ANNOUNCER: Hair loss has always been a top cosmetic concern for men of all ages, but it's only in recent years that proven medical options have become available and surgical techniques have been refined to produce remarkable results. This means real hope for men who are concerned about balding; But it's important to have a realistic understanding of the options and what they can achieve.
KEN WASHENIK, MD: I see many men in my clinical practice who come in with the problem of thinning hair, hair loss, baldness, and in the question invariably is, "What can I do about it?" And I think, you know, there are a few options.
One is surgical-surgical hair restoration, a hair transplant. The other is medical. And we only have two drugs. We have Rogaine, or minoxidil, a liquid you rub on your head, and Propecia, a pill you take once a day. These are the options.
ROBERT BERNSTEIN, MD: Hair loss is not a process where you go from having hair to being bald. What happens is the hair goes through a process of miniaturization where it gradually gets thinner and shorter, and medication can reverse that process. It can take very fine hair, which really doesn't have much cosmetic benefit, and then make it a full, thick hair.
ANNOUNCER: But do these medications work on all types of hair loss?
KEN WASHENIK, MD: Rogaine and Propecia are specifically indicated for the treatment of male pattern hair loss, the common, inherited type of hair loss that is by far overwhelmingly the majority-what the majority of patients have. There is, I think, a misconception that, well, they only work if you're losing your hair in the back. They don't work in the middle or in the front, along the frontal hairline. And in fact, that's not true.
ANNOUNCER: One of the most important factors in treating hair loss is setting the patient's expectations.
KEN WASHENIK, MD: Rogaine and Propecia can certainly help hold your hair. The question is, can you regrow some hair and gain some back, and the answer is yes. And in the case of Propecia, especially, a good number of men actually gain hair back. After two years, around two thirds of men who take Propecia will have more hair than they did two years earlier, when they started it.
ANNOUNCER: As with most treatments, timing plays a key role in achieving maximum results.
KEN WASHENIK, MD: Realistically, the earlier they start, the sooner they get on treatment, the better off they're going to be, because what we do best medically is keep your hair. Although many men can gain hair back, your goal should always be to start early enough that if you maintain the hair you have today, you'd be happy. And we do know from the clinical trial data that men who started even one year later, as a group, did not quite gain back as much hair as the men who started a year earlier.
ANNOUNCER: For men with more severe hair loss, surgery can be an effective option.
KEN WASHENIK, MD: Hair transplant surgery, because of the refinement of the techniques now, is in fact very useful for men with a wide range of hair loss. From earlier on, where they have particular needs that may not be dramatic looking to the average person, and all the way to men who have had, really, a marked or great amount of hair loss, who arguably don't have much hair at all left on the top of their head.
ROBERT BERNSTEIN, MD: Hair transplantation surgery has been around for about 40 years. It's only been the last five or six years, in a procedure called follicular unit transplantation, that it's really been really a wonderful procedure, and in that procedure, hair is transplanted from the back of the scalp in the actual way that it grows, which is in little, tiny groups called follicular units of one to four hairs. And we can now put them in the scalp in a way that totally mimics nature.
The hair becomes groomable at about six months. At about eight months, you can get really a feel for what the transplant is like, and then somewhere between eight months and a year the transplant is mature, with most people seeing the full result of the procedure in about a year.
ANNOUNCER: Hair surgery can recover some of the hair you've lost, but doesn't prevent future loss, so medications are often used in addition to surgery.
KEN WASHENIK, MD: I don't separate him, or suddenly say he's a surgical patient and not a medical patient, because I'm a firm believer that medical treatment of your hair loss-one, to halt the progression, and, boy, if you can, grow some hair back-does nothing but improve the outcome of your hair transplant and make it look better.
ROBERT BERNSTEIN, MD: The transplanted hair will grow and is permanent, regardless of medications. What I like to use medications for is to put the person on it long term so that they won't need more surgery, so that they won't have a progression of their hair loss.
ANNOUNCER: For some men, another option is not to treat hair loss at all.
KEN WASHENIK, MD: Given the diagnosis of "No, you have inherited hair loss," the question is, "Does that bother you?" I mean, this is not something you have to treat. The people who should treat it are the people who find they're bothered by it.
ROBERT BERNSTEIN, MD: Sometimes, just the idea that you can explain to them that it's normal or that they can wear their hair short, they're assured, and that's the end of it.
ANNOUNCER: But if men are bothered by hair loss, they should seek help as soon as possible.
ROBERT BERNSTEIN, MD: Cosmetic procedures in women have always been very popular and very accepted, where men have always been hesitant to seek any kind of treatment for vanity reasons. And we encourage men, even if you don't want to have treatment, at least-if hair loss is bothering you, at least see a doctor, find out what you're options are. Do something about it. Just don't feel like you're powerless, and I think once you understand that it's something-that it's normal, and that there are many wonderful options today, that you can relax and make a good choice for yourself.