Hair loss treatment

The hair loss industry is a multibillion-dollar business but the vast majority of commercially available products, estimated at 90%, are ineffective to the majority of hair loss sufferers. If one grew a single hair with each remedy out there, they would fill the entire head. Useless rubbish is not only bad for your wallet, it also wastes your valuable time while the hair loss continues. In order to find the most suitable treatment for your condition you should understand how various hair loss treatments work and what you can expect from them.

The currently available hair loss treatments can be, in the first place, divided into surgical and non-surgical therapies. Although there are only a few surgical techniques currently applied, the non-surgical spectrum is wide and confusing. There seem to be thousands of non-surgical treatment options available to those who seek to avoid hair surgery. Propecia also known under its generic name finasteride and Rogaine (minoxidil) might be amongst the best known medicinal hair loss treatments, while dried fruits of saw palmetto and a Chinese herb, He Shou Wu, also known as Fo-Ti, are the natural ingredients most often mentioned in alternative hair loss remedies.

The non-surgical hair loss therapies can be in principle broken down into medicinal and alternative treatments, whereas when considering methods of application, they can be divided into oral treatments, topical treatments and others, such as LaserComb. Alternative treatments are typically, but not exclusively, associated with using naturally derived active substances. Irrespective of the aforementioned breakdowns, hair growth treatments work either by blocking the activity of dihydrotestosterone, also called anti-androgens, or by stimulating new hair growth in the balding areas. Although scientists are constantly searching for new approaches to treating hair loss such as hair cloning any such new therapies are at least five years away.

Anyone losing hair comes to the point when one starts thinking of reversing ones condition. A quick internet search will turn up a myriad of guaranteed treatments for regrowing lost hair. It is obvious that many of them were solely designed to make money for their originators but there are some remedies that can be really helpful. The question is how useful and who can benefit.

When referring to hair loss, most people think of male pattern baldness, characteristic of it horseshoe balding pattern. Most treatments for hair regrowth target this type of baldness. Male pattern baldness affects about 40% of the male population and its female form, called female pattern baldness occurs in about 25% of women. The main cause of both forms is the male hormone testosterone being converted into the follicle harming dihydrotestosterone (DHT). This may sound weird but female body also produces the male hormone testosterone. However, despite the general assumption that it is the overproduction of DHT that is causing our hair to die it is the inability of some affected hair follicles to defend themselves effectively from these attacks that leads to hair miniaturisation and eventual hair loss. Therefore, the most effective hair loss treatments try to address this aspect and work by either inhibiting the production of DHT such as finasteride (Propecia) or bind to the receptor sites in hair follicles and protect these sites from interacting with DHT such as spironolactone. Propecia/finasteride happens to be the most effective treatment for male pattern baldness, whereas spironolactone is considered to be the same weapon for women.

However, in addition to protecting your hair follicles from DHT attacks you also need a treatment that would stimulate new hair growth. Although many treatments promise to do that the only FDA approved treatment that has been proven to promote hair growth in the majority of patients is Rogaine (minoxidil), which can be used as an effective hair regrowth treatment by both sexes. Now, reviewing the numbers Rogaine/minoxidil has been proven to regrow hair, depending on the strength and the form, in about 55% of hair loss sufferers. Finasteride/Propecia has about the same ratio of effectiveness. Spironolactone has been less well studied as a remedy for treating hair loss as its is not an approved hair loss treatment but the reasonable estimates indicate that it could be effective in about 50% of women suffering from hereditary form of hair loss. To sum it up, combining a DHT blocker with a hair growth stimulant should be helpful in no less that 55% of the patients, with higher percentages being possible. However, one should not expect to regrow the hair that has been lost more than three years ago.

Hair surgery happens to be the only natural and lasting method of hair restoration for people suffering from hereditary form of baldness and burn patients. Hair transplantation is one of few existing surgical hair restoration methods and without any doubt it is the most effective and the most popular way of regaining the lost glory. Hair transplantation consists in transplanting your own hair from the back and the sides of your scalp to the top and the front of your head. It is also possible to transplant body hair but this method is not recommended as long as you have enough donor hair on your scalp. Body hair has a different texture, length, waviness, color and is therefore less suitable for covering bald spots on your head than your hair from your own scalp.

