Hair loss in Men - Bernstein Medical - Center for Hair Restoration
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Growth factors in platelet-rich plasma (PRP) have been used to help soft tissue healing since the mid-1990’s. Recently, researchers have started to look at whether or not the growth factors in PRP might also help to reverse male– and female-pattern baldness (androgenetic alopecia).

Evidence that PRP may help to reverse this type of hair loss was found in a 2014 pilot study, “Platelet-rich plasma for androgenetic alopecia” published in Dermatologic Surgery. ((Schiavone G, Raskovic D, Greco J, Abeni D. Platelet-rich plasma for androgenetic alopecia: a pilot study. Dermatol Surg. 2014 Sep; 40(9):1010-9.)) In this study, researchers observed at least some noticeable improvement in 64 patients with androgenetic alopecia. Moreover, 47% of those patients experienced at least moderate to very good improvement, a level that the researchers defined as “clinically important.”

Platelet-Rich Plasma Possible Role in Hair Growth

Ongoing research has suggested various mechanisms by which PRP could reverse pattern baldness. For example, using human hair follicles in both cell cultures and in mice models, a 2011 study found that PRP was able to stimulate the proliferation of human dermopapillar cells, ((Takikawa M, Nakamura S, Nakamura S, Ishirara M, Kishimoto S, Sasaki K, Yanagibayashi S, Azuma R, Yamamoto N, Kiyosawa T. Enhanced effect of platelet-rich plasma containing a new carrier on hair growth.Dermatol Surg. 2011 Dec;37(12):1721-9.)) which in turn protected hair follicles cells from apoptosis, a process of programmed cell death. Additionally, this study suggested that PRP may be able to stimulate hair growth by prolonging the anagen (growth) phase of the hair cycle. More recently, a 2012 study found that PRP treatment significantly increased hair diameter. ((Li ZJ, Choi HI, Choi DK, Sohn KC, et al. Autologous platelet-rich plasma: a potential therapeutic tool for promoting hair growth. Dermatol Surg 2012;38:1040–6.))

Platelet-Rich Plasma for Androgenetic Alopecia: a Pilot Study

In order to better verify whether PRP could be a useful treatment for androgenetic alopecia, researchers used two treatments of PRP separated over a period of 3 months. Three months after the second treatment there was at least some improvement in almost all the patients due to an increase in hair thickness and/or more hairs, and 47% of the patients had at least moderate to very-good improvement. Patients with the most severe hair loss saw the greatest amount of improvement. Interestingly, both men and women in all age groups responded equally well to treatment.

Limitations of this Pilot Study

A limitation of the study was that each patient served as his or her own control. To more reliably test whether PRP therapy has clinical benefit for androgenetic alopecia, future studies will need to control for any spontaneous improvement by randomly assigning patients to separate treatment and control groups.

In addition, the data indicated that a retreatment with PRP at 10 to 12 months after an initial treatment may be advisable; however, a prolonged, more systematic observation on a larger number of patients would be needed to establish a reliable retreatment schedule.

In sum, this pilot study provides some preliminary evidence that PRP therapy may provide clinical advantage to patients with mild to moderate male or female pattern baldness.

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Growth factors in platelet-rich plasma (PRP) have been used to facilitate wound healing. Recently, studies have suggested that PRP may also serve as a safe and effective treatment option for male and female pattern hair loss, ((Schiavone G, Raskovic D, Greco J, Abeni D. Platelet-rich plasma for androgenetic alopecia: a pilot study. Dermatol Surg. 2014 Sep; 40(9):1010-9.)), ((A. Trink, E. Sorbellini, P. Bezzola et al., “A randomized, double-blind, placebo- and active-controlled, half-head study to evaluate the effects of platelet-rich plasma on alopecia areata,” British Journal of Dermatology, vol. 169, no. 3,pp. 690–694, 2013.)) but those studies lack scientific controls.

To address these limitations, researchers conducted a controlled clinical study that was recently published in the journal BioMed Research International. The researchers found that treatment with platelet-rich plasma stimulated hair growth in 10 males with pattern hair loss (androgenetic alopecia). ((V. Cervelli, S. Garcovich, A. Bielli, G. Cervelli, B. C. Curcio, M. G. Scioli, A. Orlandi, P. Gentile. “The effect of autologous activated platelet rich plasma (AA-PRP) injection on pattern hair loss: clinical and histomorphometric evaluation,” BioMed Research International Volume 2014.))

Study: The Effect of Autologous Activated Platelet Rich Plasma Treatments on Pattern Hair Loss

In a bilateral controlled clinical study of 10 male patients with patterned hair loss, researchers treated half of a subject’s scalp with PRP and the other half with a placebo. Each patient received three PRP treatments at one-month intervals.

