Giorgos Tsetis: In the beginning, we left three factories because we didn't feel confident that they could do the job at our standard. These type of factories are sourcing the ingredients for you, but you have no clue where these ingredients are coming from. You don't know the efficacy, if they're clinically tested, and what about absorption? As a company, we decided to identify these root triggers that play a role in disrupting the hair growth cycle, then rigorously tested how we can target them and what specific ingredients solve for each trigger. Then, we developed individual partnerships with top suppliers all over the world that specialized in single ingredients that actually have that efficacy. We decided to source our own ingredients because we wanted to control the entire process. At least nine of the ten companies we consulted with said we couldn't do that, because the ingredients we chose to use were incredibly expensive. That's one main reason others can't do the work we do. For example, we purchase our primary ingredient for $600 per kilo, and you can buy the standard version of that ingredient in China for $30 per kilo. Same ingredients, but ours is clinically tested and proven to be effective. We only use patented ingredients, which made others think we're crazy, but creating the absolute best product is our top priority.
Cut the fast-food diet and start getting some whole food in your life. The less processed the better; as my mom says “as close to nature as possible.” Healthy skin and hair start with a healthy diet. Aim for a diet rich in Vitamin C, Vitamin A, Vitamin E, B Vitamins, lean protein and Essential Fatty Acids. EFAs can be found in walnuts, salmon, flax seed, and most seeds. EFAs have been shown to increase prostaglandin production in those with a deficiency; prostaglandin is what prompts your lashes and brows to grow.
For women going through menopause, the cause of hair loss is almost always related to hormonal changes. However, there are many other factors that can contribute to hair loss during menopause. These include extremely high levels of stress, illness, or a lack of certain nutrients. Diagnostic blood tests that can help rule out other causes of hair loss include thyroid tests, and/or a complete blood count.
When you see more hair in the shower drain, in your hair brush or your ponytail holder goes around an extra time all of a sudden this is typically low thyroid, high stress or low estrogen. It can also be the increased inflammation or oxidative stress or as a result of nutrient deficiencies especially anemias (low iron, B12, etc.). Let’s dig into each of these.
Hair loss in women is not easy to diagnose because it is very often multifactorial in etiology and thus requires well-designed specific steps so that the patient is evaluated properly. The best way to do this is to evaluate the patient in person (rather than sending photos via email or Skype) because the patient gets a chance to meet her doctor to permit the development of a trusting relationship- critical because very often the treatment of hair loss is an involved process that requires a strong doctor-patient relationship.
Androstenedione, which is mostly produced in the ovary and adrenal glands, is converted to testosterone by 17β-hydroxysteroid dehydrogenase. Testosterone then circulates throughout the body to reach its target tissues. Androgen-metabolizing enzymes have been found in many parts of the hair follicle (Table 1; Bolognia et al., 2012). The presence of those enzymes makes the pilosebaceous unit a site of androgen metabolism and synthesis (Fazekas and Sandor, 1973). Circulating free testosterone either binds to intracellular androgen receptors in the hair bulb and dermal papilla, which facilitates miniaturization of the follicle, or is metabolized into dihydrotestosterone (DHT) by the enzyme 5-alpha-reductase. DHT then binds the same receptor but with much greater affinity (Kaufman, 2002, Levy and Emer, 2013). Of the androgens depicted in Figure 1, only DHT and testosterone bind to androgen receptors (Burger, 2002).
Alopecia areata: Researchers believe that this is an autoimmune disease. Autoimmune means the body attacks itself. In this case, the body attacks its own hair. This causes smooth, round patches of hair loss on the scalp and other areas of the body. People with alopecia areata are often in excellent health. Most people see their hair re-grow. Dermatologists treat people with this disorder to help the hair re-grow more quickly.
Medicines may also help slow or prevent the development of common baldness. One medicine, minoxidil (brand name: Rogaine), is available without a prescription. It is applied to the scalp. Both men and women can use it. Another medicine, finasteride (brand name: Propecia) is available with a prescription. It comes in pills and is only for men. It may take up to 6 months before you can tell if one of these medicines is working.
The real culprit appears to be dihydrotestosterone (DHT), a more potent form of testosterone. DHT is made from testosterone by a specific enzyme in the body, and while both testosterone and DHT are known to have a weakening effect on hair follicles, there appears to be something unique about the conversion process of testosterone to DHT that relates to thinning hair. This is why some drugs that are marketed for hair loss block the conversion of testosterone to DHT. (It’s important to note, however, that these drugs tend to be less effective in women than men, and that one of them—finasteride—is only approved for hormonal hair loss in men, not women. What’s more, the drug has been associated with increased risk of sexual side effects, depression, nausea, hot flashes, and increased estrogen levels—and too much estrogen is its own risk factor for thinning hair; more on that below.)
Liver support: is necessary to eliminate unneeded wastes from the body. Everything we take in is processed through the liver and toxins are broken down into water soluble byproducts so they can be moved into the intestine and pulled into the stool for elimination. Foods like cruciferous vegetables (kale, broccoli, collard greens) and lemon support the liver detox pathways. Herbs like milk thistle, dandelion root, and burdock root help to support liver cleansing.