At the moment it is not possible to transplant hair from one person’s head to another person. This would necessitate the lifetime commitment to immunosuppressant pills, which is too high price to pay for a hair transplant. The hair at the back and sides of your head is in people suffering from male pattern baldness, characteristic of its typical horseshoe pattern, thought to be resistant to thinning and balding. Therefore, such hair if transplanted to the top of your head will stay there for ever. Female balding pattern is often different in that women are losing their hair from their entire scalp and thus it is often impossible to identify the hair that is resistant to balding. Therefore, women do not make very good candidates for hair transplantation since they can lose their transplanted hair and will need another session.

There are two basic hair transplantation techniques used these days – follicular unit transplantation (FUT) and follicular unit extraction (FUE). The difference is in harvesting hair follicles. FUT is an older technique consisting in extracting a strip of skin from the back of your scalp. This strip can be 1.5cm wide and 20cm long and is then placed under dissecting microscopes in order to extract individual hair follicles. Such hair follicles are then implanted into small needle poke openings in the balding area. FUE consists in harvesting individual hair follicles, which are then devoid of unnecessary tissue and directly implanted in the balding area. This is a newer and more expensive method of hair transplantation. Its downside is lower yield and necessity to undergo several sessions as it is impossible to cover large areas using FUE in a single procedure. It is usually recommended to use FUT for people in advanced stages of baldness.

A hair system can be any type of supplemental hair in the form of a full wig, hairpiece, toupee, hair extension or a weave, which replaces your own missing hair. Hair systems are for many hair loss sufferers the only existing option to replace the lost hair and to regain the former appearance of a full head of hair. The quality and the price of hair systems depend on a variety of factors, such as the type of hair used, the production process used to weave the wig, the foundation of the hair system and how it is attached to the scalp.

The origin of hair is the first thing most prospective buyers will ask about. Both artificial and natural hair can be used. The natural hair can be of human or animal origin. Some hair systems blend human hair with animal hair to save on cost. The human hair can be of Asian origin (the least expensive option), Indian origin or European origin (the most expensive option). Asian and Indian hair must be usually bleached, which makes it brittle and less durable. Considering the harvesting methods, virgin hair is the most expensive and hair gained from hairbrushes and combs the least expensive option. Human hair requires more care than artificial hair but it looks more authentic, lasts longer and is more comfortable to wear. Its downside is its higher cost and the fact that it can lose its colour when exposed to direct sun for long hours or break, as normal human hair does.

As far as the manufacturing process is concerned, hair systems can be hand-tied or machine-tied. Hand-tied wigs can be also custom made, which happens to be the most expensive alternative. The foundation of a hair system can be either a polymer or a mesh. The polymer foundation is a more affordable but also a less comfortable option. A mesh structure breathes better than polymer structures and is therefore more comfortable to wear but, besides being more expensive, it is also a less durable alternative and more difficult to maintain. Mesh is suitable for creating authentic-looking hairlines, so many wigs combine both technologies, mesh for the hairline and the polymer structure for the inside of the wig.

The technique of fixing a wig to your scalp and blending it with your existing hair is an extremely important factor. There are semi-permanently attached hair systems that are either glued to your scalp or woven into your remaining hair and these can only be removed in a hair salon once every five or six weeks for cleaning and maintenance. These systems cling tightly to your scalp but can be unhealthy and uncomfortable to wear after a couple of weeks of use. The temporarily-attached hair systems use double-sided sticky tape or clips to fix the hairpiece to your scalp and existing hair. They can be removed and cleaned any time you like but can also be easily and unexpectedly removed, leading to embarrassing situations.

The final determining factor when deciding on buying a suitable hair system is the price. Any hair system happens to be temporary in nature, it will not last for ever like hair transplants do. Nevertheless, it can be quite expensive. Hair transplants can cost as much as ten thousand dollars or more. Although you can get a wig for a few hundred dollars, the more authentic looking pieces cost a few thousand dollars and require regular maintenance costing a couple of hundred dollars a month. Besides that, you have to buy at least two identical pieces, one to wear while the other is being maintained by your hair salon. Though not cheap, hair systems are often the only option to replace the lost hair for many alopecia areata patients, as well as a large percentage of female hair loss sufferers. 

