With the introduction of Propecia™ the drug approved by the FDA for the treatment of male pattern baldness, and Rogaine™ 5%, regrowth of regular or "terminal" hair -- not peach fuzz -- is finally a reality. Yet thousands of products in the $7 billion hair-loss treatment and restoration industry claim their effectiveness too. Now in The Bald Truth, consumer advocate Spencer David Kobren offers the antidote to decades of hair-raising hype. In this comprehensive, authoritative book, Kobren examines the largely unregulated baldness treatment industry and tells how, after years of research, he successfully treated his own hair loss -- and how you can too.
IN THE BALD TRUTH YOU'LL LEARN ABOUT:
* the latest in hair restoration -- including a thorough review of the breakthrough drugs Propecia and Rogaine 5%, and how they work
* how to keep from getting scalped by botched surgical procedures
* how nutrition can supercharge treatment -- the diet that helps hair grow
* the power of herbal treatments
* hair systems -- what they are and where to find the good ones
Exploring case histories, the latest scientific studies, and new treatments being developed, The Bald Truth proves that male pattern baldness can be combated -- and helps you make an educated decision about the best alternatives available today.
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Spencer David Kobren is the country's most prominent and effective hair loss consumer/patient advocate, and the Founder and Director of the American Hair Loss Association. He is also host of "The Bald Truth," his nationally syndicated weekly radio program; a feature columnist on three of the most respected hair-loss web sites, including regrowth.com; and has his own Web site: thebaldtruth.com. After years of researching hair loss and finally overcoming the early stages of his own male pattern baldness, which began at age twenty-two, he has dedicated himself to helping others prevent and treat hair loss. As a consumer advocate, he consults on issues of patient and consumer rights in this unregulated industry. Kobren and his work are the focus of the Discovery Channel documentary also titled The Bald Truth and have been featured in articles in many publications, including GQ, The Wall Street Journal, Men's Health, and The New York Times. He lives in New York City.
Chapter One: THE ROAD TO PROPECIA
Discovering the Cause and Treatment of Baldness
Innovation is not a random process. When it works, it works because someone has identified a real need and found a way to bring new ideas or new technologies to bear on that need.
LEWIS W. LEHR
Ask any balding man when he first noticed his hair thinning, and odds are he'll remember. Like any other milestone in his life, he isn't likely to forget the event or its accompanying details, like where he was, what he was doing, and, most important, how he felt.
I was in bed, stretching and getting comfortable on the pillow, just like any other night. What made this one different, though, was that when I ran my fingers through my hair, out came, not one or two, but at least ten strands of hair. I couldn't miss it because my hair was worn well below my collar, so these were long strands; a man with shorter hair might not as easily notice the earliest stages of hair loss. I was "lucky."
My heart sank because when this happened, in February 1987, 1 was only twenty-two. Not that I wouldn't have still been upset had the balding process begun in my thirties or forties, but at twenty-two, with my adult life just beginning, the last thing I wanted to worry about was losing my hair.
The next morning, while in the shower, I noticed that the drain was completely clogged -- with my hair. I had a thick head of finely textured hair, and now I was faced with the possibility of losing it to male pattern baldness.
First I tried the then widely advertised Helsinki Formula, then KeraKare, a lotion that's applied to the scalp every night. Neither worked. In fact, some of the over-the-counter topical treatments that used to be marketed as baldness cures disappeared in the wake of the FDA ruling that a product couldn't advertise itself as a hair-loss treatment unless it had specific FDA approval as a hair drug. Yet many of these useless concoctions are still advertised and flood the market because of ineffective enforcement of the law.
For seven years I unsuccessfully experimented with every treatment on the market. I found that I really had two "careers." While running my video-production company, Spence-Comm, Inc., I was on an equally time-consuming quest to save my hair. Not only did I spend hours rubbing my head with lotions, I also had "top" New York dermatologists inject hormones into my scalp at $175 per very painful injection. I researched the biological effects of pulsed electrostatic-field treatment for hair, which turned out to be one of the biggest disappointments in the industry. Then, like so many other hopeful men, I ended up using minoxidil, which was then available by prescription only but would eventually be marketed over-the counter as Rogaine.