Despite the name androgenetic alopecia, the exact role of hormones is uncertain. It is well known that androgens affect the growth of the scalp and body hair and even Hippocrates observed 2,400 years ago that eunuchs did not experience baldness (Yip et al., 2011). However, hyperandrogenism cannot be the only pathophysiologic mechanism for FPHL because the majority of women with FPHL neither have abnormal androgen levels nor do they demonstrate signs or symptoms of androgen excess (Atanaskova Mesinkovska and Bergfeld, 2013, Schmidt and Shinkai, 2015, Yip et al., 2011). Furthermore, cases have been reported in which FPHL developed in patients with complete androgen insensitivity syndrome or hypopituitarism with no detectable androgen levels (Cousen and Messenger, 2010, Orme et al., 1999).
Trichotillomania is a hair pulling disorder associated with anxiety, stress, depression, boredom and frustration. It is where a person manually removes hairs with their finger, either a few strands throughout the day or sometimes many strands at one time during an emotional outburst. This behavior is usually a means of coping with stress or emotional turmoil. However, it can sometimes become a habit that is difficult to break. The eyebrows is a commonly targeted area as is the scalp.
Tames and Goldenring described a case of bilateral loss of eyebrows and eyelashes in a patient with AIDS-related complex who had smoked crack cocaine. This has been attributed to hot vapors during the process of smoking, and which therefore caused singeing of the brows and lashes. There was a complete reversal once the patient abstained from cocaine.
Mistakenly thought to be an exclusively male disease, women make up a significant percentage of hair loss sufferers all around the world. Forty percent of women have visible hair loss by the time they are age 40. After menopause, that number increases even more. Hair loss in women can be absolutely devastating for self-confidence, self-image and emotional well-being. Although it is not a life threatening disease and sometimes underestimated by physicians, hair loss can take an emotional toll that directly affects physical health. Hair is an important part of woman’s face and beauty, therefore it is not easy for any woman to face changes that affect the quality and especially the quantity of her hair. Hair loss in women is a serious life-altering condition that shouldn’t be ignored and has to be diagnosed and treated in the best possible way.
There is some evidence of a link between baldness and prostate cancer and other diseases. Harvard Medical School reports that men with vertex baldness have 1.5 times more of a risk of developing prostate cancer than men without bald spots. The risk of coronary artery disease is also more than 23 percent higher in men with vertex bald spots. Investigations are ongoing as to whether there is a link between DHT levels and metabolic syndrome, diabetes, and other health conditions.
Testosterone replacement is becoming popular for men. Cotsarelis warns that this may accelerate hair loss. Propecia might help -- but because it prevents testosterone breakdown, it might affect the dose of male hormone replacement therapy. Cotsarelis warns men taking both Propecia and testosterone replacement to make sure their doctor carefully monitors their testosterone levels.
Lichen planopilaris and frontal fibrosing alopecia inflammatory conditions, in which the inflammation destroys the hair follicle, can cause a scar or permanent hair loss (usually present as red patches with redness and scale around each hair follicle). In the very advanced stages, they may appear as smooth, bald patches where the hair follicles have been destroyed. Androgenetic hair loss is another non-scarring type. The most common type of hair loss, it is due to the complex interplay of genes, hormones, and age.
If you have a case of estrogen dominance, you can help bring your levels down to normal by keeping your gut healthy and avoiding refined carbohydrates like white bread and white rice. Also, avoid eating any meat that has been treated with hormones. If you have low levels of estrogen, solutions include minimizing your stress, practicing a healthy diet, and exercising regularly.
The normal cycle of hair growth lasts for 2 to 6 years. Each hair grows approximately 1 centimeter (less than half an inch) per month during this phase. About 90 percent of the hair on your scalp is growing at any one time. About 10 percent of the hair on your scalp, at any one time, is in a resting phase. After 2 to 3 months, the resting hair falls out and new hair starts to grow in its place.
The process takes about two hours to complete, but you’ll need to go in for a touch up about once a year after the initial appointment (and possibly a second follow-up). Microblading costs between $500 and $1,000, and the results should last for one to three years. Your natural brow hair will continue to grow, but you likely won’t need to get waxed as often. “Most people find their regular maintenance decreased because they have the shape they want after microblading,” Studabaker says.
When a woman is experiencing hair loss and has PCOS, spironolactone is often prescribed and it can be helpful but it’s important as well to address all these other issues when it comes to PCOS related hair loss. It’s also important to know that there is only a mild correlation of elevated testosterone on a blood test and hair loss. This is likely due to the hypersensitivity of the follicle to androgens in PCOS. Basically we get an exaggerated reaction from a smaller amount of testosterone.
"Dr. Yaker was extremely personable as well as knowledgeable on hair and hair health. With his treatment plan that was tailored to my needs and requests, I have noticeable thicker and fuller hair within three months! His enthusiasm towards his work was very comforting. He truly puts the patient at the center of care he delivers and it doesn't go unnoticed! I would highly recommend him as your physician if you are struggling with the appearance of your hair!"
