IHA Summer/Fall 2019

STRATEGY

MARKETING

RESEARCH The Truth

Church & Dwight

Michael Napolitano HairUWear Embraces the Future Pg. 16

About Finasteride

Gets Personal Pg. 4

Pg. 30

BUSINESS Amin Sheybani Ultimate Hair Directory Pg. 34

The International Hair Authority

TM

Volume 23 No 81

The Professional Publication of Hair and Skin Rejuvenation

Summer/Fall 2019

Researchers Rebut Finasteride Sexual Dysfunction More than 1,000 men have filed lawsuits that accuse Merck & Co. Inc. of failing to adequately warn consumers that the hair-loss drug Propecia may cause long-term sexual dysfunction problems.

However, a survey-based, single-center, controlled study designed to evaluate the presence of sexual dysfunction in men using or not using finasteride has concluded that its use does not result in sexual dysfunction in men with AGA. Data from 762 men aged 18-82 were collected and there were no significant differences between finasteride users and non-user controls in reporting sexual dysfunction using the ASEX (Arizona Sexual Experience Scale). These data are consistent with other large survey-based controlled studies. Regression analysis indicated that self-reporting libido loss and reduced sexual performance, not finasteride use, predict a higher ASEX score (See full report on pg 30)

Banking on Follicles UK. 08/05 - HairClone, a pioneering biotech start-up headquartered in Manchester, England, has been granted a license by UK regulators to launch the world’s first follicle banking service – the first stage in their goal to make hair loss history. The medical director is Bessam Farjo, MD who previously conducted research in the same field for InterCytex and Aderans Research Institute.

More Than Hair Growth

Light therapy has cardio benefits too Researchers at the University of Colorado found that healthy human volunteers exposed to intense light experienced improved metabolisms that could provide extra protection against cardio events. "Light plays an essential part in human health, not only in regulating the circadian rhythm but in cardiovascular health as well, says the study's senior author Dr. Tobias Eckle, professor of anesthesiology at the University of Colorado School of Medicine.

Counterfeiters Beware!

Don’t Mess with the Ghost!

Tampa, FL. 08/19 - Pro Hair Labs has retained a top international law firm to go after fraudsters who are distributing fake Ghost Bond products. “As the world leader in cosmetic bonding, it is our responsibility to protect consumers from products that not only fail to perform as expected, but may actually be dangerous’ said, CEO, Howard Margolin. “We have already removed several counterfeit products with the help of Amazon and will take whatever action is necessary to identify and prosecute anyone else.” Hairloss professionals and members of the public are asked to contact Pro Hair Labs if they suspect they have been sold counterfeit product.

Stubble Beats Clean Shaven Women find short stubble the most attractive facial hair style A survey by Prim&Prep an organization that describes itself as , ”the definitive guide to male grooming” showed t that 24% of respondents ranked “short stubble” as the most attractive facial hair style. “Clean-shaven” was a close second. That might explain why the U.S. men’s market for shaving products has shrunk by over 11% in the past five years, according to data from Euromonitor. The U.S. men’s razors and blades market was worth $2.4 billion 2015 and declined to $2.2 billion in 2018 obliging Procter & Gamble to take an $8 billion write-down on its Gillette. P&G paid $57 billion in 2005 for Gillette, the world’s No.1 shaving brand.

2 Hair Authority Summer/Fall 2019

Science + Aesthetics PROVEN NON-SURGICAL SOLUTIONS FOR THINNING HAIR Science meets aesthetics to give your patients something new: a complete system that targets thinning hair inside and out. While clinically proven ViviscalTM PRO Supplements promote existing hair growth in 6 months, XFusionTM by ToppikTM Keratin Hair Fibers conceal thinning hair instantly. Together, they offer the perfect complement to your hair loss treatments and procedures, giving patients the short-term and long-term solutions that they need to fight the effects of hair loss and boost their confidence.*

XFusionTM by ToppikTM Keratin Hair Fibers • Instant Transformation • Decades of Loyal Users • Confidence Booster

ViviscalTM PRO Supplements • Over 25 Years & 10 Published Trials • Clinically Proven

Customer Service (800) 277-3316 VIVISCALPROFESSIONAL.COM XFUSIONHAIR.COM Materials of Church & Dwight, Co. Inc., the makers of Viviscal™ and XFusion™ by Toppik™. Copyright© 2019 Church & Dwight Co., Inc. All rights reserved. * These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure or prevent any disease.

Hair Authority Summer/Fall 2019 3

Editorial Authority Hair Directory

For over 20 years, the Hair Authority has been providing important information to hair loss professionals around the world. Recently, we decided to share some of this information with the public to help them make smarter decisions and better evaluate all their options.

However, better informed consumers still need to find qualified professionals whom they can trust. Where to turn? There is no shortage of information on the web and no shortage of lists. However, most of these are limited to a particular sponsor or organization and the others are frequently misleading and deceptive.

The Hair Authority has been following the situation and after talking to business owners, we decided to use our reputation and resources to create a Directory that everyone can trust. The full description and mechanics of the HairAuthorityDirectory.com are explained elsewhere in this publication, but it is hoped that this Directory will work in partnership with other marketing efforts to bring top professionals to the forefront.

Cross Marketing

While the hair loss industry was competing with itself for a slice of a very small pie, consumers were getting on with business and researching combination therapies that were both personal and more effective. Eventually, the medical and non-medical sides of the business stopped beating each other up and everybody began to recognize the benefits of collaboration. They also accepted the power of light therapy and PHP and cross marketing began to happen in a hurry.

At first it happened at an individual level, but it wasn’t long before we saw major mergers and acquisitions. Today, Tokyo-based Aderans owns Renee of Paris, International Hair Goods, Bosley and Hair Club in order to offer a full range of solutions. And Hiking, a leading Chinese manufacturer, invested in US distributors, acquiring the On-Rite company (now HairVisions) and New Image Labs. Meanwhile, Church & Dwight expanded from home care products into personal care and now hair fibers and scalp treatments, Toppik and Viviscal.

Lasers go wet - All major brands have expanded into synergistic wet goods and supplements. HairMax introduced its new ‘Density Hair Care System’ and Capillus offers its extensive ‘Cap+ collection.’ Theradome has moved in a different direction and partnered with a major PRP supplier.

Hair systems go trichological - Hair system distributors have offered styling and training at their conferences for many years.

But The World Trichology Society has gone one step further and created a special Associate Trichology program for profes-

sionals who seek specialist training and formal accreditation.

Beauty salons eye thinning hair - Thanks largely to Modern Salon alerting its readers to an aging population and the profit opportunities to be found in thinning hair solutions, many beauty salons are now actively exploring this field. This is facilitated by the annual Hair Plus conference hosted by Modern Salon which is attended by hair loss educators who see business opportunities either in selling their services or expanding the market.

Doctors go micro-pigmentation - After many years of viewing cosmetic hair loss solutions as outside their frame of reference, cosmetic surgeons are now understanding that consumers simply want the best hair loss solution or solutions irrespective of their source. Some doctors have partnered with hair replacement studios to offer a transplanted front hairline that combines a totally natural front with the density of a hair system behind. More recently, micro pigmentation has come to the forefront. A procedure that was once regarded as a sophisticated tattoo is now being re-purposed as a medical procedure and re-packaged with its own terminology and quality controls.

Leaders like Hair Club share their expertise - The hair market owes much of its growth and success to pioneers like Hair Club and Bosley. Hair Club upgraded the industry from the era of wigs and toupees into a more elegant, contemporary marketplace driven by testimonial advertising and sophisticated lead management. Today, Hair Club continues to drive the market, but recognizes that with this success comes a responsibility to enhance standards and share its expertise for the benefit of the industry as a whole. Hair Club believes the market remains undeveloped and a rising tide will lift all boats. This reminds your editor of the visionary Elon Musk. Is Hair Club the ‘Tesla’ of hair maintenance?

Retiring?

Many owners are nearing retirement ages but have failed to prepare for this second chapter in their professional lives.

The Authority receives frequent calls from owners wondering what their business is worth and how to explore sale or joint venture deals. We have published articles before on preparing your business for sale and will do so again.

Meanwhile, if we can give our readers advice or make confidential introductions behind the scenes, please let us know.

4 Hair Authority Summer/Fall 2019

Church & Dwight Co Inc. Brings Viviscal, Toppik & X-Fusion to Its Personal Care Division Church & Dwight corporate headquarters

Church & Dwight Co., Inc., is a major American manufacturer of household products that is headquartered in Ewing, New Jersey.

In 1846, brothers-in-law Dr. Austin Church and John Dwight began preparing bicarbonate of soda for commercial distribution.

From those humble beginnings, Church & Dwight has grown into an internationally respected corporation serving both consumers and professionals. The famous Arm & Hammer logo symbolizes Vulcan, the Roman god of fire, who would strike his mighty hammer on his anvil. While the company manufactures many items, it is best known for its Arm & Hammer line which includes baking soda and a variety of products made with it. Today, the company has four consumer divisions: 1. Fabric Care – Arm & Hammer, OxiClean, Xtra, more…

2. Home care - Arm & Hammer, more…

3. Health & Wellbeing – Trojan, 1sr Response, Rephresh, more…

4. Personal care: Arm & Hammer, Batiste Dry Shampoo, Toppik, Oragel, Nair, Viviscal, Arrid, Waterpik, Close-Up toothpaste, Pepsodent, more…

One of the things that impressed The Hair Authority when we did our preliminary research, was the company’s commitment to operating in a responsible and respectful manner. This is clearly defined in their ‘Global Sustainability Platform” that states, “We will conduct our business so that we preserve the environment for future Generations, provide a safe and healthy working environment for our employees, and respect the communities where we work and live while promoting the continued success of our company.” This does not mean company does not aggressively pursue new products and new marketing opportunities, but it does so with a simple mission: “Our goal is to delight our customers and consumers with high-quality, affordable products.”

