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Hair Loss Treatment: What Works?

Posted Aug 24 2008 1:49pm 1 Comment
ANNOUNCER: Whether or not men will admit it, hair or lack of it can form a big part of their self-image. And while many accept hair loss as a fact of life, others look for ways to stop or reverse it. For these men an endless variety of hair loss products are available but how many of them actually work?

CRAIG ZIERING, DO: When patients come to our office and are getting information for hair loss, there are basically three options that they can turn to. The first option is a topical preparation called Rogaine or minoxidil, and that is applied topically to the scalp with a dropper. The second is Propecia or finasteride, and finasteride is taken as a pill once a day. The third option is hair restoration surgery, which is transplanting a patient's own hair from the back of their head to the top or front of the scalp.

ANNOUNCER: These three treatments are the only ones that are proven to be effective. Other options may seem promising but there is usually little data to back them up.

CRAIG ZIERING, DO: There are very few products that I will recommend to my patients today for hair loss. There are some products that I'll recommend to my patients if they ask to thicken their hair, and as long as patients understand that that's what they're getting are hair thickeners, then I think it's okay. But most of these medications don't do anything for the patients and are a waste of money.

ANNOUNCER: So with the three proven options for treating hair loss, how do men know which path to take? For men with early signs of hair loss, drug therapies seem to be the smartest choice.

CRAIG ZIERING, DO: Those that are very early on will benefit the most, because the earlier you start either one of these medications, the better the results will be. You'll conserve more hair and have the potential to grow back hair when you start it earlier on.

ANNOUNCER: Whether you choose Propecia, Rogaine, or a combination of the two depends on a number of factors, including how the medications are used.

KEN WASHENIK, MD: The first of those, it's been around for well over a decade now, is Rogaine, or minoxidil. It's a solution that you apply to your scalp twice a day, and Rogaine helps inhibit hairs from becoming skinnier from thinning, and can, in some patients, encourage hair to grow a little more or get fatter.

Propecia, now, is different. Propecia is a pill that you take once a day. You can take it with or without food, and it doesn't matter what time of the day. It works by decreasing the synthesis of a chemical called dihydrotestosterone.

Of the two, Rogaine or Propecia, in my experience, Propecia is much more likely to actually give you one and two years later a cosmetic increase in the amount of hair on your scalp.

ANNOUNCER: Both drugs also have potential side effects that patients should consider, though the risks are low.

KEN WASHENIK, MD: Rogaine is a liquid you rub on your head. The main thing we'll see there is an itchy head, an itchy scalp. You can get an aggravation of dandruff from it But the vast majority of men are not bothered by it. And if they get a little bit of itching and dandruff, it's often very addressable with a dandruff shampoo.

Propecia, which you take as a pill, certainly doesn't have that side effect of bothering your scalp, but what can happen there? Well, somewhere around half a percent of men -- so, 5 men in 1,000 when you compare men who took Propecia versus men who took fake pills will say they had a decrease in their sex drive or trouble with erections in some way. So a very small number, I mean, a half a percent. You keep taking it, six out of ten men, 60% the side effect will go away. But for every man, if you stop taking it, the side effects go away. They are reversible.

ANNOUNCER: Since neither drug carries considerable risks, many doctors feel a combination of both medications is the ideal strategy.

CRAIG ZIERING, DO: While there are currently no studies that show that Propecia and Rogaine can be used together to give an increased benefit, I definitely believe that, in combination, that there's a synergistic response and you get even a better result than using either one alone.

ANNOUNCER: Men with advanced hair loss may not get satisfying results from drug therapy. For them surgery to restore some of their frontal hairline can be an attractive option.

CRAIG ZIERING, DO: The state-of-the-art in hair transplantation today is follicular unit grafting. And that is where you remove hair from the back of the scalp and they're divided into one-, two-, three- or four-hair units; the way they naturally occur. And this is done under some sort of magnification.

When we transplant the hair to the front or top of the scalp, then it is surgeon- and artist-dependent in the results that you're going to get, because it's an illusion. You're using a small amount of hair to recreate the idea of having much more hair.

ANNOUNCER: The procedure itself is safe and requires only local anesthesia. Though some patients may experience some tenderness or pain after the surgery. Still many men worry that the results will be worse than their initial problem.

CRAIG ZIERING, DO: Hair transplantation surgery is extremely safe nowadays and very natural. And people have to understand that the plug look is gone. People that have the old plug look need to realize that something can be done to correct that and people that are having the early loss and have had already loss need to understand that it's a very safe and effective procedure. Extremely natural and can be very gratifying.

ANNOUNCER: Most men will need multiple hair transplants to get the results they want, and Rogaine or Propecia are often used to prevent further loss. In the future, men may have other options like hair cloning and a drug called dutasteride that's currently being tested for hair loss.

KEN WASHENIK, MD: There's one new drug that was approved recently to treat enlarged prostates in men which, as I understand, is now going to be used in clinical trials to look at hair loss. And from the early, small, short clinical trials that were done, it was very promising. It certainly looks like it will work at least as well as finasteride or Propecia, and the hope would be, because it inhibits the two enzymes that make DHT and therefore would lower the DHT levels even further, that in fact may even have more of a benefit and may be able to grow more hair back.

ANNOUNCER: But while men's choices will expand down the road, it's key to take action now if hair loss is bothering you.

KEN WASHENIK, MD: Find out why you're losing your hair, get the diagnosis, review the treatment options, know what's available to you and what you can realistically accomplish from medical treatment, from Propecia, from Rogaine, from hair transplantation, and then sit back and decide, with your doctor's help, which of those is best for you. I think that's the way to do it. Don't do it sitting home alone trying to decide what's wrong and how you can fix it. Go out and get the medical advice that you need to make a sound, informed decision.

Comments (1)
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I agree, whenever someone asks me "whats the best hair loss treatment, I always say, Whatever works best for you!. And you have to get a diagnosis to see what is causing the hair loss before you look for a treatment.
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