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My Hair Lady

By Beth Landman
Posted On Jan 22, 2013

BY Beth Landman PHOTOGRAPH by Darryl Patterson

Hair loss—a problem traditionally associated with men is increasingly becoming an issue that women can’t just brush aside. From robots to cloning, we examine the future of healthy hair.

The Manhattan office of Bob Bernstein, just steps from Park Avenue, is the kind of space that makes successful men feel at home—a good thing for one of the country’s foremost specialists in hair restoration (and the co-author of Hair Loss for Dummies). The layout is part design statement, part science lab, slick with granite, slate, and glass and full of microscopes and high tech gizmos. Among the space’s most noteworthy gadgets is one of only twelve robots in the world programmed to help perform hair transplants, which has a home in Dr. Bernstein’s office.

Bernstein’s field has traditionally catered to males, but the patient in his waiting room on this sunny afternoon before Thanksgiving is Laurie Martin, a legal assistant with perky features and green eyes. Her brown hair is enlivened by blonde highlights and styled with a sweep of bangs.

“You should see it when it’s blown out,” she smiles.

Martin is one of a growing number of women suffering from hair loss, and taking action. According to the 2006 study by the International Society of Hair Restoration Surgery, 28 percent of patients seeking treatment were women. By 2010, the number grew to 35 percent. Fortunately, technological advances are keeping pace with the demand.

In 1987, when Martin was 37, she noticed her part was widening. “I went to NYU’s dermatology department and, like all naïve women, I thought they would say I had a vitamin deficiency,” she recalls. “But they diagnosed me with hair loss based on my maternal grandfather, and said they would take out plugs from my scalp the size of pencil erasers. In my mind’s eye, that was just too big, so I went on Rogaine until my insurance stopped paying.”

“Most women are shocked to find out how many options there are now,” said Dr. Joel Kassimir, a dermatologist with a practice specializing in hair loss. “Surgery made them look bizarre, safe oral medication didn’t exist, and topicals appeared to be ineffective. Now there are better ways to do transplants without risking unacceptable results, and there are safe oral medications and topicals that really do help.”

By 2002, when Martin found Dr. Bernstein, the science of hair loss had changed dramatically. Bernstein had pioneered a process called follicular unit transplantation in which hair is moved—not in large plugs, but in its naturally growing group of one to three follicles.

“I looked around the office and there were no Joe Bidens or Billy Crystals here. Everyone looked natural,” she says. “I thought, If he can make men look this good, he must be great with women. I have a progressive condition, so my hair will continue to fall out, but what he places is genetically coded to grow, so I came back for a little touch up in 2005, and last week I just had another one. I arrive at 7 a.m., have a lunch break, and leave at 2 p.m. It looks good for years.”

At this point, Martin considers her situation under control. “I was very self-conscious before about being in the sun or near a light. I will never be Kathy Ireland, but now I don’t feel like I have a problem at all. See these bangs? I was never able to wear them before because I felt like I needed every spare hair pushed back over the thin spot.”

Women generally lose their hair for two distinct reasons: heredity, as with Martin, and “situational” due to trauma or damage from stress, medication, hormonal changes, bad diet, or chemical treatments. When male pattern baldness occurs, it’s usually fairly obvious. Receding hairlines and large shiny patches are hard to miss. By the time thinning hair is detected with women, it is often very far along.

“Many women don’t realize their hair is thinning until almost half of it is gone because you can lose fifty percent of volume and still see coverage,” said Dr. Alan Bauman, a Boca Raton-based dermatologist.

For Rena Gold, 38, the transformation seemed like it came overnight. “I was running around all the time, doing marketing work and taking care of my kids, Gold recalls. “Then one day a year ago I looked in the mirror and it was like, ‘Oh my God!’” Gold visited Manhattan dermatologist Dr. Neil Sadick, who took a biopsy of her scalp, then started her on a program of low intensity red light laser and Minoxidil.

“The ironic thing was that the doctor said it was probably caused by stress, but seeing myself like that caused a whole new layer of stress. Some people swear by the laser, but for me it was the product that saved me. It’s been about a year and my hair is pretty much back to normal.”

