Hair Restoration Blog

Some hair loss is correlated to stress. This type of hair loss is generally reversible and does not require medical treatment or hair transplant. Hair loss induced by stress usually occurs after severe stress, such as surgery, starvation, emotional stressful situation or illness. Stress and hair loss don’t have to be permanent. Getting your emotional stress under control or alleviating a physical stressor usually results in your hair growing back.

How Stress Causes Hair Loss

Extreme stress can interrupt the normal hair growth cycle. Your body may want to spend its vital resources on more essential organs such as heard and brain so the luxury hair could be cut off its supply. As much as seventy percent of your hair can prematurely and nearly simultaneously enter the resting phase (telogen.) The hair that entered telogen phase will start to fall in a few days to weeks following the stressful condition.  This process can cause noticeable hair loss which is usually known as telogen effluvium.

The person will not become completely bald but the thinning is readily apparent in most cases. The delay from the trigger stressor seems causes confusion on the part of the patient concerned about hair loss. In most instances hair will begin to grow back within three to six months.  In a minute percentage of people, telogen effluvium may be only the trigger for longer term hair loss.  Those are generally people who are prone to patterned hair loss and stressor can accelerate the inevitable loss of hair that was destined to occur anyway.

Does vitamin D deficiency cause hair loss?

There are several studies that show the effect of Vitamin D Receptors in hair follicle cycling.  Most of the studies show a relationship between vitamin D receptor (VDR) and hair follicle anagen (growth phase) initiation.  View research here.

Most studies on vitamin D receptor are done on animal models and we cannot completely explain the same condition in human hair follicle. The result of most research to date is a recommendation for future research studies to explore the role of vitamin D and its receptor in human hair cycling. A more extensive body of research on the levels of vitamin D in human body is needed.  The aim of these studies should be to determine  effect of vitamin D in human hair cycling and a comparison to the observed data from the mouse model.

The business of hair loss vitamins and supplements is a multi-billion dollar business. However,  in my years of study and medical practice have not read or found  a study that shows patterned hair loss in healthy men and women could be improved with any amount of vitamin therapy.   Despite The fact that  In my medical hair restoration practice in Los Angeles we see men and women in various stages of hair loss. We often request levels for essential elements such as Iron or specific hormonal levels. Conversely we rarely find a need to order lab work to check the vitamin levels. The reason for this is that vitamin deficiencies are very rare in America. If a patient had a  vitamin deficiency that had caused him/her hair loss; then he/she would have greater medical conditions and would unlikely be able to make it to our office. The level of vitamin deficiency to create a clinical level of hair loss would present many other systemic conditions  that would occur prior to presenting hair loss.

Medical hair restoration: Hair transplants are the most successful form of hair restoration.

The advanced modern techniques used today in hair transplant surgery are a proven, natural  and preventative method to slow down and/or stop further hair loss. It could be used with or without hair transplant surgery. When you talk to friends and family about hair loss treatments, you will find a lot of do-it-yourself hair loss methods or products such as creams, ointments, lotions, nutrition supplements, scalp products and other herbal, all promising to stop hair loss and re-grow hair.

Among all the many so called remedies for hair loss  for nonsurgical treatment of hair loss for men and women (pattern baldness), you will find that only two that have been approved by the U.S. Food and Drug Administration, and are recommended by physician hair restoration specialists. Hair loss products not approved by the FDA are often enriching the manufacturer but too little to help the man or woman suffering with hair loss. Some actually even harm the individuals who experiment with these unproven methods.

The FDA approved finasteride (Propecia) and minoxidil (Rogaine) are the only two medications presently that directly address hair loss. The other products that are considered effective as hair loss treatment usually contain either of these medications or similar chemicals as ingredients.

There are many other options that are touted out in the marketplace. These products do not have enough evidence based information.  It is best to consult with your doctor about all options before committing to any of these types of treatments.

US Hair restoration combines medical treatment of hair loss with surgical options or hair transplant to create a master plan for obtaining the best final results.

 Magnetic Therapy Effects on Hair Loss

Our patients and readers barrage our offices with questions regarding  exotic methods that are claim to help hair loss.  When these claims are published in sources that appear sophisticated and reputable to the average consumer more confusion sets in.  I receive many questions regarding the validity of these devices including laser combs, LED light hats, magnetic devices, heating caps etc.

