Hair Loss in South Asia: Economics
Asia's Harsh Economic Realities and Dubious Hair Loss Cures
Hair loss treatments in South Asia include legitimate practices, but economic realities drive widespread use of poor substitutes and folk medicine.
In the United States, where thinning hair and baldness are widely considered life-altering negatives, hair loss treatment is a multibillion-dollar industry. The same negative connotations and demand for answers hold true around the world -- South Asia included.
Remarks Dr. Mahendra, "For South Asians, even having gray hair is considered a sign of weakness. Men and women go to great lengths to ensure their hair stays dark. So you can imagine the stigma attached to baldness. I believe that it is even worse, socially speaking, to be bald here than in the States."
According to Dr. Poswal, however, less than 10 percent of the population in India and surrounding regions can realistically afford hair loss treatments from dermatologists and/or surgeons. Insurance rarely covers hair loss treatment, and government assistance or free clinics are not available to combat hair loss.
Most hair loss treatments are out of reach of most people
Hair replacement procedures can be extremely expensive. Let's take the cost example of follicular unit separation extraction (FUSE), a Poswal specialization. Prices for the procedure are U.S.$4.00 per graft for the first 3,000 grafts and $3.50 per graft for any additional grafts (applicable per visit). Therefore, a patient opting for 6,000 FUSE grafts would be charged $22,500, plus a government mandated 10.3 percent service tax.
Adding to the problem of affordability is the fact that relatively inexpensive alternatives, such as Rogaine and Propecia, are not yet widely available in South Asia. While there are solutions with similar chemical composition available on the retail market, Mahendra says the effectiveness of the off-brand solutions isn't as trustworthy.
"There is finpecia to replace Propecia and generic minoxidil to replace Rogaine," he says, "but unfortunately neither works as well as their American counterpart." Of course, for millions of people living on just a few dollars a day these medications are economically out of reach.
And while laser therapy, hair transplants and other hair replacement systems are available, the increasing demand combined with a shortage of adequately trained doctors in this field keeps prices high. Adds Poswal, "The fact that we are experiencing an economic boom has helped increase the demand even further."
India has long been the world's biggest exporter of human hair, and it is estimated the export is now worth up to 8.5 billion rupees (nearly U.S.$200 million) annually. However, the cost of quality natural hair extensions and pieces within the country remains relatively high, with extensions starting at $300 at a minimum.
Alternative hair loss treatments are on the rise
Owing to high costs, along with traditional South Asian beliefs, many hair loss sufferers turn to folkloric or homeopathic solutions.
"Though many people believe in Ayurvedic and homeopathic remedies to reduce hair loss, there is very little evidence to back up any positive results,” says Dr. Patel. “One of the most common treatments we see used is nightly massage of [coconut, mustard or arnica] oils into the scalp. Though the oil may add some luster to the hair that you have, it does not stop your hair from falling out or increase hair growth.”
Scientific research and clinical experts don't support these types of fixes; nevertheless, that doesn't stop the population from using them. Patel estimates that three out of four patients he sees for hair loss have tried some sort of unconventional fix.
"Like with many things, you can't talk people out of believing it,” says Patel. “Most people can't afford expensive hair loss treatments, and if rubbing coconut oil, licorice or black bean paste on their head makes them feel a little more confident, then it doesn't hurt."
What the future holds
The South Asian culture certainly seems poised to adopt more aggressive hair loss prevention and mitigation strategies. South Asians love beauty. They have a growing economy and a two-decades-established consumer products infrastructure. They revere hair as sacred, and their popular culture rejects the shaved head as attractive. They do not like losing hair.
Going forward, expect the hair loss cures in South Asia to become even more Westernized. Homeopathic remedies will be replaced by those with research-backed efficacy. Reliable and affordable options should emerge, and the supply will eventually be better able to meet the demand. While South Asians won't see an end to hair loss -- increasing affluence might perversely bring a bad version of nutrition -- they should at least be better equipped to combat hair loss issues.
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