Hair Today, Gone Tomorrow
Posted On Aug 03, 2016
Losing the battle against baldness? The time has come for you to come out on top—literally. Leading industry experts weigh in on the best ways to treat hair loss.
By Karen Asp
If you’re among the leagues of men who are undeniably in the category “follicularly challenged,” you are not alone. Hair loss affects approximately 50 million men in the U.S., according to the American Academy of Dermatology, and it can start any time after puberty. By the time you turn 50, you have a 50 percent chance of experiencing hair loss.
The consequences of hair loss can be devastating. “First impressions make the most important ones,” says Paul T. Rose, M.D., former president of the International Society of Hair Restoration Surgery, and a board-certified dermatologist in Coral Gables, Florida. With a full head of hair, you inevitably look younger and often have greater levels of self-esteem and confidence. Society has also long equated hair with virility, Rose adds.
That may explain why hair loss is such a sensitive topic for men, many who don’t want anyone to know it’s happening. they often hide under hats or wave the white flag and shave their heads.
You don’t have to admit defeat so easily. Although non-surgical treatments can treat hair loss, recent advancements in hair transplant surgery have made this a more effective and viable option for men.
HAIR LOSS 101
Male hair loss, which is also known as androgenetic alopecia, starts when hair follicles become sensitive to dihydrotestosterone (DHT), a breakdown product of testosterone. DHT causes hair follicles to shrink.
The follicles may have once produced long, fibrous hair, yet they begin creating thinner, shorter hairs until they become so small that they stop making hair, says Alan J. Bauman, M.D., hair transplant surgeon and medical director of the Bauman Medical Group in Boca Raton, Florida. Thinning usually starts up at the temple and crown and progresses to the point that the temple recedes and the crown sports a growing bald spot.
How rapidly and to what extent that miniaturization occurs depends largely on genetics, but don’t simply blame your dad. “For most people who lose hair, baldness runs in the family, either on their paternal or maternal side,” says Keith Jeffords, M.D., a plastic surgeon in Smyrna, Georgia. Other factors like stress, certain medications, smoking, poor diet, sleeping habits, and scalp inflammation can contribute to the issue.
TREATING HAIR LOSS SANS SURGERY
You normally lose about 100 strands of hair per day, which you then grow back, Jeffords points out. Yet if you notice that you’re losing more— keep tabs on how much you routinely shed in the shower or on your pillow—you should take action.
By spotting hair loss early, you can minimize and even prevent future loss with non-surgical treatments. One of the most effective of these is Finasteride, the active compound in the prescription medication Propecia. A whopping 90 percent of men will experience positive results, Bauman says.
You can also use topical medications. Although some like Rogaine are available over the counter (OTC), you can also get prescription medications like Formula 82M, which has fewer side effects and produces stronger hair growth than OTC versions, Bauman says. Other options include laser therapy (Bauman prefers the at-home LaserCap, a low-level laser light treatment method that’s portable and “under-yourhat discreet”) and plateletrich plasma injections, which is concentrated plasma from your blood that’s injected into the treatment area.
While effective, these non-invasive treatments can only do so much. The next step for many men? Hair transplant surgery.
THE SURGERY SCOOP
Hair transplant surgery has come a long way since the eighties, when men were often left post-op with a pluggy, unnatural appearance. “Today, minimally invasive techniques can harvest hair follicles and create a natural-looking hair line,” Bauman says. There’s also significantly less downtime with the new generation of surgeries. Most men generally return to work within one to three days.
Hair transplant surgery utilizes a method called follicular unit transplantation. Follicular units—tiny structures in the scalp that include one to four hair fibers—are removed from areas where your hair is still healthy (called donor sites). They are relocated to bald or thinning spots. The hitch is that you’ll need a decent amount of donor hair to be a candidate, Bauman says. Once transplanted, those hairs continue their growth cycle throughout your life.
There are two ways hair can be harvested. With strip harvesting, a strip of hairbearing skin is removed, follicular units are dissected out using microscopes, and the wound is sutured. Thanks to new techniques, including one developed by Rose, doctors can effectively camouflage the wound by creating a narrow scar through which hair can grow.
The second method is follicular unit extraction (FUE). In this procedure, incisions are made with a punch, either motorized, non-motorized, or robotic. The small wounds leave round scars that heal on their own, although they’ll be lighter than your normal skin, says Rose.
No matter the harvesting method, you can generally expect to see new hair growth in about four months, significant growth around nine months, and full results in about a year. Know, too, that one treatment may not do it, depending on how much hair you’ve lost and how much of your head you’re trying to cover. “It’s common to have at least two treatments to the area, usually spaced about a year apart,” Rose says.
Just note that before surgery, you should avoid alcohol and stop medications that could cause bleeding. After surgery, you’ll have to curtail strenuous exercise for at least 10 to 14 days and continue non-surgical treatments, Rose says.
Although there are risks with surgery, including scarring, infection, and an unnatural look, the worst may be an unqualified doctor. “Many doctors who claim to be hair transplant surgeons haven’t had the proper surgical training,” Jeffords says. (See Newyou.com for tips on choosing the right doctor for you.)
Cost for hair transplant surgery is not covered by health insurance providers, and is based on a per-graft basis (grafts being the donated hair, hair follicles, surrounding tissue, and skin). Strip harvesting runs about $4 to $7 per graft while robotic FUE might range from $7 to $10 per graft— more if done by hand. In Rose’s practice, most men need 2,000 grafts, on average.
You can’t fight age or the normal course of nature, but fortunately, going bald no longer has to be a situation that results in a growing hat collection. Thanks to today’s technologies, hair today doesn’t have to be “gone for good” tomorrow.