Britta Bomhard Executive Vice President Chief Marketing Officer

Hair Authority Summer/Fall 2019 5 Hair Authority: Doing out background research, we were struck by the company’s strong values and commitment to the planet.

Church & Dwight: It is essential for us to make great products and to produce them in facilities with robust environmental, health and safety performance. We work toward this high-performance culture by adhering to well established principles defined in the company environmental and safety policies. These policies guide our environmental and safety practices and expectations, and they are implemented through the following approach: •

& Gamble are investing increasingly in personal care and beauty products. Is this simply a migration towards higher margin, personal products or is this an area with new needs?

C&D: Both. As a company dedicated to understanding consumer insights, we continue to evolve as trends change.

These changes include but are not limited to media consumption patterns, retail landscape and influencers in purchase decisions. The Toppik™ and Viviscal™ acquisitions allowed Church & Dwight to gain new expertise in the Direct Consumer, Beauty Class of Trade and Professional Channel.

Ultimately broadening the “It is essential for us to make great organizations capabilities and allowing our brands to evolve products and to produce them with changing trends and in facilities with robust reach consumers differently.

Accountability: Each of our facilities has a designated on-site environmental and safety coordinator responsible for monienvironmental, health and Authority: What is the toring and managing safety performance.” company strategy for enterenvironmental and ing and competing in this safety issues affecting space - revitalizing stagnant their facility. These brands, introducing new technologies… responding to an coordinators are closely networked to enable peer aging consumer, connecting with an appearance-driven, mentorship and best practice sharing across facilities. selfie generation?

• Audits and Inspections: Each of our facilities C&D: Church & Dwight has a history of acquiring niche undergoes a third-party conducted safety audit each brands that are either #1 or #2 in their respective categories. year, and a third-party conducted environmental From there, we strategically invest behind those brands and audit every other year. All facilities are subject to leverage our strong distribution footprint to make products periodic, unannounced inspections by federal, state more widely available to consumers and drive greater brand and local environmental and safety agencies. awareness.

• Awareness: We offer regular training for all our manufacturing employees to promote awareness of Authority: Recent investments have included hair fibers environmental and safety practices and procedures. and hair growth supplements. Was this because they were This includes an annual Environmental and Safety available at the time, or is this part of a broader strategy?

Conference for facility environmental and safety C&D: Fine or thinning hair can be a source of embarrasscoordinators. ment, for men and women. Whether the cause is hereditary, • Awards: Each year we recognized one of our global hormone related or from extensions or weaves, over 80 operations for exemplary environmental safety and million men & women, which is 26% of the U.S. populasustainability performance. An award is presented tion, suffer from hair loss/thinning hair. By the age of 40, to a representative of the operation at a Town Hall over 40% of Men and Women will experience significant hair event in Princeton, New Jersey. loss. The Hair thinning consumer is extremely engaged in the category because of the emotional toll it can take on their Authority: The company has begun to diversify away personal life. As an example, 79% of hair loss sufferers said it from household products into personal care, perhaps with made them feel less happy than they could be. As a leading an emphasis on anti-aging products like thinning hair consumer goods company, we are seeking best in class solusolutions. Is this part of a long-term strategy? tions to meet consumer needs. Additionally, the acquisition C&D: Maintaining a diversified portfolio has been a key of Toppik™ and Viviscal™ is consistent with our strategy of strategic pillar for Church & Dwight success. As it relates acquiring #1 or #2 brands in growing categories. specifically to Personal Care, when we look to growth, one logical option is to focus on the growing trend of beauty.

Authority: Did you choose hair care because it is one of This is reinforced by our acquisitions of Batiste, Viviscal™ the first signs of aging, or because hair “frames the face and Toppik™, leading brands in the beauty and personal care “and is a lifetime commitment? space.

C&D: As we’ve seen, more and more consumers are adopting a comprehensive approach to beauty and anti-aging, Authority: Other companies like Unilever and Procter Cont’d Pg 6

6 Hair Authority Summer/Fall 2019 combining topical products with a healthy diet and now CONTROL cat litter that eliminates 100% of dust, keepsupplements to achieve their best results, the Toppik™ and ing dander in the litter box in an allergen-free light scent Viviscal™ portfolios are right in line with consumer behavior. with a 7-day odor control guarantee. ARM & HAMMER These products help Women Plus OXICLEAN laundry and Men address their thindetergent launched FADE “As a company dedicated to ning hair to help regain their DEFENSE combining stain understanding consumer insights, fighting power with clothing confidence. we continue to evolve as trends protection to brighten and Authority: Are there any protect against fading for change.” other hair care categories of vibrant whites and bright interest; for example, laser colors. OXICLEAN launched therapy?

DARK PROTECT laundry C&D: We have recently acquired Flawless and Finishing booster for dark and black fabrics that incorporates anti-fade Touch brands (“Flawless”) from Ideavillage Products Corpotechnology, cold water solubility, and OXICLEAN stain ration. Flawless is the market leader in women’s electronic fighters. In the personal care portfolio, WATERPIK launched hair removal products. Flawless will be our 12th power SONIC-FUSION, the world’s first flossing toothbrush combrand and is a rapidly growing business. The acquisition is bining the convenience of a sonic toothbrush with a water consistent with our strategy of acquiring #1 or #2 brands in flosser in a single device. VITAFUSION and L’IL CRITgrowing categories and represents a powerful addition to our TERS launched USDA certified organic gummy vitamins. existing specialty hair care portfolio which includes Batiste BATISTE launched a Hair Benefits line with a hydrating dry shampoo, Viviscal™ hair thinning supplements and the dry shampoo for dry hair, and a volumizing dry shampoo for Toppik™ hair fibers. fine hair. NAIR launched LEG MASKS hair removal, a first for legs, with natural clay, seaweed, and charcoal. ORAJEL Authority: 40 % of your consumer prod uct sales now launched toothache strips with a patent-pending innovative come from new innovation products – what is the compastrip technology that targets pain by adhering to teeth and ny’s vision for 2020? gums for instant, long-lasting, better tasting, targeted relief.

C&D: Innovation continues to be a big driver of our sucTROJAN launched THE EDGE condom designed to excite cess. In support of our long-term strategy to drive revenue and elevate the experience with changing sensations and both and earnings growth, we have launched new products in inside and outside lubrication. several categories. In the household products portfolio, we launched ARM & HAMMER CLUMP & SEAL CLOUD To learn more about the company’s most recent hair care Before and After applying Toppik

Hair Authority Summer/Fall 2019 7 acquisitions, The Hair Authority contacted Britta Bomhard, Executive Vice President, Chief Marketing Officer. Ms. Bomhard has been Executive Vice President and Chief Marketing Officer since January 2016, prior to which she served as General Manager, Europe since 2013. From 2005 to 2013, Ms. Bomhard served in a variety of Marketing and General Management assignments at Energizer. Prior to Energizer, Ms. Bomhard worked for Wella AG and GlaxoSmithKline in their marketing organizations. Ms. Bomhard currently serves as a member of the Board of Directors of Cott Corporation, a leading North America and European water, coffee and coffee extracts, tea and filtration solutions service company. ppik™

Toppik Authority: Toppik™ is the brand that launched and perhaps drove the hair fiber category. Church & Dwight acquired Spencer Forrest, the maker of Toppik™ in 2016.

Why did you choose hair fibers as your first investment in hair care?

BB: Toppik™ began in 1981 as a direct-to-consumer company creating cosmetic solutions that disguise fine or thinning hair. Over the past 35 years, the brand has helped millions gain the confidence that comes from the appearance of fuller hair. We have expanded our product line to incorporate a range of products that help men and women who are struggling with fine, thinning, or damaged hair.

Toppik™ Hair Building Fibers instantly transform the appearance of fine, thin, thinning or limp hair with natural Keratin

Toppik Family

protein that clings to existing hair, hiding signs of hair loss.

The Toppik™ line has expanded to include support tools for flawless Fibers application, as well as hair care and hair styling products to build volume and give the look of thicker, fuller hair to all hair types. The acquisition of Toppik™ built upon our existing hair care portfolio including Batiste Dry Shampoo. The Toppik™ acquisition broadened Church & Dwight’s capabilities in the Direct Consumer, Beauty Class of Trade and Professional Channel, allowing our brands to evolve with changing trends and reach consumers differently.

Authority: How is Toppik™ different from other brands?

BB: Not all fibers are created equal. Toppik™ Hair Building Fibers are derived from a natural source, the premium Keratin nearly identical to human hair which allows the fibers to blend naturally and undetectably. The Cont’d Pg 8

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8 Hair Authority Summer/Fall 2019 Hair Building Fibers a perfect fit for any Man or Woman who suffers from thinning hair or loss to walk out of the salon feeling confident.

natural Keratin used by Toppik™ has an innate static charge that ensures Fibers adhere to any hair type. Imitators made of lower-grade sources like cotton, plant-based materials and rayon do not have this natural static charge. Consequently, there is nothing attracting them to the hair, so they tend to clump, shift or fall onto the scalp and look unnatural resulting in a texture and appearance that lacks in comparison to premium fibers found in Toppik™. Toppik™ innovative technology allows the Fibers to resist wind, rain and perspiration.

