Drs. Jeffrey Epstein and Anthony Bared, Board Certified facial plastic surgeons specializing in the treatment of hair loss at the Foundation for Hair Restoration are committed to achieving for patients not only the most aesthetic outcomes from hair restoration procedures, but also the application of proven and cutting edge therapies that may help with slowing down or even stopping the hair loss process. For while hair transplants are the only “permanent” solution to hair loss, they are not a “cure” in that in cases of male and female pattern hair loss, the hair loss can potentially continue for the rest of an individual’s lifetime. In addition, there are individuals who are better treated with these non-surgical solutions, and/or are not prepared at this time for a procedure. This may be due to being at a younger age, or being at an earlier hair loss pattern, where more conservative intervention may be indicated.
The following are the options we provide for our patients. These can work in conjunction with a transplant, or as stand-alone therapies. A consultation with the doctor, either in person or by email/phone, can provide answers to any questions our patients may have.
Finasteride is a pill, approved by the FDA for the use for male pattern hair loss in 1997. Taken once a day in a 1 mg dose, it acts by decreasing the body’s level of (DHT) dihydrotesterone, a metabolite of testosterone that can cause hair loss. Studies have shown that it increases hair diameter, growth rate, and to a lesser degree hair count. Stabilization of hair loss has been reported in studies in 51% of men and hair regrowth in 48% of men. It is generally a very well tolerated medication with adverse side effects being rare and reported in 1-2% of patients. This practice has been prescribing it for many years, with many happy patients.
In 2015, some data was brought to the scientific community’s attention about some undesirable side effects. In large clinical trials, some of the reported side effects include: decreased libido, erectile dysfunction, and decreased sperm count. Other side effects reported include: breast tenderness, breast enlargement, breast nodules, allergic reactions, testicular pain, depression / suicidal ideation, and rare cases of male breast cancer. Upon the discontinuation of the medication, the resolution of the reported sexual dysfunction side effects has resolved, except in a small subset of patients who have reported permanent sexual dysfunction, which is of obvious concern. Note that permanent sexual dysfunction has not been substantiated in double-blind placebo-controlled clinical trials as all symptoms resolved in weeks to months following the discontinuation of the medication.
Finasteride also affects the levels of PSA (prostate-specific antigen), so the male patient should inform his primary physician and/or urologist of his use of the medication.
Finasteride is only approved for the use in men. If a woman is to become pregnant while taking finasteride, it could cause defects in the male fetus.
Laser Light Therapy
Laser light therapy (LLLT- for low level laser light therapy) is an effective treatment for hair loss in both men and women, where it can help slow down the gradual progression of hair loss, stop shedding, and in some cases help to restore hair density by reversing the miniaturization of hairs to make for a fuller look. Dr. Epstein regularly recommends LLLT, where he has found it to be effective in 60-70% of patients, based on its use on over 1,000 of his patients. It is most effective for slowing down or even stopping altogether shedding and active hair loss in pre and post menopausal women as well as younger men. These results are based not only upon observation of is patients, but also confirmed by a study on LLLT performed on the Foundation’s patients, which found a 60-70% efficacy with regular (three times a week) usage over a six month period. Compared to Propecia/finasteride, LLLT has no risk of sexual side effects, and seems to be more effective in the frontal /hairline part of the scalp. In women, Propecia is not to be used, thus LLLT is an excellent therapy that can be used in conjunction with minoxidil (Rogaine®) or on its own.
How LLLT is offered by the Foundation for Hair Restoration
Patients have two options- at home devices and in office
In terms of convenience, nothing can beat the use of one of these at-home devices, two of which provide the same dose of laser light energy as the in-office device. These two devices carried by us which we recommend are the LaserCap® and the Capillus®. The third device, the iGrow®, is more cost-effective, and while it doesn’t deliver the same laser energy and is not portable like the LaserCap and the Capillus, it can be effective in many individuals.
Here at the Foundation, we have the Revage 670, which utilizes the same technology and similar laser light energy as the LaserCap and Capillus. All hair transplant patients are provided at no charge one month of in-office LLLT therapy in the Miami office after a hair transplant procedure. In addition, some patients choose to utilize the in-office device rather than purchasing an at-home unit if they live close to the office and can come by twice to three times a week.
To learn more about LLLT, please visit www.foundhair.com/pages/laser-treatments.html
Platelet Rich Plasma
PRP stands for platelet rich plasma. Blood, in addition to red and white blood cells, contains platelets which are rich in growth factors and are the most potent healers in the body. Growth factors promote healing by restoring the normal architecture and strength of the tissue. In a PRP injection, the patient’s own blood is processed at high speeds (we use the state-of-the-art Angel® system), resulting in higher concentrations of the patient’s own platelets with growth factors, which are then injected into the scalp to promote healing, increase local blood flow, and stimulate hair follicles to grow healthier. Based upon the anecdotal reports of colleagues and our own work, we have been using PRP and mixing it with ACell, a regenerative matrix product derived from porcine bladder (the bladder has the ability to regenerate when damaged) that has been specially treated so that it is safe and pure. This PRP/ACell combination is injected into the anesthetized scalp in areas of hair thinning. We then recommend the therapy be repeated on an every six to 12 month basis to retain results.
Are all PRP treatments the same?
No, after much research we have chosen to use the state of the art Angel® PRP system, made by Cytomedix. This system produces the most pure, correct concentration of PRP due to its sophisticated computer technology. In addition, we also mix the PRP with ACell which helps promote the regenerative activity of the PRP, so it is added to the treatment to improve the chances of a positive response. Your patient advisor or doctor can answer any other questions you may have.
Having your PRP performed by us means that it is being done by doctors who truly specialize in hair loss so are able to properly treat you, and also that it will be a painless, easy experience. You read more about PRP here.
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