An article in the New York Times discusses research surrounding a potential new hair loss treatment. The NY Times’ article “Old Transplant Drug May Have A Fringe Benefit” states that an immunosuppressant used to prevent organ rejection in those having liver, kidney or heart transplants also stimulated hair growth.
Dr. Bernstein addresses the common myth that hair loss is inherited exclusively from the mother’s side of the family – and, more specifically, from your mother’s father. While your mother’s (or maternal grandfather’s) genes can be the culprit, the characteristics of your hair are influenced by many different genes that may come from either or both sides of your family.
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.
In appreciation of National Hair Loss Awareness Month, Bernstein Medical has launched a fundraiser for the ISHRS’s pro bono program, ‘Operation Restore’. This program provides free hair transplants for those who experience localized hair loss due to trauma or illness.
Q: Is it ill-advised to comb one’s hair more than twice a day, especially hair that has been transplanted? Will frequent combing induce hair loss? — G.K. ~ Paramus, N.J.
A: Combing or brushing one’s hair does not cause hair loss – no matter how many times a day you do it. However, constant traction with braids or hair extensions can cause hair loss and this loss can be permanent.
An article in the September/October 2015 issue of Hair Transplant Forum International highlighted results of a 6-month study of platelet rich plasma (PRP) treatment in a 23-year-old male diagnosed with androgenetic alopecia (common male pattern baldness). The study showed a significant increase in hair density and decrease in miniaturized follicles, as well as an apparent darkening of hair pigmentation.
Dr. Bernstein contributed to an article published on the cosmetic surgery portal “Cosmetic Town” about the benefits and usage of Rogaine® (minoxidil) hair loss medication.
The article also discusses the recommended dosage of Rogaine, a comparison of Rogaine and Propecia, when a patient can expect to see results of medical treatment of hair loss, and other related topics.
Q: A while ago I saw you and you recommended FUT hair transplantation, but my friend came in and you recommended FUE. How come? — C.T., Hackensack, N.J.
A: I think that both procedures are excellent, which is why I do them both. My recommendations are determined by the individual patient. His or her age, desire to wear hair cut very short, athletic activities, donor density and miniaturization, extent of hair loss, and potential future balding are all important aspects in the decision process.
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.
Q: Is taking Propecia absolutely essential to retain the transplanted hair after a hair transplant? — D.W., Toronto, Canada
A: Propecia (Finasteride 1mg) does not affect transplanted hair. The purpose of taking finasteride is to prevent further loss of the non-transplanted hair after the hair restoration procedure.
Dr. Schweiger, our resident expert on hair loss in women, was featured in a segment about hair extensions on “Good Morning America” and ABC News online.
While many women extoll the cosmetic virtues of hair extensions — they are designed to add to the length and fullness of one’s hair — many others have realized the potential for extensions to cause hair loss. Read the rest of the post.
Q: Have there been any lab studies proving that Saw Palmetto works to prevent hair loss?
A: There have been no verifiable clinical studies that show saw palmetto can stop hair loss or cause hair to re-grow. There have been some preliminary tests showing that saw palmetto may be able to inhibit 5-alpha-reductase, but its usefulness for androgenetic hair loss has not been documented in controlled studies.
Q: Can dandruff cause hair loss? I have a lot of dandruff and use the Nizoral Shampoo for it. And can the Nizoral be a reason I am losing my hair? — K.P., Suffern, NY
A: Dandruff (the medical term is seborrhea) does not cause hair loss as it is a condition that involves scaling and redness on the surface of the scalp and does not involve the growth parts of the hair follicle that lie deeper in the skin. Although Nizoral is an ineffective treatment for hair loss (it is sometimes prescribed for this) it will not cause hair loss.
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.
Of his being selected in the 2011 issue, Dr. Bernstein 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.”
A: Kevis has a line of natural products including shampoos, accelerators, lotions and conditioners claimed to treat hair loss by blocking DHT. The primarily ingredient is HUCP, or hyaluronic acid. Hyaluronic acid has not been shown to prevent hair loss.
Q: I use Nizoral for my dandruff. Does it work for hair loss too? — M.D., Danbury, CT
A: The active ingredient in Nizoral is Ketoconazole. This medication, originally developed to treat fungus infections, has slight anti-androgen action. It is supposed to work in hair loss by inhibiting the action of DHT on hair follicles. Although, in theory, it should be useful for androgenetic hair loss, there have not been conclusive scientific studies to show that it works to treat balding when used as a topical application for balding.
Q: I heard that the sexual side effects of Propecia are irreversible. Is this true? — L.R., Parsippany, NJ
A: The sexual side effects of finasteride (Propecia) begin to subside soon after the medication is discontinued. This would make sense since the drug finasteride is a reversible inhibitor of DHT. Although it is possible for side effects to be persistent after stopping the medication, this situation seems to be very uncommon and a cause and effect relationship is still in question.
