Hair Restoration Blog

Q:

Hi Dr.,  I saw your TV show, and would like to ask you if it is ok for me to buy minoxidil and dissolve it in the shampoo?
Also there are products that says gradually will change the color of my hair to natural color, are they safe to use? wouldn’t they interfere with my scalp respiration?

Thanks a lot

A:

Minoxidil mixed with shampoo

Minoxidil is one of the FDA approved medications for balding prevention and hair loss treatment.  The recommended dose and method for its use is applying it topically on balding area twice a day and leaving the product without washing it off.
Although combination of minoxidil with shampoos are available commercially, I don’t believe you can get a complete result by using them because:
1.    Minoxidil would be diluted with shampoo and water and that will reduce its strength.
2.    The active ingredient (minoxidil) would be rinsed and it would not get enough time to have contact with the scalp skin.
3.    It would be less likely that it is used twice a day, which is the recommended method for its maximum result.

Hair product for white hair

To answer your second question, there are many products that are claimed to change the color of white and de-pigmented hair to a normal one.  Most of them are herbal extracts and there is just not enough long term studies that prove their safety that I am aware of.

Q:

I’ve been using 5% topical minoxidil in liquid form for five months and see some positive results (I think) but I have two side effects:

1) itchiness–it’s mild, I can live with it

2) a crust forms that’s dry and I can pick it off, little dry flakes–that is.

Questions are simple:

1) Can/should I still use it?

2) is the foam better to avoid these symptoms?

3) Is there an inexpensive hair conditioner or shampoo I should use? Appreciate your feedback/thoughts…thanks

A:

1) Can/should I still use it?

Minoxidil use is lifetime in most cases. If you stop using it, you may lose the hair which grew from its effect. This is called shock loss and many people experience it when they get tired of minoxidil use and stop it after using it for a few years.

2) Is the foam better to avoid these symptoms?

To avoid the itching, the foam is better based on reports I am gathering from my patients who tried them both.

3) I am not aware of any conditioner and shampoo that can be used to help the growth of hair. There are some shampoos with active ingredients such as minoxidil. However, they efficiency in comparison to minoxidil topical solution is questioned.

Q:

Dear Dr. Mohebi,

Thank you for taking the time to see me on Saturday! Your correspondence providing a summary of our discussion was very comprehensive and is much appreciated!

Since our meeting on Saturday, I have done some research and would like to trouble you with a few more questions:

1) Is Alopecia the correct term to describe my hair loss pattern?

2) Would you consider cortizon shot treatment for me?

3) Would you consider laser therapy?

4) If I were to use monoxidil, does it have to be 2% or a higher percentage would yield more and faster hair growth?

5) you recommended a complete medical evaluation, could you please recommend someone that you trust?

I wish to thank you again for all your time and patience!

Best regards,

A:

Hi,

Here are your answers in the order you asked:

1) Is Alopecia the correct term to describe my hair loss pattern?

Alopecia is a general term that means hair loss. We have many different patterns of hair loss or alopecia, like male pattern or female patterned alopecia or alopecia cicatricial. Your pattern is similar to a male pattern because you lost your hair on the frontal area while you kept your hair on the donor area intact, which is why you might be a good candidate for a hair transplant procedure considering that your medical evaluation is negative for any medically treatable cause of hair loss.

2) Would you consider cortizon shot treatment for me?

No, steroid shots are sometimes used for Alopecia Areata (AA), which is an autoimmune disorder. Alopeica Areata is a hair loss condition with patchy hair loss spots. Your condition does not seem to be Alopecia Areata.

3) Would you consider laser therapy?

I do not recommend laser therapy for hair loss in the form of laser comb or laser machines because of the lack of solid medical evidence that support their effectiveness at this time.

4) If I were to use Monoxidil, does it have to be 2% or a higher percentage would yield more and faster hair growth?

You can start with 2% and then you need to be re-evaluated in six to 12 months and a treatment plan might need to be adjusted at that time.

5) you recommended a complete medical evaluation, could you please recommend someone that you trust?

Any good internist or endocrinologist could follow through with the lab works that you need.  Our letter includes the list of medical conditions that should be considered and lab works to rule out those women like you who have hair loss. You can share my letter with any good internist or endocrinologist and he or she should be able to follow through with your lab result and treat any treatable conditions that could possibly be found.

Have a great day,

I just read a new article presenting an interesting case presentation and thought it might be useful for the readers of our hair restoration blog.  The article is published in the Journal of American Academy of Dermatology this month (July 2009).

