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Hair Restoration Research

Viviscal May Boost Hair Regrowth

A study published in the December 2015 issue of the Journal of Clinical and Aesthetic Dermatology suggests that Viviscal, an oral supplement designed for women with thinning hair, may promote hair growth. The researchers noted a 79 percent increase in healthy, terminal hairs and an almost 12 percent increase in hair diameter in female patients who took the supplement for six months. The evidence suggests that Viviscal may be a useful supplement to current hair restoration treatments, or an alternative treatment in patients not indicated for hair transplant surgery or medical treatment with finasteride.

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Hair Restoration Research

Androgen Treatment May Boost Hair Regrowth in Women

A study published in the British Journal of Dermatology suggests that subcutaneous placement of testosterone pellets may boost hair regrowth in some women.

This retrospective analysis examined patients who had androgen deficiency. Of the 285 patients studied, seventy-six had some degree of hair loss prior to beginning treatment. At one year on testosterone replacement 63% reported an increase in hair regrowth on the scalp.

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Hair Restoration Research

Melatonin Solution Found to Reverse Early Hair Loss in Men and Women

International Journal of Trichology - Oct-Dec 2012Topical application of the solution containing melatonin, ginkgo biloba and biotin was found to reduce hair loss, and in some cases grow new hair. Incidence of seborrhea was also reduced by the treatment. While the exact mechanism for this result is unknown, if effective, it is likely related to the antioxidative effect of melatonin and/or a melatonin receptor-mediated antiandrogenic effects. More research on melatonin needs to be conducted, but this study acts as a proof of concept for the use of melatonin as a treatment for early hair loss in men and women and potentially as a treatment for seborrhea.

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Hair Restoration Research

How Does Minoxidil Work? A Review Of Recent Research

Since 1993, minoxidil has been the most successful topical treatment for hair loss in both men and women, yet its exact mechanism of action remains unknown.

A 2004 review of minoxidil’s possible mechanisms of action (A.G. Messenger & J. Rundegren, 2004) suggests that the best evidence supports the idea that minoxidil causes hair follicles in the later phases of their resting phase (telogen) to shift prematurely into an active growth phase (anagen) sooner than they otherwise would; this causes rapid increase in hair growth. They also found good evidence that minoxidil works to thicken the hair by increasing hair diameter.

While minoxidil’s effects on other critical factors known to affect hair growth — such as cell proliferation, collagen synthesis, vascular endothelial growth factor and prostaglandin synthesis — remain uncertain, more recent research has found evidence that it may also suppress the androgen-androgen receptor responsible for androgenetic alopecia (Cheng-Lung Hsu, Jai-Shin Liu,An-Chi Lin, Chih-Hsun Yang, Wen-Hung Chung, & Wen-Guey Wu, 2014).

Understanding minoxidil’s exact mechanism of action remains today an important line of research both for the development of better hair loss treatments and for a better understanding of the biology of hair growth.

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Hair Restoration Research

Hair Cloning Breakthrough with “Mass Production” of Epithelial Stem Cells

Progress towards hair cloning may have just have shifted up another gear thanks to scientists at the University of Pennsylvania and the New Jersey Institute of Technology. The breakthrough study published January 28th, 2014 is the first to show the successful transformation of adult human skin cells into quantities of epithelial stem cells necessary for hair regeneration.

The researchers, led by Dr. Xiaowei “George” Xu, started with human skin cells called dermal fibroblasts, then transformed those into a type of stem cell called induced pluripotent stem cells (iPSCs). These were then transformed into epithelial stem cells (EpSCs). This important step had never been achieved before in either humans or mice. The epithelial stem cells were combined with mouse dermal cells, that can be induced to form hair follicles, and then grafted on a mouse host. The epithelial cells and dermal cells then grew to form a functional human epidermis and follicles structurally similar to human hair follicles. The exhibits that accompany the study include photographic evidence of human hairs.

Yang R, et al. 2014

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Hair Restoration Research

Early Baldness May Suggest Prostate Cancer Risk

A study of Australian men between the ages of 40 and 69 suggests that men who were mostly bald by the age of 40 were more likely to develop prostate cancer in their 50s or 60s. The Melbourne Collaborative Cohort study of about 10,000 men showed that men who have high levels of testosterone may be more vulnerable to cancerous prostate tumors.

The team of scientists that conducted the long-term study, which was published in the journal Cancer Epidemiology, Biomarkers and Prevention, reported that both baldness and prostate cancer are age-related and androgen dependent conditions, so these findings are not surprising. The statement said, “We found that baldness at the age of 40 might be a marker of increased risk of prostate cancer.”

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Hair Restoration Answers

Is Propecia Persistent Side Effects Study Reported in the Media Flawed?