According to Dr. Sadick, the number of women visiting his office to seek much needed help for hair loss has grown by 20 to 30 percent each year over the last five years. Sadick attributes part of that statistic to women being able to discuss hair loss more openly. Also, because specialists can detect and diagnose it much earlier, female patients are heading for treatment younger and sooner.

“It is rare for women to have receding hairlines, and thin- ning usually starts at least ten to fifteen years before they notice it, so early diagnosis is key,” says Dr. Oscar Hevia, a Miami-based dermatologist. Hevia’s office colleague, Bernard Cohen, invented the “Hair Check” device, a scientific ponytail that assesses mass by measuring strands in the back where women don’t tend to thin. These are compared to mass near the crown. The doctors use that calculation to provide a base to gauge further loss.

“We can also see how much miniaturization a woman has with this,” says Dr. Bernstein, wielding a probe that magnifies the scalp fifty times in order to pick up shrinking locks.

“It used to be something that affected post-menopausal patients, but now women are coming in as early as their twenties,” says Dr. Francesca Fusco, a Manhattan dermatologist, who notes that hair extensions as well as chemicals lead to shedding by putting undue stress on the follicle.

What is encouraging for those with loss due to trauma or circumstance is that it is usually short term and reversible.

Sara Lyles, 62, whose hair loss was caused by a styling technique, said that when Dr. Bernstein performed her hair transplant 12 years ago, the subject was taboo. “Women never talked about it, and I was so embarrassed that I avoided all social functions,” she recalls. “I’m African American and I slept in large tight rollers to keep frizzing under control. The traction destroyed my frontal hairline.”

At the time, she would have been mortified if someone found out she had undergone a transplant. “Even my hair- dresser had no clue,” she says. “Dr. Bernstein not only gave me my hair back, he gave me my life back.”

About six months ago, Barbara Gold, a 49-year-old investment banker, noticed that her hair was shedding and losing its shine. “Oddly, the more expensive products I was using were too harsh,” she explains. Dr. Fusco put her on a program of non-prescription shampoos, Biotin, and other nutrients available at her local drugstore. “My hair slowly improved and now, after several months, it’s almost perfect.”

As medical researchers close in on some seemingly futuristic breakthroughs, there is also exciting news for those with more challenging genetic predispositions. “We are mapping genes for hair loss in many centers and we are hoping to be able to turn them on and off,” says Dr. Kassimir. “We are also experimenting with ways to block DHT, the hormone responsible for genetic hair loss.”

There are also ongoing stem cell-based trials seeking ways to cultivate injectables rich in growth factors from a patient’s own tissue. Even edgier, the Bosley company is attempting to clone embryonic hair follicles—potentially offering patients an unlimited supply of hair without having to harvest from the scalp. “Hair multiplication could be a huge game changer,” says Dr. Bauman.

In the meantime, Bauman sees great promise in Acell, a micronized extracellular matrix (a medication that goes over the damaged tissue and acts as a bridge or scaffolding to stimulate repair) made from pig bladder and used for human tissue regeneration.

“Acell has been used for wound healing and is just starting to gain traction in the hair area,” Bauman says. He’s also enthusiastic about platelet rich plasma, therapy (sometimes referred to as ‘Vampire Injections’) in which a patient’s own growth factor inducing plasma is injected into affected areas. “We are having great results combining PRP and Acell.”

On the more immediate horizon, the Bosley team is at work with Allergan, the makers of Botox and Latisse, to produce a version of the miraculous lash lengthener for the scalp.

“Recently, we have conducted double-blind, placebo- controlled randomized studies,” reveals Dr. Matt Leavitt, an Orlando-based executive medical advisor at Bosley. “They are spending huge amounts of money on the science.” Doctors now estimate that this new, much-anticipated version of Latisse will be available in about two years.

As Dr. Bernstein emerges from his operating room, sporting green scrubs and green Nikes that match the room’s tiles, he shakes his head and sighs. “When I went into practice back in the eighties, transplantation was almost barbaric and Rogaine was the only alternative,” he remembers. He marvels at the advances and choices he and others now have to offer. “I never would have thought I would be working with robots, lasers, and cloning.”