A: Allergan, the company that makes Latisse, is conducting safety and efficacy testing of three formulations of the drug for men with androgenetic alopecia (male pattern baldness).
Telemundo47 — a Spanish-language media outlet based in New York City — interviewed Dr. Bernstein for a segment on hair loss (pérdida del cabello) and how hair treatments and styles can lead to long-term damage.
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.
CBS News has enlisted the help of Dr. Bernstein in dispelling a series of myths which circulate in the general public about the causes and treatments of hair loss. The feature is titled, “Hey, Baldy: 10 Things You Need to Know about Hair Loss.”
Q: What are the fibers in Toppik made from? — A.P., Toronto, Canada
A:Toppik is made from an organic protein called keratin – the same protein that comprises one’s hair and nails. It works by thickening the hair and adding color to the scalp, making the hair appear fuller in those with hair loss or general thinning.
CBS News’ The Early Show has picked up the “balding buzz” that first started to grow when the National Enquirer reported that New England Patriots star quarterback Tom Brady is seeking advice on how to treat his hair loss.
New England Patriots quarterback Tom Brady has a multimillion dollar contract, a supermodel wife, and not one, not two, but three Super Bowl rings. He also has androgenetic alopecia, or genetically inherited male pattern baldness, and future prospects of being a balding celebrity. Or does he?
An article in the New York Daily News reports that Mr. Brady has consulted with a hair transplant physician about his hair loss. The Daily News interviewed both Dr. Bernstein and a patient at Bernstein Medical – Center for Hair Restoration for the article. Read the full post for quotations from the article and some links on hair loss genetics.
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.
New 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.
Q: If I had a body hair transplant to my scalp and then took Propecia to prevent further hair loss, could finasteride thin out the transplanted hair? — T.M., Yonkers, NY
Q: I am a 34 year old male and my dermatologist prescribed Propecia for me today. Most of my hair loss is at the hairline, but there is some loss on top as well. It’s not bad, I just want to stay ahead of it. If I get a transplant I want to get it at your clinic, but I will give the Propecia a try first. I am going to be overseas for a couple of months starting this Sunday and I was wondering about the necessity or desirability of having someone measure my hair density prior to starting the Propecia. Would you advise waiting to start the Propecia until I come back in two months and having my density examined at your clinic? — M.R., Great Falls, Virginia
A: I would start Propecia as soon as possible. What is important for a hair transplant is the density in the donor area and this is not affected by Propecia (or minoxidil). Your donor density can be measured anytime at an evaluation prior to surgery. If you want to wait to see the effects of Propecia prior to the hair transplant, you really should wait a year; since growth, if any, can take this long. If you just want to have Propecia on board for the hair restoration procedure, or to make sure you don’t have side effects, then generally a month will do. If you would like to do a photo consult through our website to get some preliminary information about how many grafts you might need, you can do that at your leisure, but start Propecia now since the longer you wait the less effective it will be at regrowing hair.
Q: I have been taking one tablet of Propecia daily for the past 5 years, with good results, until May of this year. At that point I started to experience some hair loss and so you recommended that I switch from Propecia to generic finasteride and increase the dose to 1/2 of a 5 mg pill per day. I started taking the 1/2 tablet of finasteride daily one month ago, and for the past 2 weeks I have seen a lot of hair in the bathtub and on the towel after taking a shower. I have not made any other changes in my diet or my shampoo, and I do not have any conditions on my scalp. Please advise me on what needs to be done. — C.C., Floral Park, New York
A: Just continue the medication at the higher dose. Either the finasteride hasn’t started working yet or you are getting temporary shedding from the medication (which means that it is working).
Two new avenues of scientific research, discussed in an article in the New York Times, might just help enable human beings to regenerate 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.
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.
Q: Is it recommended to wait for 1 year after starting Propecia, when the effect of the medication kicks in and improves density of donor area, and then perform the surgery? — Z.B., Bergen County, New Jersey
A: Propecia will not affect the donor area, as this area is generally not impacted by the miniaturizing (thinning) effects of DHT –- the hormone that Propecia blocks. The purpose of waiting the year is to possibly regrow hair in the recipient area. If regrowth is significant, a hair transplant may not be necessary. If a person’s hair loss is extensive and there is little chance that Propecia will grow a significant amount of hair back to give a satisfactory improvement, then waiting the year is unnecessary.
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.
New 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.
Q: I have a friend who has been using Propecia 1mg a day for twelve months without having any regrowth. Is he likely to experience regrowth at this stage? — S.S., Long Island, NY
A: Your friend is unlikely to get any significant regrowth after one year, but that doesn’t mean that the medication is not working. He may have had even more hair loss without the medication.
WABC-TV Eyewitness News; channel 7 in New York, NY; featured Dr. Bernstein in a special report on hair loss and hair loss medications. In particular, the report, by ABC correspondent Kemberly Richardson, asked Dr. Bernstein about the effectiveness of Propecia/Finasteride and Rogaine/Minoxidil in the treatment of male pattern hair loss. Watch the report.