Authority: How important is it to give customers the instant satisfaction of fuller hair and scalp coverage?

BB: In this world we live in, consumers want instant gratification and immediate results. There are many products that work over time, like hair growth supplements such as Viviscal, but consumers often want immediate results, and that’s what XFusion/Toppik™ delivers.

Authority: What would you like the public to know about hair fibers? What are some common misunderstandings?

BB: How easy Fibers are to apply and how natural the results can look! I think people are intimidated, thinking that they aren’t going to be able to apply them well themselves at home, which couldn’t be further from the truth. I think people have a misconception that Fibers are going to look ridiculous, like “hair in a can,” but technology has evolved beyond that now. Fibers look and feel like real hair because they are almost identical in every way to real hair.

Authority: Why should every hair studio stock a hair fiber?

BB: Bringing up the topic of a client’s thinning hair can be uncomfortable for stylists and clients. Having an open conversation is essential. We have found salon professionals are eager to tell their clients what they need for their faded color or suggest a trim for split ends. But when it comes to discussing thinning hair and hair loss, it can be sensitive. However, thinning hair is a topic most people would rather talk to their stylist about than their doctor. Knowing that stylists want to provide the very best solutions to their clients makes Toppik™

Authority: Are hair fibers a replacement or a companion product to other thinning hair solutions?

BB: Toppik™ Hair Building Fibers are a great stand alone or complement to any hair thinning therapy. They are an instant solution to conceal hair thinning and loss creating immediate results. Toppik™ Hair Building Fibers can be used while waiting for the results of other solutions and can continue to be used to enhance the results of alternate hair thinning remedies. Together, they offer the perfect complement to your hair loss treatments and procedures, giving patients the short-term and long-term solutions that they need to fight the effects of hair loss and boost their confidence.

“Innovation continues to be a big driver of our success. In support of our long-term strategy to drive revenue and earnings growth, we have launched new products in several categories.”

Authority: What is the difference between fibers available only through licensed professionals and fibers sold online direct to the public?

BB: Our salon-quality XFusion Fibers have been professionally calibrated and tested based on stylist and colorist feedback to perfectly match your client’s hair. XFusion offers a full range of 9 shades to match virtually any hair color, while many other fiber ranges fall short. Plus, XFusion offers a selection of proprietary tools, such as our patented Spray Applicator, to make applying even easier.

Authority: What are the latest technological advances in hair fibers?

BB: We’re seeing a rise in thick, natural brows thanks to celebrity trends. The Toppik™ Brow Building Fibers Set uses the same natural keratin found in our Hair Building Fibers for a look that makes even the thinnest eyebrows instantly thick, full and natural-looking. Brow Building Fibers last longer than eyebrow powder and look more natural than eyebrow pencils or gels. This 3-piece kit includes a Brow Shaping Wax to shape eyebrows, Brow Building Fibers and a custom dual-end brush for wax and fibers application, making this the best eyebrow makeup for full, natural-looking brows.

Hair Authority Summer/Fall 2019 9

XFusion Authority: How is XFusion different from Toppik™?

BB: Toppik™™ began as a small company that created multiple cosmetic solutions for thinning hair. The most popular product—sold to millions of men and women—is Toppik™ Hair Building Fibers. In 2005, XFusion by Toppik™ was created—the first and only salon-exclusive line of products to cosmetically address stylists concerns for their clients with fine or thinning hair.

Authority: Do you provide special hair-fiber education/support for professionals?

BB: We provide various platforms of education for our hair fibers.

Our eLearning course called “Hair Thinning Essentials” is an online curriculum that goes through everything from hair science/ anatomy to solutions for hair thinning and loss. There are step by step application instructions for the hair fibers included in the course. Additionally, we have medical professionals who are trained in Toppik™ Hair Building Fibers and will speak on podium at medical conferences about the product and application techniques. Finally, our dedicated Professional Sales Representatives are available for local Lunch and Learns for support and education.

Authority: What should men and women with hair loss know about Xfusion when they visit their stylist?

BB: XFusion is completely safe for all hair types and works

Toppik - Before Application

amazingly well with hair transplants. No matter what your condition, if a client feels concerned about visible hair loss, XFusion will change the way they feel about themselves every time they look in the mirror. Colored fibers are made of pure keratin protein—the same protein that makes up human hair—to offer a completely natural solution to thinning hair.

“Charged” with static electricity, they bond securely to natural hair to stay in place all day and night. It comes in nine natural color shades and is undetectable even to the trained eye. XFusion Keratin Hair Fibers are an affordable daily solution for thinning hair.

“No matter what your condition, if a client feels concerned about visible hair loss, XFusion will change the way they feel about themselves every time they look in the mirror.”

Authority: Should XFusion application become part of a regular salon styling visit, or is it designed to be taken home?

BB: Both. For the best experience we recommend an initial application by the stylist to show the client how to apply for the best coverage and natural look. Once hair building fibers are applied, they stay securely in place giving natural looking thickness and fullness until the next time the hair is washed.

It is compatible with all hair products but works best when used in conjunction with the supporting XFusion line of products.

Toppik - After Application

Cont’d Pg 11

10 Hair Authority Summer/Fall 2019

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Hair Authority Summer/Fall 2019 11

Viviscal

ated. Since the professor’s discovery, Viviscal™ has been tried and tested worldwide. The efficacy of Viviscal™ is supported in ten published clinical studies, including the most recent double-blind, placebo-controlled scientific research program, which was designed exclusively to study women’s hair growth* supplements. The study demonstrated a statistically significant reduction in hair shedding and a statistically significant increase in hair thickness over a six-month period.* Authority: What would you like professionals to know about Viviscal™ Pro? BB: Viviscal™ PRO is a 100% drug free, clinically proven dietary supplement that effectively promotes existing hair growth in women or men. It is backed by 10 published clinical trials proving its efficacy with no known side effects. This combined with its endorsement by celebrities, models and stylists has made it the #1 selling hair growth supplement.

Authority: Church & Dwight acquired the Viviscal™ brand in 2017 from Lifes2good Inc. What attracted you to this hair care product?

BB: Viviscal™ is more than just a brand, it is a disruptive business model with a significant presence and influence in Consumer, Professional and Retail Channels. It is a brand that understands hair thinning, positioned as a premium, drug-free efficacious alternative to medicinal hair growth brands. Viviscal™ has been researching hair loss for over 20 years. The efficacy of Viviscal™ dietary supplements is supported by ten published clinical trials and has been endorsed

by KOLs, stylists and celebrities. As a brand that specifically targets Women, in a male-oriented category, Viviscal™ is a proven solution to help Women who experience hair thinning and loss regain their confidence.

Authority: What is the difference between the Consumer Viviscal™ and Viviscal™ Pro? BB: Viviscal™ PRO is sold exclusively by licensed professionals in salons, spas, and medical offices. Many people may already be familiar with Viviscal™ from seeing TV commercials, hearing about celebrity users, or just from word of mouth. However, there is a difference between the Viviscal™ products available professionally and those available in retail stores. Viviscal™ PRO has higher levels of the proprietary ingredient, AminoMar® and the addition of Apple Extract Powder, L-Cystine and L-Methionine.

Authority: Today, Viviscal™ is the #1 brand of hair growth supplements. What makes Viviscal™ special?

BB: Viviscal™ is a system for thicker, fuller hair that is based on powerful nutrients found in nature. We are not just any drug-store biotin supplement, we are advanced hair health.

Unlike ordinary Hair Skin and Nails supplements, Viviscal™ is specially formulated and clinically proven to promote hair regrowth. Viviscal™ users saw a 32% increase in the number of hairs and a nearly 40% decrease in hair shedding and loss in just three months.

Authority: There is a lot of misinformation about hair care, particularly when it comes to supplements/serums.

How can you educate the public and build the trust necessary for Viviscal™ to prosper?

BB: There are many dietary supplements available to help nourish hair growth. But for many, if you look closely at their claims, you’ll find that their research is thin and often not conducted on their own formulas, but on their individual active ingredients. The most clinically proven dietary supplement that you can recommend to your clients is Viviscal™ PRO dietary supplement. Viviscal™ PRO is a 100% drug free, clinically proven dietary supplement that effectively promotes existing hair growth in women or men. Viviscal™ PRO is backed by over 25 years of research and development.

Authority: What is AminoMar®? Has it been tested?

BB: Only Viviscal™ dietary supplements contain the proprietary AminoMar®® marine collagen complex, plus a blend of vital nutrients that nourish thinning hair and promote existing hair growth* from within. In the 1980’s, a Scandinavian professor studying the Inuits discovered that their great hair and skin were the result of their fish- and protein-rich diet. He isolated the key protein molecules from the Inuits’ diet and, from these origins, AminoMar® was cre-

There are many topical shampoos, conditioners, and serums that help boost hair volume and make hair look healthy.

These products offer a variety of ingredients and claims.

Although there are some topicals that claim to create hair growth, there are also lines that have purely cosmetic effects for hair thickening and densifying. Viviscal™ PRO offers a complete range of topical hair care products called Thin to Thick that promote thicker looking hair with a proprietary complex called Ana:Tel™. The Thin to Thick range includes Cont’d Pg 12

12 Hair Authority Summer/Fall 2019 Healthy hair with Viviscal

a shampoo, conditioner, and a volumizing leave-in elixir.

Ana:Tel™contains clinically tested ingredients from natural sources, including pea sprouts, that help make hair look thicker and healthier.

