Understanding hair loss - treatment

What are the treatments?

Although remedies that promise to restore hair to balding heads have been around since ancient times, most men and women with thinning hair can do little to reverse the process. For cosmetic purposes, or after hair loss from surgical or drug treatments, many people turn to wigs, hairpieces, and hair weaving - even tattooing to simulate lost eyebrows and eyelashes. Some drugs may slow hair loss, and certain alternative treatments can relieve stress or bolster the health of remaining hair, but until recently no treatment could start hair growth where no hair existed.

Minoxidil. Under certain circumstances, a topical (applied to the skin) preparation containing the drug minoxidil appears to provide moderate re-growth of hair on areas of the scalp that have gone bald. Minoxidil works on hair follicles to reverse their shrinking process to stimulate new growth. The effects are most promising in younger people who are just beginning to show signs of balding or who have small bald patches. The medication is a solution or foam that is applied to balding spots twice a day and must be continued daily; hair loss will recur if the application is stopped. More than 50% of users claim that it can thicken hair and slow hair loss, but it is not considered effective in men who already have extensive male pattern baldness. Side effects appear to be minimal, but in some users the drug may cause skin irritation. The drug is approved for use in men and women. It's available over-the-counter, and not available on the NHS.

Finasteride. Finasteride works by preventing the hormone testosterone being converted to the hormone dihydrotestosterone (DHT). DHT causes the hair follicles to shrink, so blocking its production allows the hair follicles to regain their normal size. Although more research is needed, studies suggest that two-thirds of men who take finasteride, experience some hair regrowth. In the remaining third, there is no hair regrowth, but most do not experience any further hair loss. It normally takes at least four months of using finasteride before any effect is seen, and the balding process will normally resume if treatment is stopped. Finasteride is not available on the NHS, but is available on private prescription from your doctor. It comes as a tablet that you take every day. Side effects are uncommon, although about two in 100 men who use it experience a loss of sex drive. Finasteride is not used to treat female-pattern baldness.

Hair transplantation. Hair transplantation involves the relocation of plugs of skin from parts of the scalp containing active hair follicles to bald areas. A patient may need several hundred plugs - with 10 to 60 implanted at a session. The transplanted hair may drop out, but new hair usually begins to grow from the transplanted follicles within several months. Newer hair transplantation procedures called follicular unit hair transplants can transplant one to four hairs, transplanted very close together, for a more natural look.