The reality is that we only have a few techniques that can actually help hair loss and those are:

1. Hair transplantation that can permanently move hair from permanent hair zone to balding area
2. Hair loss medications such as finasteride and minoxidil that primarily can slow down the process of hair loss.
3. Ketoconazole and Bimatoprost solutions; two other solutions that appear to stimulate hair growing as a side effect.
4. A few herbals such as Saw Palmetto with DHT blocking properties.

Hair restoration is a huge market considering that over 60% of white males over the age of 50 have some degrees of hair loss that requires some sort of treatment.  Most of those devices that claim that they can help hair loss are shooting to only sell one time to a small fraction of balding population who are desperate.  The consumers of these products don’t mind spending a few dollars on a new device with a huge claim that seem harmless to them.

If you do the math you can figure out that each of those claims can profit its seller sweetly and as long as there is no regulation to put stop on those commercials we are going to witness more and more of those ads. The best advice is to see a good hair transplant surgeon and remember the tried and true adage; “If it sounds too good to be true, it most likely isn’t.”

Q:

Dear  Dr.Mohebi,

Salam; I would like to introduce myself as a man, 43, engineer with master degree, single and currently living in Iran. As far as I remember my hair has started to shed when I was young, I would say around 18 years old. On that time I visited several dermatologists in Iran they prescribed me with Betametazone to put it on the scalp and I already got shot Vitamin E.

The top of my head became thin and the skin is seen easily. About 10 years ago Finastride and Minoxidil were introduced to the market of Iran. I first used Minoxidil but after 6 months continue using of this over counter drug I didn’t see any significant improvement so I stopped this method. I made a decision and started to take Finastride 1 mg every day, hopefully it was effective and the thin and tiny hair of the crown of my head started to grow hair and got thicker. The problem was about testicles pain, erectile dysfunction and libido decrease. I was scared and stopped taking Propecia.

And add salt to the injury I recently proposed to a woman for marriage and she rejected me for my semi-bald head. I became heartbroken and decided to transplant hair. My friends had such surgery and unanimously tolled me don’t do it; that this method has yet to be successful in Iran. They said that it would not satisfy my expectation.  I’ve studied a lot and have found out the main problem is DHT and there are some elements can be used as a DHT blocker. I would like to restart my hair re-growth regimen as follows:

1. Taking Magnesium + Zinc Sulphate + Vitamin B6 as natural DHT
   blockers each day.
2. Messaging scalp with Sesame oil before shower for moisturizing and
   natural anti dandruff.
3. Washing hair with Nizoral (ketocenazol %2 ).

My hair situation is exactly like Zidane and Agassi as per attached photo. I would be obliged if you would advise me if this method can be effective for regrowth of my hair or tot just drop it. In addition I would be grateful if you would inform me if there’s any new method without surgery for hair restore and growth. Your expertise and opinion is highly appreciated. In advance thank you very much for your understanding and help.

Best regards,
Babak

A:

I understand that you have tried everything available to you for your hair restoration. I am sorry that you experienced some adverse effects with the medication you were taking.  As you mentioned in your email, hair loss can affect on many aspects of men’s lives and many people like you try many options to find out what is the best one for them.

Unfortunately, many of the products or methods that are stated in various online sources are not scientifically or medically substantiated. These promised solutions are not real remedies for hair loss and should not be considered as viable treatments for hair restoration.  These items you propose for your regimen: taking Magnesium, Zinc Sulphate and Vitamin B6 have no direct proven effect to stimulate hair growth in men who lose hair as a male patterned baldness. If they did the store shelves worldwide would be bare. Likewise, massaging scalp and anti dandruff products are not among the known treatments for male patterned hair loss.

Washing hair with Nizoral (ketoconazole %2) is one of the few among what you described that is proven for hair loss prevention.  Minoxidil is the other medication that has similar effect on prevention of hair loss in its female or male patterned type.  I think you need to discuss the finasteride and the side effects you have had from using it with a good hair specialist.  In many cases the side effects may be psychogenic and not real.  A good doctor can discover if that is the cause in many cases.

Hair transplantation is still the only permanent, proven and natural looking solution that can restore your hair and eliminate baldness in many people. I know you have heard some controversies about hair transplantation.  However, our experience in US Hair Restoration is different.  I have to say it is a pleasure of mine that we see many life changing results in our hair restoration clinics in California on a day to day basis.  I think you should try to find a good hair transplant surgeon and be assessed before you rule out this solid option in favor of these various remedies that have no known effect on hair loss.

I appreciate your sharing your experience and trust you will find benefit in my response.

