Hair Loss Treatment Options

The medical community's knowledge of the cause of hair loss and hair loss treatments available has evolved exponentially over the last 20 years.  Unfortunately, there is no present "Magic Bullet" to cure hair loss, but there are some very legitimate and good hair loss treatments, be it surgical, medical, or cosmetic.  At times it is difficult to differentiate between the legitimate treatments, such as hair transplants, and the gimmick treatments (i.e.- snake oil vendors), so be very wary.

Medical Treatments

There are presently 2 medications that are FDA approved for male pattern hair loss:

• Propecia

• Minoxidil

There are no other medications on the market that can claim that their product causes clinically significant hair growth. There are products from Glaxo-Welcome and Upjohn that are presently in clinical trials that are showing significant promise, but they are not currently available..

Surgical Treatments

There are many different surgical techniques to correct androgenetic alopecia:

• Hair Transplants

• Scalp Reductions

• Scalp Flaps

Hair restoration clinics are springing up as quickly as 24-hour mini-marts and fast food restaurants. Unfortunately, the patient is left to determine if a particular procedure is the right match or if a doctor has adequate training to perform that procedure.

Cosmetic Treatments

There are a variety of cosmetic treatments, such as:

• Hair pieces - the natural look has greatly improved over the years to the point where  it is hard to tell normal hair from a hairpiece. The biggest down side is the continual maintenance that is involved in keeping it looking natural. Hair transplants and the present medications will never give you back the head of hair you had as a youth. I recommend hairpieces for my patients that will not be satisfied with anything less then a dense, full head of hair (like they were when they were 18 years old).

• Cosmetic concealers- there are many sprays and powders that give the illusion that there is less baldness, some are much more cosmetically elegant than others are, but none look like natural hair. All of these products need to be applied daily.

Gimmick Treatments

One needs to be aware that there are many companies and doctors that play on the vulnerability of people with hair loss. There are numerous unethical companies that make claims that their products cause "fuller and thicker looking hair" and hope you interpret that as causing clinically significant hair growth. However, you will never get these companies to put in writing that their product "cause clinically significant hair growth" because they do not!

A partial list of unsubstantiated and/or false claims is:

• Balding men have poor vascular supply to the balding area.
  
  - Numerous studies have shown that the vascular supply to the balding scalp is just as good as the non-balding scalp.
   

• Balding men have plugged follicles.
  
  - A plugged follicle will not stop a hair from growing.
   

• Balding men have diseased scalps.
  
  - There are a few rare diseases that can cause hair loss, but hair loss caused by disease is  not in the same pattern as male patterned baldness.
   

• Lack of vitamins causes hair loss.
  
  - Hair loss due to a vitamin deficiency is rare in the United States. It is more common to see vitamin toxicity as a cause of hair loss.
   

• Some companies use electrical stimulation to the scalp or massage therapy.
  
  - No studies have been shown that this causes clinically significant hair growth.
   

• The Demodex mite (a normal human mite) causes hair loss.
  
  - This is completely unsubstantiated. The Demodex mite is found in most hair follicle in adults, not in just the hair follicles of balding men. And if the Demodex mite truly did cause hair loss, why doesn't it cause hair loss of the eyebrows, of the beard region, or of the sides of the head where it is also found?

Dr. McAndrews M.D. is a Board-Certified Dermatologist specializing in the treatment of hair loss.  He is a Clinical Professor at USC School of Medicine, teaching the residents the latest advances in medical and surgical treatments of hair loss.  The single most important lesson he teaches all residents is to make sure a patient with hair loss has realistic expectations about what the various treatment options can achieve.