Q: As a Propecia user, I was alarmed when I read headlines last year about about a new study indicating very high rates of depression and erectile dysfunction caused by Propecia, with symptoms persisting even after the drug was stopped. However, when I read the articles, this “study” appeared to be survey of 61 men who had taken Propecia and already reported sexual problems who were then asked about symptoms of depression. These rates of depression were compared to a small survey of men who had hair loss but had never taken Propecia.

Anyone with a basic understanding of statistics would know such a survey was deeply flawed. First, it is a textbook example of a bad data sample — to get sound results you have to start with an unbiased and random group of people who took the drug, not a self-selected group of men already suffering symptoms. The study also confuses correlation with causation — because these men are suffering from ED or depression does not necessarily mean it was caused by the drug. Am I missing something here, or did the media just report these “findings” with no scrutiny on what was actually studied? — Jonathan, Brooklyn, NY

A: Jonathan, I think you’re right on the mark. The way the study was conducted raises a lot of concern about the accuracy of the findings. It is really important that additional data is obtained in a controlled way, as this will be most useful for physicians in advising patients. I addressed concern on these reports on the Hair Transplant Blog last year. The issue of persistent sexual dysfunction as a side-effect of finasteride is an on-going issue that we take very seriously. I sit on the International Society of Hair Restoration Surgery (ISHRS) Task Force on Finasteride Adverse Events, so this is an issue that we watch very closely.

Read more about Propecia and Persistent Side Effects

Read more about Propecia (finasteride)

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Hair Restoration Answers

What is Latest Information on Persistent Side Effects from Finasteride?

Q: I have heard that side effects from finasteride can persist even after stopping the medication. What is the most current information on this issue? — S.V., Short Hills, N.J.

A: For the past two years I have been on the ISHRS’s Task Force on Finasteride Adverse Events and struggling to make sense of this issue. There seems to be a disconnect between the relatively low incidence of side effects that we, as physicians, see in our practices, what published controlled studies have shown, and what is now being reported on the internet. For example, a 2012 study by Sato of 3,177 Japanese men published the Journal of Dermatology, showed a 0.7% incidence of adverse reactions to finasteride 1% and no persistent side effects after stopping the medication.

That said, there has been a recent increase in anecdotal reports of side effects from finasteride as well as reports of persistent side effects after the medication has been discontinued (referred to as “Post-finasteride Syndrome”).

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Hair Restoration Answers

Are Reports of Persistent Side Effects With Finasteride Real?

Q: Dr. Bernstein, I am an attending at Mass General Hospital in Boston and would like to ask you regarding your experiences using finasteride for male androgenetic alopecia. While I have not noticed any side effects in the patients that I have been treating, I increasingly get questions regarding side effects based on the recent media attention to reports of potentially permanent problems regarding libido or erectile dysfunction. I know that in the literature there is a slight increase of reversible sexual dysfunction (~4% vs. ~2% in placebo) with Propecia, and no convincing evidence to date in the medical literature that have used controlled studies regarding permanent problems even after discontinuing Propecia. — S.Z., Boston, Massachusetts

A: That is correct.

Q: I know that you have treated many patients over a long period of time, and I was thus wondering what your take is on potentially permanent sexual dysfunction after taking finasteride. Have you seen any convincing reports/patients or do you have any concerns regarding irreversible side effects?

A: I have seen 5 cases in over 10,000 patients on finasteride that complained of this but, of course, there is no way to know for sure if there is a cause and effect relationship. As you know, real side effects may be followed by psychological ones and if the sexual dysfunction has another cause, then stopping finasteride would have no effect on the symptoms. The incidence of sexual dysfunction in the population of men on finasteride is about 30%, so one would expect these numbers to be much higher just due to the normal incidence. It is really a difficult situation to understand. The experience that my colleagues and I have in our practices is much different than one would expect after reading the numerous anecdotal reports on the internet.

Q: Would you think it is safe to say that any potential sexual dysfunction is reversible after discontinuing the use of finasteride?

A: I don’t think that anyone knows at this point. The FDA is coming down on the side of caution and saying that it is possible, although it is not based on any new studies. If the phenomenon is real, the possible mechanism is not yet known.

Q: In the relatively few patients that I have treated with Propecia, they did not even report temporary problems regarding libido or erectile dysfunction. Do you think they are real or rather attributed to Propecia simply because the patient is made aware of these potential side effects?

A: I think that psychological effects may account for many cases. At this time, it is still not clear if a physiologic “post-finasteride syndrome” is real. A lot more work needs to be done before we have a definitive answer to this question.

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Hair Restoration Research

Japanese Researchers Bioengineer Hair Follicles from Stem Cells, Dermal Papillae

Japanese researchers have demonstrated that scientists can bioengineer viable, hair-producing follicles from epithelial stem cells and dermal papilla cells. Using these components, the team produced follicles that exhibit both the normal hair cycle and piloerection (the reflex contraction of a tiny muscle in the hair follicles which creates what is commonly referred to as “goose bumps”). The bioengineered follicles also developed the normal structures found within follicles and formed natural connections with skin tissues, muscle cells, and nerve cells.