Authority: How can the Hair Authority help you build consumer trust?

BB: We have a strong anti-diversion policy and can track down unauthorized resellers thru product codes. Our products are only available through licensed medical and beauty professionals.

By committing to our policies and adhering to the professional guidelines, we can continue to build consumer trust that our products are authentic, non-expired, and backed by our company guarantees.

We started this interview by stating that Church & Dwight is a company with a conscience. And we’d like to end on the same note. The following is taken from the company’s website – “We feel strongly that, as a member of the communities where we

operate, our success should be shared. To that end, in 2005, we established the Church & Dwight Employee Giving Fund, Inc. (EGF), a workplace giving program that primarily supports charitable organizations in the communities in New Jersey and Eastern Pennsylvania. In the years since its inception, the EGF has become a cherished part of our culture. Through 2018, the EGF has awarded about 1,800 grants totaling over $11 Million to charitable organizations throughout the areas where our employees live and work. Each year, we invite our employees to dedicate a portion of their paychecks to the EGF. We encourage employee donations by offering employees additional time off depending on their level of giving, and matching all employee contributions dollar for dollar, with no cap. Through our annual grant process in 2018, the EGF awarded $1.2 million to 183 deserving organizations in a variety of areas, including animal rescue, disadvantaged youth, domestic violence, education, health, homelessness, hunger relief, military services, preservation of the environment, services for the elderly, and the visual and performing arts.”

IHA

ess box.

Hair Authority Summer/Fall 2019 13

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14 Hair Authority Summer/Fall 2019

Marketing Section

Moving the Needle - How to Create a Website that Converts

Digital marketing is a skill very few hair studios and medical clinics possess. We don’t have that specialized knowledge at The Hair Authority either. That’s why we asked a top website developer to share their experience and give readers a checklist to help managers create an online plan. The company is appropriately called Incredible Marketing and they specialize in helping medical and personal care professionals We all know the importance of a website in today’s hair restoration market. 81% of clients/patients will visit a practice website before deciding to move forward. Of those, the average conversion rate to book a consultation is 1.5% While there are a lot of factors in the psychology of client/patient conversions, there are four crucial elements that you can implement today to help move the needle in your favor.

Let’s put this in perspective: if you have 1,000 monthly website visitors and convert at a rate of 1.5%, your website is giving you 15 new clients/patients per month. Now say we can convert 75% of consultations and the value of each client/patient is $8,000; your website is earning you $90,000 per month.

Now, if we can move the needle and

convert just one more percent, your website will earn you $150,000 per month. That is an additional $720,000 in annual revenue.

That sounds great, but how do we get there? These are the four steps to convert a medical patient:

1. Tell them who you are and what you do: This

might sound elementary, but it is often overlooked and plays a crucial part in your website conversion rate. The first fold of your website should focus on your brand (this can be your name or the name of the practice) as well as the primary procedure you are selling. For example: ‘Ken Williams, D.O., FISHRS, ABHRS - FUE Hair Restoration.’

2. Prove you are good at what you do: What makes

you an expert? Are you a trichologist or member of the ABHRS? ISHRS? Have you written a book or do you frequently lecture? These are all factors that patients take into account while on the first page of your website, therefore these elements should be front and center.

3.

Show that similar clients/ patients have gotten great results: For

many, this will seem like a no brainer, but you would be surprised at the amount of terrible or non-existent before-and-after photos showcased on hair restoration websites. Good before-and-after photos should be consistent, look professional and be sized appropriately for your website. They should

Hair Authority Summer/Fall 2019 15 also look like your target market; if your ideal patient is a 40 to 55-year-old male, there is no reason to have a young man or woman on your homepage. Users are more comfortable with people who look like them and have similar circumstances.

4. Make your site easy to connect to:

75% of patients will be visiting your website from a mobile phone for the first time — so how does your website look on their device?

Is there a clear, concise way to fill out a form and schedule a consultation? Are your address and phone number easy to find? These are all the things patients will be looking for on your site; the sooner they find them, the higher the probability of a conversion.

Once you have cleaned up your homepage and given clients/patients a reason not to leave your site, it’s time to give them a reason to stay. In general, website content comes in two main forms — written content and video content. Video content is often overlooked in the hair restoration market. Men, on average, watch 40% more video content than women. This is where you really have to know who your ideal client/patient is. What are they like? How and when do they consume content?

Content is the reason a user continues to use a website and what creates the connection for them to schedule a consultation. While users do want to know about their potential stylist/surgeon, at the end of the day, it is about the client/patient journey. The content should be displayed in a way that takes the client/patient on a voyage through the site and allows for a consistent personal connection. That said, we all learn in different ways; a website with outstanding content will display it through longform text,

FAQs, illustrations, photos, videos and digital renderings. This allows clients/patients to stay engaged regardless of their preferred method of learning.

Now that we have impressed your potential patients with expert content, you must call them to action. Every page on your website should have definitive calls to action that explicitly direct clients/patients to forms or your office’s telephone number. A bonus factor to consider is a live-chat feature; this gives patients 24/7 access to assistance and can be very productive in creating conversions for practices that have limited hours.

While this can all be a bit dautning the most important factor in generating content is being yourself. You are the only one who can be you and clients/patients will be grateful for your honesty and transparency in your digital presence. Once you do this and clearly define your ideal patient you can spend more time doing what you love, consulting patients.

Duke Gallo is the Lead Educator at Incredible Marketing, a full-service, digital marketing agency, specializing in the medical aesthetics space.

With a background in software development, he has created websites and web-based platforms for companies around the world. Duke has a decisive view on marketing for medical practices that is based on creating the highest return on investment. When he is not traveling, speaking to medical professionals or helping practices reach their growth goals, you can find him enjoying the California sunshine with his wife and his dog, IHA Ringo.

16 Hair Authority Summer/Fall 2019

Embracing the Future

Michael Napolitano, CEO Things aren’t like they used to be. Yes, people still want to look good. In fact, they want to look better than ever before, but it’s a different kind of look. It’s not a cover up or an add on or make-over look, It’s the look of wellness. Men and women today are eating better, sleeping better and exercising better. Welcome to the organic, hydrated, selfie era.

Marketing in this fast-changing environment is no longer about making sales, it’s about making friends. To promote your brand or product you have to bring value to the relationship. So how do you connect with an image driven, selfie generation? A smart place to start us by solving a problem; removing a source of discomfort. And few things are as discomforting as hair loss. Thinning hair is acutely personal and everyone experiences it differently. For some, it may be a lack of confidence in a social setting.

For others it might be anxiety about a critical event like a date or an interview. Then there are the dreamers. People who follow fashion and celebrities. They are more likely to be drawn to evocative imagery and the world of imagination. To create aspirational campaigns for this audience requires a special kind of vision and imagination. The important thing is to understand your market - and to show you understand in a compelling way. That’s why The Authority wanted to talk with HairUWear, a company that has stayed in tune with the market over several generations of hair care customers.

HairUWear has been a pioneer in personal marketing and continues to set the pace. Maybe it is because the company’s CEO comes from an IT background. Or is it because the management team was assembled for its imagination? Whatever the reason, HairUWear is an undisputed leader in hair additions, wigs and extensions. In the men’s hair loss market, when other companies were promoting hair as a cover up, American Hairlines, a HairUWear company, told viewers that their hair was part of their wardrobe, part of how they presented themselves to the world; a fashion accessory. In the highly intimate women’s hair loss market, the company invited visitors to “Imagine” how hair could bring style and confidence and offered “Hair Like You” that would enhance their lives without changing them. As most other brands continued to talk about the product or the company, HairUWear bonded with its customers and made friends.

Hair Authority Summer/Fall 2019 17

The Man Behind the Vision If Steve Jobs owes much of his success to his passion for design perfection, then HairUWear may owe its success to CEO, Michael Napolitano’s degree in mass communications. Michael later refined these skills working in computer sales and marketing until a unique and unexpected business opportunity came his way. His mother was working at the time at Eva Gabor International selling men’s hairpieces and the owners were ready to sell the company so they could focus all their attention on the women’s market. Pooling their resources, Michael, his mother and his wife, Denise seized the moment…and that is where, 40 years ago, the HairUWear adventure all began.

H. Authority: In this interview we’d’ like to talk about the vision, the creativity, and the force behind HairUWear. How the company got to where it is, and how you assembled the team that shares your values. Today, it’s not about hair as a cover up, it’s about hair as lifestyle. And to succeed in that environment requires a different set of marketing skills.

Michael Napolitano It’s not just skill. It’s also passion and commitment. I can’t even express how passionate I am about my company and the energy and imagination that goes into it.

You started in men’s hair additions and grew what was a very traditional business into a hip, modern company that meshes with today’s lifestyles.

It was a very long journey. I did not come from this industry. When I started out, I had a degree in journalism, but what you major in is not always what you end up doing later in life. My career started in mass communications, but then I had an opportunity to get involved in the computer industry, which was a 180-degree change of direction. I’d been producing work at ABC, for ‘Good Morning America,’ which probably sounds very sexy, but I wasn’t really getting paid that much money and it’s a pretty ruthless business. So, when I was presented with the computer opening, I grabbed it.

