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Interview with Dr. Lewenberg

January 19, 2005 recently interviewed Dr. Lewenberg by e-mail to discuss his products for treating hair loss. Dr. Lewenberg has been in the business of treating hair loss for a while and he was one of the first doctors to use retin-A in conjunction with Minoxidil to treat hair loss. We asked some hard-hitting questions. Here is the first round of the interview. We will follow up with a second round of questions soon. Hello Dr. Lewenberg and thanks for taking the time to partake in this interview. Let's start by asking you to briefly list what ingredients are in your formula including the delivery vehicle, in what proportions, and which ones are the active ingredients in treating hair loss. Does your product contain propylene glycol? The reason I ask is that many people find this particular ingredient quite irritating to the scalp.

Dr. Lewenberg: Thank you for allowing me this forum to talk to the many people out there who are tired of "magic potions" that promise to regrow hair and never do. I understand their frustrations and I want to answer any questions and alleviate any concerns that someone who is reading this interview might have. I hope that I am able to answer your questions fully and encourage anyone who is interested to call my office if they have any other questions so that I may have the opportunity to bring the trust back into a field that has been plagued with so many problems.

I was one of the first physicians to use minoxidil to treat hairloss in private practice. However, I was not satisfied with the quality of hair grown with minoxidil alone and continued to search for a way to improve my formula so that I would be able to regrow strong, natural hair that would not fall out. After finding in 1986, that Dr. Kligman discovered that Tretinoin rejuvenates the skin, I combined 2% Minoxidil with 0.025% Tretinoin (as known as Retin-A) to improve the results of minoxidil. I found that this new treatment can regrow the strong hair I desired. Unfortunately, I found that alone Retin-A was unstable and therefore added a proprietary combination of chemicals to preserve Retin-A. This allows my formula to be stable effective and safe for over a year.

Besides Dr. Lewenberg's Formula, the other aspect of my treatment that makes it effect is the application process. I found that if the solution is not easy to use, patients are less likely to use it properly. For that reason, the ingredients were also formulated into a cosmetically perfect solution that is easy to apply. Dr. Lewenberg's Formula is applied in a hair spray form. This allows for proper absorption of the formula while making it easy for the patient to use it.

There are some people who found the propylene glycol in the solution to be irritating. So, again I went back to the drawing board. I wanted my treatment to be the most effective treatment with the least amount of side effects. I am proud to announce that two years ago I was able to remove the propylene glycol from my formula, thus reducing the risk of irritation and allowing more people to enjoy the freedom of using my treatment to regrow strong, healthy hair. However, the formula still contains Ethanol. Because of this, the application method calls for patients to spray the formula from the distance of 8-10 inches, the alcohol evaporates. formula has been around for a long time now. I remember it from the mid-1990's when I first started losing my own hair. I never bought the product because at the time it was extremely expensive and I was in my early 20's so I couldn't afford it. Anyway, has your formula changed in any way since then or is it still more or less the same formula?

Dr. Lewenberg:I am very proud that Dr. Lewenberg's Formula has done so well and that I have been able to help thousands of patients regrow their hair in my many years of practice. I have two formulas now, where I only had one in the 1990's. I have my Original formula and the New formula, which was developed two years ago. The other difference is that I have been able to dramatically reduce my prices because of a reduction in the cost of materials and streamlining of production. Also, I am fortunate to have a large loyal following which has provided an ever increasing amount of patient referrals allowing me to reduce advertising. I am happy to say that I have passed this savings on to my patients. My patients can regrow their hair for as little as $1.67 a day and, amazingly, maintain their hair growth for as little as $0.50 a day. Also, in the last few years there have been many studies showing how Retin-A can repair damaged hair follicles and reduce levels of DHT. These studies have validated my research and experiences of my patients. Below, you will find a list of a few studies.

Rebecca J Morris, Yaping Liu, Lee Marles, Zaixin Yang, Carol Trempus, Shulan Li, Jamie S Lin, Janet A Sawicki & George Cotsarelis
Capturing and profiling adult hair follicle stem cells
Nature and Biotechnology; April 2004

Yong CY, Murtha PE, Andrews PE, et al.
Antagonism of androgen action in prostate tumor cells by retinoic acid.
Prostate 1994; 25: 39-45.

