There has been a lot of news recently circulating the web about a new way to help you grow your hair back; eating McDonald’s French fries. This theory is based on the findings of Professor, Junji Fukada of Yokohama University in Japan. Fukada and his team of researchers have studied the form of silicone called “dimethylpolysiloxane” that is used in frying oil at McDonalds to reduce frothing. Read more!
Q: What’s your honest take on Nutrafol? It is a product my dermatologist has recommended for my hair loss. — N.S. ~ New York, N.Y.
A: The traditional thinking is that that male pattern alopecia (androgenetic alopecia) is due to follicular sensitivity to DHT causing miniaturization and eventual loss of hair. The premise of Nutrafol is that hair loss is multi-factorial with an important inflammatory component and that it is important to address the inflammation as well as the DHT sensitivity.
This is a relatively new and important concept (I would like to stress this point!). However, the big leap is their conclusion: Since hair loss is multi-factorial, then broad, rather than targeted treatments would be most beneficial, and since naturally occurring “phytochemicals” are broader in action than targeted, FDA approved drugs (like finasteride and minoxidil), they should offer benefit in the treatment of hair loss and Nutrafol is the elixir that can accomplish this.
Although this makes sense in concept, there is no scientific evidence that Nutrafol can actually reverse or/mitigate androgenetic alopecia or any other type of hair loss. We need independent, blinded, controlled studies to show that Nutrafol actually works. Until then, it is very difficult to recommend this product and, more importantly, to recommend it over other treatments known to be effective.
Dr. Angela Christiano and her team of researchers at Columbia University studying the autoimmune disease Alopecia areata, have shed new light on how to move hair follicles from their resting (telogen) stage into the anagen phase where they can produce normal hairs. Their study, published in the October issue of Science Advances, introduces the possibility of a new topical medication for hair growth. The finding has implications in the treatment of androgenetic alopecia (common hair loss) as well as Alopecia areata, which causes a non-scarring form of localized hair loss.
Could a hormone that plays a critical role in red blood cell production also play a critical role in hair follicle production? According to a 2010 research report published in the Journal of Dermatological Science, this may be the case.
Q: Does transplanted hair grow faster after a robotic FUE? — P.P., Flatiron, NY
A: There is no difference in the rate of growth between manual FUE verses robotic FUE. However, with robotic FUE, the actual growth should be better due to less transection (damage to follicles during the harvest).
In general, one can expect transplanted hair to start to grow within two to five months with the transplanted hair taking on its final appearance after approximately one year.
Q: Have you any experience with Azelaic Acid as a hair loss treatment — is this something you would recommend using with Rogaine (minoxidil) 2% or 5% solutions? — S.V., Short Hills, N.J.
A: Azeleic acid has no direct benefit in promoting hair growth. Azelaic acid (like retinoic acid) increases the absorption of minoxidil, but also the side effects, so I would especially not recommend it in your case.
Could it be that Vitamin D is the cure for baldness that scientists have been looking for all these years? New research on Vitamin D, and its receptors in hair follicles, has taken us down a previously untrodden path that could, potentially, lead to new medical treatments for hair loss.
The Vitamin D receptor was previously known to stimulate hair follicles, which were in the dormant phase of hair growth, to grow hair when activated. The research into Vitamin D and its effect on hair and skin, centers around this receptor.
RepliCel Life Sciences; a company based in Vancouver, Canada; is investigating hair cloning techniques in order to develop a treatment for androgenetic alopecia, or common genetic hair loss.
Research conducted by the company’s scientific founders and lead scientists, Drs. Kevin McElwee and Rolf Hoffmann, has shown that a certain type of cell, called a dermal sheath cup cell, is integral in initiating the growth of mature hair follicles. This mechanism of follicle growth, when coupled with previous research on dermal papillae cells, is key to our understanding of hair loss and is a potential avenue for developing a treatment that could reverse hair loss.
Researchers at the University of Pennsylvania, who were investigating the biological causes of androgenetic alopecia or common genetic hair loss, have discovered that levels of a certain inhibitor protein, called Prostaglandin D2 (PD2), are elevated in bald areas on the scalp. This discovery could be an important breakthrough in developing a medical hair loss treatment that regulates the production of the protein, or one that blocks it from attaching to its receptor protein.
Summary of “Hair Regrowth Following a Wnt- and Follistatin-Containing Treatment: Safety and Efficacy in a First-in-man Phase 1 Clinical Trial,” which was originally published in the November 2011 issue of the Journal of Drugs in Dermatology (Volume 10, Issue 11).
