Hairloss Interview with Dr. Adam Lewenberg

Dr. Lewenberg, thank you for taking some time to answer these questions. A lot of people have heard about you and your treatment but don't know that much about it or you. Even those who know a bit about your treatment have some questions that would help them become more informed. Hopefully these questions make people more informed about what your treatment has to offer.

regrowth: Let's start easy. Could you tell me a bit about your credentials and your past?

Lewenberg: After finishing medical school in Europe in 1957, I had my residency in internal medicine, pathology, and military surgery in Israel. When I arrived in the United States in 1966, I repeated my internship and 3 year residency in internal medicine. I finished at Mt. Sinai Medical Center in New York in 1970. In the early 80’s, when I heard about people using minoxidil (then called Loniten) to treat hairloss, I became interested in improving treatments for hairloss. I was one of the first physicians to use minoxidil in private practice and have been working in the medical hairloss field ever since.

regrowth: Tell us how you found out about Minoxidil combined with Retin-A and came to develop your formula.

Lewenberg: In 1986, I learned from another doctor, Dr. Kligman of the University of Pennsylvania, that tretinoin, a skin rejuvenation medication and the active ingredient in the acne medication Retin-A, could be used to influence hair growth. In response to this information and to other successful studies, I began experimenting with different formulations, dosages, and applications. Once I began using a combination of 2% minoxidil and 0.025% tretinoin, applied 4 times daily in a hair spray formulation, my patients’ results improved dramatically. Nearly 90% of my patients showed visible improvement in hair quality within three months with this treatment, and 92% were able to regrow natural, healthy hair after six months of consistent treatment. I was then satisfied that my methodology achieved the highest success rate possible for regrowing normal, natural hair.

regrowth: Since your treatment is a prescription drug, how does someone get it if they don't live near New York City?

Lewenberg: Many patients, even international patients, choose to come to our New York City office. If this is not possible, patients can order the medication directly from us after an initial consultation with one of our physicians. However, I ask that these patients take photos of the front and top of their head to evaluate their progress. These patients contact me every three months-this way I am able to supervise their treatment by phone or e-mail.

regrowth: Are there other ways to get your treatment or are you the only distributor?

Lewenberg: At this point, I am the only distributor of the Dr. Lewenberg’s Formula. There are numerous people who try to copy the Formula, but they don’t know how to. I prepare the formula exacting standards and compound it into a cosmetically perfect hairspray that is perfectly through the hair and scalp. Usually, patients who have used an imitation of my formula complain of skin irritation, hairloss, and lack of results.

regrowth: Can you ship your treatment to overseas countries and does it require a prescription in all countries?

Lewenberg: We can and do ship our formula around the world. In fact, we have hundreds of clients that come to us internationally. I only ask that they adhere to the same regimen as my other patients – taking pictures of their progress and keeping in contact with me for evaluation every three months

regrowth: How much does your product currently cost per bottle?

Lewenberg: The cost is currently $60-$70 per bottle depending on how many bottles are purchased at a time.

regrowth: If someone in New York comes in to see you and get a prescription for your treatment, how much are they charged, or is it covered by the cost of the treatment?

Lewenberg: The initial consultation fee is $100, which is covered by almost all health insurance plans. All follow-up consultations are included in the cost of the medication.

regrowth: Do you have any independent, double-blind, placebo-controlled studies testing your formulation? What were the results?

Lewenberg: I conducted a clinical study of over two thousand people, the results of which were published in the September-October edition of the international, peer reviewed, medical journal Advances in Therapy. Although my study was not double-blind, many of the patients involved had already tried numerous other medications, including varying levels of minoxidil, with little or no success. Since almost every one of these patients was successful in regrowing their normal hair using my treatment, one could consider this group more significant than a placebo-controlled group because they were actually using medical treatments, not a placebo.

Currently, I am in negotiations with various companies to start a double-blind study, which is required to get FDA approval. Despite the fact that FDA approval typically takes several years and is very costly, running into the millions of dollars, I fully intend to gain FDA approval because I believe that my formula can work for so many people.

regrowth: Do you offer any sort of money back guarantee to unsatisfied users of your product?

Lewenberg: When one uses aspirin or penicillin, it does not come with a money back guarantee if it does not produce the result one wants. Just like aspirin and penicillin, my formula has been medically proven to work in a vast majority of the cases, and just like aspirin and penicillin, there are no guarantees. However, the guarantee we can offer is that a patient using our treatment will know in 3 months whether or not the treatment will work for him/her. It is my opinion that a money-back guarantee is simply a sales gimmick used by those who have less success in regrowing hair.

regrowth: How much hair can a person reasonably expect to regrow from your treatment?

Lewenberg: The majority of our patients are regrowing most of their hair, but what is important is that they are growing normally strong and healthy hair, not fine or limp hair.

regrowth: What is the 'ideal' candidate for using your treatment? What is the least ideal?