Slobodan M. Jankovic and Snezana V. Jankovic
The control of hair growth
Dermatology Online Journal(1):2
Link to article Why do you use 2% instead of a higher concentration of minoxidil?

Dr. Lewenberg: For the best results, I found that the proportion of Retin-A to Minoxidil must be the same. Increasing the amount of minoxidil alone did not allow patients grow normal hair. The hair grown was weaker and more difficult to maintain. Unfortunately, I can't safely increase the amount of Retin-A without increasing the likelihood of irritation.

It is safer and more effective for patients to increase the amount of Dr. Lewenberg's Formula used per application. While there have been studies showing some efficacy for retin-A in treating hair loss, it is also quite irritating to the skin, since it acts as a chemical peel? Wouldn't constant exposure to it over a long time (presumably indefinitely) potentially be hazardous to the skin?

Dr. Lewenberg: Prolonged use of Retin-A is not harmful to the skin. It rejuvenates the skin and may even protect against skin cancer. Retin-A increases the production of new layers of skin and hastens the turnover of dead skin. This not only gives patients healthier skin, but also can clear up or reduce the occurrence of inflammatory conditions, such as seborrheic dermatitis or psoriasis, that are common in patients with alopecia. Moreover, Retin-A vastly increases the absorption of the minoxidil and may help repair damaged hair follicles. It should be noted, that the young skin of the scalp is more sensitive and should be protected. New hair on the scalp can protect the skin, but sunblock or a hat is generally useful and necessary for patients with large areas of exposed scalp, especially when a patient is in the sun. On your website, it's mentioned that your product is to be used as a hair spray, instead of directly applying the formula to the scalp. Why is this?

Dr. Lewenberg: When I started working on my formula I wanted to produce the most effective treatment with the least amount of side effects. Both formulas are extremely effective and I wanted them to be in a form that would allow my patients the easiest application. In a hair spray form, my formulas can be applied with the least possibility of irritation. The formula is dispersed through the entire scalp and slowly absorbs over a period of about half an hour. Also, because my formula is most effective with the slow absorption to the follicle, the treated hair should not be combed or brushed until that half hour period is over. I designed my formulas so it is the last thing you put on your hair after it is styled. Another wonderful advantage of this type of application is that the hair actually has a healthy luster after being sprayed. You also recommend using the formula 4 times a day. While this will mean a relatively constant exposure to the active ingredients, for many people this is also very difficult to comply with. I have personally been using various topicals to treat my hair loss for years and have found that even the twice a day applications with one in the morning and one at night were impractical because I didn't like the feel of the topicals on my hair and scalp during the day. The whole point was that I wanted the hair to look its best during the day. So eventually I settled for once a day application just before bed time. Isn't it extremely difficult to comply with the regimen?

Dr. Lewenberg: Through out my many years in the hair growth profession, I have learned that consistent absorption of my formulas produced better results. I also realize that four times a day can seem like a lot, but that is why the formula is in a hairspray form. This allows treatment to be a few squirts taking a mere 20 seconds. You do not rub the formula into your hair, messing up your hairdo or even weighing it down as with other topical treatments. You do not even need brush your hair. Just spray and go, leaving your hair looking shiny and healthy. Do you recommend that at some point the frequency of use and/or amount of formula used be reduced, if and when a person gets the maximal regrowth benefit?

Dr. Lewenberg: My treatment consists of two phases, regrowth and maintenance. Every patient is different and we all regrow our hair at different rates depending on the reason for starting my treatment, so I cannot tell you how long each phase will be. Generally, patients with genetic baldness can take up to two years to regrow their hair, with results starting in as little as three months. After the regrowth phase, patients enter the maintain phase. In this phase patients only spray either of my formulas 1-2 times a day. Also, because the hair a patient regrows is strong healthy hair, it is possible to suspend treatment for a few months. Some patients, such as women wishing to improve the quality of their hair and patients regrowing their hair after chemotherapy can even completely stop my treatment after a few months. Have there been any studies done on your formula showing its effectiveness? You claim to have 90% of your patients see an improvement after 3 months of use. How did you come up with this number?

