How to Pick the Right Treatment for You

Men who lose their hair can still look great. But some are really bothered by it. And women, who are nearly as likely as men to experience some degree of age- and hormone-related hair loss, are more likely to suffer from feelings of unattractiveness.

If you’re losing your hair and it bothers you, here’s what you need to know about the latest treatments…

Medications

Minoxidil Topical (Rogaine). This treatment is effective for men and women. Studies have shown that it is about 60% to 70% effective at stopping hair loss, stimulating growth and making hair thicker and longer. It works best when started soon after hair loss begins—it will not cause hair growth in areas that already are bald. It causes no serious side effects, although some people may have a little scalp irritation.

How to use it: Minoxidil is sold over the counter as a liquid or foam. The newer foam version is less irritating and may be more effective. Men apply it twice a day and women once a day when hair and scalp are dry.

What to expect: Most people notice improvement after about two months, with peak improvement after four to six months. You’ll need to keep using it—if you stop, hair loss will ­resume. Cost: About $20 a month.

Finasteride (Propecia, Proscar). Finasteride, an oral drug sold by prescription, works by blocking dihydrotestosterone (DHT), the androgen hormone that causes hair loss in men. The drug was developed to treat enlarged prostate, and during clinical trials, researchers noted an intriguing side effect—hair growth. It is not FDA-approved for women. Finasteride works best for thinning hair—not on a bald scalp. It is more effective than minoxidil for some patients. Rare side effects include diminished sex drive and sexual function.

How to use it: Take one (1-mg) tablet daily.

What to expect: Growth may improve within a few months, but it can take up to a year to show the full benefit. You will need to continue the treatment—if you don’t, hair loss will resume. Cost: $20 to $50 a month.

Transplants

Today’s hair transplants are much more sophisticated than the unsightly plugs from the past because hairs are transplanted exactly as they grow naturally, in follicular units (groupings of one to four hairs).

The outpatient procedures are minimally invasive and often can restore a full head of hair (unless you lose more hair in the future).

How it works: The scalp is numbed. Follicular units are extracted from areas where there’s still hair and then implanted where they’re needed using one of three techniques (below). Because the ­“donor” hairs are impervious to androgens, they’ll continue to grow indefinitely. It takes six to nine months before there’s full improvement. Most patients with limited hair loss require only one procedure. Patients with more extensive baldness may need a second procedure. Most patients can return to work after a few days, using existing hair or a hat to cover up the surgical area.

Three types of surgical transplants…

  • Follicular unit transplantation (FUT). This is an older method that’s still commonly used. A narrow strip of hair is removed from the back of the scalp. Technicians separate the hair units, and the surgeon implants the units in an equivalent number of tiny slits in thinning areas. It might take 1,000 to 1,500 grafts to “fill” a bald area. Cost: About $5,000.
  • Follicular unit extraction (FUE). Rather than taking a strip of donor hair, the surgeon uses a punchlike device to remove individual hair units, which are then implanted. Advantage: There is less postoperative discomfort and less chance of visible scarring in the donor area than with the FUT procedure ­described earlier. However, the results with FUE are less predictable, and the cost is 20% to 30% more.
  • Robotic follicular unit extraction. This technique is the same as follicular unit extraction except that hairs are extracted robotically. A device using cameras and a computer precisely calculates cutting angles and can remove hairs without damaging the roots. It’s more accurate than manual FUE, and the operating time is shorter. The downside is that it costs more. Cost: About $8,000.

Platelet-Rich Plasma

This new treatment isn’t yet FDA-­approved for hair loss. But it is effective in more than half of patients and is a good choice for those who don’t want to take a drug or submit to surgery.

How it works: A tube of blood is drawn from the patient. Platelets are separated out, processed and then injected into the scalp. The concentrated platelets contain growth factors that stimulate hair follicles and thicken hair.

Patients are treated again at three months…six months…and once a year thereafter. When the procedure works, improvement becomes visible within a few months. It can be a stand-alone treatment or used in conjunction with other treatments. The only side ­effect may be some mild swelling of the forehead lasting one to two days. Cost: About $1,000 to $1,200 per treatment.

Laser Therapy

This is a safe, nondrug and nonsurgical treatment that has been cleared by the FDA. In my experience, it’s less effective than minoxidil, finasteride or platelet-rich plasma, but it helps in some cases. Studies reported a 35% increase in hair count in men and a 37% increase in women after four months of treatment.

How it works: The scalp is exposed to low-level laser light. This can be done in a doctor’s office or by wearing a cap (or using a comb) with light-emitting diodes. The light increases blood flow and the release of nutrients and other stimulating factors. There is no discomfort or skin damage. People typically use the devices for 10 to 15 minutes, three times a week.

If losing your hair doesn’t bother you, see If You Decide to Shave Your Head.