The researchers evaluated the benefit of PRP treatments by comparing the treated half of a scalp to its non-treated (control) half using three measures of hair growth: mean hair count, total hair density, and terminal (healthy) hair density.

Results

Compared to the non-treated portion of the scalp, the researchers found an increase in hair density of 27.7 hairs/cm2 while in the non-treated portions the mean total hair density decreased by 2.0 hairs/cm2. They also found significant increases in terminal hairs compared to the control side.

A Possible Mechanism of PRP-Driven Hair Growth

Past research has suggested that the presence of keratinocytes in the outer root sheath and in the dermal papilla causes growth in new blood vessels (angiogenesis) during anagen, ((L. Mecklenburg, D. J. Tobin, S.M¨uller-R¨over et al., “Active hair growth (anagen) is associated with angiogenesis,” Journal of Investigative Dermatology, vol. 114, no. 5, pp. 909–916, 2000.)) the growth phase of the hair follicle. Research suggests that these new blood vessels play an important role in hair growth.

This new study suggests that PRP may stimulate hair growth by causing an increase of keratinocytes in the epidermis and in the follicular bulge cells, along with an increase of small blood vessels around the hair follicles in the treated area.

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Q: How common is hair loss in adult men and women? — N.F., Bronxville, NY

A: The incidence of androgenetic alopecia (common baldness) is quite high for both men and women. By age 50, 50% of men and 30% of women are affected. By age 70, that increases to 80% of men and 60% of women. Fortunately, in spite of significant thinning, women often preserve their hairline and have a diffuse pattern, so their hair loss can be camouflaged for many years.

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Research published in the Journal of the European Academy of Dermatology and Venereology found that autologous platelet-rich plasma (PRP) preparations containing CD34+ cells might be an effective treatment for male and female pattern hair loss. ((Kang JS1, Zheng Z, Choi MJ, Lee SH, Kim DY, Cho SB. The effect of CD34+ cell-containing autologous platelet-rich plasma injection on pattern hair loss: a preliminary study. J Eur Acad Dermatol Venereol. 2012 Jan;28(1):72-9))

Background

Autologous PRP (concentrated blood plasma and growth factors obtained from a patient’s own blood) has been shown to improve blood vessel growth around hair follicles. ((Takikawa M, Nakamura S, Nakamura S et al. Enhanced effect of platelet-rich plasma containing a new carrier on hair growth. Dermatol Surg 2011; 37: 1721–1729)), ((Li W, Enomoto M, Ukegawa M et al. Subcutaneous injections of platelet-rich plasma into skin flaps modulate proangiogenic gene expression and improve survival rates. Plast Reconstr Surg 2012; 129: 858–866)) Researchers have suggested that this is one of the ways PRP can promote hair growth. ((Mecklenburg L, Tobin DJ, Mu¨ller-Ro¨ver S et al. Active hair growth (anagen) is associated with angiogenesis. J Invest Dermatol 2000; 114: 909–916))

CD34+ cells are also known to promote new blood vessel growth. These cells are typically found in bone marrow, but are also found in the body’s circulating blood, having migrated from the bone marrow. Since the CD34+ cells in circulating blood occur in such low amounts, and because they age after migrating from the marrow, they usually lose much of their ability to create new blood vessels. ((Mackie AR, Klyachko E, Thorne T et al. Sonic hedgehog-modified human CD34+ cells preserve cardiac function after acute myocardial infarction. Circ Res 2012; 111: 312–321)), ((Jujo K, Ii M, Losordo DW. Endothelial progenitor cells in neovascularization of infarcted myocardium. J Mol Cell Cardiol 2008; 45: 530–544))

Because PRP preparations only contain CD34+ cells from the body’s circulating blood supply, researchers tested the idea that adding bone marrow-derived CD34+ cells to PRP preparations might improve the efficacy of PRP as a treatment for genetic hair loss. ((Kang JS1, Zheng Z, Choi MJ, Lee SH, Kim DY, Cho SB. The effect of CD34+ cell-containing autologous platelet-rich plasma injection on pattern hair loss: a preliminary study. J Eur Acad Dermatol Venereol. 2012 Jan;28(1):72-9))

Results

PRP preparations containing CD34+ cells were found to grow significantly more hair with greater thickness at up to six months after treatment. There were no major side effects of the treatment.

The researchers suggest bone marrow-derived CD34+ cells have a synergistic effect on PRP’s ability to form new blood vessels, and this is what might explain the effects on hair growth. This results suggest that the PRP/CD34+ preparation had a positive therapeutic effect on pattern baldness in both men and women.

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Dr. Robert M. Bernstein — pioneer of the follicular unit transplantation (FUT), follicular unit extraction (FUE), and Robotic FUE hair transplant procedures — was selected for the 13th consecutive year to be included in New York Magazine’s ‘Best Doctors’ issue.

