Hair Growth Phases
Mostly men, but women too, experience hair loss for a number of reasons - genes and aging, hormones, stress, environmental factors, alcohol consumption, auto-immune disorders, diet, and deficiency in vital nutrients necessary for the metabolism and hair growth.
There are three stages of hair growth: anagen, catagen, and telogen.
From the viewpoint of these three phases, hair thinning and loss of visible hair occurs when the anagen stage becomes shorter and/or less hair is in the anagen phase, and the hair follicles spend more time in a dormant phase, telogen.
As the process progresses, the hair follicles miniaturize, hair becomes thinner, until the hair follicles die out.
There are three stages of hair growth: anagen, catagen, and telogen.
From the viewpoint of these three phases, hair thinning and loss of visible hair occurs when the anagen stage becomes shorter and/or less hair is in the anagen phase, and the hair follicles spend more time in a dormant phase, telogen.
As the process progresses, the hair follicles miniaturize, hair becomes thinner, until the hair follicles die out.
Types of Hair Loss
androgenetic (androgenic) alopecia
In men, up to 95% of hair loss is caused by androgenetic (androgenic) alopecia. It results in what is typically known as the male pattern hair loss. Androgenetic alopecia affects women too, but typically results in the female pattern hair loss. It is estimated that in the USA alone, 50 million men and 30 million women are affected by the androgenetic alopecia. The direct cause of the androgenic alopecia is hormonal and some people are genetically predisposed to it. In androgenic alopecia, a by-product of the testosterone metabolism, dihydrotestosterone, leads to shrinking of the hair follicle.
alopecia areata
Alopecia Areata is another well known, but less common type of hair loss.
This type of hair loss is an auto-immune disease where the body's immune system is attacking hair follicles. The hair loss happens in irregular patches of varying size.
This type of hair loss is an auto-immune disease where the body's immune system is attacking hair follicles. The hair loss happens in irregular patches of varying size.
FRONTAL FIBROSING ALOPECIA
Frontal Fibrosing Alopecia (FFA) is more rare than the other types of hair loss.
It looks like a receding hairline, sometimes with bolding on the sides, and is frequently accompanied by minor scarring where the hair is being lost.
Sometimes FFA exhibits together with the Androgenetic Alopecia. FFA typically affects women over the age of 50. It is not common in men and younger women. The precise cause of FFA is unknown.
Current studies show that 5-alpha-reductase inhibitors (for example, the oral drug Finasteride, see under Oral Supplements and Drugs), are currently the most effective treatment for FFA (Vañó-Galván, 2014; Fertig, 2016).
It looks like a receding hairline, sometimes with bolding on the sides, and is frequently accompanied by minor scarring where the hair is being lost.
Sometimes FFA exhibits together with the Androgenetic Alopecia. FFA typically affects women over the age of 50. It is not common in men and younger women. The precise cause of FFA is unknown.
Current studies show that 5-alpha-reductase inhibitors (for example, the oral drug Finasteride, see under Oral Supplements and Drugs), are currently the most effective treatment for FFA (Vañó-Galván, 2014; Fertig, 2016).
TELOGEN EFFLUVIUM - A GROUP OF REVERSIBLE HAIR LOSS TYPES
Telogen Effluvium (Malkud, 2015) is expressed as a diffuse hair thinning and is listed as the second most common reason for the hair loss treated by dermatologists. In reality this diffuse hair thinning is an external expression of various health issues and conditions. It can be caused by and accompany:
Dermatologists consider TE fully reversible; this is the type of hair loss that can be treated with less invasive and dramatic measure and/or by addressing the root cause.
- Postpartum effluvium (postpartum hair loss);
- Disease: typhoid, malaria, tuberculosis, HIV;
- Stress: emotional, from injury and surgery, crash diet, starvation, haemorrhage, difficult labor, severe febrile illness;
- Drugs: oral retinoids, oral contraceptives, antithyroid drugs, anticonvulsants, amphetamines, Captorpil, hypolipidemic drugs, beta blockers;
- Heavy metals in the body;
- Nutrient deficiency from improper diet;
- Endocrine reasons: hypothyroidism, hyperthyroidism.
Dermatologists consider TE fully reversible; this is the type of hair loss that can be treated with less invasive and dramatic measure and/or by addressing the root cause.
All Available Hair Loss Treatment and Management Options
treatment vs management - set realistic expectations
Hair loss may be caused by different reasons.
At a high level, there is –Telogen Effluvium.
