Hair transplantation may not be the appropriate first step for someone in early stages of hair loss, in poor health, experiencing excessive hair loss or for an individual with unrealistic expectations.
There are some non-surgical solutions that can provide cosmetic improvement until hair transplantation is likely to result in a satisfactory, long-term cosmetic outcome.
In some men, hair loss may be slowed or even new hair growth stimulated by medical hair loss treatments. The two such treatments approved by the U.S. Food and Drug Administration are finasteride (Propecia®) and minoxidil (Rogaine®).
Minoxidil is topically applied and is available without a prescription. Finasteride is a prescribed drug taken orally in pill form. The medical treatments may be used separately or in combination, as recommended by the physician hair restoration specialist. Medical treatment may retard the rate of hair loss and preserve an acceptable appearance until the physician determines hair transplantation can be undertaken.
Medical treatment is sometimes continued as a complement to hair transplantation. It is likely that, once started, hair transplantation procedures will have to be continued for some years to keep pace with progressive hair loss.
When you consult family, friends and the Web about hair loss treatments, you will find a host of “do-it-yourself” hair loss products such as creams, ointments, lotions, nutrition supplements, scalp stimulants and other “miracle cures”, all promising to stop hair loss and regrow hair.
Among all the options for nonsurgical treatment of androgenetic alopecia (pattern baldness), you will find only two that have been approved by the U.S. Food and Drug Administration, and are recommended by physician hair restoration specialists. Hair restoration products not approved by the FDA are often a waste of money and can be harmful. Two drugs approved by the FDA for treating hair loss that are used in our practice are Propecia and Rogaine.
Propecia – (Finasteride) manufactured by Merck & Co
This is by far the most effective prescription treatment. Studies have shown up to 66% of men demonstrate some regrowth after 12 to 18 months of using Propecia. This product requires taking a 1mg. pill daily. It works by blocking the formation of DHT (the male hormone) from binding with the hair follicle. This appears to interrupt the development of male pattern hair loss in men. The generic name is Finasteride and is also used for prostate enlargement under the brand name Proscar. (Not recommended for women.)
Since Propecia became available in January of 1998, the entire concept of medically treating hair loss has changed. Prior to its release there was only 2% Rogaine. Rogaine, also known as Minoxidil, had only limited effectiveness, mostly to slow future hair loss.
Extra Strength Rogaine – (Minoxidil) manufactured by Pharmacia & Upjohn
This over-the-counter product claims 45% more hair regrowth than Regular Strength Rogaine (2% Rogaine). Although this may be true Rogaine 2% grew very little or no hair on most people. Rogaine 2% appears to be more effective with women and is usually the first course of treatment in female pattern hair loss. (Currently 5% Rogaine is not recommended for women.)
Cosmetic Cover ups, Camouflage
A number of non-prescription products offer “camouflage” for thinning hair. They are applied to the scalp and/or hair to give the appearance of “fullness” to thinning scalp hair. All camouflage products are offered in a variety of colors to match natural hair color. Camouflage agents may be, for some young men, an acceptable short-term solution to improve cosmetic appearance while waiting for hair transplantation.
A well-designed hairpiece/ hair system can provide an acceptable appearance for some patients with thinning hair. A hairpiece requires monthly maintenance and must be replaced regularly. The patient and physician hair restoration specialist can determine whether a hairpiece is an acceptable short-term alternative while the patient waits for hair transplantation. There are patients for whom a hairpiece and camouflage agents may be a long-term or even life-time solution to hair loss.