologist first, not hair transplant surgeons, said Dr. Robert M. Bernstein, a dermatologist in Manhattan who specializes in hair restoration. After determining a cause, dermatologists can offer advice about options from the medical to the surgical. Many women with hair loss try Women’s Rogaine, a solution with 2 percent minoxidil that is applied to the scalp, twice daily. Others prefer Rogaine’s foam for men, because it has 5 percent minodixil, dries quickly and feels less greasy. (But even the women’s formulation warns to discontinue use if facial-hair growth occurs.)

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Dr. Bernstein summarizes a New York Times article on stem cell research:

A major advance in regenerative medicine has recently been announced. A new technique, which can convert adult skin cells into embryonic form, has been successfully performed on interbred mice by Dr. Shinya Yamanaka of Kyoto University. The technique, if adaptable to human cells could allow new heart, liver, or kidney cells to be regenerated from simple skin cells. This tissue could potentially replace organ tissue that has been damaged due to disease. As this tissue would be formed from the patient’s own skin cells, it would not be subject to rejection by the patient’s immune system.

Prior to this discovery, the conversion of adult cells into embryonic cells was done only through nuclear transfer; the implantation of the nucleus of an adult cell into an egg. The egg then reprogrammed the adult genetic material into an embryonic form.

This new technique involves the insertion of four genes into a skin cell. These genes would then complete the reprogramming of the nucleus of the skin cell into embryonic form, just as the egg had in nuclear transfer.

If adaptable to human cells, this could provide a simple, inexpensive and politically uncontroversial technique for regenerating stem cells. It should eliminate the ethical debates regarding stem cell research.

But this discovery does not mean that cloning will be available anytime soon. There are many obstacles which must be overcome prior to its implementation. The most immediate problem is discovering if this technique, which has been performed only in mice, can be used successfully with human cells. Another problem is that the mice that were used in the experiment were interbred, something obviously not acceptable for humans. In addition, the cells must be infected with a gene-carrying virus, a process that may not be safe for humans. Finally, two of the four genes which are needed to begin this regenerative process are carcinogenic (potentially cancer forming). In fact, 20% of Dr. Yamanaka’s mice died of cancer.

Although scientists cannot begin to predict when these considerable problems might be overcome, they are still confident in this advancing breakthrough and that these obstacles will someday be overcome.

Reference: Biologists Make Skin Cells Work Like Stem Cells by Nicholas Wade, NYT, June 7, 2007

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The advantage of using embryonic stem cells in cloning research, organ transplantation, and in finding cures for disease, is that these cells are basically “unprogrammed.” This means that the stem cell has not yet determined what it will grow to become so, in theory at least, scientists can manipulate them into becoming anything that they are programmed to be.

Two teams of scientists working independently (Kazutoshi Takahashi and Shinya Yamanaka at Kyoto University, Japan and James Thompson’s team at the University of Wisconsin) announced that they had successfully replicated the biological abilities of the embryonic stem cell using only skin cells. Called “induced pluripotent stem cells” these former skin cells were programmed to become other types of cells, acting in the same way as the embryonic stem cells.

This transformation was accomplished by introducing four basic genes into skin cells, via a viral carrier. These genes cause the adult skin cells to revert and become the equivalent of embryonic stem cells. The breakthrough is in the ability to “unprogram” skin cells so that they revert to cells that have the same response and abilities as embryonic stem cells.

The debate regarding embryonic stem cells has been focused on the harvesting of the cells. A fertilized embryonic egg is allowed to mature until it formed blastocysts. These blastocysts contain the newly formed stem cells. When these stem cells are removed, the embryo is destroyed. If skin cells can be successfully converted to stem cells, this could negate the ethical questions of the use of embryonic stem cells and produce a large amount of readily available stem cells for research.

Caution must be taken with this new technology. For example, one of the genes used to unprogram the skin cells is carcinogenic (cancer-causing).

Research must also be done to verify that these reprogrammed cells don’t have subtle differences between themselves and true embryonic stem cells.

Although the ability to “unprogram” skin cells to form pluripotent stem cells is a significant breakthrough, it is important to stress that this is still a research tool and it will take quite some time before it is known if these cells can truly substitute for stem cells in the treatment of disease.

References:

Kazutoshi T, Tanabe K, Ohnuki M, Narita M, Ichisaka T, Tomoda K, Yamanaka S: Induction of Pluripotent Stem Cells from Adult Human Fibroblasts by Defined Factors: Cell (2007), 131, 1-12.

Kolata G, Scientists Bypass Need for Embryo to Get Stem Cells, New York Times, 2007; A-21:23.

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