Lewenberg: The best candidates are women and younger men. Practically all the women in my study showed substantial improvement in hair growth over less time and with smaller dosages than men. Young men had similarly good results. Older men can anticipate to regrow hair that was lost in the last 10 years and maybe a few hairs that were lost before.

regrowth: How well have you seen people respond to your formula who have extensive baldness for long periods of time? Do people who are Norwood 6 and 7 respond to your treatment? How about someone who has been a 6 or 7 for 10 or more years?

Lewenberg: Although patients with more severe hairloss might require longer and more intensive treatment, my formula has been successful for people who have been losing hair for up to 10-20 years. Unlike minoxidil, Dr. Lewenberg’s Formula able to grow hair anywhere on the scalp including the hairline.

regrowth: Do you ever recommend transplants or other treatment options to persons with extensive long term baldness such as in the question above?

Lewenberg: I do not recommend transplants for these patients for several reasons. In their case, the transplant would cost $30,000-$40,000 or more, and would probably not be effective enough; also, because a hair transplant is a surgical procedure, it carries with it a greater risk than does a non-surgical procedure. In addition, hair transplants do not allow patients to regrow normal hair, and many surgeries are needed to keep advanced hairloss in check.

However, if a patient is determined to have a hair transplant or has already had one, I would recommend using our formula in conjunction with the transplant because Dr. Lewenberg’s Formula will help increase the patient’s chances for growing hair from all the transplanted follicles. Our formula is also useful in improving the donor hair before the transplant also increasing chances for a successful surgery.

regrowth: A few past users of your formula have complained of irritation due to the Retin-A. What do you do when someone experiences irritation?

Lewenberg: Due to the fact Dr. Lewenberg’s Formula is not a cream or lotion that needs to be rubbed into the scalp, it is distinctly superior to other formulas that cause skin irritation through their application. The formula is designed as a hairspray, to be used approximately 6-8 inches from the skin which is then absorbed through the hair into the scalp. With our application method one is not rubbing an alcohol-based compound directly on the skin as one does with minoxidil. Instead, the alcohol in our formula dries in the air before it even reaches the scalp.

However, if a patient experiences skin irritation, he is encouraged to contact us immediately. We will then evaluate the situation and correct for any errors of application that may be causing the irritation, such as distance from which the medication is sprayed. The patient may continue using the medication after the problem causing the irritation has been resolved. If irritation persists, the patient should discontinue use and contact us and continue only after the irritation has been eliminated.

regrowth: If someone using your formula does not respond, what is the next course of action?

Lewenberg: The first thing we do is to make certain that the patient is properly following the instructions and application procedures as well as using a sufficient amount of formula. In cases that require it, we make adjustments and evaluate again after 3 months. If there are no results after 6 months, patients should stop trying to medically regrow hair or evaluate the possibility of combining our treatment with transplants. Happily, a very small percentage of patients using our treatment ever get to this point.

regrowth: What is the best response you have ever seen from someone using your treatment?

Lewenberg: I frequently see patients growing a normal head of strong, beautiful hair. Even those patients who could not regrow hair – and in some cases, even lost hair – with other medications tend to thrive with our formula.

regrowth: One of the main reasons some people are leery about your formula is the large cost. If places like Dr. Lee's Regrowth and other pharmacies can make 5%+Retin-A formulations so much cheaper (half your current cost or less), why aren't your formulations cheaper? Do you have plans to lower prices any time in the future to make it more accessible to people?

Lewenberg: The cost of our treatment is much less than the cost of hair pieces, when you include the cost of maintenance, and much lower than transplants, which also require frequent upkeep. Although other formulations may be less expensive initially, over a patient’s lifetime, our treatment will cost far less then other methods. With other methods one needs to use the same dosage and frequency of application for a lifetime in order to maintain the hair that is regrown. However, with the Dr. Lewenberg’s Formula, after a patient has regrown all his or her hair (typically after 1-2 years of use), the patient can switch to a maintenance program during which he/she can dramatically decrease the dosage and frequency of application without losing hair. With Dr. Lewenberg’s Formula one can even stop using it for a month every year during the maintenance phase without losing hair.

regrowth: Why do you believe your formula is superior to a well-formulated Minoxidil 2%+Retin-A formulation by any other pharmacy?

Lewenberg: Our treatment is easier to apply, is safer, and has a better history of results than any other treatment. Our method is superior because we are able to combine this medication in the form of a convenient cosmetic hair spray with perfect absorption that patients can use 4 times per day, every 5-6 hours. This frequency of application and application method greatly enhance a patient’s chances for success. In addition, our treatment, spreading hairs to rub the formula onto the scalp is not necessary, and there are no embarrassing runs to the bathroom to apply the product because it is formulated as a cosmetic hair spray you can apply anytime, anywhere. You can carry it with you just as you would any small hair spray bottle and no one will know the difference when you use it.

regrowth: Some users of Minoxidil have experienced a 'tolerance' or reduced effectiveness of Minoxidil after prolonged treatment. Have you ever noticed this with your product?