New York Magazine - Best Doctors 2012New York, NY — Robert M. Bernstein, M.D., F.A.A.D., the world-renowned hair transplant physician, pioneer of the Follicular Unit Transplantation (FUT) and Follicular Unit Extraction (FUE) and founder of Bernstein Medical – Center for Hair Restoration, was included in New York Magazine’s ‘Best Doctors‘ issue for the thirteenth consecutive year.

When asked of his inclusion in this annual peer-reviewed list, Dr. Bernstein, a Clinical Professor of Dermatology at Columbia University in New York City, said:

“It is such an honor to be recognized by New York Magazine. Our passion for providing the best hair loss treatments has served as the impetus for pushing the envelope in utilizing new state-of-the-art hair restoration techniques such as Robotic assisted hair transplants.”

New York Magazine’s Best Doctors issue is a directory of physicians that is compiled through a peer-review survey conducted by Castle Connolly Medical Ltd. The company also publishes “Top Doctors: New York Metro Area,” a guidebook based on the results of the same survey of doctors. Each year, physicians in the New York metropolitan area — including Manhattan, Brooklyn, Queens, The Bronx, Staten Island, Westchester County, Long Island, and counties in New Jersey and Connecticut — nominate their choice of the best doctors in a specific field. The physicians make their recommendations based on criteria including: qualifications, reputation, skill in diagnosis, and skill in treating patients.

Dr. Bernstein, a native New Yorker, has spent two decades developing new hair transplant techniques. His medical publications on FUT and FUE hair transplantation have revolutionized the field of hair restoration surgery and provide the basis for modern techniques used by hair transplant surgeons worldwide. Bernstein Medical – Center for Hair Restoration is a state-of-the-art hair restoration facility in New York City. Located in midtown Manhattan since 2005, the center is dedicated to the diagnosis and treatment of hair loss in men and women and specializes in both corrective hair transplants as well as the traditional restorative FUT and FUE techniques. Dr. Bernstein is the first hair transplant doctor on the East Coast to offer Robotic FUE hair transplantation to hair loss patients.

Dr. Bernstein has regularly appeared in notable media programs and publications over the years. Some highlights include: The Oprah Winfrey Show, The Dr. Oz Show, The Today Show, Good Morning America, CBS News, The Early Show, Fox News, National Public Radio, NY1, New York Times, Men’s Health Magazine, GQ Magazine, Telemundo, “O” the Oprah Magazine, and more. He is co-author of Hair Loss & Replacement for Dummies.

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Miniaturized human hair follicle shows concentration of Prostaglandin D2 (in green). Credit: Garza and Cotsarelis/Penn Medicine)
Miniaturized human hair follicle shows concentration of Prostaglandin D2 (in green). Credit: Garza and Cotsarelis/Penn Medicine)

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.

Prostaglandins are a family of proteins that have a wide range of functions, including controlling cell growth and constricting and dilating muscle tissue. According to an article in ScienceDaily, the researchers had previously found evidence that something was inhibiting hair growth, but they did not expect to find prostaglandins involved in the miniaturization of hair follicles:

“Our findings were unexpected, as prostaglandins haven’t been thought about in relation to hair loss, yet it made sense that there was an inhibitor of hair growth, based on our earlier work looking at hair follicle stem cells,” said George Cotsarelis, MD, chair and professor of Dermatology, and senior author on the studies.

In men with androgenetic alopecia, Prostaglandin D2 was found to be three times higher in bald scalp tissue versus areas of the scalp with hair. Additionally, when hair follicles in a laboratory culture were treated with PD2, the hairs were significantly shorter than non-treated ones. A derivative of PD2, called 15-dPGJ2, was found to completely inhibit hair growth.

The receptor protein that is active with both prostaglandins, called GPR44, may hold the key to limiting the effects of PD2 and, therefore, in regulating hair loss in both men and women. While the study looked only at men, the GPR44 receptor protein exists in women as well. So, theoretically, a topical hair loss treatment may be developed that would prevent or limit thinning or hair loss in both sexes.

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Dr. Robert M. Bernstein, pioneer of the follicular unit transplantation and follicular unit extraction hair transplant procedures, was selected as one of New York metropolitan area’s top physicians.

NY Magazine - Best Doctors - 2011

New York, NY — Robert M. Bernstein, M.D., F.A.A.D., world-renowned pioneer of the Follicular Unit Transplantation and Follicular Unit Extraction hair transplant techniques and founder of Bernstein Medical – Center for Hair Restoration, was included in New York Magazine’s Best Doctors issue for the twelfth consecutive year.

Dr. Bernstein, a Clinical Professor of Dermatology at Columbia University in New York, said that he is honored to be recognized again for the Best Doctors issue. He said, “My inclusion in the Best Doctors issue for the twelfth year in a row is a testament to the hard work and dedication of my staff, our consistently high quality of care, and our passion for treating patients who are struggling with hair loss.”

