Valery Joseph, a hair salon on Manhattan’s Upper East Side, is the kind of place where everyone who arrives seems to look as if they could be leaving. Almost to a person, their hair is thick, lustrous, and as long as my college-age daughter’s.
I clearly missed that memo. After Joseph’s assistant openly grimaces at my “frizzy” and apparently unmanageable hair while blowing it dry, I feel like I’m owed their secrets. Joseph acknowledges that his clientele is, in general, intimidatingly polished. (I added “intimidatingly.”) If one comes in with less-than-luscious hair, “we kind of have a recipe, how we can get you to where you want to get,” Joseph says. He sometimes adds extensions and recommends a nutritionist, who advises his clients to follow a diet rich in lean proteins and healthy fats, similar to what could be found in a Mediterranean diet.
But beyond all of that? While it’s true that some of us are natural-born Beckys, everyone’s hair starts to thin after they turn 40. It’s a process scientists call miniaturization, explains Lars Skjøth, founder and head of research and development at Hårklinikken, a Danish company dedicated to treating hair loss that has clinics in New York City and Los Angeles. This happens, he says, when each hair shaft returns thinner at every growth cycle. (This is unlike sudden hair shedding, which is often related to a stressful event, poor nutrition, hormonal changes, or hereditary hair thinning.)
Hårklinikken’s method of increasing hair density—and they claim they can achieve this by as much as 150 percent with diligent program adherence—includes an in-person scalp exam, personalized regimens of botanical extracts and shampoos, and regular check-ins at the clinic.
Morgan Rabach, a dermatologist in New York City, says that treatments involving platelet-rich plasma (P.R.P.) are especially popular. P.R.P. is made by spinning a patient’s blood and extracting the growth factors, then applying them to the scalp after micro-needling. Rabach describes it as “a maintenance treatment, sort of like a chemical peel” that is done once a month for three months and then quarterly to keep hair looking like something out of a shampoo ad (the look I’m going for, naturally).
While it’s true that some of us are natural-born Beckys, everyone’s hair starts to thin after they turn 40.
“You lose hair over time. Now there is this preventive aspect,” says Rabach, who also prescribes a topical solution of 7 percent minoxidil, which she has compounded in a local pharmacy. (The standard dose for women is 2 percent, and men are usually prescribed 5 percent. Some of its side effects can include fluid retention, scalp irritation, and headache.)
There’s no shortage of new treatments in and out of doctors’ offices. The over-the-counter serum Nulastin is claimed to replenish elastin in follicles and revive hair’s root system so that hair stays anchored longer. (The brand also has a wildly popular formulation for eyebrows.) Laduora Duo is a comb outfitted with four scalp stimulators: red-light therapy, microcurrent energy, scalp massage, and heat. These tools are said to encourage blood flow to the scalp, which may support hair growth. Some dermatologists are also offering stem-cell transplants that use nanofat harvested through liposuction, which is purported to help revive hair follicles.
Anil Shah, a facial plastic surgeon in Chicago who is known for his natural-looking hair transplants, is not a fan of scalp injections of any sort. “I am skeptical about them penetrating the thickness of the scalp,” he says. Penetration is indeed an issue. Howard Sobel, a cosmetic dermatologist in New York City, employs a trans-epidermal-delivery (TED) machine, which uses ultrasound technology to help deliver growth factors farther into the follicle, improving their effectiveness.
Sobel supplies the TED device with exosomes (tiny vesicles released by cells that carry proteins, DNA, and other components through the body) and is seeing promising results. But, he says, “it’s not a cure, so it’s important to continue therapy.” The initial three treatments are $3,600, and Sobel recommends patients schedule them once every two to three months until, perhaps, the end of time. Otherwise, hair will return to its previous state.
Possibly just as effective—and much less expensive—is oral minoxidil. “It’s very cheap, and it does a better job than most of the other things,” says Gary Linkov, a hair-restoration expert and facial plastic surgeon in New York City who recently launched Feel Confident, a line of hair-growth products. The catch? One of its side effects can include the growth of unwanted facial fair, and if you go off it, you’ll lose all the hair you’ve gained. That’s because the drug lengthens the hair’s anagen phase, when cells are rapidly dividing to grow new strands, and shortens the telogen (or “resting”) phase, in which follicles are dormant. When patients stop using the drug, the body reverts to telogen mode, shedding a lot of hair all at once.
I didn’t spy any fuzzy cheeks on my Valery Joseph muses, but, then again, they probably have dermaplane-wielding aestheticians on call. And my eyesight, like my hair, isn’t what it used to be.
Tatiana Boncompagni Hoover is a New York–based journalist and novelist