Researchers were aware of the importance of follistatin, a binding protein; Wnt 7a, a signaling protein; and wound healing factors on hair growth. In this study, researchers tested the safety and efficacy of an injection of a mixture of naturally derived molecules on hair growth.
The mixture called the Hair Stimulating Complex (HSC), contained follistatin, as well as keratinocyte growth factor (KGF), and vascular endothelial growth factor (VEGF). The mixture also showed activity similar to the Wnt signaling protein.
Q: I am interested in trying home laser therapy for my androgenic alopecia? Which handheld laser device do you recommend? — N.M., Northfield, NJ
A: There are several handheld lasers currently marketed as a home use treatments for androgenic alopecia. To my knowledge there has never been a clinical study comparing different laser devices. Most of the devices use diodes to emit a narrow band red light. This wavelength of light is actually similar to those that are used in hair removal lasers, except they are at a much lower intensity. The theory is that high intensity laser damage hair follicles causing hair loss, but low level laser energy can have a bio-stimulation effect and actually induce hair growth.
If you would like to try laser therapy for hair loss, I suggest using a HairMax laser comb. This is the only device that is FDA approved. They sell a few different “strengths” of lasers for different costs. They have not shown any clinical evidence supporting one laser comb versus another. The more expensive ones have more diode lights so it would be reasonable to conclude that they are “stronger” and require less frequent use. I have patients who have used the “mid tier” laser comb, the Premium Lux 9 successfully, so that is the one I recommend to other patients.
In what might be another illuminating discovery on the inner-workings of hair growth, Yale University scientists have discovered that cells from the fat layer in the skin of mice contribute to the stimulation of hair follicles.
Dr. Bernstein, who was interviewed for the ABC News article, called the findings, “An interesting development in understanding why millions of people go bald.”
Following some new research on stem cells, and their relationship with androgenetic alopecia (genetic hair loss), an article on stem cells and the way they organize hair growth was published in the April 29th issue of the journal Science. At issue is the way in which large numbers of stem cells coordinate the cycle of hair growth over thousands of hair follicles. How do all of those hair follicle stem cells know when to grow hair, and how do they know what their “neighbor” hair follicles are doing?
Robert M. Bernstein, M.D., F.A.A.D., the renowned hair transplant surgeon and founder of Bernstein Medical – Center for Hair Restoration in New York, is studying four different applications of ACell MatriStem™ extracellular matrix in a type of hair cloning, called hair multiplication, as well as current hair restoration procedures. Click the link to read the whole press release.
After trading anecdotes with fellow hair loss physicians about how finasteride can reduce body hair in some patients, Dr. Sharon A. Keene asked whether finasteride might have a negative effect on patients who have body hair transplant (BHT) procedures. While the current research is inconclusive, her review sheds light on how to avoid any possible negative impact that finasteride might have on patients who have body hair transplant procedures.
Q: After my hair transplant procedure I had some shock loss, and then after about 4 1/2 to 7 months I had tremendous growth — really thick. I was amazed actually. Now, at 8 months it has thinned again, quite a lot compared to the growth I had before. I just wondered if this was a normal growth pattern and whether further growth could be expected? — N.T., Brooklyn, NY
A: This is not the most common situation, but should not be a cause for concern. The newly transplanted hairs are initially synchronous when they first grow in — i.e. they tend to all grow in around the same time (with some variability). This is in contrast to normal hair, where every hair is on its own independent cycle. Sometimes the newly transplanted hair will shed at one time before the cycles of each hair become more varied asynchronous.
Q: I heard that there have been some new advances in hair cloning and that it may be available sooner than we thought. I was planning on doing a hair transplant soon. Considering that hair cloning may be available at some point in the future, should I do FUE or FUT, or wait for cloning? — K.R., Fort Lee, NJ
A: Although there has been a major development in hair cloning with the use of ACell, an extracellular matrix to simulate hair growth, the model, at this point, is still in its earliest stages of development. It is hard to know when the technology will reach a state where it can be useful in hair restoration.
With respect to which you should do FUE or FUT if, theoretically, cloning is around the corner, the answer would be FUT, since FUT will give you the fuller look.
If the goal is to eliminate any trace of the traditional hair transplant, again FUT will most likely be the best choice, since the single linear scar would be easy to camouflage with cloned hair. With FUE, this would be much more difficult, since there are literally thousands of tiny scars. However, neither FUE nor FUT will preclude a patient from fully benefiting from cloning if, and when, it becomes available.