It goes over mesotherapy, a remedy that has been proposed for hair loss and its adverse side effects.  Mesotherapy has recently become an advertised method for the treatment of different types of alopecia despite the lack of any data regarding its efficacy and possible side effects. The substances injected into the scalp include “cocktails” of natural plant extracts, homeopathic agents, vitamins, vasodilators, and drugs that may stimulate hair growth such as finasteride and minoxidil.

The authors report two cases of patchy alopecia that developed after mesotherapy for the treatment of androgenetic alopecia. In the first patient, alopecia developed after injections of the heparinoid vasodilator mesoglycan; the 3-month follow-up examination revealed a small residual area of cicatricial alopecia. The second patient developed reversible alopecia after multiple scalp injections of homeopathic agents. These cases underline the possible risks of mesotherapy as a therapeutic technique for hair loss.

This could be considered another modality that was presented for male hair loss without a solid value like many other similar hair loss products.  We have always said in this blog that the hair loss product market is a “buyer beware” market and you need to do your research and, preferably, discuss with your doctor before you try any new modality for treatment of your hair loss.

Q:

Hello,

I did a search for hair re-growth, hair loss, etc. and I found your email address.  These internet searches are definitely far from perfect, in fact sometimes they are way off!  So if this is not the type of business or practice you’re in, I apologize and please disregard this email.

I’m a 43 year-old male.  I started losing my hair, very slightly, at age 27.  I really haven’t lost a whole lot since then, however, my hairline has receded a little and I have been using Rogaine pretty faithfully.
I’m trying to find the best way or multiple ways of re-growing my hair.  First, I am curious to know if it is okay to use Rogaine (5%) and take Propecia?  Do you know if Nioxin or any other shampoos or hair thickeners are helpful?  Would you recommend any?  Are there any other factors that make a difference in re-growing hair such as: vitamins, hormones, foods or physical exercise?

Do you think these types of remedies are all stop-gap solutions and I will need to look for something more permanent? Do you have any insight or additional thoughts or sell any products or services that I can purchase that will help?

Thank you,

A:

Thanks for your email.  You have asked many questions which most have been answered in our Hair Restoration Blog.  There are many hair loss products in the market, but most of them do not have any active ingredients that can help your hair loss condition.  There are only two FDA approved medications that have been approved and proven to be effective and safe for hair loss treatment and prevention.  Those two medications are Rogaine and Propecia.  If you are suffering from male pattern baldness, hair transplant surgery may be the only option that can improve or eliminate the appearance of baldness by bringing good quality hair from the permanent zone to the front and balding areas.

I do not have any particular hair loss product nor recommend many different lotions and potions that are out there in the market for hair loss.  You can find other valuable information on our postings in our blog and can answer your questions on:

• Nioxin - hair loss product
• other shampoos for hair loss
• vitamins for hair loss
• balding and hormones
• foods for hair restoration
• physical exercise and hair loss

I recommend that you find a good hair restoration doctor who can evaluate you and come up with a master plan for your condition.  This may include medications, surgery or even cosmetic changes that you need to bring your hair and beauty back to your life.  We do offer an online consultation for hair restoration through pictures and if decided that you are a candidate and you choose to have a hair transplant with us, it could be easily done.  Our California offices of hair restoration can arrange your trip to our Los Angeles office for your hair restoration surgery.

You can contact our office at 888-302-8747.

Good luck,
Parsa Mohebi, MD

Q:

My hair is very thin and I want to strengthen it. There are two products I tried before, one suggested by my hairdresser called “Chronostin” and the other one prescribed by my skin doctor, called Minoxidil, Estradiol Vateral, Esopropyl Acohol, if I read it correctly.

I would highly appreciate your advice,
Best regards,

A:

It was good that you saw a dermatologist.  I am sure you have been examined by your doctor for miniaturization of the hair as part of his diagnostic for male patterned hair loss.  Combining minoxidil with other hormonal medications is not proven to add any value to its effect for the treatment of hair loss.  The doctor who put you on minoxidil probably diagnosed male pattern baldness.   If that is the case you can benefit from using finasteride as well which is a medication with more potency in comparison to minoxidil based on several studies.

I have not heard of Chronostim which was recommended to you by your hairdresser.  However, I did some research on it. Chronostin is claimed to be a solution that allows it to act on the group of factors which play a part in the loss of hair. It has both morning and evening solutions where the day one serum contains sabal enriched in lauric acid (seborrhea regulating ), tocopherol Nicotinate (microcirculation stimulating, oxygenating bulbar), glycyrrhetinic Acide béta (reinforces the activity of 5-alpha réductase), Excipient alcohol-silicone, and Perfume- hypoallergenic.

