Hair Loss and Traditional Alternatives

Head rubbing liquids and topical solutions, Minoxidil and Propecia, toupees, wigs and hair pieces, hair systems, hair weaves, non-surgical hair replacement, hair transplants and other surgical hair restoration alternatives. All have had their place in modern times as solutions for hair loss. Which hair loss solution is best for you? And is there something new for men and/or women?

Men’s hair loss and women’s hair loss has been troublesome for their sufferers since time immemorial. Indeed, potions and lotions to regrow hair were prevalent back in the days of the ancient Egyptians, while toupees and wigs were not uncommon during the time of the Caesars.

In some ways, things haven’t changed all that much through the centuries: men and women are still losing their hair and neither gender is very happy about it. All the while, many of the same alternatives and treatments, from topical lotions to men’s toupees and women’s wigs, are still being used today. Of course, there are also other alternatives today that are far more sophisticated. And if we don’t know how to “cure” baldness in the 21 st century any better than we did in the first century, at least we better understand hair loss’s cause.

All pattern baldness is androgenic

The most common type of hair loss, the irreversible kind that affects both sexes, is caused by the body’s inability to break down the hormone, testosterone. Though testosterone is a male hormone, it is also found in women, just as women’s hormones are often found in men.

In both sexes, much testosterone is produced in the scalp. When the body is unable to break down testosterone in an efficient manner, one of its by-products, dihydrotestosterone (DHT) afflicts the hair follicles, causing them to atrophy and fall into a dormant state. The hair follicle will recover and begin producing hair again, but the hair will not be as robust and healthy as it was previously. As more testosterone pervades the follicle, the period of dormancy becomes longer and longer until the hair follicle will go into a permanent “resting” stage and atrophies to the point where it will no longer produce any hair at all. When this happens to enough follicles over a period of time, the result is baldness.

The most obvious solution is to attempt to “regrow” hair

For years, and to this day, the most obvious way to solve baldness was to simply regrow the hair that had disappeared. Before the real cause of hair loss was known, all kinds of treatments were attempted, from rubbing the hair with olive oil to sleeping with a shower cap filled with mayonnaise or other common foodstuffs right out of the refrigerator. Some treatments employed exotic herbs and plant derivatives while other consisted of various concoctions that could include everything from rubbing alcohol to urine. As you might expect, none of these “lotions” and “potions” ever worked.

In more modern times, creams and lotions containing vitamins, amino acids (the building blocks of proteins), and various other nutrients were suggested as a way to revive dormat follicles, also without success.

Minoxidi* and Propecia (Finestaride)

The first drug to be granted approval by the FDA as a hair growing treatment was Minoxidil, first sold under the brand name Rogaine. Minoxidil was first used as a drug to control high blood pressure, but during laboratory experiments it was found to have hair growing properties. Minoxidil is available in 2% and 5% concentrations, the 2% variety being the only dosage that women can take. The treatment consists of Minoxidil being rubbed into the scalp where baldness is occurring twice a day, every day. In some cases, hair loss does stop, but it will resume again if the Minoxidil treatments are discontinued. In fewer cases, hair growth will occur, but only in the crown area of the scalp. And in these cases, the hair growth will not be cosmetically significant, that is, not enough hair will grow to mask the balding area.

The active ingredient in the brands Propecia and Proscar is Finestaride, a drug initially used to treat urinary problems caused by an enlarged prostate. Like Minoxidil, Finestaride was found in laboratory studies to have some hair growing properties. Also like Minoxidil, any effects that finestaride has will disappear if use is discontinued. Unlike minoxidil, finestaride cannot be used by women and is taken orally in the form of a pill. Unfortunately, while finestaride is more effective in stopping hair loss than minoxidil, it also has a side effect that many men are not willing to endure: partial or full erectile dysfunction. And like its minoxidil counterpart, finestaride has shown little or no effectiveness in growing cosmetically significant hair in the temporal and frontal hairline regions.

Lasers

Laser therapy for hair has been something that has been widely practiced in Europe for the past fifteen years. It’s been prevalent in this country for the past five years or so. The FDA, in fact, has actually approved of one particular hand held laser as a hair regrowth treatment.

How does it work? Low level laser light has already been shown to treat successfully many ailments of the skin. Some believe that the laser is able to energize skin tissues (or for the sake of our discussion, scalp tissue) and therefore, revitalize it. Others believe that the laser light stimulates blood flow and that this could be the reason for its success.

But just as is the case with minoxidil or finestaride, the level of success varies wildly from individual to individual. The amount of hair loss, the person’s stage on the hair loss continuum, the degree and velocity of hair loss, all play a part, as does the individual’s age and a myriad of other physical factors. Lasers generating new hair growth? It’s certainly possible. But how much hair growth is the question.

Toupees, hair pieces and wigs

Toupees. also known as hair pieces, and wigs have been around since the days of ancient Greece. Toupees and hair pieces generally refer to items that cover just a part of the head, while wigs generally provide full coverage of the head. The principle behind all three items has gone largely unchanged for the past 2,500 years: Hair is sewn into a base made of cloth or some type of mesh that conforms to the shape of the scalp. The item is then secured to the scalp by means of glue or adhesive tape.

As primitive as this sounds, today’s toupees and wigs are vastly improved. Modern technology has yielded toupees and wigs that are incredibly realistic and difficult to distinguish from real, growing hair. For those who don’t have a particularly active lifestyle, and don’t mind having a head of hair that they wear, they’re a good baldness alternative.

