Hair-Loss Treatment

Quick Facts About Hair-Loss Treatment

Procedure Time: 1 hour or more, depending on size of the area
In/Outpatient: Outpatient
Anesthesia: Local or general
Recovery Time: 2–3 days; strenuous activity in 3 weeks
Duration of Results: Permanent
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What you should know

What Are Hair Loss Treatments

If you’re experiencing any type of hair loss, see your doctor so that it is accurately assessed and properly treated. There are a number of hair-loss treatment options available to address different types of hair loss.

Hair-loss treatments may include any of the following:

  • Topical Treatments
  • Prescription Pills
  • Hair Restoration Surgery

Topical Treatments

Minoxidil is a daily topical hair loss treatment that works by stimulating blood flow to the hair follicle. Some experts even believe that minoxidil is much more effective on women than on men. “Hair growth is increased in females by 20 to 25 percent, and in the majority of patients, it may slow or stop hair loss,” Boca Raton, FL, dermatologist Marta Rendon, MD, notes.

In some cases, your doctor may recommend using the 5-percent formula off-label, if he or she feels that you can better benefit from a stronger concentration. “And since it’s available as a foam, it’s less irritating and easier to saturate the scalp with,” Philadelphia, PA, dermatologist George Cotsarelis, MD, adds. With both versions of minoxidil, it can take up to a year before you begin to notice any changes.

“Two-percent minoxidil is the most commonly prescribed medication for female pattern baldness,” says Worcester, MA, hair restoration surgeon Mark DiStefano, MD. “I always recommend that my female patients, who are experiencing hair loss or the first signs of it, start off with the FDA-approved 2-percent formula.”

A more aggressive over-the-counter treatment like Rogaine may help encourage hair growth. Rogaine contains minoxidil, an FDA-approved ingredient said to re-grow hair in women. Rogaine works at the root to increase the size of hair follicles and stimulate their ability to produce thicker hair. This process may simultaneously jumpstart growth in existing hairs as well, but it’s still important to condition and protect hair to lengthen its lifespan.

Prescription Pills

If you prefer a pill instead of an often-messy topical formula, ask your doctor about Propecia. Available by prescription, Propecia is a men’s-only medication, in pill form, that treats male pattern hair loss on the crown and mid-scalp by reducing DHT. Taking Propecia daily should show an increase in the amount of hair after one year, and you may start to notice a difference in hair growth after about three months. “I often prescribe Propecia along with topical Rogaine for maximum benefit,” says New York, NY, dermatologist Dr. Judith Hellman.

Hair Restoration Surgery

Hair restoration surgery is a surgical procedure that involves hair removal from a donor site, sectioned into micro-grafts and then transplanted into a balding or thinning area on the scalp. The micro-grafts transplant technique is the most common hair restoration surgery. Other hair restoration grafting techniques include: flaps, tissue expansion and scalp reduction.

How Hair Restoration Surgery Works

Once you and your doctor have decided that hair restoration surgery is the appropriate option for you, your doctor will select a donor site at the back of the scalp where the hair follicles will be removed.

“The donor area is anesthetized, using local anesthesia, and a strip of hair containing the follicles is removed,” Worcester, MA, hair restoration surgeon Mark DiStefano, MD, says. Next, the follicles are harvested under a microscope and the hairs are divided into follicular units, which are groups of one, two or three hairs, to create a more natural look. “The areas where the units will be transplanted are also anesthetized, and the transplanted hair is placed into the recipient sites,” Dr. Mark DiStefano adds.

Hair restoration surgery is an option if your hair isn’t too thin, fine or light in color. “A strip of dense hair taken from a donor site on the patient’s scalp is divided into single-, two- or three-strand hair groups and transplanted into the thinning areas. Tiny grafts are then placed on a recipient site where they will grow as permanent hair. If the hairs are grafted properly, you’ll never be able to tell it was a transplant,” explains Montclair, NJ, plastic surgeon Barry DiBernardo, MD.

At this time, hair restoration surgery is the only proven permanent surgical option available to treat permanent hair loss for both men and women. Unlike other transplant surgeries, only your own hair and tissue are used. “Hair restoration surgery for females is only recommended if you’ve suffered hormonal hair loss or hair loss that stems from the likes of a scar or cosmetic surgery,” Philadelphia dermatologist George Cotsarelis, MD, director of University of Pennsylvania’s Hair and Scalp Clinic, says.