HIM from American Hairlines This was the late 70s and the IT market was just starting to emerge. The computer systems were monsters; milliondollar installations. They were interviewing people for Cont’d Pg 20

18 Hair Authority Summer/Fall 2019

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Hair Authority Summer/Fall 2019 19

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marketing and sales positions by the hundreds just to get one candidate and I was lucky enough to get chosen. I was put into an intense management training position for a year. Think of it as an MBA with a computer technology twist and it became a business launchpad for me. Once that was completed, I was put out in the field and here I am, twenty-seven years old, dealing with all these presidents and vice presidents of Fortune 500 companies, building computer systems for them.

Now, while I am doing this my mother is working at Eva Gabor. The company originally only sold women’s wigs, but they decided to expand into men’s hair replacement and put my mother in charge. Shortly after, management decided this was not a good fit for the company and decided to go back to the women’s market. With the men’s operation now up for grabs, my mother approached me and said this is a great opportunity, how about going into business together? Now I was doing well in my own career so I told her I didn’t want to give that up. Anyway, long story short, she talked me into giving it a try for one year and my employers agreed to take me back after I got the new hair business up and running. I confidently expected to return to the computer field. But of course, that never happened.

The hair business wasn’t an easy start up. I was a fish out of water and went through a major culture shock. One day I was in boardrooms of Fortune 500 companies and the next day I’m trying to sell a barber hair pieces. I had

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Hair Authority Summer/Fall 2019 21 no marketing team, it was just me, my mother and my wife. That was it. But I put my training to work and did the best I could. I went on the road and met our customers and began a personal metamorphosis. We created new marketing programs and slowly the business began to grow, but it still wasn’t the kind of business I dreamed about.

When did things begin to change?

I wanted to create a company that could hold its own within the professional beauty industry. And little by little, we accomplished that. The Eva Gabor company had gone through a lot of things like leveraged buyouts and it ended up in in a basket of companies owned by Cargill Industries, which has zero to do with anything beauty. Cargill is all about financing grain, steel and food products and Eva Gabor was not a good fit for them. When we asked Cargill about a possible acquisition their attorneys were pretty tough, but I was used to working with every level of management and we got through the negotiations and I acquired the company in 1996. At that time, it was still a little old lady’s wig company, but I wanted to build on that foundation and create an expanded portfolio. I had to lay the train tracks before I could build the train.

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Our first challenge was to create a hairpiece line that was attractive and aspirational. So, we did surveys to see who women looked up to and the top person was always Raquel Welch. We reached out to her management and, long story short, we created the Raquel Welch signature line in 1997. If we fast forward to today, I don’t have to tell you that this collection has now become a huge global brand. We did some magnificent video and photo shoots that look like they came from a movie set! With this kind of inspirational marketing, Raquel just took off! It was unbelievable.

You started with classic marketing; consumer surveys and role model research. But somewhere along the way, this turned into a passion. Were you aware of that happening?

The original mission was to create a well-respected new beauty company. And in order to do that, we had to create a powerful image that had wide appeal to women.

That’s why I spent the money on the surveys. I felt my competitors were just throwing darts. There was no intelligence or creativity behind it. I knew that in order to build a beauty brand we needed creativity and aspiration.

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22 Hair Authority Summer/Fall 2019 Raquel Welch

crash and burn and that I was going to kill the company. I told them that we’re going to build another division and it’s going to be great. But they insisted, “This is not our business. It’s going to take away from our regular Eva Gabor line.” And I replied, “This is going to be big in the salon industry. Everybody’s got to suck it up, and we’re going to make it happen!” So, we went ahead, but rather than going it alone, I thought, why not partner? And that’s what we did. We created a plan that went beyond selling hair. We offered education. Without education, the hair is meaningless. So, we built an education team and did all the marketing. We had a partner who was making the product, but we did everything else ourselves.

The first thing that I wanted to do after education was to really Wow the industry and the consumer! So, we ran full page ads in In-Style magazine, Elle and other publications. Clients started showing the ads and photos to their stylists, telling them, “Look at the before, look at the after… can you do this?” Most salons will tell you that’s how they gained most of their new clients. We gave them an advertising vehicle that drove consumers into the salon. Then the word started to spread, as those consumers started telling their friends about us. It was like a snowball.

a special event and wants to look amazing. She doesn’t suffer from hair loss, but she may have fine hair and can’t get the style she wants. That was kind of the code that I wanted to crack and so we worked at it with Raquel and both parts of the business started to really grow.

Shortly after, I had the opportunity to bring Great Lengths into the United States. It is now a dynamic hair extension division, but in 1998 it didn’t exist. In those days, hair extensions were a black girls’ service. There was no branded, education-based program hair extension company. I first became aware of the potential of the extension market when I saw a model with this awesome long hair at a hair show in Berlin. She was standing by a booth with a guy singing songs and playing music with a little box speaker. I’m wondering what the heck this all is, so I introduce myself; and that’s how I meet David Gold, the man who created the extensions that became Great Lengths. I studied the product and realized this could be the next big boom back home, so, when I returned, I told my team I’d seen something I really believed in and the results overseas were really great. I explained that these hair extensions were the answer for every woman who goes into a salon and asks for a special style only to be told, “your hair is too fine” or too “flimsy” and you need more density or more length.

They thought I was nuts. They thought it was going to

To maintain that high level of satisfaction, we continued to educate and built a network of 7,000 certified studios.

And, of course, we continued to invest heavily in trade marketing. In fact, we spend more money than any major beauty brand for professionals. We also had a great PR Great Lengths

Hair Authority Summer/Fall 2019 23 TM

Great Lengths

THE INTERNATIONAL HAIR AUTHORITY

The Hair Authority’s mission is to provide hairmanagement professionals from all disciplines with accurate information that will help them provide superior service to their clients and patients. It is a full-color tabloid, published quarterly and distributed worldwide.

EDITOR IN CHIEF Christopher Webb

cwebb@hairauthority.com

CREATIVE DIRECTOR Dylan Case dcase@hairauthority.com

CONTRIBUTING EDITOR Larry Oskin info@hairauthority.com

LEGAL NOTICE

company that got us tremendous publicity. We would do PR events in New York City and invite 50 - 60 beauty editors. We were written up in every magazine. There also used to be a TV program called “Greatest Cities of The World” where they would show amazing products and places where celebrities would hang out. In one episode, they showed clips of Rodeo Drive and stars wearing Great Lengths. This was a huge hit for us, and Great Lengths Extensions were ranked number 35 among the greatest things in the world! Salons went ballistic! Phone calls were coming in like mad. Everybody started noticing what we were doing, but the beauty of it was when I started, I didn’t have any competitors. It was just us.

How did you find people with the same vision to join the team?

When I bring team members into the company, I want to people who are smarter than me. There are a lot of people who want their business to be kingdom; it’s their way or no way. I wanted to reverse that. So, we brought in brilliant hairdressers and professionals who had done tremendous editorial, fashion and photo work. And we sought out the top educators in the

Cont’d Pg 24

The views expressed in The International Hair Authority are those of the individual author or contributor and not those of The International Hair Authority, its editors or staff. The Authority’s contents reflect the opinions of the authors and are not analyzed, peer-reviewed or otherwise investigated before publication. All authors and contributors are asked to disclose any interests they have of a commercial nature.

The International Hair Authority makes no attempt to validate the sufficiency of such disclosures and makes no warranty, guarantee or other representation, expressed or implied with respect to the accuracy or sufficiency of any information provided. The publication of an advertisement does not constitute on the part of the International Hair Authority a guarantee or endorsement of the quality or value of the representations or claims made by the advertiser. The International Hair Authority accepts no responsibility for unsolicited materials.

All articles and letters become the property of the International Hair Authority and may be edited for clarity, presentations and space. By allowing your articles, interviews and personal commentary to be used in The International Hair Authority, you are giving the publication permission to use these materials in its pages, websites and other information materials.

Advertisers are required to sign a formal advertising agreement indicating that they are not violating any trademarks or other intellectual properties. Full details are outlined in The International Hair Authority Media Kit.

COPYRIGHT

The material published in The International Hair Authority is copyrighted and may not be utilized in any form without the written consent of the editor.

THE INTERNATIONAL HAIR AUTHORITY 39252 Winchester Road #107-383 Murrieta, CA 92563 Email: info@hairauthority.com Tel: 626-709-6397

24 Hair Authority Summer/Fall 2019 Michael Ferrara, Chief Marketing Officer

companies and hear what that they have to say. We also subscribe to many trend services that exists in the fashion industry and closely monitor all the major fashion shows.

You don’t only follow the media; you are part of the media. You are in Hollywood movies and you were part of Legally Blonde, you are a regular part of popular TV shows.

professional beauty industry. Our Executive Director of Creative is the 2018 AHA Hairdresser of the Year for all of North America. These are the kind of people we have.

When you put that kind of team together, you not only have a vision for the hair itself, but a deep understanding of the needs of the salons, stylists and the consumer.

But beyond that, my executive team shares my vision because they come from beauty; they’re not stuck in a box. Like I told you earlier, when I came back from Berlin, people said you can’t do that? That’s the one thing I don’t want. I want people around me who are ready, able and passionate about breaking the barriers? I now have that kind of team. Take Mike Ferrara for example.

Here’s someone who’s incredibly accomplished and has advocated for large companies and was ready for a challenge. Reality is we’re not a Coty or a L’Oréal. We’re not a $10 billion company with layers and layers of people where you can get lost. We’re scrappy group and we all collaborate together, regardless of title.

‘Legally Blonde’ was a great experience. We provided hair for the movie and for the premiere party in Hollywood, they created a special exhibit and we sent a team of a dozen hairdressers to do the hair of all the hostesses.