Chronostim ” NIGHT” has extract of Ruscus enriched in Neoruscine (stimulating of the VEGF), Diguanosine tétraphosphate (GP4G) (cellular stimulant), Piroctonolamine (cleansing, anti-irritant). Excipient hydro-alcoholic, Perfume- hypoallergenic.

Sounds confusing, Right?  These components have not been studied through medical research as to have any effect on male hair loss in this combination.

I would stick with finasteride (Propecia) if it is OK with your dermatologist.  Obviously, if you continue to have hair loss or currently have a balding area, hair transplant surgery is probably the answer to restore the balding area.

–
Best,

Parsa Mohebi, M.D.
Medical Director
US Hair Restoration

Dear Parsa Mohebi,

I hope you’re doing great. I hope you also remember me - it’s ….. - I visited your office in January in Mission Viejo, California. I am currently in Dubai! Thank you for the letter which you sent me regarding the tests I should take. I appreciate the time you took out for me. I have taken the tests and wait for the results.

I wanted to ask you a question regarding the hair growth. Recently I was going through some websites and landed on a product called ScalpMed.  I was quite alarmed at how this product worked (as it says it does). I am aware that there are numerous type of products available in the market but for some reason this really got me interested. Can you please have a look at it and advice me whether or not to take it seriously?

I appreciate for your time. Looking forward to hear from you!

A:

As my patients ask, I often answer questions on hair loss products on this blog.  Scalp Med makes a series of products for hair loss and hair thickening.  They are put together as different kits such as a Detoxifying Cleanser Kit, Scalp Med For Women and Mega-Multi Vitamins.  Scalp Med ads, like many hair loss products, claim that they are FDA approved hair loss products. You can find many pictures, testimonies and so on from balding patients who try to promote the product.  Here are the ingredients of Scalp Med:

Scalp Med has different products including topical Vitadil-5A for men, Vitadil-2A for women, topical NutriSol-RM, and Cortex Enlarger hair thickening spray.  The firs two Vitadils are topical solutions that contain minoxidil, which is also the key component of Rogaine.  They claim that they have a unique delivery agent formulated to increase the absorption of minoxidil in men and women.

When it comes to NutriSol-RM and Cortex Enlarger thickening spray, Scalp Med is a bit more vague as to its ingredients. Basically, other than the active ingredient minoxidil, the other ingredients do not seem to be scientifically proven to help the growth and health of hair. The cleansers that are put into many hair loss products should not do anything with the growth of your hair and advertising on the effect of better cleanser for hair growth is more like a myth.

My recommendation to you is to complete your medical evaluation to make sure you are not losing your hair due to a treatable cause.  If you are diagnosed to have a typical female patterned hair baldness, then you can use Rogaine.

Biatoprost has been available and prescribed as a glaucoma medication, used to control the progression of glaucoma and to manage the ocular hypertension. Biatoprost reduces intraocular pressure.  One of the side effects of this glaucoma medication is lengthening of the eyelashes.  In December 2008, the use of this product for eyelash lengthening was approved by the FDA.  The cosmetic formulation of bimatoprost is now sold as Latisse by Allergan.

This is not the first time that we take advantage of a side effect of a medication for other applications.  Another example is minoxidil which was originally used only as a blood pressure medication. As a result, growing hair was reported as one of its side effects.  Now minoxidil, or Rogaine, is one of the FDA approved medications for hair loss prevention and treatment.

Latisse is in the market for those who are interested in having longer eyelashes.  Eyelash hair transplant surgery is another method that uses scalp hair to be implanted into the eyelash area.  The best candidates for eyelash hair transplantation are the people who do not have any eyelashes on all or part of their eyelashes.  If you have eyelashes and are looking forward to having them longer and fuller, Latisse might be a better option.

Q:
Well I am only 18 yrs old from India and I have got a hair problem. usually when I was young I didn’t care much about my hair, but now I have  found that I have  lost my hair and they r falling very rapidly.

Well my diet is also not too good as I am very lean…..now I am getting very worried about my .They have not completely gone…. but volume or (say) quantity of hair has reduced very much from all over the head and the effect can be seen more on the crown area I don’t use much shampoo and usually I didn’t use to use oil but have started now.

My father is too bald so please help me that what should I do …so that I can restore my hair back……

A:
Your hair loss is most likely genetic and you might be experiencing the early stages of male pattern baldness.  Although malnutrition may cause some types of hair loss, it won’t happen until your are severely deficient of some particular elements.

Having said that, it is a good idea to see your doctor to confirm the diagnosis of the hair loss, especially if your hair loss does not follow a typical male pattern like what you can probably see in other male members of your family.  Men hair loss in its male pattern type is seen in men between their early 20s and will deteriorate for many years.  There are many hair loss products out in the market, but none of those are really proven to work except a few medications that are FDA approved such as minoxidil and finasteride.