The two main methods of non-surgical hair replacement today involve the use of hair systems and hair loss concealers. Various types of hair systems such as full wigs, hairpieces, hair extensions, toupees and weaves can look extremely authentic and have been used for ages to cover bald spots and typically with good rates of success. Their main weaknesses are high maintenance costs and, in some situations, the discomfort of wearing them. Hair loss concealers and hair thickeners on the other hand have been around for a shorter period of time and have often been looked down upon for being incapable of withstanding adverse external conditions and for appearing unnatural. This does not seem to be true any longer as many of them have greatly improved recently, both in terms of their authentic appearance and their resistance.

There are three types of hair loss concealers: those that simply paint your scalp to match your hair colour, then there are hair thickeners that thicken your hair by coating and penetrating the hair and trapping moisture and volume-building proteins inside the hair shaft and, lastly, there are bald spot concealers that apply microfibers that cling to your hair like branches to the trunk of a tree, increasing the hair density. Some products combine two of the aforementioned approaches and paint your scalp and thicken your hair at the same time. All of these products come in various forms, such as a powder, cream or a spray. Hair loss concealers do not contain any ingredients that would combat hair loss but some of them allow you to continue with a topical hair loss treatment such as minoxidil.

Microfiber-based hair loss concealers can be typically applied in as little as 30 seconds versus a minimum of five minutes needed for hair thickeners. However, microfibers are less water-resistant and it is quite difficult to apply them precisely and, therefore, they are not too good for creating an authentic-looking frontal hairline. Their greatest advantage is that they are unrecognisable in your hair, even with a very close inspection. Hair thickeners, mainly those that also colour your scalp, are extremely water-resistant and excellent for frontal hairlines but they take longer to apply. They cover your scalp with a layer of colouring substance, which makes it difficult to effectively apply any topical hair loss treatment. Their greatest weakness in comparison to microfibers is that in direct sunlight it can become visible to the sharp eye that the scalp has been painted.

The common complaint about all products used for concealing hair loss is the limited choice of available shades. Some hair loss sufferers use a combination of two products simultaneously to overcome the weaknesses of individual products and to achieve the most authentic shade and appearance. Most often a combination of a hair thickener and a micro fibrous concealer is used. The results of such combinations are typically very satisfactory. If you want to try any such combinations, make sure that you apply the scalp-painting, hair loss thickener first and then use the microfibers to hide the remaining imperfections. There are many different products in all three categories of hair loss concealers and you may want to test several of them in order to identify those that best match you hair colour and style of application.

The current medical options for reversing hair loss in people suffering from hereditary forms of hair loss are limited to relatively few products which are most effective in the early stages of baldness. Once you have lost a substantial portion of hair due to hereditary factors or an accident, such as a burn, the only remaining option is to replace the missing hair. Your options can be either of a temporary nature, such as the use of hair pieces and hair loss concealers, or a permanent surgical solution. Hair transplantation happens to be the most effective way of surgical hair replacement and the only permanent solution that offers satisfactory results.

Hair transplantation consists in transplanting your own hair follicles from the back of your scalp to the frontal, balding area. The main limiting factor of hair transplantation is the shortage of donor hair and, therefore, many patients do not make a good candidate. The suitable hair transplant candidate should have a high hair density in the back of the scalp, his hair should be wavy and thick, his scalp flexible and the contrast between the colour of his hair and scalp should not be too great, and he must be in good physical condition. Women usually suffer from a diffuse form of hair loss and thus do not make very good hair transplant candidates. Hair transplantation also cannot be performed on patients suffering from unpredictable forms of hair loss such as alopecia areata.

Given the shortage of donor hair, the hair transplant surgeon must be able to utilise the little hair he can use to create the optical illusion of a full head of hair. This represents the biggest risk in hair transplantation, as it can happen that the patient does not like the final result. Although you can usually arrange for another hair transplant session, some damage can be irreparable. Other risks and side effects occurring during and after hair transplant surgery include excessive bleeding and scarring, the lengthy healing of wounds, the transaction and eventual death of many implanted hair follicles, post transplant shock hair loss, which, though temporary, can affect your newly-implanted hair as well the hair in the donor area, scalp tension and numbness and the further progression of hair loss after surgery, which can lead to unnatural patterns of baldness. In one recent study, which analysed the experiences of 425 hair transplant patients who had undergone 533 hair transplant procedures in total, it was determined that about 5% of the patients experienced complications either during or after surgery.

