If you’re losing your hair, don’t tear out the remaining strands in frustration. You could simply accept going bald â€“ it’s a natural part of life after all, for a significant proportion of men. Give the combover a miss, but try clipping your hair close or shaving your head completely â€“ a pretty common (and even fashionable) look these days.
However, if you’d like to try to keep a full head of hair, you might want to consider hair loss treatments.
There are plenty of practitioners and products out there promising to restore your hair, but in this vanity-driven industry with more than its fair share of sharks, it’s very much a case of caveat emptor (let the buyer beware).
The facts are:
Hair loss and balding is not uncommon â€“ androgenetic hair loss affects more than half of all men, and many women, at some point in their lives.
There are treatments that can slow or stop hair loss, and in some cases reverse it. However, there are plenty of shonky operators and products out there, which can be traps for the desperate.
You’ll have more treatment options available to you if you see your doctor as early as possible in the hair loss process.
We review the main hair loss treatments available, including:
- Finasteride and dutasteride
- Saw Palmetto
- Hair transplant surgery
- Low level laser therapy (LLLT)
- About hair loss
Androgenetic alopecia, also called male-pattern hair loss, is a hereditary pattern of hair loss affecting about 30% of men in their 30s, and about 50% of men in their 50s. In men who have inherited the condition, testosterone is converted to dihydrotestosterone (DHT) in large amounts, actively targeting the hair follicles from temples to crown. Over time, the hair follicles shrink and the hair shaft is reduced until it is short, fine and downy.
Many women can also experience androgenetic alopecia, which causes general thinning on the crown. However, it appears in women that there are a number of different hormones involved, rather than just the one, so diagnosis and treatment is less straightforward.
Other less common kinds of hair loss include alopecia areata, where hair is lost in spots or patches, and hair loss due to illness, stress or dietary issues. In this article, however, we focus on androgenetic alopecia.
Hair loss treatments
Finasteride is a prescription medicine usually taken to treat an enlarged prostate, and works by blocking one of two enzymes (called 5-alpha reductase) that convert testosterone to dihydrotestosterone (DHT). It’s the DHT that causes hair follicles on the temples and crown to shrink, so finasteride’s action helps prevent or slow hair loss, and taken in the early stages may even regrow hair. Clinical trials have found it helps nine out of 10 men.
Side effects are uncommon but may include impotence, breast cancer and depression. It may also cause birth defects so it is not recommended for women. It costs about $30-40 per month, although your hair-loss medical specialist may determine you need it less often, which reduces the cost and risk of side effects. You’ll need to take it for at least a year to know whether it’s proving effective.
Dutasteride has a similar action to finasteride, but blocks both DHT-making enzymes instead of one. It may be a more effective option if finasteride isn’t working for you, although at present it’s only prescribed ‘off-label’ for hair loss.
Saw palmetto is a herbal remedy sometimes taken instead of finasteride for treating an enlarged prostate. It was hoped it might prevent hair loss too, and is often promoted as such, but this hasn’t been shown in large-scale clinical trials so far.
Minoxidil (for example Regaine)
Minoxidil is a topical treatment applied to your scalp twice daily. It works best on people with recent or mild hair loss, but less effectively on people who’ve had large areas of baldness for a long period of time. There’s also a genetic basis for its effectiveness: some people produce the enzyme to convert the minoxidil in solution to the active compound minoxidil sulphate, while others don’t, making it less effective for them. It may take up to a year to see results. Hair loss will rapidly restart when you stop the medication. It costs $30-50 per month.
Some hair loss clinics promote a pharmacist-compounded solution of minoxidil with retinoic acid, which supposedly helps the minoxidil penetrate the skin. However, there’s no good evidence it increases minoxidil’s effectiveness, and it’s more likely to irritate your scalp.