A large number of conditions and events that result in hair loss and that are typically grouped under Telogen Effluvium (see the above section on the Types of Hair Loss). It is reversible and treatable, especially if the root cause is addressed. Therefore, in case with Telogen Effluvium, we can talk about treatment.
Androgenetic Alopecia, Frintal Fibrosing Alopecia, Alopecia Areata.
These types of hair loss are caused by deep biological reasons: genes, aging, metabolism, autoimmune problems, and/or hormones and also by unknown reasons. And the true hair loss treatment would mean treating the underlying causes, which are aging, hormones, metabolism, and possibly other related factors, which are not yet fully understood by science, and reversing those underlying reasons.
Modern Western medicine does not have such capabilities.
To have proper expectations of what efforts to address hair loss may result in, it is therefore more appropriate to speak of the hair loss management. Even the most effective and invasive 'treatment', hair transplantation, does not stop the progression of the hair loss, and for this reason, many doctors would recommend a maintenance regimen such as annual PRP/PRFM injections, or an LLLT/LED, or continued use of minoxidil etc.
At a high level, there is –Telogen Effluvium.
A large number of conditions and events that result in hair loss and that are typically grouped under Telogen Effluvium (see the above section on the Types of Hair Loss). It is reversible and treatable, especially if the root cause is addressed. Therefore, in case with Telogen Effluvium, we can talk about treatment.
Androgenetic Alopecia, Frintal Fibrosing Alopecia, Alopecia Areata.
These types of hair loss are caused by deep biological reasons: genes, aging, metabolism, autoimmune problems, and/or hormones and also by unknown reasons. And the true hair loss treatment would mean treating the underlying causes, which are aging, hormones, metabolism, and possibly other related factors, which are not yet fully understood by science, and reversing those underlying reasons.
Modern Western medicine does not have such capabilities.
To have proper expectations of what efforts to address hair loss may result in, it is therefore more appropriate to speak of the hair loss management. Even the most effective and invasive 'treatment', hair transplantation, does not stop the progression of the hair loss, and for this reason, many doctors would recommend a maintenance regimen such as annual PRP/PRFM injections, or an LLLT/LED, or continued use of minoxidil etc.
the overall approach depends
Modern Aesthetic Medicine offers a number of treatment and management options falling anywhere on the spectrums of inexpensive and a heavy price tag, simple and invasive, possibly effective for some and those with proven results.
Reasons for hair loss differ, and therefore it is not always possible to predict which solution will prove effective.
It may be a good idea to start with supplements and/or topical products, and/or try addressing the root cause (for example, in case with TE), and if the results are not satisfactory, then move to more drastic treatments.
As a general rule, the more advanced the hair loss stage is, the more radical treatment may be required.
For non-invasive or minimally invasive treatments to work, there should still be hair follicles inside the scalp even though there may be no visible hair on the surface. Once the hair follicles completely die and disappear, the only way to bring the hair back to the area is a hair transplant. Typically, if an area has been bold for three to five years, it means that there are no hidden hair follicles left and the only option is the hair transplant.
Reasons for hair loss differ, and therefore it is not always possible to predict which solution will prove effective.
It may be a good idea to start with supplements and/or topical products, and/or try addressing the root cause (for example, in case with TE), and if the results are not satisfactory, then move to more drastic treatments.
As a general rule, the more advanced the hair loss stage is, the more radical treatment may be required.
For non-invasive or minimally invasive treatments to work, there should still be hair follicles inside the scalp even though there may be no visible hair on the surface. Once the hair follicles completely die and disappear, the only way to bring the hair back to the area is a hair transplant. Typically, if an area has been bold for three to five years, it means that there are no hidden hair follicles left and the only option is the hair transplant.
the list of treatment and management options available today
The hair loss treatment and management options available today include:
- Separately purchased vitamins, minerals, nutrients,
- Multi-ingredient oral supplements,
- Finasteride (oral drug),
- Peppermint oil and lavender oil (topical application), applied topically once or twice a day,
- Minoxidil 2% to 10% (topical solution), applied topically twice a day,
- Treatments with non-invasive LLLT/LED (Low Level Laser Therapy/Light Emitting Diodes) devices,
- Regenerative medicine: PRP/PRFM injections into scalp (platelet rich plasma/platelet rich fibrin matrix derived from patient's own blood),
- Regenerative medicine: SVF injections (stromal vascular fraction derived from patients own fat tissue, alone or combined with fat),
- Nanofat injections or ALMI (autologous lipocyte micronized injections - patient's own micronized fat),
- Microneedling or (possibly - at home) derma roller,
- Combination micro needling + PRP or micro needling + growth factors,
- Hair transplantation,
- Oossibly: Chinese acupuncture.
