Non-Surgical Hair Replacement Options
There are four commonly used non-surgical or “medical” options you may want to consider. Early, when your hair starts to thin, one or all may work to stimulate follicles that are diminished in size. The hope is that these smaller, weaker follicles will strengthen to provide better quality hairs with longer growth cycles. This could delay the way your hair goes from thinning to balding.
Minoxidil is applied as a solution directly to the scalp. It seems to help follicles survive longer by extending their growth cycle and may stimulate follicles to produce better quality hairs. It is best used in the earlier stages of thinning/balding. Once a scalp is completely bald, i.e. devoid of hair follicles, Minoxidil will be useless. It can be used in both men and women.
In my practice, I dispense an enhanced formulation that features a higher concentration of Minoxidil and an analog of Latisse®, a product that successfully grows longer eyelashes, and seems to do the same for scalp hair.
The cost of my product is $60 for a bottle that is used once daily and should last 3 months. Because it is a prescriptive product, I can only dispense it to my patients. I offer consultations for both medical and surgical treatments. While Minoxidil products are available over-the-counter, it is advisable to consult with a hair specialist before undertaking what might become long-term therapy.
Finasteride (a.k.a. Propecia®)
Finasteride is taken orally and is best used only by men. The pharmaceutical company Merck first marketed finasteride (as Propecia®). Their initial testing demonstrated no usefulness for women. It is an anti-androgen that slows the production of DHT (dihydro-testosterone), the “bad” male hormone that facilitates genetic baldness and increases prostate growth as men age. Like minoxidil, finasteride may keep follicles functioning for longer time periods with stronger hairs.
As with minoxidil, finasteride works better on individuals who still have active hair follicles, but are thinning, especially in the crown area. Because you will probably taking finasteride for many years, a consultation with a physician specializing in hair loss is most helpful in evaluating whether or not you may benefit from taking this medication.
The cost of finasteride, 1 mg., varies from about $0.20 per tablet for the generic product to around $2.50 for the brand name product. Since the generic version is ok, you might do best by shopping online for the best price.
PRP ( Platelet Rich Plasma )
PRP stands for Platelet Rich Plasma. The platelets are the tiny chips present in blood that mechanically help blood to clot. They contain growth factors that are believed to enhance healing and stimulate new tissue growth. To obtain these platelets, your own blood is withdrawn, spun down in a centrifuge, and the platelets, now in a concentrated band, are removed and injected back into the area that requires treatment.
PRP is FDA approved only for orthopedic injuries. It has been used a lot for ballplayers who have damaged various joints. After one or multiple injections, there is improvement in many cases.
Over the past few years, PRP injections have been used to stimulate hair growth in a thinning scalp. There have been many enthusiastic reports about the efficacy of these treatments as a medical hair restoration procedure. Many studies, but not all, showed an increase in hair density and quality. However, in one recent scientific study of women with genetic balding, a double-blind technique was used, i.e. actual platelets were injected in half the patients and a placebo injected in the other half. Only 13% of the patients had less hair loss and thicker hair, and, for the rest, there was no real improvement with either the actual or bogus treatment. While some of the women thought they had regrowth even with the placebo procedure, there still is no absolute evidence that PRP really works.
I have not been overly impressed with this type of therapy because I believe, that in many thinning or balding individuals, there are too few follicles left to stimulate. In addition, too often, the cost and time needed for multiple treatments are wasteful. I don’t believe that anyone can predict whether or not PRP will work for you. But, like other medical treatments for hair loss, if you are thinning, the earlier therapy is started, the better your chance for improvement, or, at least, the better your chances to slow down the balding process.
Laser Therapy For Hair Loss
Laser light in low, safe energy levels, emitted in a narrow wavelength is thought to stimulate hair follicle cells, allowing them to function better over a longer time period.
Like other medical hair therapies, nothing will work if you’re trying to stimulate follicles that aren’t there. You should first consult with a physician hair specialist to properly evaluate your chances of improving your hair density with a laser or any other form of medical therapy.
I recommend the i-Grow® Low-Level Light Laser (LLLT) that uses two sources of light energy, both a laser and LED, allowing a wider area in the scalp to be stimulated.
i-Grow® claims to provide the highest percentage of new hair growth in any published clinical studies. The company has shown that after 4 to 6 months, most people using it have had enhanced hair growth.
The lights are fitted into a helmet that should be used for 20 minutes 3 times weekly. It retails for $695, but Amazon is selling it for $430. There are many other hair-growth lasers being marketed and I’m sure that most are ok.