Hair loss is a common condition that affects both men and women. About 80 million men and women in the United States have hereditary hair loss (alopecia) that progresses with age. Hair loss can significantly affect a person’s self-image and emotional well-being. While there is no true cure for genetic hair loss, there are treatment options that may help slow down the progression or mask its effects. Understanding the causes of hair loss and the available treatment options can help you determine the best approach for your situation.
What causes hair loss?
There are many different causes of hair loss. The most common is hereditary hair loss or androgenetic alopecia. This genetic condition accounts for over 95% of hair loss in men and 50% in women. In male-pattern baldness, hair loss occurs in a well-defined pattern, beginning above both temples. Over time, the hairline recedes to form an “M” shape. Eventually, hair at the top of the head starts to thin as well, leaving an island of hair. In women, hereditary hair loss is characterized by thinning throughout the scalp while the frontal hairline is usually maintained.
Other common causes of hair loss include:
- Hormonal changes or imbalances
- Medical conditions such as thyroid disease, lupus, or iron deficiency
- Medications like blood thinners, antidepressants, cholesterol drugs
- High fever, severe infection, surgery, or severe stress
- Autoimmune disorders
- Childbirth
- Poor nutrition
- Chemical or heat styling treatments
In some cases, a dermatologist may be needed to determine the exact cause of unexplained hair loss.
Can hair loss be reversed?
While there’s no true cure for genetic hair loss, treatments can slow or stop progression and even help regrow hair. However, the sooner treatment is started, the better the results.
The two medications approved by the U.S. Food and Drug Administration (FDA) to treat male and female pattern baldness are:
- Minoxidil – Applied directly to the scalp twice daily, this over-the-counter medication prolongs the growth phase of hair. Minoxidil is available in 2% and 5% solutions. Many experts recommend the 5% version for women.
- Finasteride – This prescription medication blocks production of dihydrotestosterone (DHT), the hormone that signals hair follicles to stop growing hair. It’s taken daily in pill form and is approved for men only.
Using minoxidil and finasteride together has been shown to be more effective than using either alone. One study found that after 2 years, men using both medications grew an average of 277 more hairs than those only using minoxidil.
Other medical treatments
Other medical treatments that may help reverse hair loss include:
- Low-level laser therapy – Non-invasive laser light pulses applied to the scalp may stimulate hair growth.
- Platelet-rich plasma (PRP) therapy – Injections of a concentration of a patient’s own platelets applied to areas of thinning may stimulate growth.
- Medications like spironolactone or oral contraceptives – Anti-androgens and estrogen therapy sometimes prescribed for women to treat hair loss.
- Immunosuppressants – Medications that suppress the immune system show some promise in treating alopecia areata, an autoimmune form of hair loss.
- Steroid injections – Direct injection of steroids into balding scalp patches might aid hair regrowth.
Natural and lifestyle remedies
While not as effective as medical treatments, some natural and lifestyle remedies may provide modest improvement:
- Scalp massage – Massaging the scalp increases circulation which may stimulate follicles.
- Onion juice – Applied topically, onion juice may have anti-inflammatory effects.
- Saw palmetto – An herb that may block DHT production.
- Stress reduction – Lowering stress levels can minimize hair shedding linked to high stress.
- Hair care – Gently washing, conditioning, and styling hair to avoid damage.
- Balanced diet – Eating a nutritious diet supports healthy hair.
- Vitamin supplements – B-complex vitamins, zinc, iron, vitamin D may nurture hair.
Hair transplant surgery
For those with permanent hair loss looking for more dramatic results, hair transplantation is an option. This type of surgery involves harvesting hair follicles from parts of the scalp where hair is fuller and transplanting them to balding areas. Techniques have greatly improved over the years to deliver natural-looking results.
During follicular unit transplantation – the gold standard – surgeon carefully extracts intact hair follicles out under local anesthesia. The follicles are then inserted into tiny incisions made where hair is thinner. As transplanted follicles are genetically resistant to balding, the results are permanent in most cases.
ARTAS is an advanced robotic system that aids surgeons in follicular unit extraction. This technology allows for a high degree of precision and accuracy.
In general, results from a hair transplant procedure can be seen after about 4 months. Multiple sessions are often needed to achieve the desired density. When performed correctly, modern hair transplants produce natural-looking, permanent results.
