Quality Assurance Program for Hair Transplant & Hair Replacement

Crinagen now in its 3rd version with the added potency of Proanthocyanidins - grape seed extract. Dr. Razack began distributing the new Crinagen in December 2000. The bottle label resembles that of the second version, but the new version has the word "Proanthocyanidins" on the front. The Proanthocyanidins is derived from grape seed extracts and are strong anti-inflammatory agents. The most obvious difference in the 3rd version is its orange color primarily due to Saw Palmetto extract. There is no added fragrance. 

The latest version of Crinagen now includes the following ingredients: Distilled water; Polysorbate 20; Azelaic acid; Proanthocyanidins (from grape seed extract); Glycerine; Zinc acetate hydrate; Niacin; Vitamin B6 (as Pyridoxal‑5‑phosphate); Saw palmetto extract (serencia repens); and Ginkgo biloba extract.

About Proanthocyanidins

There is sufficient evidence in the medical literature to support the inclusion of proanthocyanidins in Crinagen. As we learn more, we will report it here. For now, you may wish to begin your study of it with this article, which reports research done on mice.

"Proanthocyanidins promote hair follicle cell proliferation and the anagen phase of hair growth"

In recently published research, Takahashi et al examined 1000 different plant products to determine if any of them could influence hair growth. They determined that proanthocyanidins extracted from grape seeds promoted the proliferation of hair cells by 230% [1]. They also determined that proanthocyanidins converted the telogen (non‑growing) phase of hair growth into the anagen (growing) phase of hair growth [1]. In this experiment, proanthocyanidins displayed hair‑cycle‑converting activity which was similar to that of minoxidil [1]. At the end of their report, the authors say that "We are now investigating the possibility of the use of proanthocyanidins as agents for curing androgenic alopecia."

1. Takahashi T, Kamiya T, Yokoo Y. Proanthocyanidins from Grape Seeds Promote Proliferation of Mouse Hair Follicle Cells In vitro and Convert Hair Cycle In vivo. Acta Derm Venereol (Stockh) 78: 428‑432, 1998

About Azelaic Acid

Azelaic acid (pronounced az-uh-LAY-ic) is a simple molecule ( HOOC(CH2)7COOH, CAS Number 123‑99‑9, also known as 1,9‑Nonanedioic acid) that is found in some whole grains and in trace amounts in human bodies. Although it is an acid, it is an extremely weak acid ‑ much weaker than vinegar. Its current use in medicine is in Azelex, which is a cream base containing azelaic acid as 20% of its weight. Azelex is available by prescription in the USA and is used in the treatment of acne. More description of its medical properties, including cautions, can be found here: http://www.nursespdr.com/members/database/ndrhtml/azelaicacid.htm

Azelaic acid may be useful as a hair growth stimulant. A research report by Stamatiadis in 1988 suggested that azelaic acid (and combinations of it and zinc ion and vitamin B6) was a strong type I 5-alpha reductase (5AR) inhibitor. The enzyme 5‑AR (both types I and 11) convert testosterone to dihydrotestosterone (DHT). DHT has been shown to contribute to male prostate enlargement (benign prostatic hyperplasla, BPH) and to damage hair follicles.

Abstract of Starnatiadis' 1988 study on Azelaic Acid-

Br I Dermatol 1988 Nov; 119(5):627-632 Inhibition of 5 alpha-reductase activity in human skin by zinc and azelaic acid. Starnatiadis D, Bulteau-Portois MC, Mowszowicz Laboratoire de Biochimle B, Hopital Necker-Enfants-Malades, Paris, France.

The effects of zinc sulphate and azelaic acid on 5 alpha-reductase activity in human skin were studied using an in vitro assay with 1,2[3H]-testosterone as substrate. When added at concentrations of 3 or 9 mmol/1, zinc was a potent inhibitor of 5 alpha-reductase activity. At high concentrations, zinc could completely inhibit the enzyme activity. Azelaic acid was also a potent inhibitor of 5 alpha-reductase; inhibition was detectable at concentrations as low as 0.2 mmol/I and was complete at 3 mmol/l. An additive effect of the two inhibitors was observed. Vitamin B6 potentiated the inhibitory effect of zinc, but not of azelaic acid, suggesting that two different mechanisms are involved, When the three substances were added together at very low concentrations which had been shown to be ineffective alone, 90% inhibition of 5 alpha-reductase activity was obtained, If this inhibition is confirmed in vivo, zinc sulphate combined with azelaic acid could be an effective agent in the treatment of androgen related pathology of human skin. PMID: 3207614, UI: 89087983

We have not seen research that directly links the use of topical azelaic acid (or azelaic acid with zinc and B6) with hair growth. However, we feel that there is sufficient literature backing (in the Stamatladis study and others) to include it in a Crinagen preparation. Dr. Lee (not associated with Raztec) made a similar decision. His Xandrox contains 5% azelaic acid

About Saw Palmetto

Saw palmetto is believed to work as an antiandrogen. It has been used as an herbal remedy for the treatment of prostatic disease. It is currently marketed in Germany as an over-the-counter medication for the treatment of benign prostatic hypertrophy. Prostatic disease is being discussed here because of its similarity to androgenic alopecia, since both conditions depend on the production of dihydrotestosterone. 

Although formal studies on the use of saw palmetto as an antiandrogen have not been conducted in the U.S, many have been done in Germany. In one study, an extract of this herb was given to 2080 patients with benign prostatic hypertrophy . Most patients reported an improvement in their symptoms.

Symptomatic complaints of prostatic disease, such as urinary obstruction, are directly related to the size of the prostate. This improvement in symptoms was due to reduction in prostate size. The physicians rated this extract's effectiveness as "good" to "very good" in the treatment of prostatic disease. Of the 2080 patients treated, fifteen of them (0.72 %) had mild side effects.

In yet another study, 1,334 patients with benign prostatic hypertrophy were given an extract of saw palmetto and virtually all of their symptoms (consisting of increased frequency of urination, increased frequency of urination at night, pain during urination, inability to void all the urine from the bladder) were substantially reduced . This herb was rated as "good to excellent" in over 80% of the patients studied. This study concluded that the improvement in the quality of life in these patients with benign prostatic hypertrophy justifies this form of therapy.

Another similar study was performed with forty-two men with benign prostatic hypertrophy . Again, saw palmetto was conclusively proven to be effective in the treatment of benign prostatic disease. The study also demonstrated that the symptoms of benign prostatic disease improved significantly by the sixth month of therapy, at the latest. Also, no side effects were observed.

All of these studies indicate that saw palmetto is an effective antiandrogen. 

Since saw palmetto is an effective antiandrogen for the treatment of prostatic disease, it may also have applications in the treatment of hair loss. Remember, androgenic alopecia and prostatic disease are related since 5 alpha-reductase is required to convert the hormone testosterone into dihydrotestosterone for either disease process to occur. If saw palmetto blocks the effects of this enzymatic reaction in prostatic disease, there is a good chance that it might do the same in androgenic alopecia. By blocking the enzyme 5 alpha-reductase and the formation of dihydrotestosterone, this herb has the potential to prevent the progressive miniaturization of hair follicles. In other words, by acting as an antiandrogen, it can block the progressive loss of hair.

In many ways, the proposed mechanism of action of this herb is similar to that of the drug finasteride. Finasteride is a 5 alpha-reductase inhibitor used in the treatment of prostatic disease and will soon be available for the treatment of androgenic alopecia. Whereas side effects of finasteride use include decreased sex drive and impotence, saw palmetto is recommended by herbalists as an aphrodisiac. Again, side effects associated with this herb are essentially nonexistent . 

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