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Treating Hair Loss (Hair Care)
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Treating Hair Loss

Mariusz J.A. Sapijaszko, MD FRCPC (Dermatology)

Hair loss has long been thought of as an inevitable and irreversible process of aging. While this may still hold true, prevention of hair fallout and hair restoration treatments are now available to fight natural hair loss. Hair is an important feature in determining first impressions, and loss of hair can negatively affect our own self-image. Just as there are temporary and permanent solutions for unwanted or excessive hair (for more information, visit, there are treatments to address loss of scalp hair. For the purposes of this article, we will review male pattern hair loss and female pattern hair loss, and its treatment methods.  

There are many factors of male pattern and female pattern hair loss that are still left unknown to us. We do know that its causes are complicated, involving hereditary factors as well as individual sensitivity and susceptibility to hormones. Genetics play a large role for hair loss in both men and women, and these traits are affected by both parents. We also know that androgen levels are a key factor in male pattern hair loss. Higher levels of DHT (dihydrotestosterone) in the scalp area are strongly linked with baldness, and in men with hair loss problems, consistently high levels of DHT are seen. There is much more that is left unknown with regards to hair loss in women, but we do know that some treatments for men are also effective for treating women with hair loss. 

Minoxidil (RogaineÒ), a drug that was developed to treat high blood pressure, is now an effective drug that treats hair loss for both men and women. Initially a side effect of increased hair density, the drug is now one of the most effective hair loss treatments. Currently, the drug is used as a topical solution, which aims to decrease hair loss and increase hair density. Interestingly, this drug has been shown to be more effective for women. Finasteride (PropeciaÒ) is a powerful oral agent that lowers the production of DHT, and is an effective treatment of male pattern hair loss. PropeciaÒ 1mg per day has proven decrease in hair loss and increase in hair density in a large sample of treated men, and is shown to be more effective than with use of RogaineÒ alone, or a placebo. This drug is intended for men over the age of 18, and should not be used by women who are or plan to become pregnant.

Hair transplantation is an alternative to pharmacological solutions, and its effects are more permanent. There have been significant advances in both the methodology and the practice and art of hair transplantation, allowing this procedure to recreate hairlines and hair density that looks natural. Donor dominance is the idea that transplanted hair growth is largely determined by its origin, rather than the growth potential of the area that it is being transplanted to. That is, if hair is transplanted from an area of healthy growth such as the back of the scalp where hair loss is typically absent, it retains these characteristics when transplanted to an area with hair loss such as the frontal scalp, and grows as if it were growing from the back of the scalp where hair growth is strong. All hair transplantation revolves around this theory.

Harvesting methods from the back of the scalp such as single or multi-blade techniques have become efficient, and very few hair grafts are wasted in a single transplant session. Techniques like micrografts (single hair), follicular unit graft (grafting of natural bundles of hair, usually between one and three), and minigrafts (4 to 8 hairs) allow for greater flexibility and allows for customization of hair placement, and production of a natural looking hairline. These techniques are available for both men and women. However, for optimal results, multiple treatment sessions are recommended.

Hair loss should not be treated as a purely medical problem. It can negatively affect one’s well being and self-esteem, and be a cause of social anxiety. Fortunately, advancements in topical and oral medications and restorative options such as hair transplantation have helped individuals reduce hair loss and restore a fuller hair. It is important for physicians to offer patients as many options as are available so that patients are satisfied and happier with the options.

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