Hair Restoration Blog

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

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.

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.

Q:

You have mentioned shock loss in some of your articles that may happen after hair transplant surgeries in young men. Does it happen to everyone and if happened, is it reversible.

A:

Shock loss used to be a big problem for many hair transplant patients. Shock loss generally happens in the first 1 to 3 months following the hair transplant procedure and can be reversible in some patients and to some degrees. Remember that shock loss happens mostly to the hair follicles that have some degree of miniaturization are already in the process of falling out and the stress of surgery just accelerates the rate of hair loss. Strong terminal hairs are usually resistant to the shock loss.

There are several ways to minimize shock loss after hair transplant surgeries. Topical medications like minoxidil could prevent shock loss to some degrees. Finasteride (Propecia) would perhaps be the most helpful medication for reducing the shock loss after hair restoration surgeries, if patient starts taking Propecia right before his hair transplant surgery.

My recommendation to most patients is to start finasteride even a few days before the surgery so it is locked in the system by the time of surgery and can protect hair from shock loss phenomenon. The rate of shock loss has significantly dropped in our hair transplant patients in the last few years, and it has to do with us strongly recommending finasteride use before hair transplant surgery to all our male patients.

hey doctor!

As I read through forums and articles, people mention that propecia works better in conjunction with something else, such as rogaine for exmaple. At the moment, the vertex area of my scalp seems emptier than than the crown and minoxidil works well with the vertex. Do you recommend me go back on minoxidil for the vertex, or should I just focus on propecia?

Answer:
I generally prescribe finasteride to most of my patients who have significant miniaturization whether they are getting hair transplants or not. There are several studies on using Rogaine (minoxidil) and Propecia (finasteride) as single therapy and in combination with each other or with other medications.

Comparing minoxidil and finasteride for treatment of male pattern baldness clearly shows that treatment with only finasteride is more effective than treatment with only minoxidil. Combination of finasteride with minoxidil and with some other medications shows improved outcome, but the rate of improvement is not significant enough that I can convince myself to prescribe combination therapy to all my patients for the rest of their lives, considering difficulty of using topical minoxidil (topical spreading of medication twice a day on the balding area of scalp).

If you want to do everything possible to prevent or slow down further hair loss and maybe grow some, you can consider combination therapy, but remember when you start minoxidil you are committed to continue it for the rest of your life or until there are better alternatives.