The New York Magazine Best Doctors issue is an annual compilation of physicians that is based on a peer-review survey conducted by Castle Connolly Medical Ltd., a research company that publishes Top Doctors: New York Metro Area. Each year, medical professionals in the New York metropolitan area nominate their choice of the best doctors in a field. The physicians make their recommendations based on several criteria including: professional qualifications, reputation, skill in diagnosis, and skill in providing treatment for patients.

Dr. Bernstein, a New York native, is a true innovator in the field of hair restoration. His medical publications on follicular unit transplantation (FUT) and follicular unit extraction (FUE) have revolutionized hair transplantation and provide the foundation for techniques in use by hair transplant surgeons across five continents. His medical practice has been solely devoted to the treatment of hair loss since 1995 and he has provided hair loss treatments and hair restoration surgery at his state-of-the-art hair restoration facility in New York City since 2005. The Bernstein Medical – Center for Hair Restoration, located in midtown Manhattan, is dedicated to the diagnosis and treatment of hair loss in men and women and specializes in both restorative and corrective hair transplants.

Dr. Bernstein has appeared on a wide variety of notable media programs and publications. Some of these include: The Oprah Winfrey Show, The Dr. Oz Show, The Today Show, Good Morning America, ABC News, CBS News, Fox News, National Public Radio, New York Times, Men’s Health Magazine, GQ Magazine, Univision, Telemundo, “O” the Oprah Magazine, and more. He is co-author of Hair Loss & Replacement for Dummies and The Patient’s Guide to Hair Restoration.

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Robert M. Bernstein, M.D., F.A.A.D., Renowned Hair Transplant Surgeon and Founder of Bernstein Medical – Center for Hair Restoration in New York, is Studying Four Applications of ACell MatriStem™ Extracellular Matrix in a Type of Hair Cloning, Called Hair Multiplication, as well as in Current Hair Restoration Procedures.

New York, NY (PRWEB) March 15, 2011 – Robert M. Bernstein, M.D., F.A.A.D., Clinical Professor of Dermatology at Columbia University in New York and founder of Bernstein Medical – Center for Hair Restoration, has been granted approval by the Western Institutional Review Board (WIRB) to study four different applications of the ACell MatriStem extracellular matrix (ECM) in hair restoration.

Hair Cloning with ACell MatriStemHair Cloningwith ACell MatriStem

Two of the studies include its use in a type of hair cloning, called hair multiplication, where plucked hairs and transected follicular units are induced to generate new hair-producing follicles. The other two areas of study include evaluating the use of the ECM in current hair transplant procedures to enhance hair growth and facilitate wound healing.

Approval by the WIRB allows the researchers to conduct double-blinded, bilateral controlled studies. Controlled studies are the best way to increase the objectivity of the research and insure the validity of the results.

“The medical research we are performing is important because it may lead to hair multiplication as a way to increase a person’s supply of donor hair. In this way, patients would no longer be limited in the amount of hair which can be used in a hair restoration procedure,” said Dr. Bernstein. “Additionally, in the near-term, the extracellular matrix may be able to improve the cosmetic benefit of current hair transplant procedures. We are simultaneously pushing the boundaries of hair cloning methods and follicular unit transplantation.”

Hair multiplication, a variation of what is popularly known as hair cloning, is a procedure where partial hair follicles are stimulated to form whole follicles. These parts can either be from hairs derived from plucking or from follicles which have been purposely cut into sections. Generally, damaged follicular units will stop growing hairs. However, there is anecdotal evidence that an extracellular matrix applied to partial follicles may stimulate whole follicles to grow and, when applied to wounds, may stimulate the body’s cells to heal the damaged tissue.

This new medical research also attempts to show that ACell can improve the healing of wounds created when follicular units are harvested for hair transplant surgery. Currently, in follicular unit hair transplant procedures, a linear scar results when a surgeon incises the patient’s scalp to harvest follicular units. Occasionally, this scar can be stretched, resulting in a less-than favorable cosmetic result. If ECM can induce the wound to heal more completely, the linear scar may be improved. The extracellular matrix may also benefit general hair growth in hair transplantation in that the sites where hair is transplanted, called recipient sites, can be primed with ECM to encourage healthy growth of the hair follicle.

Dr. Bernstein is known world-wide for pioneering the hair restoration procedures of follicular unit transplantation (FUT) and follicular unit extraction (FUE). Follicular units are the naturally-occurring groups of one to four hair follicles which make up scalp hair. These tiny structures are the components which are transplanted in follicular unit hair transplants.