Toyoshima K, et al. 2012

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Hair Restoration Research

Research Points To Vitamin D Receptors As Possible Clue To Reversing Hair Loss

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.

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Hair Restoration Research

Sato Finasteride Study Points to Long-term Safety, Efficacy in Use of Propecia

Led by Dr. A. Sato, a Japanese team of medical researchers published the largest finasteride study ever performed, “Evaluation of efficacy and safety of finasteride 1mg in 3,177 Japanese men with androgenetic alopecia.” It investigated the effects of finasteride over a 3 1/2 year period in men with androgenetic alopecia, or common baldness.

The study found that patients who had experienced hair loss for an extended period of time and were treated with finasteride exhibited notable hair growth. While a fairly small proportion of patients with a hair loss duration over 10 years exhibited “greatly increased” growth, 85% of patients with hair loss duration of more than 15 years experienced “moderate” or “slightly increased” growth. Physicians have thought that people with advanced hair loss do not respond as well as patients in the early stages of hair loss. However, in light of the results of this study, that determination should be reconsidered. Continue reading this article.

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Hair Restoration Research

Hair Cloning Study Shows RepliCel’s Efficacy In Increasing Hair Density

RepliCel Life Sciences; a company out of Vancouver, Canada; is studying the use of hair cloning techniques to treat male pattern baldness and hair loss in women.

The study is in progress, but analysis of the 6-month interim results of the first phases have been published. As indicated in the graphic above, the preliminary results at 6 months show that vellus hair density has increased 24.9%, terminal hair density has increased 14.5%, overall hair density increased by 19.2%, and cumulative thickness per area increased by 15.4%.

Also, almost two-thirds of subjects (10 subjects out of 16, or 63%) received a greater than 5% increase in hair density at the injection site. Of that group of 10 subjects, 7 of them saw hair density improve by more than 10%, with the biggest improvement in hair density being an increase of 19.6% in one subject.

Lortkipanidze N, et al. 2012

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Bernstein Medical In The News

Fat Cell Discovery An “Important Step” In Understanding Hair Loss

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.”

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Hair Restoration Answers

Are There Any Lab Studies Proving that Saw Palmetto Helps Prevent Hair Loss?

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.

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Hair Restoration Research

Hair Loss Cure A Possible Result Of Stem Cell Communication Research

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?

Chuong C, et al. 2011

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Bernstein Medical In The News

Press Release: Hair Transplant Pioneer Studies Hair Cloning, Hair Restoration Procedures Using ACell’s Extracellular Matrix

Hair Cloning with ACell MatriStemRobert 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.

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Hair Restoration Research

Researchers “Accidentally” Reverse Hair Loss Caused by Stress

Sometimes an “accident” in the laboratory can lead to a remarkable breakthrough. Penicillin, Botox, Viagra, and Minoxidil — the active ingredient in Rogaine — were all unintended discoveries that led to treatments for a variety of conditions. A similar twist of fate, this time by researchers at UCLA, could lead scientists to a new hair loss treatment.

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Hair Restoration Research

Research Points to Decreased “Progenitor” Stem Cells as Cause of Male Pattern Baldness

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 a progenitor cell, is significantly reduced in men with common baldness compared to men who are not bald. Read on for more details on this breakthrough.

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Hair Restoration Answers

Is Lgr5 Gene Discovery a Hair Cloning Breakthrough?

Q: I heard about the Lgr5 gene being a breakthrough in hair cloning. What’s the latest on that?

A: Many scientists feel that adult stem cells house the answer to cloning (regeneration) of hair follicles. One of the problems of hair cloning, however, is that the cells, once duplicated, “forget” that they are hair follicle cells.

It has recently been discovered that the Lgr5 gene, located in stem cells, appears to contain the “global marker” present in all adult hair follicles. If Lgr5 gene is the “calling card” of the cell, it may carry the cell lineage and shoulder the responsibility of signaling to surrounding stem cells what they are actually supposed to do as they multiply.

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Hair Restoration Answers

Does Low Level Laser Therapy (LLLT) Affect Hair Loss in Men and Women Differently?

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.

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Hair Restoration Research

Skin Cells Substitute for Embryonic Stem Cells in Cloning Research

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

Two teams of scientists working independently announced that they had successfully replicated the biological abilities of the embryonic stem cell using only skin cells.

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Bernstein Medical In The News

Dr. Bernstein’s Hair Restoration Innovations Acknowledged In ‘Millennium Paper’ History Of Dermatologic Surgery

Dermatologic Surgery - January 2000 Vol26 Issue1The innovations Dr. Bernstein has described through his medical publications are now a part of history. In the Millennium Paper of the journal Dermatologic Surgery, a comprehensive history of the field of dermatologic surgery cites Dr. Bernstein as being one of the three physicians who played a leading role in hair transplantation in the 1980′s and 1990′s.

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