Asylum.com reporter Brett Smiley interviewed Dr. Bernstein to get his take on hair loss and the balding pattern known as a “power alley”:
“Power alley is an accurate term for that type of balding,” says Dr. Robert M. Bernstein, a clinical professor of dermatology at Columbia University and world-renowned hair-transplant surgeon. “It’s Norwood Class III balding, which is the most common type.”
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: Is using Minoxidil combined with Retin-A better than regular Minoxidil for Hair Loss? — L.W., Gowanus, New York
A: Minoxidil has been prescribed (off-label) in combination with other medications, such as topical retinoic acid (Retin-A), to enhance its penetration into the skin and thus increase its effectiveness. This combination of medications can increase the absorption of minoxidil into the bloodstream and may increase the risk of potential side effects, including changes in blood pressure and scalp irritation. It is important to use combination therapy under the supervision of a physician.
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.
Q: Is it worth getting the genetic test for balding?
A: You’re referring to Hair DX (hairdx.com), which costs about $150 and came to market in January of 2008 as the first test for androgenetic alopecia, aka male pattern baldness.
The test screens for variations in the androgen receptor gene on the X chromosome, the gene that is associated with male pattern hair loss. The purpose of the test is to identify persons at increased risk of developing hair loss before it is clinically apparent – so that medical intervention can be started early, when it is most effective.
Note from Dr. Bernstein: This article, by my colleague Dr. Rassman, is such important reading for anyone considering a hair transplant, that I felt it should be posted here in its entirety.
Areas of Unethical Behavior Practiced Today
William Rassman, MD, Los Angeles, California
I am disturbed that there is a rise in unethical practices in the hair transplant community. Although many of these practices have been around amongst a small handful of physicians, the recent recession has clearly increased their numbers. Each of us can see evidence of these practices as patients come into our offices and tell us about their experiences. When a patient comes to me and is clearly the victim of unethical behavior I can only react by telling the patient the truth about what my fellow physician has done to them. We have no obligation to protect those doctors in our ranks who practice unethically, so maybe the way we respond is to become a patient advocate, one on one, for each patient so victimized.
A new study, using hair cloning therapy to regrow hair, shows promise for all individuals suffering from alopecia areata. The study — conducted by Marwa Fawzi, a dermatologist at the University of Cairo Faculty of Medicine, and reported on Bloomberg.com — used stem cells from the scalps of eight children with alopecia areata to regenerate their own hair.
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.
Dr. Bernstein discusses the technique of follicular unit hair transplantation in a Fox News segment on hair loss and hair transplantation.
In the video, he discusses the use of the follicular unit hair transplant (FUT) procedure to correct hair loss and camouflage scarring that resulted from the surgical removal of a large skin cancer on the patient’s scalp.
What thoughts go through the head of your average hair loss sufferer before, during, and after a hair transplant?
The answer to that question may now be revealed. ABC News correspondent Cari Nierenberg and associate producer Ryan Stevenson take us directly into the mind and life of Bernstein Medical patient Adam Khoudja in a three-part video diary and feature on hair loss and hair restoration.
Announcer: PRWebPodcast.com, visiting with newsmakers and industry experts.
Interviewer: I am here today with Dr. Robert M. Bernstein, Clinical Professor of Dermatology at Columbia University and founder of Bernstein Medical – Center for Hair Restoration in New York. Dr. Bernstein is the co-author of the highly anticipated Hair Loss & Replacement for Dummies book. Welcome, Dr. Bernstein.
Dr. Bernstein: Good morning, thank you for having me.
Interviewer: Dr. Bernstein, why don’t you tell us a little bit about the book?
Dr. Bernstein: Sure. We wrote Hair Loss & Replacement for Dummies for anyone who wants to learn more about hair loss and its treatment. In the book, Dr. Rassman and I not only discuss common balding, but we cover a host of other conditions that can all lead to the loss of one’s hair. In the book, we give readers a basic understanding of hair and offer tips for taking better care of both the hair and scalp. Most importantly, the book describes the most up-to-date treatments for both male and female pattern hair loss.
Interviewer: This sounds interesting, why did you and Dr. Rassman decide to write the book?
Dr. Bernstein: Well, hair loss affects so many men and women. There is lots of information available on the web, but much of it is unreliable and the medical literature is often a bit too technical for the average reader. We wanted to provide a resource that was factual and comprehensive but, at the same time, very easy to understand. Hopefully, this book will allow those experiencing hair loss to be able to get straightforward, honest information and be able to make informed decisions if they require treatment.
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.
Hair Loss & Replacement for Dummies is filled with important information for men and women of virtually all ages anxious to preserve their full head of hair, put the brakes on balding, or explore the safest and most reliable hair replacement techniques currently available. The book offers readers not only the full gamut of modern-day hair-care options but crucial tips on how to avoid unscrupulous hair transplant doctors and potentially harmful products as well.
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.