While hair cloning has been of great interest to hair restoration physicians and sufferers of common genetic hair loss, the method by which this can be achieved has yet to be determined. The use of ACell’s extracellular matrix to generate follicles is a promising development in achieving this elusive goal. In addition to the longer term implications of using ECM in hair multiplication, its impact on hair restoration will be more immediate if it can be proven effective when used in current FUT procedures.

About Dr. Robert M. Bernstein:

Dr. Bernstein is a certified dermatologist and pioneer in the field of hair transplant surgery. His landmark medical publications have revolutionized hair transplantation and provide the foundation for techniques used by hair transplant surgeons across five continents. He is respected for his honest and ethical assessment of a patient’s treatment options, exceptional surgical skills, and keen aesthetic sense in hair transplantation. In addition to his many medical publications, Dr. Bernstein has appeared as a hair loss or hair transplantation expert on The Oprah Winfrey Show, The Dr. Oz Show, Good Morning America, The Today Show, The Discovery Channel, CBS News, Fox News, and National Public Radio; and he has been interviewed for articles in GQ Magazine, Men’s Health, Vogue, the New York Times, and others.

About Bernstein Medical – Center for Hair Restoration:

Bernstein Medical – Center for Hair Restoration is a state-of-the-art hair restoration facility and international referral center, located in midtown Manhattan, New York City. The center is dedicated to the diagnosis and treatment of hair loss in men and women. Hair transplant surgery, hair repair surgery, and eyebrow transplant surgery are performed using the follicular unit transplant (FUT) and follicular unit extraction (FUE) surgical hair restoration techniques.

Contact Bernstein Medical – Center for Hair Restoration:

If you are a journalist and would like to discuss this press release, please email us or call us today (212-826-2400) to schedule an appointment to speak with Dr. Bernstein.

View the press release at PRWeb.

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Research published in the January 2011 issue of the Journal of Clinical Investigation (Vol. 121, issue 1) reveals another breakthrough in the medical community’s understanding of the causes of — and possible cure for — androgenetic alopecia, or common male pattern baldness. The new research shows that the presence of a certain type of cell, called progenitor cells, is significantly reduced in men with common baldness compared to men who are not bald.

An article on AOL, which calls these “faulty” stem cells the root of hair loss in men, sheds light on the findings:

Using cell samples from men having hair transplants, a team led by University of Pennsylvania dermatologist Dr. George Cotsarelis compared follicles from portions of bald scalp to follicles from scalp areas with hair.

They learned that on the same person, the bald patches had an equal number of stem cells as the patches with hair. But they did find a difference: the areas of bald scalp had a significantly lower number of a more mature type of cell, called a progenitor cell.

That finding suggests that stem cells in parts of the head without hair have malfunctioned, losing their ability to convert into progenitor cells. ((AOL, “Scientists Trace Root of Male Hair Loss to Faulty Stem Cells,” January 5th 2011))

The study showed that, contrary to conventional wisdom, it is not the total “number” of stem cells that causes hair loss. In fact, the scientists’ original hypothesis was that, “the miniaturization of the hair follicle seen in [androgenetic alopecia] may result from loss of hair follicle stem cells.” That hypothesis turned out to be inaccurate. Instead, the authors of the study indicate that the findings:

…Support the notion that a defect in conversion of hair follicle stem cells to progenitor cells plays a role in the pathogenesis of [androgenetic alopecia]. ((J Clin Invest. doi:10.1172/JCI44478.))

The study’s results suggest that further research into the mechanism for the conversion of hair follicle stem cells to progenitor cells is warranted. If scientists can devise a way to correct that mechanism, then, in theory, stem cells in men who are predisposed to have androgenetic alopecia can be converted to progenitor cells at a normal rate. That correction would, in theory, eliminate that person’s susceptibility to the hair follicle miniaturization which causes hair loss, and would effectively cure his male pattern baldness.

Progenitor Cells vs. Stem Cells

Compared to stem cells, progenitor cells are further along in the process of differentiating into their target tissue, in this case mature hair follicles. Whereas stem cells are pluripotent, meaning that they can differentiate into a number of types of cells, progenitor cells are already committed to a specific cell line. Another important difference between stem cells and progenitor cells is that stem cells can replicate indefinitely, whereas progenitor cells can only divide a limited number of times.

For further reading on this stem cells and the causes of hair loss, here are some links:

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Q: I have been on finasteride for about 7 months. After my latest haircut I can see that my scalp is shiny. I read that is from sebum buildup and it can cause a layer that clogs the growth of hair. I was wondering if this is true and, if so, how can it be treated? — T.C., Philadelphia, PA

A: It is not true. Hair loss is caused by the miniaturizing effects of DHT on the hair follicle, not by blocked pores.

For more on this topic, view our pages on the causes of hair loss in men or the causes of hair loss in women.