Dr. Lewenberg:In the September/October '96 issue of the internationally respected medical journal Advances in Therapy, I published the results of his two-year clinical study on results observed in over 2,200 patients.

This research shows that nearly 90% of patients who used Dr. Lewenberg's Formula as prescribed started to regrow their lost hair in just three short months. Furthermore, 91% of patients who continued the treatment for 18 to 24 months had either "grown beautiful, normal hair" or showed "marked hair growth" improvement.

Here is the abstract

I am always happy to send a reprint to a prospective patient who inquires. You have also said that you don't recommend the use of Propecia in conjunction with your formula. Here is a quote taken directly from your website: "We want to only grow normal healthy hair, which Propecia cannot grow, and we want to avoid the side effects associated with Propecia. Propecia cannot improve our results. Your results can only be improved by using more of Dr. Lewenberg's formula in the proper manner." I find this statement to be quite shocking because Propecia has been proven beyond any doubt to be effective in treating hair loss. Sure, it has side-effects in a small percentage of men, but it has been shown to be even more effective when combined with Minoxidil. Also, it treats hair loss from a totally different modality than Minoxidil by tackling DHT. Why do you make the claim that it cannot improve your results?

Dr. Lewenberg: The issue is one of need. While Minoxidil does not affect levels of DHT, Retin-A does reduce the production of DHT. As the formula is applied externally, its effects are limited to the scalp and hair follicles. Propecia (1mg finesteride) is an imprecise solution. Not only does it reduce DHT-2 levels through out the body, but it does not reduce levels of DHT-1, which is most prevalent in the hair follicle and sebaceous gland. Of course, some patients do take 5-alpha reductace inhibitors such finesteride or dutasteride either to supplement my formula or as treatment for Benign Prostate Enlargement. Some have claimed improved results, while others have seen no change.

Given the questionable benefits and possibly serious side effects, I do not support use of Propecia. Do you plan on adding any new ingredients to your formula?

Dr. Lewenberg: I do not plan to change my formula since it is both extremely effective and has little to no side effects. What are your thoughts on the HairMax Lasercomb?

Dr. Lewenberg: I cannot objectively critique the Lasercomb. My only exposure to the Lasercomb comes from patients, who sought my help after unsatisfactory results with this or other treatments. Do you offer a refund to anyone who has used your products but not had the results that you claim?

Dr. Lewenberg: Of course; I stand behind my treatment or I wouldnÂ’t have put my name on it. I have a policy of refunding any unopened medication that is returned. What do you see on the horizon when it comes to hair treating hair loss in the next decade?

Dr. Lewenberg: I am unsure about the advances in the next decade. Looking beyond that, I hope that we will find a cure for baldness by transplanting and stimulating adult stem cells, which would create new follicles. Adult stem cell treatments differ from the more controversial embryonic stem cell treatments, in that they use stem cell found in the patient's own hair. Research on this type of transplants is only starting now and it will take many years to go from initial promising studies to FDA approval.

In my opinion, hair loss is largely genetic. Certain hair follicles are programmed to whither or die in half the population. In most women with a genetic predisposition to hair loss, damage to hair follicles is less, and is normally expressed as thinning hair. For these women, hair loss is noticeable only with other contributing factors such as use of birth control pills or pregnancy. This is why testing testosterone levels in women is unimportant.

Until the new methods of treatment are produced, my Formula with Retin-A, which stimulates adult hair stem cells, is the solution for most forms of hair loss. By activating hair stem cells, we can repair, or possibly replace, damaged hair follicles for 90% of patients who have lost hair in the past 15 years.

I am also certain that new treatments tacking the conditions in different ways will also be developed. Unfortunately, I also see ill conceived programs with large marketing budgets being unleashed on unsuspecting patients. That is why I am a fan of patients studying the causes of and treatments for hair loss on information sites like I hope that my answers will help those suffering from hairloss make an informed decision on the proper treatment solution.

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