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Hair Loss Treatments – Do They Work?

Reviewed by Robert V. Mandraccia, MD

Hair transplants offer excellent results for many people with hair loss, but they are not for everyone. For example, a person who does not have an adequate supply of head or neck hair from which to harvest hair follicles for transplantation is likely not a viable candidate for the procedure. Some medical conditions or prescription medications, including blood thinners, may also preclude a person from having a hair transplant. In cases like these, other hair loss treatments can help. Some of these treatments may also be used in conjunction with hair transplantation to improve the overall results.

Surgical Hair Loss Treatments

Scalp reduction is one approach that can be performed alone or in conjunction with a hair transplant. During scalp reduction, your surgeon removes all or a part of the bald scalp and brings the hair-bearing scalp closer together to reduce the size of the balding area.

Scalp expansion is a more involved procedure that can be used to treat certain types of hair loss that occur in a small population of individuals. This procedure involves the insertion of surgical tissue expanders under the scalp for about three to four weeks. During this time, sterile saline water is added to the expanders at prescribed intervals to stretch out the skin. Scalp expansion may be performed before a scalp reduction to make the scalp looser. It also can be performed solely to stretch hair-bearing areas, which may reduce balding.

Scalp flaps are another hair loss treatment option. During this procedure, a hair-bearing segment of your scalp (not just smaller follicular units) is surgically moved and placed where hair is needed.

Surgical procedures to treat hair loss can be expensive and painful, and they do require a recovery period of several weeks or longer. Possible risks include scarring and infection. Expect a period of six or more months before the final results of your surgery are apparent.

When considering any of these surgical procedures, consult first with a board-certified plastic surgeon or dermatologist who has extensive experience in this field. He or she can diagnose the cause of your hair loss and go over individualized treatment options with you, including non-surgical treatments.

Medications and Devices

A number of medications and devices to treat hair loss are also available and may be suggested by your doctor. They include:

Finasteride (Propecia) is a prescription medication in pill form that was originally developed to treat enlarged prostate glands. During drug trials, it became apparent that it could also slow hair loss and stimulate hair regrowth in men. Generic finasteride was approved by the Food and Drug Administration (FDA) in 1997 to treat male pattern baldness (androgenic alopecia); it is not approved for the treatment of hair loss in youth or for female hair loss. It is part of a class of medications called 5-alpha reductase inhibitors, which block the conversion of testosterone into dihydrotestosterone (DHT), a hormone that shrinks hair follicles and is an important factor in male hair loss. It may take several months to see positive results with finasteride. Side effects are rare and include diminished sex drive and sexual function. The benefits of finasteride stop if you stop using it. Note: Finasteride poses a significant danger to women of childbearing age, and pregnant women should not handle the drug because it may cause serious birth defects in male fetuses.

Minoxidil (Rogaine), originally used in pill form to treat high blood pressure, is an over-the-counter topical solution (liquid or foam) that's used twice a day on hair follicles to slow the progression of hair loss and stimulate some hair regrowth. Minoxidil is available in both a 2 percent and 5 percent solution. It was the first drug approved by the FDA for the treatment of male pattern baldness, and it's the only hair regrowth ingredient approved by the FDA for use by both men and women. Minoxidil has no effect on the hormonal process of hair loss. It can take up to 12 weeks for new hair to start growing. Side effects can include irritation of the scalp. The positive effects of this drug are considered to be temporary and will cease when the patient stops taking it.

Latisse is the first drug that is FDA-approved to promote eyelash growth. A prescription drug, Latisse contains the active ingredient of the glaucoma drug Lumigan. Its manufacturer, Allergan, has launched a trial to determine if a related product is effective in treating moderate male-pattern and female-pattern hair loss.

Laser devices include brushes, combs and other handheld devices that emit low laser light that may stimulate hair growth or make hair look more youthful. Such devices may not be approved by the FDA for stimulating hair regrowth; consult with your doctor before investing in and using them.

Wigs and hairpieces are an alternative to medical treatment and can be used to cover permanent or temporary hair loss. They come in a variety of natural and synthetic materials, colors and styles to suit almost every individual.

The risks, benefits and cost of each procedure, medication or device listed here should be discussed with a knowledgeable doctor before moving forward.

Hair loss treatments are considered cosmetic and are usually not covered by health insurance. If treatment costs are prohibitive, ask your surgeon about any financing or payment programs he or she offers.

About the Reviewer of This Article

Robert V. Mandraccia, MD, graduated from Temple University Medical School in Philadelphia, where he also completed his internship. Dr. Mandraccia did his general surgery residency at Temple, and his plastic surgery residency at the University of Oklahoma in Oklahoma City. He is now in private practive in Cape Coral, Fort Myers and Bonita Springs, Florida. A member of several prestigious societies including the American Medical Association, the Lipoplasty Society of North America, the American Society of Plastic Surgeons and the American Society for Aesthetic Plastic Surgery, Dr. Mandraccia is also a fellow of the International College of Surgeon sand board-certified by both the American Board of Surgery and the American Board of Plastic Surgery.