A so-called "prominent hair specialist" in New York City was providing me with his own concoction of minoxidil and Retin-A, and he told me to spray this on my scalp four times a day in order to grow hair. According to him, I was the perfect candidate for his potion: I was in my midtwenties then and my hair loss was not that extensive. My crown was beginning to thin, and my hairline had receded by about half an inch. But I was losing a tremendous amount of hair every day; the balding process was progressing very quickly.
The First Approved Hair Loss Drug
Minoxidil (Ioniten) was the first drug approved by the FDA for treatment of baldness. For many years, minoxidil, in pill form, was widely used to treat high blood pressure. It had one strange side effect, though: It grew hair in an unexpected manner. People grew hair on the backs of their hands, or on their cheeks, and some even grew hair on their foreheads.
Some enterprising researchers had the notion that applying minoxidil topically, directly on the head, might grow hair on balding areas. It did, in varying degrees depending upon the extent of hair loss, and at the time it was revolutionary.
Like all legitimate hair loss treatments, minoxidil works in varying degrees, depending on many hair loss factors. Now marketed over-the-counter under the brand name Rogaine, at the standard 2‰ solution or the extra strength 5‰ solution, the drug's side effects include dry, itching or flaking scalp (which is the most common, but easily reduced or eliminated by using common overthe-counter dandruff shampoos like Neutragena T-Gel, Head and Shoulders or Nizoral), and low blood pressure (which is rare and reversible once you stop using the drug). Minoxidil is not advised, however, for anyone who has heart disease because of the potential for cardiac side effects in those people at risk.
The most recent studies show that Rogaine Extra Strength for men (5‰ solution) regrew 45‰ more hair than regular strength Rogaine (2‰ solution). In the same group of studies, hair regrowth that was shown in month four while using regular strength was visible by month two while using extra strength. This indicates that Rogaine Extra Strength actually speeds up the hair growth process, making treatment that much more effective.
Rogaine is thought to work by stimulating and enlarging miniaturized hair follicles and reversing the miniaturization process. According to Pharmacia & Upjohn, which manufactures and markets Rogaine, regrowth is more likely to occur if you have a large number of only partially miniaturized hair follicles. These kinds of follicles still produce hair, but this hair will be thinner than unaffected strands, and must be at least 3/8 of an inch or more in length for it to favorably respond to Rogaine.
Unfortunately, according to Pharmacia & Upjohn, any area of your scalp with no hair or where only vellus (peach fuzz) hair remains is less likely to respond to treatment. Rogaine is the most effective for the earliest stages of hair loss. The manufacturer also cautions that Rogaine should not be used by those under 18 years of age; those using a topical prescription product on the scalp; those experiencing sunburned, inflamed, infected, irritated or painful scalp; or those whose hair loss was sudden, indicating that it is not male pattern baldness, but some other form of hair loss.
Rogaine's effectiveness can be enhanced by simultaneously using other treatments, including Propecia, herbal, and nutritional approaches. Some men with sensitive scalps do not make good candidates for treatment with Rogaine, and once those men stop using the drug, their scalp irritation will go away.
The DHT Connection and Finastefide
By late 1994, 1 had amassed quite an amount of information on baldness, so when I read in the New York Times that a number of drug companies had committed to putting the next baldness breakthrough on pharmacy shelves, I was intrigued that among the drugs that were being studied was finasteride, the prescription prostate drug that Merck & Co., the pharmaceutical company, manufactured and marketed in a 5 mg. dose under the brand name Proscar. Finasteride prevents testosterone from converting into DHT (dihydrotestosterone), the androgen that can cause not only prostate problems but the demise of hair follicles. I knew from my reading about testosterone that Merck was on to something. Only a product that changes the body's chemistry, introduced internally (with a pill, for instance), could combat the hormonal assault on hair follicles.
Doctors and patients discovered that Proscar, originally prescribed to treat benign prostate enlargement, had an exciting, positive side effect: It grew hair on bald men's heads -- "regular" (called terminal) hair, not peach fuzz. The stage was finally set for a truly effective balding treatment.
To understand why this is the case, here's a crash course on how testosterone causes hair loss: For many years, the scientific...
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