Future Treatments

Topical treatments and surgery remain at the forefront of tackling hair-loss problems today. But could science hold new and improved solutions for tomorrow? Here is a sampling of what’s in the works, although neither of these treatments has been FDA approved or introduced to the public as an option to date:

Gene Therapy to Treat Genetic Hair Loss: A complicated and advanced technique for inherited hair loss, gene therapy would change the genetic makeup of existing cells in the body, in turn altering their functions and actions. However, this treatment is far from being approved or introduced to the public since it involves several genetic decoding steps.

Clone New Hair Follicles: Cloning is widely debated in the scientific community, but hair cloning may be the next big thing as a means of eradicating hair loss. Hair cloning involves isolating follicles from hair-growing areas and in essence, making copies of those existing follicles. Once the follicles have been successfully cloned, they may be able to be re-implanted into the bald areas, adding many follicles as a product of the original few isolated ones.

Researchers from the University of Pennsylvania announced they successfully created new hair cells—from skin cells—in mice. But unlike earlier attempts to clone hair follicles that have yet to yield consistent outcomes, this study found that when the mice’s skin cells were wounded, they responded by assuming the same properties as hair follicle cells, and eventually led to the growth of hair. In the treated mice, hair growth was seen regardless of the mouse’s age, and this presents a major breakthrough for the potential treatment of baldness. The one snag: There was no pigment in the new hair follicles. The head of the research team, Philadelphia dermatologist George Cotsarelis, MD, director of University of Pennsylvania’s Hair and Scalp Clinic now plans to use a dermabrasion-like procedure to wound human skin samples in hopes that they will react in a manner similar to the injured skin cells in mice. Although this treatment is still years away from a doctor’s office near you, it could set the stage for baldness treatment options in the years to come.

Who They Are For

It’s normal to notice some hair shedding. But when does it become too much, and how can you know for sure? According to a study in the Archives of Dermatology, a simple 60-second hair count is an easy and reliable way to assess hair shedding. The study followed 60 healthy men between the ages of 20 and 60 who had no evidence of hair loss. Hair was combed forward over a towel or pillowcase for 60 seconds and the number of hairs shed was counted. On average, the shedding range was zero to 78 hairs for those in the 20 to 40 age bracket and zero to 43 hairs for those ages 41 through 60.

If you are losing too much hair, one of the many options for hair loss restoration might be right for you.

Who They Are Not For

It is best to discuss with your doctor whether a hair-loss treatment is appropriate for your hair-loss concerns.

What to Expect With Hair-Loss Treatments

Some of the risks and/or side effects from hair restoration surgery are:

  • Differences in transplanted hair texture and density
  • Scalp numbness
  • Infection
  • Bleeding
  • Wide scars
  • Anesthesia-related complications
  • Surgery may have to be repeated if grafts don’t take
As with any hair restortion procedure, it's important to know what you're getting into. Beverly Hills, CA, hair restoration specialist Craig Ziering, MD, says, "It's important to have realistic expectations.  Surgical hair restoration cannot give you the hair of your youth, but it can significantly improve your appearance."

Post-Treatment Care: Hair-Loss Treatments

After hair loss surgery is complete, your head will most likely be wrapped in a gauze bandage and your doctor may even give you some sort of scalp therapy treatment before you go home. While you may experience some pain and a little bit of swelling, which should subside after a few days, it’s important not to wash or style your hair for the first few days after surgery. Scabbing at the transplant site may also occur during the first five to seven days after the procedure. About a week after surgery your sutures will be removed.

What to expect post-procedure:

“Three months after the procedure you’ll start to see some growth, but it usually takes a good six to nine months to see a noticeable difference,” says Worcester, MA, hair restoration surgeon Mark DiStefano, MD. And once your hair has begun to grow, it will look, feel and act as if it were never lost.

Inside Tips

  • Most of the buzz surrounding niacin, a member of the B complex vitamins, is associated with improving skin tone and texture, but some studies support it as a hair-growth stimulator.
  • Slow hair loss with the mineral silica, which is believed to slow down hair loss and possibly prevent it. It’s naturally found in vegetables like peppers, potatoes and sprouts.
  • When it comes to treating female hair loss, it’s important to use medications and prescriptions targeted specifically for women. The men in your life may be using hair loss medications or prescriptions, but don’t assume they’ll work for you too. Check with your doctor to make sure you have the right prescription or medication for you.
  • Even at the very first signs of temporary hair loss, you should seek out the advice of your doctor or dermatologist. Failure to treat the problem in its early stages could result in a misdiagnosis or even permanent hair loss.
  • Initial studies show that light-based therapy treatments may be effective for stimulating hair growth, and many hair restoration physicians are beginning to use this technology–especially in conjunction with hair restoration surgery–for optimal results

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