Men and Women Hair Loss Differences
Men and Women Hair Loss Differences
hair loss in men
- Estimated 95% of hair loss in men is caused by Androgenetic Alopecia; infrequently may also be caused by Alopecia Areata (an auto-immune disorder); sometimes may be caused by the lack of nutrients and other factors listed in the Telogen Effluvium description (Types of Hair Loss section above);
- Androgenetic Alopecia results in male pattern hair loss;
- All possible treatment and management options - oral supplements (likely less effective than for women), oral finasteride, topical minoxidil (up to 10%), PRP/PRFM (platelet rich plasma/platelet rich fibrin matrix), SVF (stromal vascular fraction), nanofat/micronized fat/ALMI injections, LLLT/LED (low level laser therapy/light emitting diodes), microneedling or dermaroller, microneedling/dermaroller with PRP of growth factors, hair transplant, acupuncture.
Hair loss in women
- Hair loss in women is frequently caused by Androgenetic Alopecia, the major cause of hair loss in men too;
- Androgenic Alopecia in women results mostly in female pattern hair loss;
- Hair Loss in women is also frequently correlated with the lack of vital nutrients, hormonal imbalances, stress and other reasons included in the Telogen Effluvium (see the Types of Hair Loss section above);
- Infrequently female hair loss may be caused by Alopecia Areata and and Frontal Fibrosing Alopecia (affects mostly post-menopausal women);
- Frontal Fibrosing Alopecia looks like a receding hairline and sometimes bolding on the sides and typically does not affect women younger than 50 years;
- Possible treatments - oral supplements (likely more effective than for men), oral finasteride, topical minoxidil (up to 5%), topical peppermint oil and lavender oil, PRP/PRFM (platelet rich plasma/platelet rich fibrin matrix), SVF (stromal vascular fraction), nanofat/ALMI, LLLT/LED (low level laser therapy/light emitting diodes), micro needling or derma roller, microneedling/dermaroller with PRP of growth factors, hair transplant, acupuncture.
Hair Loss Treatment References and Literature
Afifi L, Maranda, EL, Zarei M, Delcanto, GM, et al. Low-level laser therapy as a treatment for androgenetic alopecia. [Published online ahead of print April 25, 2016]. Lasers Surg Med. doi:10.1002/lsm.22512.
https://www.ncbi.nlm.nih.gov/pubmed/27114071
Avci P, Gupta GK, Clark J, Wikonkal N, Hamblin MR. Low-Level Laser (Light) Therapy (LLLT) for Treatment of Hair Loss. Lasers in surgery and medicine. 2014;46(2):144-151. doi:10.1002/lsm.22170.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3944668/
Araki J, Jona M, Eto H, et al. Optimized preparation method of platelet-concentrated plasma and noncoagulating platelet-derived factor concentrates: maximization of platelet concentration and removal of fibrinogen. Tissue Eng Part C Methods. 2011;18(3):176-85.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3285602/
Badri T, Kumar D D. Minoxidil. [Updated 2018 Jan 12]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2018 Jan-.
https://www.ncbi.nlm.nih.gov/books/NBK482378/
Bora P, Majumdar AS. Adipose tissue-derived stromal vascular fraction in regenerative medicine: a brief review on biology and translation. Stem Cell Research & Therapy. 2017;8:145. doi:10.1186/s13287-017-0598-y.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5472998/
Cervantes J, Perper M, Wong L, L, Eber A, E, Villasante Fricke A, C, Wikramanayake T, C, Jimenez J, J: Effectiveness of Platelet-Rich Plasma for Androgenetic Alopecia: A Review of the Literature. Skin Appendage Disord 2018;4:1-11. doi: 10.1159/000477671
https://www.karger.com/Article/FullText/477671#
Dhurat R, Sukesh M, Avhad G, Dandale A, Pal A, Pund P. A randomized evaluator blinded study of effect of microneedling in androgenetic alopecia: a pilot study. Int J Trichology. 2013;5(1):6-11.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3746236/
Dhurat R, Sukesh M. Principles and Methods of Preparation of Platelet-Rich Plasma: A Review and Author's Perspective. J Cutan Aesthet Surg. 2014;7(4):189-97.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4338460/
Dhurat R, Mathapati S. Response to Microneedling Treatment in Men with Androgenetic Alopecia Who Failed to Respond to Conventional Therapy. Indian J Dermatol. 2015;60(3):260-3.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4458936/
Dhurat R, Chitallia J, May TW, et al. An Open-Label Randomized Multicenter Study Assessing the Noninferiority of a Caffeine-Based Topical Liquid 0.2% versus Minoxidil 5% Solution in Male Androgenetic Alopecia. Skin Pharmacol Physiol. 2017;30(6):298-305.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5804833/
Eppley BL, Woodell JE, Higgins J. Platelet quantification and growth factor analysis from platelet-rich plasma: Implications for wound healing. Plast Reconstr Surg. 2004;114:1502–8.