Hair weaves

A hair weave is essentially a toupee that is woven into the person’s hair, be it a man or a woman. There are various ways to attempt this: in essence, what all varieties of hair weaves have in common is that the hair piece or toupee is “sewn” by threads to the person’s growing hair. The benefit of a weave is that it is a semi-permanent method of attachment, i.e., the hairpiece or toupee is not removed nightly and can be worn when swimming or doing other strenuous activities. The disadvantage of a weave is that as the person’s real hair grows, the attachment to the hair piece becomes loose. There is also a “bulked up” appearance that is often associated with weaves, since the hair piece is never really flush to the scalp.

Hair systems

A hair system is actually a more modern version of the toupee and wig. Its chief difference is the method of attachment, generally a device that makes the hair system semi-permanent, i.e., it doesn't’t have to be taken off at night and can be worn for strenuous activities, even swimming and other sports. Unlike a weave, most hair systems are not “sewn” directly to the person’s growing hair. However, variations on this practice, such as track bonding--where the person’s growing hair is tied into a “track” that is then promulgated with snaps so the hair piece can be snapped on—are fairly common. Like the weave, if the hair system is attached to growing hair, the attachment to the hair piece becomes loose as the real hair grows. The advantages of most hair systems however, is that they can be secured flush to the scalp, so there is no “bulked up” look as is the case with a hair weave.

Hair transplants

Hair transplants involve the surgical removal of hair from a donor area (usually in the back of the scalp) to an area of the scalp that is bald, anywhere from the crown to the frontal hairline. As best exemplified in men who have male pattern baldness, hair fall out generally only occurs on the top of the scalp, leaving a “horseshoe” area of hair that continues to grow (this is also true of women, though the “horseshoe” may not be as pronounced). For reasons still unknown to doctors, this remaining area of growth is impervious to the effects of DHT after the other hair follicles have long since ceased hair production.

It’s from the back of the scalp that hair is harvested surgically. The harvested hair is then surgically implanted in the desired areas, generally beginning in the frontal hairline. The newly transplanted hair will continue to grow for a couple of weeks and then will fall out. But in two to three months time, the hair follicles will resume their production and new hair will grow in the transplanted area.

Of course, hair transplants don’t create new hair. They just move “old” hair around. And that’s one of this surgical procedure’s major limitations: the amount of hair that can be transplanted is limited to the size and available amount of hair in the donor area. Obviously, a person wouldn't’t want to have new hair growing in the front of his scalp, only to be rendered bald in the back. Complicating the issue is the person’s age and stage of hair loss who undergoes the procedure. It would be unwise for a person in his late twenties in the beginning stages of hair loss to have a transplant, since at that time, it would be unclear how much donor hair he actually has, versus hair that will eventually fall out in the back.

It must be said that the appearance of transplants has greatly improved over the past decade. It used to be that hair was harvested as plugs. These hair plugs contained from 10-15 hairs. The problem with transplanting such large plugs was that they tended to give a “rows of corn” appearance when implanted to the hairline and mid-scalp regions.

Today, it is possible to transplant much smaller units of hair. Called mini grafts and micro grafts, these mini transplant units can contain as few as two to three hairs. When these are transplanted, they can generate a much more realistic appearance of natural hair growth. As well, they reduce the amount of long-term scarring, though the recovery time from ease transplant surgical session (reduction of swelling and scabbing) remains the same, generally two weeks. However, the small amount of hair transplant with each incision means that more surgical transplant sessions will be required to produce the desired effect: anywhere from three to ten sessions could be necessary.

Of course, the issue of acceptable cosmetic coverage still remains due to the amount of hair in the donor area. Men and women who have thicker natural growing hair and/or curly hair tend to have greater success with transplants, since the amount of transplanted hair seems greater due to its girth. But even in these cases, “tricks” such as combing hair over from other parts of the scalp, or even further surgical procedures such as scalp reduction, might be advised in order to adequately cover the patient’s balding areas.

Hair transplants are not for everybody. But for those who have a significant donor area, a significant amount of money to spend, and who do not mind the fact that end result may very well be that of someone in the middle stages of hair loss, hair transplants are a very viable alternative.

Gene splicing and other futuristic solutions

Every so often, you read about a new development that will make hair loss a thing of the past forever for both men and women. One such item is gene splicing, in which the person’s DNA is genetically altered to prevent hair loss. There’s another, called a “gene” wash, in which healthy hair follicle genes are introduced to the scalp. This, too, promises to grow new hair, but it has been cautioned that the method best be used in conjunction with transplants.

There is also talk of other miracle drugs, much like there was years ago about minoxidil and finestaride. All of these drugs are “just around the corner”, which means, in accordance with FDA testing procedures, any thing from ten to fifteen years away.

The hard truth

The fact of the matter is that the best way to solve a hair loss problem is either to stop if from every occurring, or to be able to grow hair back over the entire head using some drug or chemical derivative. Everything other than those solutions will be something less than the ideal of a growing head of hair.

That having been said, the fact remains that new procedures and developments, short of regrowing a person’s own hair, are being discovered and brought to market all the time. The hard truth is that unless a person is willing to settle for some compromise short of hair regrowth, there’s no possible viable alternative for that person. On the other hand, with the advent of today’s technological advances, there will be alternatives to the traditional alternatives, whether that means a treatment option that is more successful than a transplant or minoxidil, or one that is more natural than a hair system. Only the individual can decide what compromises he or she will be willing to make for the sake of having a full head of hair once again.