Bald decisions
By Edward M. Eveld
Knight Ridder News Service
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| Besides shaving your head or covering it up, there are three basic options for combating hair loss — drugs, hair additions and hair transplant surgery. The treatments have grown more sophisticated, but they're all expensive.
News services and Advertiser library photos Hairy facts Normal hair loss is 50 to 100 hairs from the head every day. Each head hair grows for three to five years before shedding. About 50 million men and 30 million women in the United States have hereditary hair loss. Hair on the scalp grows about a half-inch a month. Each person has about 100,000 hairs on the scalp. (Blondes have 140,000; brunettes 105,000; red heads 90,000.) Hairy myths One hundred brush strokes a day make your hair healthier. Hats cause hair loss. Shaving your head makes hair grow back thicker. Only genes from your mother's side determine hair loss. If you're 40 and haven't lost your hair, you're home free. |
Over here, bald. Then, next to it, are mounds of hair, seemingly sprung right out of formerly baby-bottom-smooth scalps.
The new hype notwithstanding, there are still three basic options for people who want to combat hair loss: drugs, hair additions and hair transplant surgery.
All have drawbacks: cost, for one. But while the methods haven't changed, they have grown sophisticated. Hair additions are more artful now, and transplant surgery has been fine-tuned from plugs to micrografts, a procedure that moves hair-growing follicles in tiny numbers.
An oft-repeated survey claims that the number of hair transplants has dropped precipitously in recent years. But Kenneth A. Buchwach, a Kansas City-area facial plastic surgeon and an expert on hair transplant surgery, says that's not so. The surveyors polled the wrong people, he said.
"My business has doubled over the last five years," said Buchwach, who has written two textbooks about hair loss.
There is a fourth option for those with thinning tops, more in the category of attitude adjustment, advocated by John Capps, founder of Bald-headed Men of America. Capps disagrees with the idea that people "suffer" hair loss.
"There's no suffering at all," he said. "It's relatively easy. You go from buying shampoo to buying Drano."
Men and women can join the club for $10, which includes a subscription to the Chrome Dome Bulletin and an official "Bald Is Beautiful" bumper sticker. (Club address: 102 Bald Drive, Morehead City, N.C., 28557.) Capps maintains that hair is way down on the list of things people notice about you.
"It's what's in the head, not what's on the head," he said.
Here is what happens in typical hereditary hair loss: Hair-growing follicles get smaller and smaller, at first producing thinner hair and eventually, in some people, no hair at all. The chief culprit is testosterone. The skin of the scalp changes testosterone to dihydrotestosterone, or DHT. Heredity makes some people sensitive to DHT, causing follicles in the usual balding areas to shrink.
Below is an outline of what works. Experts warn that herbal remedies generally lack scientific study.
Hair transplant
- What: Hair-bearing skin from the back and sides of the head is surgically moved to the balding areas. The "donor" skin grows hair in its new location.
- Pros: Considered a permanent solution because hair from that part of the scalp is resistant to the hormone that brings on hair loss.
- Cons: The usual risks of surgery, the cost, the possible need for time off work, the potential need for follow-up surgeries.
- Cost: Can range from $4,000 on up, depending on the degree of hair loss, among other things.
Propecia
- What: A pharmaceutical option, Propecia is a pill, a 1 milligram dose of finasteride, taken once a day to inhibit the production of a hormone that contributes to hair loss.
- Pros: Slows hair loss and, for a few, may promote some growth.
- Cons: Approved for men only; side effects could include a reduction in sex drive and erectile dysfunction. Results can take several months, and hair loss resumes if the drug is stopped.
- Cost: About $50 a month.
Rogaine
- What: A solution of 2 to 5 percent minoxidil applied directly to the scalp, often twice a day, to combat hair loss.
- Pros: Slows hair loss.
- Cons: Results may take several months. Side effects can include itching and scaling of the treated areas, and hair loss continues if treatment ends.
- Cost: About $12 a month.
Hair additions
- What: Nonsurgical hair restoration includes hairpieces, wigs and hair additions achieved by adding real and synthetic hair.
- Pros: No risks from surgery or side effects from drugs.
- Cons: Some hair additions are anchored to existing hair and may require reattaching or tightening as the existing hair grows. Additions attached to the skin may be cumbersome and may require reattaching and blending when existing hair is trimmed.
- Cost: $750 to $2,500, depending on materials and design, but the cost of maintenance and new hairpieces can reach $10,000 or more over a decade's time.
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