My recommendation is not to start using hair loss medications before your diagnosis of male patterned baldness is confirmed by a doctor.  Hair transplant might be an option for you in the future so it is good to start your relationship with a hair transplant surgeon now.

Dear Dr Parsa Mohebi,

I have been experiencing male pattern baldness for some years now. Initially used Rogaine, it worked at first but now no longer respond to it. Next used Propecia, but had to stop due to side effects. Lasercomb failed too. I am currently saving up and considering getting a hair transplant maybe in 4 years time. I’ll have enough money by then.

There’s one thing I’m really curious about. Would you happen to know anything about Revivogen from www.revivogen.com. It’s a topical lotion combined with shampoo/conditioner that was invented by Doctor Alex Khadavi, MD, a US Board-certified dermatologist. I have a question below which I hope you can answer and shed light on.

All I just want to know before trying the product and applying the lotion to my scalp is for my “safety” concerns. If this product was developed by a dermatologist is it okay to allow myself to test it out even if it may not grow/and or stop hair loss but at least I can be rest assured it won’t cause allergic reactions on the localized surface of my scalp. Although I don’t have sensitive scalp skin, some of the things I’m scared of are like more hair loss(worse than pre-treatment) or cause unknown severe harm like scalp dermatitis/acne/burn/swolleness, stain my scalp permanently orange etc.(I’ve probably just exaggerated every side effect.May or may not true!). This is what I mean by safety. What’s the worse a topical solution like Revivogen could do to my scalp anyway? Any potential risks? Are the ingredients mentioned on the website even safe on humans?
Finally, do you believe it is safe enough and whether its worth a try for me to test out what appears to be a very safe and sound consumer product and hopefully not a scam? There’s nothing else on the market and I’m really desperate too to give it a go.

Please do feel free to take your time and answer me whenever you can. Your comments and recommendations would be very appreciated. Thanks.

Kind regards,
-

A:

It seems like you tried everything for your hair loss, but stopped them all due to either side effects or inefficiency. You are now exploring other options before you can get a hair transplant surgery. You are not alone and there are many other young men who are going through the same path.

First of all, I really like to know what kinds of side effects you experienced with finasteride (Propecia), because finasteride is an effective hair loss medication, although it has been blamed unfairly for many side effects. I put most my patients at our Los Angeles and Orange County Hair Restoration Clinics who have significant miniaturization on finasteride. Finasteride can help prevent further hair loss. Some of your hair loss might be irreversible by medication and you may need hair restoration surgery, but at least you can stop further hair loss by the time that you can restore your hair surgically. Revivogen® is a hair loss product with some natural compounds that mainly inhibit 5-Alpha-Reductase. 5-Alpha-Reductase is the enzyme that converts testosterone to dihydroxytestostrone (DHT). Prevention of DHT production can slow down hair loss in male pattern baldness.

One of the components of Revivogen is Saw Palmetto Extract, which is a DHT blocker and is used systemically for prevention of both hair loss and prostate enlargement. The efficacy of its topical product is not studied as extensively in large human experiments. Other components include a variety of fatty acids like: Gamma Linolenic acid (GLA), Alpha Linolenic acid (ALA), Linoleic Acid and Oleic Acid without strong human research on their absorption from skin level as well as their efficacy on human hair growth. Other components such as Azaleic acid, Vitamin B, Zinc, Beta-Sitosterol and Procyanidin Oligomers have shown some effects on the DHT production in labs, but the extensive studies to compare their effect with more researched medical treatments for hair loss is lacking.

The absorption level of the ingredients of Revivogen® from human scalp skin is not studied as extensively as well. I personally have not heard anything about any serious side effects of Revivogen, but I would rather have more information about long term studies, which are published in peer reviewed medical journals, before I can recommend the product to my patients. There are many hair loss products out there, which are safe, but you do not have a life time to go around and try them all to find out whether they have any effect on your hair or not.

You need to establish a good relationship with a good hair specialist that you can trust. He or she should be able to document the level of your current hair loss and miniaturization of hair and can come up with a master plan, which includes medication treatment, surgery and even cosmetic alterations that can make your hair look better. Side effects of the medications that you tried before need to be re-evaluated closely by your doctor.

You don’t want to deprive yourself from effective, FDA approved hair loss medications that their safety and efficacy are confirmed in scientific studies and instead start looking around to see what else is in the market. If you have no alternatives, your doctor may have some suggestions for your individual condition to preserve whatever hair you have with a product with minimal side effects.