By Dr. Cole, FUE Hair Transplant Pioneer

Dr. Cole Live: Anti-aging, Treatment Progress, and FUE Europe

Dr. cole and Chiara insalaco, Anti-aging, Hair loss


Hair ages with time, leading to a shorter duration of the growth cycle and thinner strands. This is due to T cell inflammation, which surfaces during the resting, or telogen, phase of the hair growth cycle. Such inflammation debilitates and eventually kills stem cells responsible for hair growth. The first line of defence against hair loss, therefore, is an early anti-aging regimen that encourages the hair’s growth phase. Prolonging growth, essentially, also prolongs the anagen phase, extending the hair cycle itself. In turn, this diminishes stem cell damage from T cell inflammation.

The best plan of action, therefore, is the earliest. The earlier patients act, the greater chance there is of hair retention, health, and thickness. Products abound that claim to encourage hair growth or otherwise encourage retention. Some are effective, most particularly those with an adequate amount of their ingredient. However, as our StreamCast later examines, there is huge nuance in the preparation of ingredients that encourage hair health and retention. Many products are less effective than they tout or, to cut costs while cashing in, highlight ingredients regardless of their subpar processing and unsubstantial presence in the formula. Some brands are better than others, of course, but such research demands time and word-of-mouth. Vested in the best results possible, Dr. Cole offers numerous solutions and continues researching new options and enhancements for hair retention. As the next segment covers, these innovations are leading to unprecedented results.


The first FDA-approved oral treatment for pattern baldness, finasteride has a mixed reputation. A large minority of males experience noticeable, but modest, results from the treatment and eight of ten males probably enjoy greater retention. However, there is concern about side effects that include sexual dysfunction and depression. Complicating matters even more, such side effects can both impact the emergence of such issues and/or surface after a long duration of finasteride use. A small minority undergoes such effects, but the risk is enough to deter patients and understandably why. Without question, though, finasteride’s antiandrogen capability is viable therefore so is its ability to prolong hair growth cycles. The solution, as research by Dr. Chiara Insalaco, shows, maybe to apply it topically.

Dr. Insalaco’s research into the effectiveness of topical finasteride is showing remarkable promise. Localization is the treatment’s primary strength; absorbing finasteride from the scalp contains and focuses its effect, unlike oral options that equally spread throughout the body. The patients in Dr. Insalaco’s study are showing exceptional results, particularly in comparison with oral finasteride, without undergoing any of the negative side effects. Look below to see the before and after photos!

Dr. Cole Live: Anti-aging, Treatment Progress, and FUE Europe, Forhair
Dr. Cole Live: Anti-aging, Treatment Progress, and FUE Europe, Forhair
Dr. Cole Live: Anti-aging, Treatment Progress, and FUE Europe, Forhair
Dr. Cole Live: Anti-aging, Treatment Progress, and FUE Europe, Forhair
Dr. Cole Live: Anti-aging, Treatment Progress, and FUE Europe, Forhair
Dr. Cole Live: Anti-aging, Treatment Progress, and FUE Europe, Forhair

Such results from oral finasteride are, for the most part, nonexistent. Research also shows topical finasteride’s effects arrive within a reasonable time. The above after photos range between two and six months. Dr. Insalaco theorizes results depend on the progression of hair loss and its age. As already mentioned, hair loss happens due to T cell inflammation incapacitating and eventually destroying follicular stem cells. The more viable stem cells, the greater a chance of increasing density, growth, and retention.

Of course, processing and formula both matter. Dr. Insalaco personally creates topical finasteride with locally sourced compounds that include 2% finasteride, as it matches 5% in results after six months, and a small amount of minoxidil. One cannot simply powder oral finasteride and apply it to the scalp, as its activator is different. Topical finasteride varies by its source, and patients can expect results will vary as well. Dr. Cole would recommend topical finasteride from Italy. For those in the U.S, he offers prescriptions for a pharmacy in Alabama; one of the few that create it. A number of patients are using topical finasteride but there is no definitive study about its results. Patients see a difference, however, and it should help retention, health, and growth.


Stem cell therapy is an emerging option that offers considerable results. Research shows it increases overall hair density between 24% and 34%, of note unto itself, within 23 weeks. Unprecedented is its effect of consistently increasing hair count. A few treatments can elevate hair count, but only in select circumstances, for select patients, and in small amounts. Stem cell therapy, on the other hand, activates enough follicles to make a very noticeable effect.

The procedure itself entails small biopsies to the scalp, separation of stem cell-bearing tissue and regular adipose, centrifugation of stem cell regions, and injection the day of the procedure and another 60 days after.

Stem cell therapy research is ongoing. Already superior to generic platelet-rich plasma (PRP), a blood treatment that can promote growth, results may increase with further study. We know that stem cell-bearing tissue varies in its type and amount of stem cells, but distinction necessitates further clinical studies. Processing may also change to encourage results. As the StreamCast next covers, Dr. Cole and Dr. Salico’s research into PRP indicates that little differences in its creation can have big impacts.


Processing makes a huge difference in PRP’s effectiveness. Studies with Dr. Salico show that high platelet count, what most clinics offering PRP claim spur results, is actually less important than the concentration of growth factors and cytokines. Dr. Cole and Dr. Salico used two different machines, Regen and Arthrex, to generate PRP and then tested growth factor count via ELISA as well as charted their effects on patients. Each PRP type’s growth factor counts relative to their effectiveness is profound.

PRP from Arthrex showed far greater growth factor counts and increased patients’ hair density by around 50%. Regen, which had much lower growth factor counts, may have helped retention but still showed a 25% decrease in overall hair density.

Further study shows the PRP’s activator matters a great deal. Platelets not only need to contain growth factors, essential as they are, but to also open their alpha granules and release said growth factors. Calcium gluconate is a go-to activator that, studies show, is more effective than saline. Unheard of is the use of sonication or the practice of using sound to activate alpha granules. Dr. Cole used a soundproof box to administer the noise over half an hour at thirty-second intervals, thereby preventing any overheating of the PRP.

ELISA tests show the resultant serum, cytokine rich plasma (CRP), has five to eight times the growth factors than PRP without sonication. Further research is necessary to measure CRP’s full impact, but it is significantly greater than any current PRP. The growth rate is particularly impressive. Along with greater graft retention, transplant patients injected with CRP enjoy 100% graft growth in four and a half months. Transplant patients with PRP treatments, meanwhile, had to wait a year for 100% activity. We can reasonably expect CRP results for patients without transplants to be similar.


From April 26th to the 28th FUE Europe is hosting its 7th congress in Malaga, Spain. Dr. Insalaco is co-chair with Dr. Christian Bisanga, who also worked with Dr. Cole in the past. Presentations will range considerably. Dr. Insalaco will present on stem cell therapy, as well as showcase patients’ results. Attendees will have the opportunity to learn about the latest in hair restoration, as well as meet some of its more significant contributors. Hair transplant live streams will happen on the third day, an excellent time for doctors entering the field to get a first-hand glimpse of the procedure in action. A global conference, FUE Europe attracts leading experts and innovators across the field.


Below are audience questions Dr. Cole answered on air. They range from treatment suggestions to explanations of the above topics. They go into specific detail and are worth the read for anyone looking to take action on their hair loss.


What's Your Next Step?

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