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On our Facebook and Instagram feeds, billboards, on the side of buses, and lining the walls of the subway, are ads of young, attractive men with voluptuous locks and titles saying things like “Hair loss is optional” and “Handsome, healthy you.” These are the ads for the millennial men’s wellness brand, Hims. Hims, and fellow start-up Keeps, offer hair loss solutions (that would normally be prescribed in-person, by a doctor) in one simple package to your home.

Though it seems like Hims and Keeps are bringing new medicines to the table, their hair loss “kits” and hair loss “gummies,” are just the same hair loss products that you can receive from a doctor or from online stores like Amazon, such as minoxidil, finasteride, biotin, salicylic acid shampoos and other topical and oral medications. The medical patent on Propecia (finasteride) expired in 2014 allowing other drug companies to sell a generic version of Propecia under a different name. This enables companies like Hims and Keeps to market these drugs under their own brands, mix or add ingredients without proven efficacy, and present them as completely new solutions to hair loss.

A crucial part that is missing in this business model is the importance of a conversation between a board-certified physician and the patient. Both minoxidil and finasteride have important side effects that need to be discussed with a physician and should only be prescribed to those that would benefit from the medicine. In addition, there are ways in which the medications can be used that will add to their efficacy. Finally, there other options, such as hair transplantation that might be appropriate to consider at some point.

This relationship between a patient and doctor is an invaluable part of the hair loss treatment process, and one that you will not receive through online medical treatments. If you would like more information about the diagnosis and treatment of hair loss, an excellent resource is bernstm.devgmi.com.

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Q: In what cases do you think Scalp Micro-Pigmentation (SMP) is most useful?
— M.O., Greenwich, CT

A: Scalp Micro-Pigmentation (SMP) is used in patients who want to make their thinning hair look fuller and want to avoid the nuisance of daily application of cosmetic concealers, powders or fibers. It is for patients who want a permanent solution, but who do not want, or who are not candidates for hair transplant surgery. It can achieve a variety of looks such as a buzz cut by tattooing hundreds of microdots that appear like follicles or it can reduce the contrast between generalized dark hair that is thinning over a pale scalp. It can even give the appearance of hair over a scar that has now become noticeable.

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Q: What is Scalp Micro-Pigmentation (SMP)?

What is SMP? — M.O., Greenwich, CT

A: Scalp Micro-Pigmentation (SMP) is a medical-grade scalp tattoo. It is a form of permanent cosmetic camouflage that can mimic the appearance of hair in locations such as scars or balding areas. SMP gives the appearance of fullness of hair without actual hairs being present. Although permanent dyes are generally used, semi-permanent materials can be substituted that will purposely fade over time.

Dr. Shaver is our dedicated in-house physician for Scalp Micro-Pigmentation procedures.

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