https://www.ncbi.nlm.nih.gov/pubmed/15509939
Fertig R, Tosti A. Frontal fibrosing alopecia treatment options. Intractable & Rare Diseases Research. 2016;5(4):314-315. doi:10.5582/irdr.2016.01065.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5116872/
Garg S, Manchanda S. Platelet-rich plasma-an 'Elixir' for treatment of alopecia: personal experience on 117 patients with review of literature. Stem Cell Investig. 2017;4:64. Published 2017 Jul 18. doi:10.21037/sci.2017.06.07
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5539389/
Gupta AK, Charrette A. Topical Minoxidil: Systematic Review and Meta-Analysis of Its Efficacy in Androgenetic Alopecia. Skinmed 2015 May-Jun;13(3):185-9.
https://www.ncbi.nlm.nih.gov/pubmed/26380504
Ji Young Oh , Min Ah Park, and Young Chul Kim. Toxicol. Res. Vol. 30, No. 4, pp. 297-304 (2014)
Peppermint oil promotes hair regrowth without toxic signs.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4289931/
Joo HJ, Jeong KH, Kim JE, Kang H. Various Wavelengths of Light-Emitting Diode Light Regulate the Proliferation of Human Dermal Papilla Cells and Hair Follicles via Wnt/β-Catenin and the Extracellular Signal-Regulated Kinase Pathways. Annals of Dermatology. 2017;29(6):747-754. doi:10.5021/ad.2017.29.6.747.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5705357/
Khatu SS, More YE, Gokhale NR, Chavhan DC, Bendsure N. Platelet-Rich Plasma in Androgenic Alopecia: Myth or an Effective Tool. Journal of Cutaneous and Aesthetic Surgery. 2014;7(2):107-110. doi:10.4103/0974-2077.138352.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4134641/
Kim W-S, Calderhead RG. Is light-emitting diode phototherapy (LED-LLLT) really effective? Laser Therapy. 2011;20(3):205-215. doi:10.5978/islsm.20.205. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3799034/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3799034/
Lanzafame RJ, Blanche RR, Bodian AB, Chiacchierini RP, Fernandez-Obregon A, Kazmirek ER. The growth of human scalp hair mediated by visible red light laser and LED sources in males. Lasers in Surgery and Medicine. 2013; Oct; 45(8):487-95. doi: 10.1002/lsm.22173
https://www.ncbi.nlm.nih.gov/pubmed/24078483
Lanzafame RJ, Blanche RR, Chiacchierini RP, Kazmirek ER, Sklar JA. The growth of human scalp hair in females using visible red light laser and LED sources. Lasers in Surgery and Medicine. 2014;46(8):601-607. doi:10.1002/lsm.22277.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4265291/
Lee BH, Lee JS, Kim YC. Hair Growth-Promoting Effects of Lavender Oil in C57BL/6 Mice. Toxicological Research. 2016;32(2):103-108. doi:10.5487/TR.2016.32.2.103.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4843973/
Lee C-Y, Wei C-C, Yu M-C, et al. Hair growth effect of traditional Chinese medicine BeauTop on androgenetic alopecia patients: A randomized double-blind placebo-controlled clinical trial. Experimental and Therapeutic Medicine. 2017;13(1):194-202. doi:10.3892/etm.2016.3935.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5245083/
Lee C-Y, Yang C-Y, Lin C-C, Yu M-C, Sheu S-J, Kuan Y-H. Hair growth is promoted by BeauTop via expression of EGF and FGF-7. Molecular Medicine Reports. 2018;17(6):8047-8052. doi:10.3892/mmr.2018.8917.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5983978/
Lee HW, Jun JH, Lee JA, Lim H-J, Lim H-S, Lee MS. Acupuncture for treating alopecia areata: a protocol of systematic review of randomised clinical trials. BMJ Open. 2015;5(10):e008841. doi:10.1136/bmjopen-2015-008841.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4636638/
Malkud S. Telogen Effluvium: A Review. Journal of Clinical and Diagnostic Research : JCDR. 2015;9(9):WE01-WE03. doi:10.7860/JCDR/2015/15219.6492.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4606321/