Hair transplants can cost around ten thousand dollars, depending on the technique used, the location and reputation of the clinic, the extent of hair loss and the number of hair transplant sessions needed to achieve the eventual effect. However, sometimes it is impossible to estimate the final cost, which represents another risk you take when deciding on hair transplantation. Given the pain, time and cost involved, it pays to educate oneself prior to signing up for hair transplant surgery. The hair transplant industry is a fast-growing business and the quality and affordability of hair surgeries are improving, so do not let anybody push you into hasty uninformed decisions.

The first hair transplantations were performed in Japan in the 1930s. In the early days of hair transplant surgery relatively large pieces of skin of four millimetres in diameter, the so called punch grafts, were transplanted from the back of the scalp to the frontal receding area. Hair transplantation techniques have evolved tremendously since then and today’s hair transplantation can give you a genuinely natural look. This is due to the miniaturisation of hair transplants, which now contain only one hair follicle (holding between one and four hairs) and are less than one millimetre in diameter. These tiny, single follicle grafts are then implanted into the needle-made incisions in the balding area. Today’s technology enables dense packing of hair follicles, which gives you a truly natural-looking frontal hairline. Gone are the days of ‘pluggy’ grafts that made you look like a toothbrush.

The two leading technologies that are used today are called Follicular Unit Transplantation (FUT) and Follicular Unit Extraction (FUE). The main difference between them is in harvesting hair follicles. The FUT is the older method, using strip harvesting, when a linear strip of skin of up to 20 centimetres long and 1.5 centimetres wide is removed from the back of the scalp and the opening is then sewn closed. This strip is then placed under special dissecting microscopes and dissected into small grafts, containing just one follicular unit each. Such follicular grafts are then implanted into the receding area. The advantage of this method is its high yield, measured as a percentage of the follicles that are successfully transplanted into the balding area. This yield is around 98%. The weakest point is that it leaves the patient with a linear scar at the back of the head. The FUT is less expensive than the FUE and is used when a large area needs to be filled with transplanted hair in one single session.

The FUE method uses a micro-extraction technology to harvest individual follicles that can be directly implanted into the small needle-poke holes in the balding area. The FUE method is the latest technology, introduced only a few years ago. Its greatest benefit is the fact that it leaves the patient with only minuscule scars at the back of the head, which are hardly visible, and the healing time is significantly shorter than with the FUT, due to the small size of the wounds. However, this technique cannot be used to cover large areas in one session and it is more expensive than the FUT. Additionally, its yield is much lower, due to the transaction of many follicles, and since the supply of donor hair is limited, it cannot be used in patients whose hair loss has progressed above NW4 level.

Currently explored surgical hair restoration technologies, such as hair cloning and the generation of new hairs in wounds, should in the future help solve the constraints of the limited amount of donor hair. It seems that hair transplants will in the long future only be used for frontal hairlines and, therefore, the follicular harvesting should manage to provide a sufficient number of hair implants. However, none of the aforementioned potential future techniques is expected to become commercially available before 2013. Hence, the immediate future probably lies in improving the harvesting methods of the FUE in order to improve its yields and make it financially more affordable to customer. The FUT with its strip harvesting, which started a revolution in the hair transplant industry less than two decades ago, may become history in the not too distant future.

Men have been seeking an ultimate cure for hereditary hair loss for thousands of years but until very recently all available cures were either simple cosmetic cover-ups or unsophisticated supplement pills and herbal lotions, with many of them just being scams. It was only with the advent of finasteride and minoxidil and improvements made in hair transplantation in recent years that the new era began, enabling hair loss sufferers to halt the further progression of the balding process and replace the missing hair on top of their head using the hair left at the back of their scalp. However, to this day no ultimate cure for hereditary hair loss exists. There are presently several promising drugs and surgical techniques under development but none of these new therapies is expected to hit the market before 2011.

NEOSH101 is being developed by the US company Neosil and it is currently undergoing phase IIb clinical trials. NEOSH101 has been proven to be a more powerful and faster-acting, hair growth stimulant than minoxidil and it only needs applying once daily. Though significantly improving the current hair loss treatment options, NEOSH101 is not going to become an ultimate cure for hereditary hair loss. The clinical testing seems to be advancing slower than most hair loss sufferers would like and, hence, do not hold your breath for it hitting the market anytime soon. NEOSH101 is mainly expected to replace minoxidil and other currently available hair growth stimulants.