There were probably 100 of them. I mean, it was massive party. We put Raquel wigs on them and they’re walking around and looking glamorous everybody sees them and start converging on the exhibit. David Hasselhoff comes over to me and says, “So, Raquel’s in the hair business, can I get some wigs for my family?” That’s just one example of what was happening. It was crazy! Our products are part of a lot of shows and movies. A year ago, we were in LA helping Rachel Zoe with her Spring fashion show. Our artistic team went to LA and did the

How do you stay alongside the consumer in a fastchanging market?

What we do is fashion, so, we’ve got to parallel that.

The pace of change continues to accelerate, but we’re successful because of our ability to stay ahead of trends and sometimes even be the creators of change. Take Great Lengths hair extensions. We created a mainstream service in the salon industry that did not exist. Of course, we now have thousands of competitors, but we paved the way. Innovation is part of our culture and I constantly preach that innovation is the key to staying on top. How do we do that? We attend all the major shows worldwide.

At CosmoProf Bologna we participate not only as an exhibitor, we take a team of about 30 people so they can get involved in everything going on with all the different

Reese Witherspoon as Elle Woods in Legally Blonde hair for all the models, including Rachel. We did all the styling with our vision. It was Great Lengths of course.

We stay on top the trends because of great people and our involvement in the right places.

IHA

Hair Authority Summer/Fall 2019 25

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28 Hair Authority Summer/Fall 2019

Trichology Section Presidents Message I am delighted to announce that the World Trichology Society (WTS) has invited members from around the world to become Area Representatives of the WTS. The representatives are not only emissaries of our organization, bringing the WTS name, its vision and values to each part of the world, but also listening and observing what the local Trichologists and hair-specialists are thinking or concerned about.

With this in mind, they will be writing about their thoughts on the major issues of trichology facing many Trichologists today as well as writing about local issues regarding our industry.

In this edition, Certified Trichologists Bissan Debsi, Cynthia Jones, and Anthony Pearce have given their feedback on issues that have concerned them or feel need to be presented to the Trichological community.

David Kingsley, PhD. President World Trichology Society

I’m sure you will find their thoughts enlightening and If you have any comments or wish to make your own observations, we would be happy to hear from you.

Members’ Feedback

Ending Hair Discrimination

Californian liberal policies are a daily and vital conversation in California. Hair discrimination is topic that is long overdue.

California lawmakers are working on a bill to end discrimination against people who wear a natural hairstyle like braids, dreadlocks, and twists. - https://abc7.com/5220598/. According to this new bill, there is no room for discrimination in California depending on how a person styles his/her hair.

It’s called the, “Crown Act.” **To this day, people of color across the country are fired, harassed, and consistently targeted for sporting dreadlocks, afros, and cornrows, among other natural styles. If and when passed, much like New York, the bill would make it illegal for employers to discriminate against anyone based on their hair, raising an important debate for the rest of the country where the racist tradition persists. **https://sd30.senate.ca.gov/news/news/2019-03-28-march28-2019-paper-magazine-california-set-end-hair-based-discrimination Bissan Debsi, WTS WTS professor for Arabic course WTS Regional Representative for California, USA

“Real” Trichology It takes years of intense dedication and study to earn the title “Certified Trichologist”, but now in some cases you can get a certificate stating you are “certified” after taking a 2- or 3-day class. As a result, some people suffering from hair loss are seeking help with unqualified trichologist, that put on their

white lab coats and know very little about identifying hair loss and scalp disorders.

Cosmetologist are seeing more clients with hair loss and desperately want to help them. Some are taking the easy way to gain the title by attending these small seminars. Some of the instructors, that are teaching these classes aren’t certified themselves and travel state to state to salons, certifying large groups of cosmetologists. After completing these mini classes, they motivate their students, telling them they are ready and able to go back to their salons to battle hair loss. What good is being motivated if you don’t receive the knowledge and education needed to help your clients? Giving these small classes are generating a lot of money. These days it seems like everyone is looking for that quick fix to fame and fortune.

I received my certification from World Trichology Society (WTS) an internationally renowned organization dedicated to educating, supporting and promoting trichologist worldwide. WTS is the only official US - based trichological Institute and the premier US education resource taught by David Kingsley, PhD. President of World Trichology Society. I worked very hard for my WTS certification and after completing all my courses, I traveled to New York City to do my clinicals with Dr. Kingsley. I’m extremely proud of myself because it wasn’t easy. I diligently studied and stayed focused on what was yet to come and prevailed. As they say, the better things in life aren’t easy.

I’m still educating myself going to seminars and taking advance Trichology classes. I have furthered my education earning a CNHP and ND certification which focus on nutrition and natural health fundamentals to encourage a healthy

Hair Authority Summer/Fall 2019 29 body, mind and spirit. I am encouraging anyone who reads this and wants to become a Certified Trichologist to invest in a reputable school and remember,’ there are no shortcuts for true excellence, but many shortcuts to failure.

Cynthia Jones, WTS

EQUOL EQUOL is a product (from Europe) that appears to show real promise in the treatment of androgenic thinning in adult males and Women of peri/post-menopausal age.

Equol is a compounded isoflavanoid capsule derived from Soy, requiring gender-titrated co-factors (Zinc + Selenium) to be scalp hair follicle-specific. Equol ‘PLUS’ binds with free DHT, thereby inhibiting DHT-induced follicle miniaturization and ‘pattern’ hair loss. There are NO known adverse side effects with Equol ‘PLUS’ as there are with the oral prescription drugs (Finasteride et al or Spironolactone) Anthony Pearce, AP Trichology

The importance of a careful transition into a new diet With the popularity of various diets such as ketogenic, vegan and the like, it is easy to transition into the new lifestyle but

World Trichology Society Scientific Conference

overlook your hair and those beautiful strands get lost in between.

Whether you change your diet for health reasons, clean eating, or losing weight, the initial weeks and months are a period of acclimation for the human body. This sudden change will directly and significantly affect the health of the fragile organ, the hair follicle. For example, while adopting a ketogenic diet, our body takes at least two weeks to adjust to the low carb, high protein/fat intake. This may shock the body as it adapts to the unusual high ketone production.

Since our bodies function as a whole; any deficiency, shock, or sudden change will affect the health of our hair first.

Vegetarian diets are another example, especially when red meat intake is restricted. In this situation, the body may suffer from iron deficiency and/or vitamin B12 deficiency and hair, needs a constant supply of nutrients to stay healthy. A mindful, slow transition into a new diet may take more time to implement, but it is the kindest, safest way to care for your hair.

Bissan Debsi, WTS WTS professor for Arabic course WTS Regional Representative for California, USA

IHA

Orlando, Florida - March 1-2, 2020

��  � ­ € �­‚ ­ ƒ „ …†­� ‡�� ˆ‰ Š „ Š „

Â? ‹ Â? Â? ‰ Š ÂŒ Â? ÂŽ † ‘ ÂŒ Â’ How this is different: • Be the first to discover the most advanced hair management solutions. • Explore latest research with the analysts themselves. • Only conference that covers all hair care solutions including; cosmetic, medical, non-medical, pharmaceutical, homeopathic & light therapy.

Topics include; Healthy Scalp Maintenance, Finasteride – Side effects, How European hair is different, Biostem - Clinical Trials, Living with Trichotillomania, Stem cell and cell based treatments, Hair color and personality, Proteoglycans as treatment for hair loss, Using Oriental Medicine, Medical tourism - a warning, Connecting with today’s consumer‌ The World Trichology Society conference will include presentations from some of the best-known names in trichology and hair-loss research.

It will be ideal for networking, learning about new research, experience-sharing, and discussions of ways to direct the public to qualified professionals.

For more information and registration

 � ��

30 Hair Authority Summer/Fall 2019

Finasteride for Androgenetic Alopecia Is Not Associated with Sexual Dysfunction A Survey-Based, Single-Centre, Controlled Study

Robert S. Haber, MD, FISHRS I Cleveland, Ohio, USA I HaberDerm@gmail.com; Aditya K. Gupta, MD, PhD, FISHRS l London, Ontario, Canada; Edwin S. Epstein, MD, FISHRS l Virginia Beach, Virginia, USA; J.L. Carviel I London, Ontario, Canada; K.A. Foley l London, Ontario, Canada

ABSTRACT Background: The occurrence of sexual dysfunction side-effects associated with finasteride use in men with androgenetic alopecia (AGA) is thought to be less prevalent than is publicized. There is a need to investigate sexual dysfunction among finasteride users with population-based controls.

Objective: To evaluate the presence of sexual dysfunction in men using finasteride or not using finasteride.

Method: Adult men visiting a dermatologist’s office for any reason were asked to complete a survey including a modified version of the Arizona Sexual Experience Scale (ASEX) to assess the presence of sexual dysfunction with and without finasteride use.

Results: Data from 762 men aged 18-82 were collected: 663 finasteride users and 99 non-finasteride users. There were no significant differences between finasteride users and non-user

controls in reporting sexual dysfunction using the ASEX. Regression analysis indicated that self-reporting libido loss and reduced sexual performance, not finasteride use, predict a higher ASEX score.

Conclusion: The use of finasteride does not result in sexual dysfunction in men with AGA. These data are consistent with other large survey-based controlled studies.