Maria-Angeliki G, Alexandros-Efstratios K, Dimitris R, Konstantinos K. Platelet-rich Plasma as a Potential Treatment for Noncicatricial Alopecias. International Journal of Trichology. 2015;7(2):54-63. doi:10.4103/0974-7753.160098.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4502475/
Olsen EA, Dunlap FE, Funicella T, Koperski JA, Swinehart JM, Tschen EH, et al. A randomized clinical trial of 5% topical minoxidil versus 2% topical minoxidil and placebo in the treatment of androgenetic alopecia in men. J Am Acad Dermatol. 2002;47:377–385
https://www.ncbi.nlm.nih.gov/pubmed/12196747
Perez-Meza D, Ziering C, Sforza M, Krishnan G, Ball E, Daniels E. Hair follicle growth by stromal vascular fraction-enhanced adipose transplantation in baldness. Stem Cells and Cloning : Advances and Applications. 2017;10:1-10. doi:10.2147/SCCAA.S131431.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5506773/
Rami Anderi, Nehman Makdissy, Albert Azar, Francine Rizk, Aline Hamade Cellular therapy with human autologous adipose-derived adult cells of stromal vascular fraction for alopecia areata
Stem Cell Research & Therapy. 2018: 9:1 - 1
https://link.springer.com/article/10.1186/s13287-018-0889-y#enumeration
J.L. Roberts, V. Fiedler, J. Imperato-Mcginley, et al. Clinical dose ranging studies with finasteride, a type 2 5α-reductase inhibitor, in men with male pattern hair loss J Am Acad Dermatol, 41 (1999), pp. 555-563
https://www.ncbi.nlm.nih.gov/pubmed/10495375
Sclafani AP. Safety, efficacy and utility of platelet-rich fibrin matrix in facial plastic surgery. Arch Facial Plast Surg. 2011;13:247–251.
https://jamanetwork.com/journals/jamafacialplasticsurgery/fullarticle/1105679
Shah KB, Shah AN, Solanki RB, Raval RC. A Comparative Study of Microneedling with Platelet-rich Plasma Plus Topical Minoxidil (5%) and Topical Minoxidil (5%) Alone in Androgenetic Alopecia. Int J Trichology. 2017;9(1):14-18.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5514790/
Shapiro J, Kaufman D. Use of Finasteride in the Treatment of Men With Androgenetic Alopecia (Male Pattern Hair Loss). Journal of Investigative Dermatology Symposium Proceedings. 2003 Jun;8(1):20-3.
https://www.sciencedirect.com/science/article/pii/S0022202X15529357
Vañó-Galván S, Molina-Ruiz AM, Serrano-Falcón C, et al. Frontal fibrosing alopecia: A multicenter review of 355 patients. J Am Acad Dermatol. 2014; 70: 670-678.
https://www.ncbi.nlm.nih.gov/pubmed/24508293
Vestita M, Filoni A, Bonamonte D, Elia R, Giudice G. Abstract: The Use of Nanofat in Androgenic Alopecia. a Prospective Blinded Study. Plastic and Reconstructive Surgery Global Open. 2017;5(9 Suppl):90. doi:10.1097/01.GOX.0000526293.77976.7f.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5636413/
Weibrich G, Kleis WK, Hafner G, Hitzler WE. Growth factor levels in platelet-rich plasma and correlations with donor age, sex, and platelet count. J Craniomaxillofac Surg. 2002;30:97–102.
https://www.ncbi.nlm.nih.gov/pubmed/12069512
Zarei M, Wikramanayake TC et all Low level laser therapy and hair regrowth: an evidence-based review. Lasers Med Sci. 2016 Feb; 31(2):361-70
https://www.ncbi.nlm.nih.gov/pubmed/26690359
https://www.ncbi.nlm.nih.gov/pubmed/27114071
Avci P, Gupta GK, Clark J, Wikonkal N, Hamblin MR. Low-Level Laser (Light) Therapy (LLLT) for Treatment of Hair Loss. Lasers in surgery and medicine. 2014;46(2):144-151. doi:10.1002/lsm.22170.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3944668/
Araki J, Jona M, Eto H, et al. Optimized preparation method of platelet-concentrated plasma and noncoagulating platelet-derived factor concentrates: maximization of platelet concentration and removal of fibrinogen. Tissue Eng Part C Methods. 2011;18(3):176-85.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3285602/
Badri T, Kumar D D. Minoxidil. [Updated 2018 Jan 12]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2018 Jan-.