When compared with no treatment, patients who received ethinyl estradiol 50 μg and cyproterone acetate 2 mg with cyproterone acetate 20 mg on days 5 to 20 of the menstrual cycle for 1 year had a significant increase in their percentage of anagen hairs with trends toward a larger shaft diameter of full anagen hairs and a decreased number of hairs that were less than 40 microns (Peereboom-Wynia et al., 1989). A 12-month randomized control trial of 66 women compared treatment with topical minoxidil 2% plus an oral contraceptive (ethinyl estradiol 30 μg + gestodene 75 μg) with treatment with cyproterone acetate 50 mg plus an oral contraceptive (ethinyl estradiol 35 μg + cyproterone acetate 2 mg) and demonstrated that treatment with cyproterone was more effective in hyderandrogenic patients but otherwise less effective (Vexiau et al., 2002). Side effects of cyproterone acetate include weight gain, breast tenderness, and a decreased libido (Kelly et al., 2016). Hepatotoxicity and development of multiple meningiomas may occur when doses exceed 25 mg daily (Medicines and Healthcare products Regulatory Agency, 2009). Cyproterone acetate is used widely in Europe and Canada, either in an isolated form or in combination with ethinyl estradiol, but it is only available in the United States as an orphan drug for the treatment of hirsutism (Carmina and Lobo, 2003, Jurzyk et al., 1992, Kelly et al., 2016). Cyproterone acetate is classified as pregnancy category X.
There are numerous nonsurgical treatments that when combined, can offer significant hair improvements. Dr. Yaker’s TCHR Volumizing Glycolic Acid Shampoo and Conditioner help restore vitality to the hair by deep cleaning the scalp and reestablishing lost moisture content and physiological pH to the scalp and hair. Dr. Yaker has also formulated his own oral supplement, which is a blend of Aminoplex hair repair vitamins. This is made up of amino acids (building blocks of protein) that produce keratin, which makes up close to 97% of our hair. In addition, Dr. Yaker’s specially compounded FDA approved topical medication, Minoxidil (brand name: Rogaine®), is clinically proven to help slow down, stop and even reverse hair loss in women. Other nonsurgical therapies offered are Low Level Laser Therapy (LLLT) using the advanced LaserCap®, and Platelet Rich Plasma (PRP) with placenta-derived extracellular matrix therapy to help restore thinning hair. Lastly, Dr. Yaker offers scalp and facial micropigmentation where permanent ink is applied to the skin, creating micro dots that replicate the natural appearance of hair. This is used for the scalp and eyebrows.
Testosterone converts to DHT with the aid of the enzyme Type II 5-alpha reductase, which is held in a hair follicle's oil glands. Scientists now believe that it's not the amount of circulating testosterone that's the problem but the level of DHT binding to receptors in scalp follicles. DHT shrinks hair follicles, making it impossible for healthy hair to survive.
Both benign and malignant tumors such as seborrhoeic keratosis, molluscum contagiosum, basal cell carcinoma, squamous-cell carcinoma, sebaceous cell carcinoma, and sclerosing sweat duct carcinoma have been shown to be associated with loss of eyelashes.[1,111–113,119,120] A sebaceous cell carcinoma very often presents as a recurrent chalazion. An associated madarosis (due to lid infiltration and follicle destruction) would help to differentiate the two.[121,122] Tsuji et al. reported a rare case of primary epithelioid hemangioendothelioma of the eyelid associated with madarosis. Primary leiomyoma of the eyelid has been reported with madarosis. Kuan described a case of lacrimal gland tumor masquerading as blepharitis with madarosis.
When this process is disrupted you end up with thinner hair, increased hair loss, a failure to regrow new hair and all in all a super sad experience! No one love losing their hair and it’s such a huge source of upset for women I work with but I’ll be honest, it is often the last thing to change as we work through getting your hormones and metabolism more balanced. It’s simply not your body’s priority.
Hair loss on the eyebrows can be partial where the hair falls off in patches or the eyebrow thins and shortens abnormally. It may occur on one side or both sides. It can also be complete where all the hair on one or both eyebrows are lost. These patterns of eyebrow hair loss can give some indication of the underlying cause even when there are no other symptoms. Some of these conditions may be specific to the eyebrows (the hair follicles and skin in that region) or can be an extension of problems affecting surrounding skin like the face, forehead or scalp.
Well, maybe that’s a new adage from instagram, but it’s true all the same: eyebrows are the essential defining feature of every woman’s face. That’s exactly why eyebrow loss can feel like a death sentence to the beauty-conscious woman. With thick, lush eyebrows in style, eyebrow loss can feel more traumatizing than ever. Hair one day, gone the next!
Monitor any hair loss when starting new medications. Numerous medications can cause temporary or permanent hair loss, including chemotherapy, antidepressants, and mood stabilizers. Nonetheless, many other medications can cause hair loss in isolated cases. If you've noticed hair loss after starting a new medication, talk to your doctor about this side effect.