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ACell, Inc. - Regenerative Medicine TechnologyNew developments in regenerative medicine, presented at the 18th Annual Scientific Meeting of the International Society for Hair Restoration (ISHRS) this past week, may have opened the possibility that a patient’s hair can be multiplied in his own scalp.

ACell, Inc., a company based in Columbia, Maryland, has developed and refined an Extracellular Matrix (ECM), a natural biological material that can be implanted at the site of an injury or damaged tissue in order to stimulate a unique healing response. The ECM stimulates the body’s own cells to form new tissue specific to that site (a process referred to as “Auto-cloning”).

The ACell MatriStem devices have had some preliminary success in allowing plucked hairs that were placed into recipient sites on the patient’s scalp to grow. Although this is a major breakthrough, significant work remains in order for hair multiplication to become a practical treatment for hair loss in men and women.

It is also anticipated that the regenerative properties of Extracellular Matrix will facilitate the healing of the incision in the donor area after a hair transplant. We are currently offering ACell to all patients undergoing follicular unit transplant procedures at no additional charge.

We are currently studying the use of ACell for scalp hair multiplication as well as the facilitation of wound healing in follicular unit transplantation procedures. We are also treating select patients outside the studies. If you are interested in participating, please give us a call.

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Men's Health - Hair HealthMen’s Health has published a new spotlight, called “Hair Health.” The multi-article spotlight is featured on the magazine’s website homepage and covers a wide variety of topics related to men’s hair loss and hair transplant surgery. Dr. Bernstein was asked to contribute to the series of articles, including an “expert advice” feature which answers five commonly-asked questions about hair loss myths.

The centerpiece articles in the spotlight include the article, “Scalped,” which details the best treatments for hair loss in men, and, “Keep Plugging Away,” about best-practices on finding a great doctor who can treat your hair loss.

In “Scalped,” Dr. Bernstein speaks to the urgency of halting your hair loss using Propecia and Rogaine, while he cautions younger patients on the side effects of the drug Dutasteride:

“Start [Propecia and Rogaine] as soon as your hair begins to thin for the best results.”

[…]

“The reproductive side effects [of Dutasteride] — decreased libido and ejaculation disorders — may be persistent, so I don’t usually recommend this medication for younger patients.”

On hair transplantation, Dr. Bernstein says:

“Hair transplants are most appropriate for people who have not responded to medical treatments.”

“Keep Plugging Away,” centers on hair transplant surgery and the repair of hair transplants that used out-dated, large, “pluggy” hair grafts. Dr. Bernstein – the hair transplant physician most responsible for the new pioneering techniques of follicular unit transplantation and follicular unit extraction – had this to say about hair transplant repair:

“Reversing the unnatural appearance of older plugs is more involved than using the right technique in the first place,” he says. “But in most cases, it can be accomplished with excellent results.”

Visit the “Hair Health” feature online at MensHealth.com.

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Dr. Robert M. Bernstein, founder of Bernstein Medical – Center for Hair Restoration, was selected by Castle Connolly as one of the New York metropolitan area’s top physicians through a peer-review survey of medical professionals.

Best Doctors 2010 - NY MagazineNew York, NY — Robert M. Bernstein, M.D., F.A.A.D., world-renowned pioneer of the hair transplant techniques, Follicular Unit Transplantation and Follicular Unit Extraction, and founder of Bernstein Medical – Center for Hair Restoration in Manhattan, has been included in New York Magazine’s “Best Doctors” issue for the eleventh consecutive year.

Dr. Bernstein, a Clinical Professor of Dermatology at Columbia University in New York, said he was honored to be chosen by his peers for the magazine’s special annual issue. He said, “It is a privilege to be involved in the care of treating patients struggling with hair loss and an honor to be recognized by my peers for contributions that I have made to the rapidly evolving field of surgical hair restoration.”

Dr. Bernstein has performed hair transplant surgery at his state-of-the-art Center for Hair Restoration in New York City since 1995. The practice is solely devoted to the diagnosis and treatment of hair loss in men and women and specializes in both restorative and corrective hair transplants.

The list of physicians in the Best Doctors issue is based on an annual peer-review survey conducted by Castle Connolly Medical Ltd., a research company that publishes Top Doctors: New York Metro Area. Each year, Castle Connolly distributes 12,000 nomination forms to medical professionals in New York metropolitan area. These medical industry peers are asked to nominate their choice of best doctors in a particular field and to take into account not only professional qualifications and reputation, but also skill in diagnosing and treating patients.

Dr. Bernstein has appeared on such notable programs and channels as The Oprah Winfrey Show, The Dr. Oz Show, The Howard Stern Show, The Today Show, Good Morning America, ABC News, Fox News, Discovery Channel, and National Public Radio. He also appeared in New York Magazine’s special issue Best Beauty Docs in New York, where he was included for his pioneering work in Follicular Unit Transplantation and Follicular Unit Extraction. He is co-author of Hair Loss & Replacement for Dummies: The Patient’s Guide to Hair Restoration, and numerous medical publications.