The outlook for reversing hair loss
While hereditary baldness can’t be cured, today’s medical treatments provide hope. About 60% of men using finasteride experience regrowth or halted hair loss. For those considering hair transplants, refinements in surgical techniques allow surgeons to transplant hair follicles one-by-one for natural-looking hairlines. With professional guidance, consistent use of proven treatments, and some patience, significant improvement is possible in many cases of age-related hair loss.
Who are the best candidates for hair loss treatment?
In general, the earlier hair loss treatment is started, the better the results. Those experiencing the first signs of progressive thinning or loss are ideal candidates. Minoxidil and finasteride work best at the onset of male pattern baldness while the hair follicles are still alive.
Good candidates for medical treatment include:
- Men or women noticing more hairs than usual on their pillow or in the shower drain
- Men with a balding crown or widening part
- Women experiencing diffuse thinning hair on the top of the scalp
- Those with family history of baldness
- Patients concerned about early signs of hair loss
Hair transplants may benefit:
- Men with male pattern baldness stabilized by medications
- Men or women with areas of permanent hair loss
- Those with realistic expectations about results
- Healthy individuals who are good surgical candidates
It’s best to consult a dermatologist at the first signs of progressive hair loss. Early intervention offers the most potential.
What results can be expected?
With medical treatments like minoxidil and finasteride, results will vary from person to person. In general, about 60% of men using these medications experience some regrowth of hair, while about 30% stabilize with no further loss. For others, thinning continues despite treatment. Those using both medications together tend to experience better results.
With minoxidil, new hair growth becomes visible between 3-6 months. It works by stimulating follicles that have shrunk to start regrowing hair. Continued use is required to maintain benefits. Once treatment is stopped, hair loss resumes within 6-12 months.
Finasteride (Propecia) also stimulates regrowth in men. It may take up to a year to notice increased thickness. This medication must be taken ongoing to maintain results. If discontinued, DHT levels rise again and hair loss returns.
For hair transplantation, results are permanent once transplanted follicles grow in – usually around 4 months. Multiple sessions may be required to achieve desired density, as each session generally involves moving 1000-2000 grafts.
With any treatment, patience is required to observe new growth. Consistent use is key to achieving and maintaining improvements.
How long do results last?
With medications like minoxidil and finasteride, positive effects last only as long as treatment is continued. If either treatment is stopped, progression of hair loss returns within 6-12 months. To sustain results, daily application or use is required. Some choose to use these medications indefinitely to stave off inherited baldness.
For hair transplants, results should be permanent. Transplanted hair follicles taken from the back and sides of the scalp are genetically resistant to the balding process. As they are not prone to thinning, transplanted hair will usually continue growing for a lifetime. In some cases, subsequent hair loss may occur and require additional touch-up procedures. But in general, results from a correctly performed hair transplant procedure are permanent.
What are the possible side effects?
When used as directed, FDA-approved hair loss medications are generally well tolerated. Some potential side effects may include:
- Minoxidil – Irritated or dry scalp, unwanted hair growth elsewhere if solution spreads onto face or forehead
- Finasteride – Decreased libido, erectile dysfunction (uncommon)
Hair transplant surgery is considered very safe when performed by an experienced surgeon. Possible side effects include:
- Pain – Typically managed with over-the-counter medication
- Swelling – Subsides within days
- Numbness – Temporary due to local anesthesia
- Bleeding – Minor bleeding at graft sites
- Infection – Rare with proper wound care
- Scarring – Fine scars heal covered by surrounding hair
Choosing an experienced surgeon and following all postoperative care instructions can minimize risks.
How much does treatment cost?
The cost of hair loss treatment varies depending on the method chosen.
Approximate costs are:
- Minoxidil (Rogaine) – $30-$60 per month for brand name version
- Finasteride (Propecia) – $60-$100 per month
- Laser devices – $200-$600 per treatment
- PRP injections – $500-$1500 per treatment
- Hair transplant – $4,000-$15,000 per session
Health insurance typically does not cover hair loss treatment as it is considered cosmetic. However, those with alopecia areata (autoimmune hair loss) may qualify for coverage.
Various financing options may be available, including payment plans through treatment providers. Overall costs can add up, so researching all options thoroughly is advised.
Conclusion
Hair loss can be distressing, but rest assured treatments are available. Minoxidil, finasteride, laser devices, PRP, and hair transplantation are proven methods to slow down, stop, or even reverse hair loss for many people. While hereditary baldness can’t yet be cured, consistent use of today’s medical treatments – especially when started early – can achieve meaningful results. Working with an experienced dermatologist or hair restoration surgeon to find the right treatment regimen provides the greatest potential to stimulate regrowth and regain a fuller head of hair.