Another promising field of development is the telomerase research. Telomerase is an enzyme that is able to put natural caps on telomeres and thus protect them from shortening. Telomerase thereby helps maintain the genomic integrity. Shortened telomeres are associated with the premature aging processes. However, the uncontrolled activation of telomerase can cause cancer growth. Cancer research is the main focus of the telomerase study but scientists are also looking for other applications, such as anti-aging drugs and drugs against hereditary hair loss and gray hair. Although still under development, there are already some products commercially available that seek to emulate the mechanism of telomerase action but they have no scientific backing and should be avoided. Telomerase research could really change the world of medicine but its commercial application might be a good decade away.

Hair multiplication, often called hair cloning, is the next hopeful treatment approach being developed. This technique involves extracting the hair follicles from the back of the patient’s scalp, culturing and multiplying them and injecting the newly-grown, hair cells into the bald scalp. Among several teams of scientists on three continents researching hair multiplication, the UK healthcare company Intercytex appears to be the frontrunner. Intercytex reported results of the latest stage of the clinical phase II study of ICX-TRC (a suspension of a patient’s own dermal papilla cells) in March 2008 and they were quite positive. The next release is expected in Q4 2008. This therapy might hit the market in 2011 at the earliest. The main benefit of hair multiplication would be solving the shortage of donor hair that is the main limiting factor in hair transplantation.

Generating hair follicles in wounds of hair-free skin is a completely new approach to regrowing lost hair. It was discovered accidentally as wounded skin in mice started producing new hair. This technology is currently being developed by the US medical device company, Follica, which licensed this technology from the University of Pennsylvania. Though this approach may sound weird it only uses common instruments and drugs that have already been medically approved and thus it might not take too long for it to become available.

This is the list of only a few promising treatment options for hereditary hair loss that are being currently developed but many others are in the pipeline. It seems that becoming bald may soon be by choice rather than destiny.

Restoring lost hair is to many of us a distant dream. However, there are some existing options for replacing lost hair that may seem surprisingly effective even to the most sceptical hair loss sufferer. The three main methods of hair restoration include surgical hair restoration, non-surgical hair replacement and therapies for re-growing hair using pills and topicals. The main technique of surgical hair restoration is hair transplant surgery, whereas wigs, hairpieces, hair loss concealers and hair thickeners are the most popular aids used to quickly replace the lost hair by non-surgical means. The non-surgical camouflage is obviously the quickest and the least expensive method of replacing lost hair, though not tremendously popular, as many people think that wigs and concealers cannot withstand wind and rain and do not look natural. In spite of this common belief, some of them are extremely resistant to external influences and can appear reasonably authentic. Wigs and concealers are often the only remaining option of restoring lost hair for people suffering from non-hereditary forms of hair loss such as unpredictable alopecia areata.

Hair transplantation is the most expensive method of restoring lost hair but also the most elegant solution. It can only be used in people suffering from hereditary hair loss and burn patients. Hair transplant candidates are required to have sufficient hair density at the back of their scalp and many women suffering from female form of hair loss with its typical diffuse balding pattern do not meet this basic requirement. Hair restoration surgery has made great advances in the past twenty years with the introduction of the two main techniques used today - follicular unit transplantation and later the follicular unit extraction. These advances in hair transplantation techniques enable the grouping of hairs very close together, which gives modern hair transplants a completely natural look. The main weakness of hair transplant surgery, besides the cost and the pain involved, is the limited supply of donor hair and the need for multiple surgeries to achieve the final change. Furthermore, patients have to commit themselves to the use of finasteride or any other adequate medicinal hair loss therapy for the rest of their lives to prevent further loss of hair. Unfortunately these medicinal therapies often cease to work after several years of continued use.

Hair loss pills and topicals do not seem to provide satisfactory hair restoration results yet, despite great scientific advances and the discoveries of recent years. The two most frequently prescribed hair loss drugs, finasteride and topical minoxidil, can be effectively used to reduce hair loss but their ability to re-grow lost hair is relatively poor. Their effectiveness typically declines sharply in the later stages of the balding process. There is no existing medicinal or natural hair loss remedy that can deliver adequate visual results comparable to either hair transplant surgery or non-surgical hair replacements such as wigs and hair loss concealers. Although there are some promising medicinal hair loss drugs currently under development, especially in the area of genetic research, the ultimate cure for baldness is not expected to become commercially available within the next fifteen to twenty years. Other advances in hair science, such as hair multiplication or the generation of new hair follicles in wounds, also hold out some promise but it appears that hair transplant surgery will in the next decade or two remain the most complete method of hair restoration.