https://www.ncbi.nlm.nih.gov/books/NBK482378/
Bora P, Majumdar AS. Adipose tissue-derived stromal vascular fraction in regenerative medicine: a brief review on biology and translation. Stem Cell Research & Therapy. 2017;8:145. doi:10.1186/s13287-017-0598-y.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5472998/
Cervantes J, Perper M, Wong L, L, Eber A, E, Villasante Fricke A, C, Wikramanayake T, C, Jimenez J, J: Effectiveness of Platelet-Rich Plasma for Androgenetic Alopecia: A Review of the Literature. Skin Appendage Disord 2018;4:1-11. doi: 10.1159/000477671
https://www.karger.com/Article/FullText/477671#
Dhurat R, Sukesh M, Avhad G, Dandale A, Pal A, Pund P. A randomized evaluator blinded study of effect of microneedling in androgenetic alopecia: a pilot study. Int J Trichology. 2013;5(1):6-11.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3746236/
Dhurat R, Sukesh M. Principles and Methods of Preparation of Platelet-Rich Plasma: A Review and Author's Perspective. J Cutan Aesthet Surg. 2014;7(4):189-97.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4338460/
Dhurat R, Mathapati S. Response to Microneedling Treatment in Men with Androgenetic Alopecia Who Failed to Respond to Conventional Therapy. Indian J Dermatol. 2015;60(3):260-3.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4458936/
Dhurat R, Chitallia J, May TW, et al. An Open-Label Randomized Multicenter Study Assessing the Noninferiority of a Caffeine-Based Topical Liquid 0.2% versus Minoxidil 5% Solution in Male Androgenetic Alopecia. Skin Pharmacol Physiol. 2017;30(6):298-305.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5804833/
Eppley BL, Woodell JE, Higgins J. Platelet quantification and growth factor analysis from platelet-rich plasma: Implications for wound healing. Plast Reconstr Surg. 2004;114:1502–8.
https://www.ncbi.nlm.nih.gov/pubmed/15509939
Fertig R, Tosti A. Frontal fibrosing alopecia treatment options. Intractable & Rare Diseases Research. 2016;5(4):314-315. doi:10.5582/irdr.2016.01065.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5116872/
Garg S, Manchanda S. Platelet-rich plasma-an 'Elixir' for treatment of alopecia: personal experience on 117 patients with review of literature. Stem Cell Investig. 2017;4:64. Published 2017 Jul 18. doi:10.21037/sci.2017.06.07
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5539389/
Gupta AK, Charrette A. Topical Minoxidil: Systematic Review and Meta-Analysis of Its Efficacy in Androgenetic Alopecia. Skinmed 2015 May-Jun;13(3):185-9.
https://www.ncbi.nlm.nih.gov/pubmed/26380504
Ji Young Oh , Min Ah Park, and Young Chul Kim. Toxicol. Res. Vol. 30, No. 4, pp. 297-304 (2014)
Peppermint oil promotes hair regrowth without toxic signs.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4289931/
Joo HJ, Jeong KH, Kim JE, Kang H. Various Wavelengths of Light-Emitting Diode Light Regulate the Proliferation of Human Dermal Papilla Cells and Hair Follicles via Wnt/β-Catenin and the Extracellular Signal-Regulated Kinase Pathways. Annals of Dermatology. 2017;29(6):747-754. doi:10.5021/ad.2017.29.6.747.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5705357/
Khatu SS, More YE, Gokhale NR, Chavhan DC, Bendsure N. Platelet-Rich Plasma in Androgenic Alopecia: Myth or an Effective Tool. Journal of Cutaneous and Aesthetic Surgery. 2014;7(2):107-110. doi:10.4103/0974-2077.138352.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4134641/
Kim W-S, Calderhead RG. Is light-emitting diode phototherapy (LED-LLLT) really effective? Laser Therapy. 2011;20(3):205-215. doi:10.5978/islsm.20.205. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3799034/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3799034/
Lanzafame RJ, Blanche RR, Bodian AB, Chiacchierini RP, Fernandez-Obregon A, Kazmirek ER. The growth of human scalp hair mediated by visible red light laser and LED sources in males. Lasers in Surgery and Medicine. 2013; Oct; 45(8):487-95. doi: 10.1002/lsm.22173
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