INTRODUCTION Androgenetic alopecia (AGA) refers to pattern hair loss believed to be a result of follicle miniaturization in dihydrotestosterone (DHT) sensitized areas of the scalp.1 Despite the common occurrence in over 70% of men,2 onset has been shown to induce loss of self-esteem, depression, introversion, neuroticism and psychological impairment.3-7 Thus, with only two Food and Drug Administration (FDA) approved medications available,8 the 5-alpha-reductase inhibitor finasteride is generally considered an important contributor to male health and quality of life. Conversely, a small percentage of finasteride users have associated the medication with sexual dysfunction and Post-Finasteride Syndrome (PFS). The term PFS refers to a combination of the former side-effects with a host of additional symptoms including fatigue, muscle weakness and cognitive problems.9.10

Hair Authority Summer/Fall 2019 31 Supporting evidence comes from a controlled trial where a slightly higher proportion of finasteride-treated vs. placebo-treated patients reported adverse events related to sexual function.11 Additionally, an increase in reports of sexual dysfunction has been associated with both finasteride12 and dutasteride13 (similar 5-alpha-reductase inhibitor) in an extensive post-marketing database. Moreover, identifying finasteride-related sexual dysfunction may not be straightforward as onset has been described as varied, with reports shortly after drug commencement, during later treatment or after medication discontinuation.9-1O There have also been critiques that the clinical trials which promoted finasteride as safe and well tolerated had inadequate safety reporting.14 A mechanism is unknown but it has been proposed that finasteride may lead to a decreased production of neurosteroids, which may regulate sexual desire and function15 and that impaired testosterone metabolism might lead to relative oestrogen excess.16 Nonetheless, it has been stated that observations of finasteride-related sexual dysfunction are less prevalent in the actual clinical experience compared to reports in the literature.17 Similarly, meta-analysis and systematic review of the literature17. Similarly, meta-analysis and systematic review of the literature found a lack of significant association of finasteride use for AGA treatment and sexual dysfunction18.

To address the discrepancies, the International Index of Erectile Function (IIEF) questionnaire (standardized method for assessment of sexual dysfunction”) was employed to specifically investigate sexual side-effects of finasteride use in the treatment of AGA. In three large studies (in = 186, 20 236,17 58621), no difference was observed in comparison with age-matched controls. The Arizona Sexual Experience Scale (ASEX) is an additional survey that has been shown to be a reliable, valid and sensitive tool for measuring sexual dysfunctiont.21 Benefits include short, easy to understand questions that are less intrusive and are easy to score and interpret while covering five major global aspects of sexual dysfunction.22 Therefore, the ASEX was used to further investigate claims of finasteride-associated sexual dysfunction in AGA patients and compare this to sexual dysfunction in non-users.

METHOD This was a survey-based study in a single-center setting. Adult men visiting a dermatologist’s office in Ohio, USA, for any reason were asked to complete a survey about sex. The survey included a modified Arizona Sexual Experience Scale (ASEX) and additional questions related to duration of finasteride use, reduced sexual performance and loss of libido during finasteride use (yes/no), and steps taken if sexual dysfunction was reported. Non-finasteride users completed the same survey, but questions did not refer to finasteride.

The ASEX consisted of 5 questions, with possible responses

on a Likert scale ranging from 1 (extremely affirmative) to 6 (extremely negative) on each question. For example, the question “How easily can you reach an orgasm?” is scored from 1- extremely easily, to 6 - never reach orgasm. Scores on the ASEX were summed for a total score with possible scores of 5-30. A score of 19 or higher was considered indicative of sexual dysfunction,22 15-18 mild sexual dysfunction, and 14 or less, indicative of no sexual dysfunction.

A one-way analysis of variance (ANOVA) was used to compare ASEX scores of finasteride and non-finasteride users.

Chi-square tests were used to determine whether there were differences between finasteride and non-finasteride users for categorical variables (e.g., libido loss). A multiple regression was performed to determine whether finasteride use, age, libido loss and reduced sexual performance predicted ASEX scores. Analyses were performed using SPSS Statistics 20 (IBM, New Orchard Road, Armonk, New York, USA) with significance set to a = 0.05.

RESULTS

A total of 762 men completed the study, with 663 men reporting they were taking finasteride for varying lengths of time. There was no significant difference between the finasteride and the control group in mean age (P = 0.832; Table 1). The percentage of men self-reporting loss of libido (P = 0.805) or reduced sexual performance (P = 0.332) did not significantly differ between men taking finasteride and the control group (Table 2). However, a one-way ANOVA showed an effect of finasteride on total score of the modified Arizona Sexual Experience Scale (ASEX), F(1,760) = 14.69, P < 0.001. The mean score on the ASEX was slightly lower in the finasteride group of men compared to the control group of men (Table 2).

Cont’d Pg 32

32 Hair Authority Summer/Fall 2019 crease in age of 1 year is associated with an increase in ASEX score of 0.063. If men self-reported a decrease in libido or sexual performance, ASEX score was predicted to be, on average, 2.64 and 2.03 points higher, respectively, than men that did not self-report libido loss or reduced sexual performance. Duration of finasteride in our model was compared to not using finasteride at all. Thus, for all durations of finasteride use, ASEX score was predicted to be, on average, less than that of no finasteride use. This does not mean that using finasteride results in lower scores on the ASEX. Rather, for two individuals of the same age with libido loss and reduced sexual performance, the individual taking finasteride is predicted, on average, to have a lower ASEX score (better sexual performance) by 1.2-1.6 points compared to the individual not taking finasteride.

DISCUSSION However, a one-way ANOVA showed an effect of finasteride on total score of the modified Arizona Sexual Experience Scale (ASEX), F(l,760) = 14.69, P < 0.001. The mean score on the ASEX was slightly lower in the finasteride group of men compared to the control group of men (Table 2). Men were further divided into three categories: no sexual dysfunction (score of 14 or less); mild sexual dysfunction (score of 15-18); and sexual dysfunction (score of 19 or higher). The number of men with ASEX scores of 19 or higher was significantly lower than the number of men with ASEX scores indicating no or mild sexual dysfunction in both the finasteride and the control group, v2(2) = 22.53, P < 0.001. There was no difference between finasteride and control in the number of men with ASEX score of 19 or higher.

To address the question of what factors may predict scores on the ASEX, a multiple regression was performed using the independent variables of age, finasteride use (four levels: no use, To address the question of what factors may predict scores on the ASEX, a multiple regression was performed using the independent variables of age, finasteride use (four levels: no use, <1 year, 1-5 years and 5+ years), self-report of libido loss and self-report of reduced sexual performance. The regression model was significant, with independent variables predicting ASEX score, F(6, 723) = 58.28, P < 0.001, adjusted R2 = 0.32.

Table 3 shows the regression coefficients and standard errors. All four of the independent variables significantly added to the prediction of the ASEX score. An in-

Using the ASEX survey, sexual dysfunction reports in a population of 762 men were not significantly associated with finasteride use. Between the control group and finasteride-experienced patients, there was no difference in loss of libido, reduced sexual performance or the number of men with an ASEX score indicating sexual dysfunction. In contrast, results showed that increased age and self-reporting a decrease in libido or sexual performance were indicators for predicting a higher ASEX score. Therefore, the use of finasteride is not believed to be the cause of sexual dysfunction in AGA patients.

The association of sexual dysfunction and AGA patients might be explained through another aspect of the disease.

Sexual dysfunction has previously been linked to both depression23 and a negative body image24 such as the possible impact of hair loss, especially in young men.25 In a recent study, an increased risk of sexual dysfunction was observed in men 18-40 years of age with moderate to severe AGA and psychosocial impairment accredited to body image changes due to hair loss.25 Likewise, an investigation of PFS patients revealed major depressive disorder in 50% (n = 16) of the population.26 It has also been pointed out that an increased risk of sexual dysfunction may be inherent to alopecia-diagnosed men due to a modified conversion of testosterone to dihydrotestosterone observed in these patients.27 Similarly, it has been suggested that prescribing guidelines have resulted in finasteride treatment arm populations that are naturally more susceptible to the development of sexual dysfunction vs. comparator populations. This scenario is illustrated in benign

Hair Authority Summer/Fall 2019 33 prostate hyperplasia trials where the former have been diagnosed for a longer duration and are often less healthy because alpha blockers are the preferred first-line treatment with finasteride recommended once the disease has progressed.27 Once this variable is controlled for, no significant increase is observed in patients prescribed finasteride.27

“The use of finasteride does not result in sexual dysfunction in men with AGA. These data are consistent with other large survey-based controlled studies.”

In addition, there is evidence of a nocebo effect28 (an adverse side-effect that is not a direct result of the specific pharmacological action of the drug). Consequently, patients counseled on potential sexual side-effects are more likely to experience them.28 It is also important to examine the AGA studies which suggest that sexual dysfunction symptoms from finasteride use worsen with time and persist after medication is discontinued.10 29 30 Key aspects to consider are the use of a retrospective design; a targeted patient population recruited from biased websites; and lack of placebo controls. Therefore, the results are subject to selection bias, possible placebo

effects due to unknown prior counseling and recall bias as many had been experiencing sexual side-effects for more than 3 years.31 Additionally, care must be taken when selecting a study population; for example, the prevalence of sexual dysfunction in the general population should be considered.

Studies investigating prevalence in various regions and age groups have reported a high likelihood, from approximately 5-50 percent,”32-44 stressing the requirement for age-matched controls in the research of drug-induced sexual side-effects.