Lewenberg: No, None of our patients have reported experiencing any ‘tolerance’ or reduced effectiveness at any point in our treatment.

regrowth: A lot of people consider applying Minoxidil twice per day a big enough hassle, much less four times per day. How inconvenient is it really to have to apply your formula so often?

Lewenberg: Our formula is very convenient to use as a cosmetic hair spray-it only takes about 5 seconds, four times a day to use the formula.

regrowth: The original patent-holder of the Minoxidil 2%+Retin-A .025% treatment has recently regained development and marketing rights from L'Oreal who failed to do much with it. How does this effect your business? What do you know of her and her plans to market the combination?

Lewenberg: I am now in negotiation with Dr. Bizzano, the original patent-holder, to purchase the patent so that I may begin the FDA approval process.

regrowth: Many users of oral Finasteride (Proscar/Propecia) in combination with topical Minoxidil have noticed a faster response and a better response. Have those using oral finasteride concurrently with your formula experienced a faster or better response?

Lewenberg: I don't advise my patients to use finasteridine with our treatment. I have treated numerous patients who lost hair using Proscar (5 - 10mg/day) and minoxidil in tandem. These patients started to respond positively to my treatment in 3 months.

The results of recent studies by Merck show that reducing dosages of Proscar to 1 mg per day slightly reduces the severity of its side effects, but the results for treatment of male baldness were only slightly better than the results with a placebo (no medical treatment whatsoever). Our formula is 90% effective and has no side effects.

regrowth: What do you recommend to people who want to use oral Finasteride at the same time as your formula?

Lewenberg: Because our formula corrects the unwanted hormonal effects of male baldness, it grows normal, healthy hair from the start. Therefore, finasteridine will not benefit our patients, and its potential side effects will only harm our patients’ well-being.

regrowth: If a person comes in to get a prescription for your treatment and adamantly wants to use Finasteride as well, will you prescribe it to them?

Lewenberg: No. I do not prescribe finasteridine to my patients.

regrowth: Upjohn's Rogaine Extra Strength (5%) was just approved by the FDA advisory committee for over the counter distribution. Final approval is almost guaranteed and we should see this on store shelves sometime before the end of the year. Do you believe your product is better than 5% Minoxidil, and if so, why?

Lewenberg: My formula is superior to plain minoxidil of any strength because it allows patients to grow normal, strong, healthy hair that will not fall out, unlike the hair grown using only minoxidil. In addition, minoxidil alone is incapable of regrowing hair in the front of the head and has only been proven to have some effect on the vertex of the scalp. Our formula is successful at regrowing hair anywhere on the scalp including the hairline.

regrowth: Dr. Lee's Regrowth and a few other pharmacies are now offering well formulated Minoxidil 5% combined with Retin-A .025% by prescription. If 2% Minoxidil combined with Retin-A .025% is good, why do you believe 5% Minoxidil combined with Retin-A .025% isn't better?

Lewenberg: We have found our formulation to be both effective and safe. Our formula is designed to be used as a safe and convenient cosmetic hair spray. An increase in concentration of minoxidil would only increase chances for skin irritation since minoxidil is alcohol based. In addition, if you increase the percent-amount of minoxidil without increasing the percent-amount of tretinoin, the result is hair that is not strong enough. And if you increase the amount of tretinoin to correspond with the minoxidil, you will irritate the skin, which disables hair growth entirely.

regrowth: Do Upjohn's 5% formula or Merck's Propecia pose a threat to your business or is there room in the market for all of them?

Lewenberg: Rogaine alone in any concentration or finasteridine in any dosage are not competition to my treatment in the long term, since neither are able to generate the high level of success our patients experience reversing all forms of baldness.

regrowth: Do you follow emerging new treatments such as Piliel or Trichomin, which promise to be pretty effective? If so, what do you think of them and how they will impact hairloss treatment?

Lewenberg: There are thousands of promises for new treatments. Even if these promises work in clinical research, they never worked to regrow normal hair in practice. I am aware of these treatments, however, I cannot follow all of these promises because there are new ones coming and going every month.

regrowth: If a treatment for hairloss that was virtually 100% effective were discovered and on the market within a few years, what would you do?

Lewenberg: Our treatment has been medically proven to be 90% effective. It is very difficult for me to believe that 100% results will be possible in the near future. If I did believe such a treatment were forthcoming in the near future, I would not invest my time and money obtaining a patent and FDA approval for our formula, as I intend to do.

Editor's Note: I obviously don't agree with some of Dr. Lewenberg's opinions, especially about Proscar.