Q: I am currently 28. I have been taking Propecia for 6 years and recently began to grow sparse chest hair for the first time in my life. Is the Propecia causing these effects? — H.L., Gowanus, Brooklyn, NY
A: DHT causes male pattern baldness and stimulates the growth of body hair. The use of Finasteride, a DHT blocker, will permit scalp hair to grown and inhibit the growth of body hair, not stimulate it.
However, the effects on body hair are quite small, so your natural tendency to grow chest hair over time is probably not being blocked by the treatment.
Dr. Angela Christiano of Columbia University in New York and a team of scientific researchers, have identified a new gene involved in hair growth. Their discovery may affect the direction of future research for hair loss and the diagnosis and ultimate prevention of male pattern baldness.
The condition, which leads to thinning hair, is called hereditary hypotrichosis simplex. Through the study of families in Pakistan and Italy who suffer from this condition, the team was able to identify a mutation of the APCDD1 gene located in chromosome 18. This chromosome has been linked to other causes of hair loss.
Bizymoms.com, the premier work-at-home community on the Internet with more than 5 million visitors per year, has interviewed Dr. Robert M. Bernstein in order to answer readers’ common questions about hair restoration and hair loss.
Q: I know that Propecia works in only about half of patients. Are younger people more likely to be helped by this medication? — V.C. Greenpoint, Brooklyn
A: The main studies by Merck looked at men between the ages of 18 and 41. The five year data (which, in my view, is most important) showed that 48% of men had an increase in hair growth and 42% had no change over baseline. Thus a full 90% held on to their hair or had more over a 5-year period. This compares very favorably to the placebo group where 75% lost hair over the 5-year period.
Q: I just read a press release saying that researchers have developed a successful technique to clone hair by using a wound healing powder called MatriStem MicroMatrix. Is this new technique really a breakthrough in hair cloning? And if so, when can we start cloning hair?
A: It appears from preliminary studies that plucked hairs stimulated by ACell are in some cases able to regenerate new hair. Because the hair is placed into the recipient area and is partially derived from cells in the dermis, it is not yet clear whether the hair will be effected by androgens over time or if it will continue to bald.
The research so far is promising and a number of doctors are doing research in this area, including Dr. Schweiger and myself at Bernstein Medical – Center for Hair Restoration.
Japanese scientists have located a gene that seems to regulate hair loss in mice. They feel that this gene may also play a role in hair loss in humans. The results of the studies were recently reported in the Proceedings of the National Academy of Sciences.
The 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.
We all have seen that some bald sons have bald fathers, even when no one on the mother’s side of the family has any hair loss. This suggests that the genetics of male pattern alopecia is more complicated, with multiple genes influencing hair growth. And it is likely that the inheritance of baldness is polygenetic, with relevant genes coming from both the x-chromosome of the mother and non-sex chromosomes of either parent. So where are the other genes?
Two independent research groups, one from England and the other Germany, both published in the journal Nature Genetics, have identified a gene locus p11 on chromosome 20 that seems to be correlated with male pattern hair loss, and since the gene is on a non-sex chromosome, it offers an explanation for why the inheritance of common baldness can be from either side of the family.
Columbia University Medical Center has awarded Dr. Bernstein, Clinical Professor of Dermatology, a “Certificate of Appreciation” for sustained contributions to the academic programs of the Department of Dermatology at the renowned university.
The Department stated that they were, “deeply grateful for your continuing support of Columbia’s academic programs and of graciously giving your time and sharing your wisdom with the house staff and medical residents.”
Through this study, it was shown that the signaling pathways introduced by the administration of noggin and sonic hedgehog alone were insufficient to develop a hair follicle. When Laminin-511 protein was introduced to the tissue culture, the dermal papilla developed. When the protein was inhibited, hair follicle growth again ceased. This information supports prior studies suggesting that Laminin is critical in the early stages of follicle cell development and is required for continued follicle development and growth.
Follicular cell implantation (FCI) is based on the ability of the dermal papilla (DP) cells, found at the bottom of hair follicles, to stimulate new hairs to form. DP cells can be grown and multiplied in culture, so that a very small number of cells can produce enough follicles to cover an entire bald scalp.
In order to produce new follicles, two types of cells must be present. The first are Keratinocytes, the major cell type in the hair follicle, and the second are dermal papillae cells (DP) which lie in the upper part of the dermis, just below the hair follicle. It appears that the DP cells can induce the overlying keratinocytes to form hair follicles. There are a number of proposed techniques for hair regeneration that use combinations of cells that are implanted in the skin. The two major techniques involve either transplanting dermal papillae cells by themselves into the skin, or implanting them with keratinocytes.
