Hair Restoration

Hair restoration is big business. But are those advertised hair restorers any good? You'll want to do your homework before you invest any time or money in a hair replacement product or procedure.

Some prescription medications may help with hair loss.

About Thinning Hair

Losing your hair is a natural part of being a man. It's not uncommon in women, too, although they don't usually talk about it. Hair loss is caused by a combination of hormones and genetics, and a tendency toward baldness can be inherited from either side of the family. Folk wisdom - and many advertisers - will tell you that poor circulation to the scalp is the culprit, or that you're losing your hair because you're not taking the right vitamins. Temporary hair loss can, indeed, be caused by poor diet or and some medical conditions. But for classic male pattern balding, most doctors agree that folk remedies won't do a thing.

Medicines for Hair Restoration

The FDA has approved several drugs specifically to help with hair restoration. Common treatments for male pattern baldness are minoxidil and finasteride. Minoxidil is sold under the brand name Rogaine. Finasteride is sold as Propecia.

Minoxidil is available over the counter. It's a cream that you apply to your scalp twice a day. Minoxidil doesn't seem to work well for everyone. When it does work, it will help prevent more hair from falling out. In some people it will also stimulate new hair growth. It probably won't return your hair to its original thickness, but many people find that it does enough to camouflage a bald or thinning spot. Minoxidil's effects continue only while you're using it. If you stop, your hair will begin to thin again and new growth will stop.

Finasteride is a prostate drug that also happens to affect hair growth. Packaged as a pill called Propecia, it's sold specifically to help slow down balding. In most people, finasteride will simply stop or slow hair loss. Sometimes it may also cause new hair to grow. As with minoxidil, the effects will cease as soon as the medicine is stopped. Given the fact that many men use this drug to make themselves more attractive to potential mates, finasteride has an interesting, if uncommon, side effect. Because it works by interfering with the male hormone testosterone, it can reduce a man's sex drive and even cause temporary impotence. This medicine should not be used by women of childbearing age, and pregnant women shouldn't even touch the tablets. Finasteride can cause serious birth defects.

Surgical Options

Surgery may be an option.

Hair transplants are an option for individuals who want more permanent hair restoration. Transplants are not a perfect solution, however. The result depends on the degree of thinning or baldness and, perhaps most important, on the surgeon's skill. Hair transplantation requires a degree of artistry to make the hair look natural.

The most popular type of hair transplant involves taking thin strips of hair from areas of the scalp that aren't balding, diving the strips into smaller pieces, and then placing that hair in thinning or bald spots. In the past, hair was transplanted as "plugs" containing many strands. Done poorly, it looked like the hair on a doll's head. Modern transplants using micro-grafts - just one or two hairs at a time - can look much more natural. The transplanted hair should be taken from what's called a permanent donor site, an area of the scalp that isn't likely to become bald.

Other hair restoration surgeries include scalp reduction and skin flaps. In a scalp reduction surgery, part of the bald area is removed and the remaining, hair-bearing skin stretched to cover the spot. The surgeon may begin by implanting skin extenders, balloon devices that lie below the skin and stretch it out over a period of weeks. A skin flap procedure involves cutting a flap of hair-bearing skin from one part of the scalp and rotating or moving it to fill in a bald space.

For More Information

• The American Society for Dermatologic Surgery has a brief but informative article about hair restoration options.
• The American Society of Plastic Surgeons has a longer article about surgical options, including some drawings to show the procedures.
• The Mayo Clinic has an article about the different types of hair loss, not just male pattern baldness, and some of the options for treatment.

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