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Q: Why is hair loss in women harder to treat with hair transplants than hair loss in men?

A: The majority of women present with diffuse hair loss (i.e. thinning all over) rather than the patterned hair loss seen in men (where the hair loss is localized to the front and top of the scalp).

Diffuse thinning presents two problems for a potential hair transplant candidate.

The first is that there is no permanent area where the hair can be taken from. If hair is taken from an area that is thinning, the transplanted hair will continue to thin after the procedure, since moving it doesn’t make it more permanent.

The second problem is that since the areas to be transplanted are thin, rather than completely bald, the existing hair in the area of the hair transplant is at some risk to shedding as a result of the procedure.

When women have a more defined pattern (i.e. more localized thinning on the front part of the scalp with a stable back and sides), they can make excellent candidates for surgery. This pattern occurs in about 20% of women. A small percentage of men have diffuse thinning and are, therefore, poor candidates for a hair restoration surgery as well.

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Q: Have there been any studies showing the difference between men and women in their response to laser treatments for hair loss?

A: In the International Journal of Cosmetic Surgery and Aesthetic Dermatology (Vol. 5, Number 2; 2003), a study on low level laser therapy (LLLT) was conducted which indicated that there was a 55% increase of growth (hair count) in the temporal area as well as 64% in the vertex of the female subjects who were treated with LLLT for hair loss. The study also indicated a 74% increase in the hair counts of the male subjects in the temporal area and 120% in the vertex region. These results would initially indicate that LLLT works better in men than in women, but there were four times as many men in this study so the results might be different in a larger test group.

However, even in this notably smaller female group, the tensile strength of the hair increased dramatically over the tensile strength observed in the male subjects after treatment. This would indicate that, at least in this study, there was not only an increased hair count in women, but the tensile strength of that hair was greatly improved as well. This would be initially indicative that LLLT may be found to be more beneficial to women than to men.

It is important to note that this study was published in 2003. Further studies need to be conducted to confirm the initial results and to further elucidate the possible mechanisms of low level laser light therapy in both men and women with alopecia. As important, long term data needs to be accumulated to show the continued efficacy of this treatment. It had been our clinical experience that LLLT is not as effective as one would assume from the results of the initial studies.

Visit the page on Laser Therapy for more information, or read more answers to questions about laser therapy.

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Hair Loss & Replacement for Dummies

Hair Transplant Surgeons Author Hair Loss for Dummies Book

An authoritative guide explaining the causes of hair loss and the newest ways to treat it.

Hair Loss & Replacement for Dummies

New York, NY (PRWEB) December 1, 2008

Renowned hair restoration surgeons Robert M. Bernstein, M.D., F.A.A.D., and Dr. William Rassman, have co-authored the first authoritative, but user-friendly guide, to help both men and women understand hair loss, its prevention, and their medical and hair transplant options. The book, published by John Wiley & Sons, Inc., is set for a December 3 publication date. Titled Hair Loss & Replacement for Dummies, the book follows in the tradition of the other informative books in the popular For Dummies series.

Dr. Bernstein is the author of numerous medical publications on hair restoration, which can be found at www.bernsteinmedical.com.

Those who follow the current trends in hair restoration and hair transplant procedures know Dr. Bernstein for his pioneering work in the development of the Follicular Unit Transplantation procedure which has revolutionized the treatment of hair loss. Recently awarded a certificate of achievement from Columbia University, he has been named one of New York Magazine’s “The Best Doctors in New York” for the ninth consecutive year.

“Dr. Rassman and I felt it was necessary to write this book because we wanted to dispel many of the myths about hair loss and give men and women basic, easily understandable information about their hair loss,” Dr. Bernstein explained. “We feel that this book will provide men and women suffering from common baldness and other types of alopecia with the tools necessary to make informed decisions about their condition. There are a lot of options when it comes to the treatment of hair loss and we want to make certain that consumers are making the decisions that are the best fit for them as individuals – whether it is medical therapy or a hair transplant.”

In addition to providing readers with information about the latest trends in hair loss medications and hair transplants, the book also aims to caution against potentially harmful products that are currently on the market for treating hair loss. Finally, the text also gives tips for maintaining a healthy head of hair: from washing and drying correctly, to caring for children’s hair.

About Dr. Bernstein
Dr. Bernstein is Clinical Professor of Dermatology at the College of Physicians and Surgeons of Columbia University in New York. He achieved worldwide recognition for pioneering Follicular Unit Hair Transplantation. He is founder of Bernstein Medical – Center for Hair Restoration in Manhattan which is devoted to the treatment of hair loss using his state-of-the-art hair restoration techniques.

