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Restoring Hair continued...

For women, minoxidil (Rogaine) is the primary medical treatment available. It’s used topically and has some effectiveness.  About 20% of women report moderate hair regrowth after using it. Doctors may also prescribe spironolactone, a type of blood pressure medication that also slows down the production of hormones that can lead to hair loss, and hormones or oral contraceptives. Both of these treatments are used in women that have hair loss secondary to hormonal abnormalities such as those with polycystic ovarian syndrome.

But what’s really advanced in recent years is the surgical capability to do more complete and more natural-looking hair replacement. "The state of the art for the last decade has been follicular unit transplantation, or FUT," says Epstein. In FUT, hair from an area of your head that’s not yet balding is grafted to the thinning area, in naturally occurring groups of 1 to 4 hairs.

"Once, the most grafts anyone would do was about 1,500 to 2,000," says Epstein. "Now, we can routinely do 3,000 grafts, which offers much more impressive results. With a bald scalp, we can fill in the frontal half with reasonable to good density in just one procedure. For women, smaller grafts allow us to place more of them in a single procedure and treat not only female pattern hair loss, but also hairline advancement. So women can have a high hairline restored back down." The small size of the newer grafts also creates a more natural appearance.

Of course, to get the hair for the transplant, you have to remove it from your head (or, less commonly, another part of the body), a process called follicular unit grafting (FUG). New techniques for this process make it much easier, and the results are virtually unnoticeable.

"Today, we can use a technique called follicular unit extraction, which means we don’t have to make an incision at the donor site," Epstein says. "The grafts are harvested one at a time with tiny 0.8 [millimeter] punches, which then heal as essentially undetectable dots in the scalp. This leaves patients with no detectable donor site scar. They can cut their hair even shorter than before, or even shave their head." Not everyone has the expertise to use this newer approach, and it takes a lot longer than FUG -- around eight hours.