NY Japion — a weekly newspaper in the Japanese language, published in the New York tri-state area, and distributed for free in the Japanese community — has featured Robert M. Bernstein, MD, in their series on hair loss in men and women.
In the series, TV producer, Hideo Nakamura, who is bald himself, goes on a mission on behalf of fellow bald men. His column hopes to help others with hair loss to have a more fulfilled, fun life and to raise their self-esteem.
Q I had a hair transplant 15 months ago at a well known clinic in Manhattan. There were about 1000 grafts transplanted in the front hair line. At this point I am upset with my results. My guess is that only about 50 new hairs have grown. My question is what would cause this to happen? It seems to me that the hair transplant took longer than expected and my grafts died before they were placed! Please help! — B.E., Ithaca, N.Y.
A There are many factors that can contribute to poor growth during the hair restoration process including grafts that are left out of the holding solution too long or kept under the microscope for a prolonged period of time where they dry out.
Grafts can be injured in the dissection process or can be traumatized during the placing – if they are grasped too tightly or manipulated too much.
SUMMARY of Dr. Epstein’s Abstract from his presentation at the International Society of Hair Restoration Surgery, 2005 – Sydney, Australia
Dihydrotestosterone (DHT) is known to be the more potent androgen in both Benign Prostatic Hyperplasia (BPH) and in Androgenetic Alopecia (AGA). Testosterone is converted to DHT by the enzyme 5-α reductase in several organs including the prostate, hair follicles, skin, liver and sebaceous glands. 5-α reductase exists in two isoforms: type 1 and type 2. Type 2 is the predominant enzyme in prostate and hair follicles. Finasteride, approved in 1992, inhibits the type 2 isoenzyme, and is available in two doses: 1mg dose for AGA, and 5mg for BPH. Dutasteride, approved in January 2003 to treat BPH, is a dual inhibitor of both isoenzymes.
This study also demonstrated that the Hedgehog agonist is active in human scalp in vitro as measured by Hedgehog pathway gene expression. The results suggest that topical application of a Hedgehog agonist could be effective in treating hair loss conditions, including male and female pattern genetic hair loss.
Julie Chen: Dr. Bernstein, I want to go through all the options that are available for women, but what is the difference between female and male hair loss option-wise. What can we do to treat it? Dr. Bernstein: The main difference medically is that women have hair loss often from hormonal changes and it’s due to an imbalance between progesterones and estrogens. That equilibrium can be reestablished with medication. Often birth control pills can do that.
“Good Morning America” interviewed Dr. Bernstein in their two-part series on hair transplant surgery. Below is an excerpt from the interview:
Charles Gibson: Are there good candidates and bad candidates for this? Dr. Bernstein: Yes. And actually people that wear hairpieces are sometimes tricky because their baseline is a full head of hair, so one of the important things that we had to discuss in the first consult was what his expectations were and whether he realized that a transplant wouldn’t give him the fullness of a hairpiece, but of course, it would look much more natural.
Dr. O’tar Norwood discusses the origin of follicular transplantation, and the influence that Dr. Bernstein’s research and publications have had on the evolution of the hair transplant procedure. Read a segment of the article:
The evolution of “follicular transplantation” can be attributed to three people. Dr. Robert Bernstein coined the phrase and advanced the concept. Dr. Bob Limmer introduced the use of the binocular microscope, providing the technology, and Dr. David Seager showed by direct hair counts, comparing the growth of grafts cut with and without the microscope, how the hair growth was improved when the follicular unit was kept intact.
Cosmetic Surgery Times features Dr. Bernstein’s presentation to the 55th annual meeting of the American Academy of Dermatology in their April 1997 issue.
The article describes Dr. Bernstein’s introduction of the concept of Follicular Unit Transplantation to the academy as well as the keys to making the technique successful. From the article:
“‘Hair doesn’t grow singly it grows in naturally occurring groups of from one to four hairs. In follicular transplantation, we use these naturally occurring groups as the unit of the transplant,’ he told CST.
Although the procedure is highly labor intensive, it can actually be less expensive than conventional hair replacement surgery, because it can be performed in a single, but lengthy, session.
‘It is also much more efficient and conserves donor hair much better than conventional hair transplants. Every time you make an incision in the person’s scalp you waste some hair and make the remaining hair more difficult to remove. Accessing the donor area just once or twice will increase the total amount of hair that is available for the transplant,’ Dr. Bernstein told CST.”
Hair loss has a variety of causes. Diagnosis and treatment is best determined by a board-certified dermatologist. We offer both in-person and online photo consults.