Dr. Bernstein has been chosen as one of “America’s Top Doctors,” by Castle Connolly Medical and New York Magazine’s “The Best Doctors in New York” for nine consecutive years. He has been selected to be among New York Magazine’s “Best Beauty Docs in New York” for his pioneering work in Follicular Unit Transplantation and Follicular Unit Extraction and is the most widely published author on these subjects. He is the founder of Bernstein Medical -Center for Hair Restoration in New York City (www.BernsteinMedical.com).

About John Wiley & Sons, Inc. /For Dummies Series
John Wiley & Sons, Inc. was founded in 1807 during the Jefferson presidency. In the early years, Wiley was best known for publishing the works of Washington Irving, Edgar Allan Poe, Herman Melville, and other 19th-century American literary giants. By the turn of the century, the company was established as a leading publisher of scientific and technical information.

In recent years, Wiley has focused its efforts on delivering its deep reservoir of “must-have” content to global communities of interest, forming collaborative relationships with such significant partners as Dow Jones/Wall Street Journal, CNBC and PricewaterhouseCoopers, among others. In 2001, Wiley acquired Hungry Minds, Inc., including the latter company’s wildly popular For Dummies series of books. Cleverly written, packaged and marketed, all For Dummies books utilize a lighthearted approach and down-to-earth style (often including cartoons and humorous icons) to dispel fears, inspire confidence and educate the public. For more information on John Wiley & Sons, Inc., visit wiley.com.

For further reading see the Hair Loss & Replacement for Dummies summary, the transcript of an interview with Dr. Bernstein about the book, or purchase the book at Amazon.com.

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Q: I’m 52 years old and have been taking Propecia (finasteride) for two years. It seems to maintain the status quo with no apparent regrowth. I am considering adding a dose of Avodart (dutasteride) once a week in conjunction with the daily Propecia. My question is twofold: (1) Since dutasteride blocks production of both enzymes (type I and II) that produce DHT from testosterone, is it redundant to take the finasteride that only blocks the type I enzyme? — Y.B., Orlando, Florida

A: It is redundant to take both.

However, you may not be taking the optimal dose of dutasteride which seems to be at least 0.5mg a day for hair loss.

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NY Japion - Dr. Robert M. Bernstein

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.

Nakamura interviewed Dr. Bernstein for this weekly series that began in October 2006. In issues No. 1 and 2, Dr. Bernstein explained the basic mechanism of balding for both men and women which are quite different in its causes, balding types, and progression of hair loss. The NY Japion’s readers were all very surprised by the fact that balding for men is actually related to genes on both the mother’s side as well as the father’s side of the family. Dr. Bernstein also shared his unique theory of why Japan’s Samurai had the uniformed bald look.

The column discussed post-op care after hair restoration surgery and explained the drug Propecia, a men’s oral hair growth treatment, minoxidil and some cosmetic hair products.

Reporter Nakamura was also examined by Dr. Bernstein and with the patient’s permission was allowed to observe a hair transplant surgery. Issues No. 3, 4, 5 are about the surgical hair restoration procedure known as Follicular Unit Hair Transplantation (FUT), a method that Dr. Bernstein helped to pioneer. By using the patient’s own hair, FUT can give totally natural looking results. The patient’s own hair starts growing where there was no hair before.

You can download a PDF version of the original series (in Japanese) at the link below:


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Q: I was told that if men have a lot of testosterone that that’s when they lose hair. Is this true? — Y.B., Lake Forest, Illinois

A: Although androgenetic hair loss is dependent upon normal levels of testosterone, it is not due to increased testosterone. It is caused by a sensitivity of the follicles to normal levels of testosterone.

So someone that is bald doesn’t have extra levels of male hormones and is not necessarily over-sexed.

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Q: Dr. Bernstein, a lot of older women are taking testosterone to restore libido, but are they going to experience hair loss as a consequence?

A: They can. In women there is a delicate balance between the androgens, i.e. testosterone and estrogens. Estrogen is protective to some degree against hair loss in women, which is why most women don’t experience such severe hair loss as do men.

When a woman takes testosterone supplements it upsets that balance and can cause hair loss. However, hair loss in post-menopausal women is usually due to age related changes. Typically, the hair decreases in size in a genetically determined progression that seems not to be directly related to changes in the levels of hormones.

For more information, please see the Causes of Hair Loss in Women page on the Bernstein Medical – Center for Hair Restoration website.

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Q: Why do some people have a full head of hair into their seventies or eighties and others start to go bald in their late teens or early twenties?

A: The cause is genetic and this poly-genetic trait can be inherited from the mother’s side, the father’s side, or both.

There is an old wives’ tale that it is inherited only from the mother’s parents. Although the inheritance can come from either side, it is actually greater from the mother’s side – but only slightly.

Read about Hair Loss Genetics

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