Skip to content

Hair Loss Health Center

Font Size

The Sweet Hair After

Future Hair-Loss Treatments Promise What's not Hair Today will Be Hair Tomorrow.

Today's Hair-Loss Treatments: Drugs continued...

"Two-thirds of men do get acceptable hair growth -- moderate to very good hair growth," Andrew Kaufman, MD, tells WebMD. Kaufman, a hair-transplant surgeon, is assistant professor of clinical dermatology at UCLA, and medical director of the Center for Dermatology Care, Thousand Oaks, Calif.

"Minoxidil definitely has an effect in most men," Cotsarelis agrees. "It is not something a bald person would use, but someone starting to go bald would use it. The goal is to maintain the hair you have."

The other currently approved drug for hair loss is Propecia (generic name, finasteride). It works only for men. Why? It keeps the male sex hormone testosterone from forming its DHT by-product. DHT signals shorten the growth phase -- and lengthen the rest stage -- of hormone-sensitive follicles.

One side effect of Propecia can be loss of libido. But it usually goes away over time, Cotsarelis says.

Testosterone replacement is becoming popular for men. Cotsarelis warns that this may accelerate hair loss. Propecia might help -- but because it prevents testosterone breakdown, it might affect the dose of male hormone replacement therapy. Cotsarelis warns men taking both Propecia and testosterone replacement to make sure their doctor carefully monitors their testosterone levels.

Many men use both minoxidil and Propecia for maximum effect. The drugs can also be combined with hair replacement surgery.

"It's possible to take one or the other or both," Kaufman says. "But if a person isn't going to use Rogaine twice every day, or take the Propecia pill once every day, he shouldn't use them."

Why? Once treatment with either minoxidil or Propecia stops, hair loss resumes -- and any gains soon are lost.

What About Surgery?

One way to combat hair loss is to transplant hair follicles from the sides and back of the head to the top of the head. This surgery has evolved over the years, Kaufman says.

"In the late 1980s, the standard of care was to take large grafts, plugs of 12 to 20 hairs, and implant them," he says. "It would give either a very good or acceptable result. But some men, as they got older and lost some more hair, they got that doll's-hair or corn-row phenomenon: Little poles of hair jutting out."

Today's hair grafts are called follicular unit hair transplants of one to four hairs, transplanted very close together for a more natural look.

Another mostly out-of-favor technique is scalp reduction.

"Scalp reduction is to cut balding scalp out and suture the remaining skin together to reduce the bald area," Kaufman says. "After several of these, you have a smaller area to transplant. But you leave a scar that is visible and needs to be transplanted into to be invisible."

Similarly out of fashion are flap-type procedures, where a flap of hair from a hair-bearing area is partially removed, swung around, and attached to a frontal area. But this can lead to scarring or death or a portion of the scalp.

How well do hair transplants work? That depends. It depends on how much healthy hair a person has available for transplant. And it depends on a person's expectations.

"The best candidate for hair restoration surgery has had hair loss for a number of years but has stabilized and is not losing more hair quickly," Kaufman says. "A person needs to have realistic expectations of what can be done to give them a natural appearing hair line."

Although most people who seek hair replacement surgery are men, Kaufman says women make excellent candidates.

Today on WebMD

hair in hairbrush
Ways to go about it naturally.
Young woman with thick curly hair
Causes and solutions.
 
man with thinning hair
How to keep the hair you have.
Closeup of Hairbrush with Hair Loss
Understand the basics.
 
Mens Hair Loss When To Start Treatment
Article
A Dermatologist Talks About Hair Loss
Article
 
Rogaine And Propecia For Hair Loss
Article
Woman looking at thinning hair in hand mirror
Video
 
Balding man in mirror
Slideshow
Close up of comb in woman's hair
Quiz
 
Young woman with thick curly hair
Slideshow
hair problems
Slideshow