Overall, the use of the ASEX survey to investigate sexual dysfunction in 752 men aged 18-82 resulted in no connection to finasteride use. This reflects recent research which suggests that men with alopecia may be inherently more susceptible to sexual dysfunction regardless of treatment and that sexual dysfunction is not uncommon in the general population regardless of alopecia status. Therefore, as one of only two FDA-approved medications, it is recommended that finasteride continue to be prescribed for the treatment of AGA. Editor’s note: This article was funded by a research grant from the International Society of Hair Restoration Surgery. It was previously published by the European Academy of Dermatology and Venereology. (/ Eur Acad Dermatol Venereal. 2019 Mar 5. DOI: 10.1111/jdv.15548) and Hair Transplant Forum International, May/June 2019 and is reprinted with their permission for the education of other hair loss professionals.

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Alfonso, M., et al. The psychosocial impact of hair loss among men: a multinational European study. Curr Med Res Opin. 2005; 21:1829-1836.

Budd, D., et al. The effects of hair loss in European men: a survey in four countries. Eur J Dermatol. 2000; 10:122-127.

Mella, J. M., et al. Efficacy and safety of finasteride therapy for androgenetic alopecia: a systematic review. Arch Oermatol. 2010; 146:1141-1150.

Healy, D., et al. Enduring sexual dysfunction after treatment with antidepressants, 5a-reductase inhibitors and isotretinoin: 300 cases. Int J Risk Saf Med. 2018; 29:125-134. lrwig, M.S.1 and S. Kolukula. Persistent sexual side effects of finasteride for male pattern hair loss./ Sex Med. 2011; 8:1747-1753.

Kaufman, K. D., et al. Finasteride in the treatment of men with androgenetic alopecia. Finasteride Male Pattern Hair Los Study Group. / Am Acad Derma tol. 1998; 39(4 Pt 1):578-589.

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Green, L., et al. Gynecomastia and breast cancer during finasteride therapy. N Engl I Med. 1996; 335:823.

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Rosen, R.C. Assessment of sexual dysfunction in patients with benign prostatic hyperplasia. 8/U Int. 2006; 97(Suppl 2):29-33; discussion 44-45. .

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Narasimhalu, C.R.V. Randomized questionnaire-based case-control research study on evaluation of sexual function in Indian patients taking oral finasteride for androgenetic alopecia. Dermatol Ther. 2015; 5:231-234.

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Blanker, M.H., et al. Erectile 9nd ejaculatory dysfunction in a community-based sample of men SO to 78 years old: prevalence, concern, and relation to sexual activity. Urology. 2001; 57:763-768.

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Teles, A.G., et al. Prevalence, severity, and risk factors for erectile dysfunction in a representative sample of 3,548 Portuguese men aged 40 to 69 years attending primary healthcare centers: results of the Portuguese erectile dysfunction study. J Sex Med. 2008; 5:1317-1324.

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IHA

34 Hair Authority Summer/Fall 2019

“This could be your most valuable marketing tool”

Says Amin Sheybani, The man behind The Hair Authority Directory Hair Loss professionals, spend considerable amounts of money, attending workshops and conferences around the country. Whether you are a cosmetic surgeon, barber or cosmetologist, there are multiple trade shows and special events to help you network, improve your skills and stay current with the latest products. The

problem is this investment in continuing education goes unnoticed by the public. It’s not like getting a university degree or MBA, which becomes part of your resume. When you attend professional events. The only person who knows about your newly acquired skills, is you and your credit card. And yet, in the field of restoration and replacement.

These skills are of vital importance. Because this is a zerotolerance profession. Even the smallest error can result in major embarrassment, and even a possible lawsuit. That’s why The World Trichology Society has recently created a special educational program to train hair loss professionals from all disciplines in the medical reasons for hair loss and the different therapies available. But these qualifications mean little unless they are brought to the attention of the public. That’s where the newly created hair authority directory comes in. This valuable online tool tells the public how to find professionals with special qualifications so they can select the procedure or person, best equipped to help them with hair their loss problem. Authorityhairdirectory. com is managed, and directed by Amin Sherbani and we met with him to learn more about the different ways this website can help professionals

Authority: There are many different directories available online. What makes authorityhairdirectory.com different?

Amin: It has been prepared by hair loss professionals for hair loss professionals. They told us what the public is looking for and how to present this information quickly and efficiently.

Authority: Could you give us a couple of examples?

Amin: Yes, everybody wants the best. But how to find it? In our market there are a number of professional groups that have rigorous operational and ethical standards. The International Society of Hair Restoration Surgery (ISHRS) is a good example. They host live surgery workshops, an annual scientific conference and several international events which are attended by leaders in hair transplantation. They also have a rigorous exam and accreditation program. At a time when it is tempting

for hair loss patients to go overseas for cheap surgery, ISHRS points out that there are serious cosmetic, medical and legal risks in “medical tourism.”

They have even started a campaign to alert the public to the risks of these cut-price procedures and urge patients to look for certified ISHRS doctors who commit to a strict code of conduct. That’s why we prominently display the ISHRS logo in our medical provider listings.

Authority: What about non-medical centers?

Amin: Until recently, there was no central, coordinated way for hair stylists and technicians to showcase their special skills. They could attend multiple workshops and trade shows and build a wealth of experience, but this experience was invisible to the public who needed to know about it most. So The World Trichology Society created a formal program specifically for non-medical hair replacement professionals. Graduates from this program receive a special Diploma and are able to identify themselves as Associate Trichologists and authorityhairdirectory.com provides a stage for them to proudly display these credentials.

Authority: It’s an image driven world today. People want to create and share their selfies. Does the need to look good make tools like authorityhairdirectory.com more valuable?

Amin: Absolutely. People, especially young people, are very image conscious and will go to great lengths to research and find the best possible gym, clothes and personal care products. We provide a vital link for this demanding segment of the population when it comes to hair care. We have done all the groundwork for them.

They only have to search for a hair loss solution, and we will show them every provider in their area and list their special skills and qualifications.

Authority: There are other places, consumers can go for information, for example, a simple Google search. What makes authorityhairdirectory.com special?

Amin: You’re absolutely right, there are multiple search possibilities, but none of them bring all the important information together the way we do. If you did a Google search for hair loss, you would come up with “74,300,000 results (0.56 seconds)”, but much of this information

Hair Authority Summer/Fall 2019 35 is misleading. Many websites copy each other’s language and images, and some of them may be illegal because they make exagerated claims that are not backed up by research or clinical evidence. It’s confusing. Men and women don’t know whom to trust, so they stay home and do nothing. Everybody loses.

Authority: What about professional groups who list their members? Don’t they provide a reliable database?

Amin: You’ve half answered your own question. There are professional organizations like ISHRS whom we talked about a few minutes ago, but, as you would expect, these groups prioritize their own members. They don’t provide a list of all the available services and most people searching for a hair loss solution want to see all their choices then decide for themselves which organization or product is best for them.

Authority: Does authorityhairdirectory.com, accept advertising?

Amin: No. It is fundamentally important for visitors to know that there are no commercial links and no special interests. The only difference in our listings is the amount of detail that subscribers choose to display. That is a decision made by the salon or clinic, not by us. We display every facility. Business owners can then go to our website, see if their facility is already listed and claim it. Once we have verified that this is a genuine connection, they can go ahead and update or change the information as they see fit.

Authority: What is the cost to subscribe?

Amin: Everybody is invited to display their business at our premium level absolutely free for 60 days. That way, they can add or delete data and experiment to see what is most effective. They can then select the subscription level that is best for their business. They can stay at the premium level to display and add extra data like photographs, interviews, video snippets, links to YouTube and so on, or if they don’t need those features, they can convert to ‘standard’ or ‘light’ plans. There is a small maintenance fee to cover site security, management and hosting. The fee is based on the participation level selected, but even the premium subscription costs less than $2 per day. As you would expect, most centers want to showcase all their skills and achievements and they can do this for a fraction of what they would spend generating leads on their own website.

Authority: How does a listing on authorityhairdirectory. com fit into a studio’s business plan?

Amin: We believe this could become the most valuable tool in most clinic’s or studio’s marketing program. It’s expensive and difficult to drive traffic to your own website. However, by combining the cost of SEO, social media, and other overhead expenses into one central directory, we are able to spread these costs over hundreds of facilities and provide maximum exposure at minimum cost.

Authority: How do consumers learn about the directory?

Amin: We have a number of unique marketing tools. We are fortunate to have an exclusive link to Hair Authority News, which has over 20 years of top-level interviews and feature articles that are now going to be shared online. These will not only be attractive to Google’s search engines; they will also be valuable to members of the public wanting serious information. So, we generate what IT specialists call “eyeballs” and will create an environment of trust and goodwill that will help visitors make a comfortable purchase decision. At the same time, we will continue to invest in social media, professional endorsements and SEO. Authority: What if somebody wants to cancel, either because they have sold their business, they are retiring, or they have found another solution.

Amin: It’s easy. A subscriber can cancel at any time for any reason. We only ask that they give us 30 days’ notice and we will take down any information they do not wish to display and revert to the basic listing, which is just the business name and location.

Authority: How can a business list their company in Hair Authority Directory?

Amin: Chances are most businesses are already listed. So, the only thing a visitor needs to do is find their listing and claim it. There are simple instructions on our website https:// hairauthoritydirectory.com/new-professional/. It should only take 5-10 minutes.

Authority: Are there any other features or enhancements that we can expect to see from hair authority directory?

Amin: Websites are always a work in progress. We are talking constantly with different web developers.

Today, it is vital that you not only have a professional business structure, but that you look professional and attractive, too. We have invested a lot of time and money in our website cosmetics, as well as the search engine. backbone.

Authority: Thank you for taking time out of your busy day. We wish you good fortune with this important new IHA business tool.

36 Hair Authority Summer/Fall 2019

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