Regards,

Dr. Mohebi

Q:

I was told that a spot has opened up for my hair transplant surgery. I told them to slot me in, but now that I’ve jumped into the deep end I’m a bit nervous. My nerves don’t have to do with what it will look like six months or a year from now, but for the weeks following the surgery.
I need to take the next day to really meditate on this. Although my hair loss does bother me, it’s not as if I’m noticeably bald. So I’m deciding if this is something that makes sense for me.

A:

It is completely normal to have a touch of nervousness prior to this elective surgery. Since it is an elective procedure, it is common to have questions and/or
reservations. We need to remember that it is simply hair and not some life threatening procedure! Many patients have this reluctance and there is never a clear or definitive answer aside from your intuitive feelings.

Your particular situation is for the enhancement and detailing in order to complement what you already currently have. Your hair loss is probably going to progress in the future but again, it depends on when you want to address the issue.

Having experienced seeing many other patients who had similar feelings before their hair restoration procedure, I think you will very happy you did it!! Either way, I support whatever decision you make. US Hair Restoration is always going to be a resource for you with whatever questions or concerns you have regarding hair loss and the treatment options available.

Meditate  on that assurance and clarity will present itself!

Turban Alopeica due to chronic use of turban and knotting hiar - Bottom: hair line design before hair transplant surgery

Turban Alopecia is a type of traction alopecia that is seen in people who wear tight turbans, such as Sikhs.  Turban Alopecia can also occur as a result of knotting and braiding long hair which results in hair being pulled continuously for long periods of time.  This can cause hair loss with the same mechanism as many other types of traction alopecia – chronic pull on hair follicles can destroy them permanently.

Prognosis of Turban Alopecia is similar to other types of traction alopecia.  It might be reversible to some degree only in some patients.  However, if re-growth is not seen after a year of stopping the use of the turban and tight hair braiding, it is unlikely that new growth will occur at all, leaving the affected areas of the scalp with permanent hair loss.

Turban Alopecia is generally seen in the frontal area of the scalp and in some cases in temple areas.  Those are the areas that are directly affected by the traction effect of the turban and hair braiding.  (This could be seen in most members of a Sikh family.)  Unlike the more common androgentic alopecia, which is a genetic predisposition to hair loss, Turban Alopecia is not genetic, but being predisposed to familial male patterned baldness is an accelerator factor and can cause occurrence of male patterned hair loss prematurely.

The risk of traction alopecia in Turban Alopecia type could be reduced by not knotting or braiding the hair and by wearing turbans more loosely. But for those who have experienced permanent hair loss due to Turban Alopecia, there is a natural and proven treatment option available through surgical hair transplantation. (It will be important to control hair braiding and tight turbans following hair transplantation to insure continued hair growth in these areas.)

Also see: Hair loss for cap

Q:

Hi Parsa,

Thanks for meeting with me last Sat for consultation regarding hair transplantation. I very much liked your “bedside manner”! And your explanation of the procedure, etc. As I mentioned to you my brother is also very interested and would like more information. He lives in another state but would be willing to travel for a procedure – you mentioned an internet consult?

Best,

A:

I enjoyed meeting you too.

As previously discussed, internet consultations are available to your brother and other clientele of his circumstance. To proceed with scheduling an internet consultation for hair loss, you can forward your brother the following link and request that he personally fill and forward the information to us at his convenience. The form is on our Online Hair Restoration Consultation Page.

I will be attending a medical meeting in Orlando, FL this week, but my staff will set up a phone consultation for him as soon as they receive his information.

Have a great day and do not hesitate to contact me if you have any other questions. I look forward to seeing you for your hair transplant procedure soon and thank you for your inquiries.

Diffuse Unpatterned Alopecia (DUPA) is a hair loss condition in which hair thinning is seen diffusely throughout the scalp.  In DUPA, there is no a reserved area with good quality hair even on the areas of the back and side which are typically designated as the donor area in hair transplant patients.

A microscopic evaluation of the scalp generally shows significant miniaturization (fineness) of scalp hair diffusely.  DUPA can be seen in both men and women but its female type may at times be mistaken with typical female patterned baldness due to its close similarities.

A thorough medical evaluation with supporting lab work to rule out other causes of diffuse hair loss is always warranted before determining eligibility for a hair restoration procedure.  Hair transplantation is generally not a good option for people who have DUPA due to instability of the scalp hair on the back and side areas of the scalp.  Many people who have DUPA may suffer from other medical conditions that cause hair loss such as Iron Deficiency, thyroid or other hormonal imbalances or autoimmune disorders.  Medical treatment such as minoxidil in women and finasteride in men could be helpful in treatment of this condition.

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.