Hair Loss

The two main techniques of non-surgical hair replacement today involve the use of hair systems and hair loss concealers. Various types of hair systems such as full wigs, hairpieces, hair extensions, toupees and weaves can look extremely authentic and have been used for ages to cover bald spots, typically with good rates of success. However, their main weaknesses are high maintenance costs and, in many situations, the discomfort of wearing them. Hair loss concealers on the other hand have been around for a shorter period of time and have often been looked down upon for being incapable of withstanding adverse external conditions and for appearing unnatural. This no longer appears to be true as many of them have greatly improved recently, both in terms of their authentic appearance and their resistance.

There are three types of hair loss concealers: those that simply paint your scalp to match your hair colour, then there are hair thickeners that thicken your hair by coating and penetrating the hair and trapping moisture and volume-building proteins inside the hair shaft and, lastly, there are bald spot concealers that apply microfibers that cling to your hair like branches to the trunk of a tree, increasing the hair density. Some products combine two of the aforementioned approaches and paint your scalp and thicken your hair at the same time. All of these products come in various forms, such as a powder, cream or a spray. Hair loss concealers do not contain any ingredients that would combat hair loss but some of them allow you to continue with a topical hair loss treatment such as minoxidil.

Microfibre-based hair loss concealers can be typically applied in as little as 30 seconds versus a minimum of five minutes required for hair thickeners. However, microfibres are less water-resistant and it is quite difficult to apply them precisely and so they are not very good for creating an authentic-looking frontal hairline. Their biggest advantage is that they are unrecognisable in your hair, even with a very close inspection. Hair thickeners, especially those that also colour your scalp, are extremely water-resistant and excellent for frontal hairlines but they take longer to apply. They cover your scalp with a layer of colouring substance, which makes it impossible to apply any topical hair loss treatment. Their greatest weakness in comparison to microfibres is that in direct sunlight it can become visible to the sharp eye that the scalp has been painted.

The common weakness of all kinds of substances used for concealing hair loss seems to be the limited choice of available shades. Some hair loss sufferers use a combination of two products simultaneously to overcome the weaknesses of individual products and to achieve the most authentic looking shade and appearance. Most often a combination of a hair thickener and a microfibrous concealer is used. The results of such combinations are typically excellent. If you wish to try any such combinations, make sure that you apply the scalp-painting, hair loss thickener first and then use the microfibres to mask the remaining imperfections. There are many products in all three categories of hair loss concealers out there and you may want to test several of them in order to identify those that best match you hair colour, type and style of application.

Alopecia areata is known to be an unpredictable hair disease affecting about 2% of the world’s population and is the second most common type of hair loss after hereditary baldness. It is often called patch baldness or spot baldness due to its patchy, balding pattern. In severe cases, it can affect the whole scalp (alopecia totalis) or the entire body (alopecia universalis). It is not yet known what causes alopecia areata. It is thought to be an autoimmune disease triggered by a person’s autoimmune system, which decides to attack its own hair follicles. Sometimes the hair grows back a few years later and stays and sometimes it falls out again. Although there is no treatment for alopecia areata that works 100%, some treatments have been proven to improve this condition. The most popular treatment option, which does not require a doctor’s prescription, is topical minoxidil, such as Rogaine. It can be used alone or in combination with other medicinal treatments that will be discussed later.

The best known prescription treatments for alopecia areata are corticosteroid shots, injected straight into the bald spot, and steroid gels and creams. Corticosteroid injections are a more effective but also the more painful option of the two. The aim of this approach is to suppress the autoimmune reaction but it has been proven to work only on small bald spots. Another common treatment for small bald spots, which is supposed to affect the autoimmune reaction, is the application of topical anthralin. Anthralin is a tar-like substance used to treat psoriasis.

Topical immunotherapy is the most common form of treatment for extensive conditions. It uses an immunosuppressant such as cyclosporine that is applied to the skin to cause a skin reaction similar to mild eczema, which in some cases leads to hair regrowth. This method is also the most drastic form of treatment, causing various negative side effects.

Another therapy for extensive alopecia areata is PUVA, which stands for "psoralen plus ultraviolet A radiation", consisting of a topical or oral application of psoralen, followed by ultraviolet radiation. This treatment is better tolerated than topical immunotherapy but is also less effective.

A recently conducted research study with sulfasalazine also spells some promise for patients with severe conditions of alopecia areata. Sulfasalazine is an anti-inflammatory medication first used to treat rheumatoid arthritis and is hoped to be soon used to treat alopecia areata.

This is the brief overview of the most common medicinal treatments for alopecia areata. There obviously is a number of other alternative therapies that are claimed to help treat this condition and do not require a doctor’s visit. Consumers should be aware that none of these products has ever been clinically shown to be effective in treating alopecia areata and such claims are legitimate only because these products are not regulated pharmaceuticals but non-regulated cosmetics.

Hair loss and eventual baldness can be caused by a number of factors but heredity appears to be the main reason why men and women lose their mane. Hereditary hair loss in men and women happens to have the same main cause, which is dihydrotestosterone (DHT) attacking and killing our hair follicles. DHT is a metabolite of the male hormone testosterone but it also happens to be present in the female body. Men and women lose their hair not because of increased levels of DHT in their bodies but due to the susceptibility of their hair follicles to harmful DHT attacks, although the mechanism and reasons why some hairs, mostly those on the top of the head, are more vulnerable to such attacks are not yet exactly know.

The main difference between the male and female form of hereditary hair loss is in its shape. The male form has a characteristic horseshoe pattern whereas the female form is typically a diffuse thinning across the entire scalp and is thus less easily-recognised. The female form of hereditary baldness is, in its form, practically indistinguishable from hair loss caused by various other factors. The second most common reason for a woman to lose her hair is hormonal imbalances during and after pregnancy or menopause. Such changes are typically of a temporary nature and so also is the hair loss, although post-menopausal hair loss is in most instances permanent.

When it comes to treating hair loss in female patients there are certain specifics. First, most women do not make very good candidates for hair transplantation due to their diffuse thinning pattern, which makes it impossible to identify the hair that will be resistant to future miniaturisation. Secondly, finasteride, which is one of the only two FDA-approved hair loss treatments available today, cannot be used in women and neither can dutasteride, which is its closest and assumedly yet more powerful relative. Rogaine (generic name minoxidil) is the second FDA-approved hair loss treatment and its approved concentration for women is only 2% versus 5% for men. However, many doctors recommend their female patients use male formulations of minoxidil, with a concentration of 5%, such as Rogaine foam. Aminexil is a molecule similar to minoxidil and it is most often recommended to women who are pregnant or breastfeeding as a safer option than minoxidil.

Although some antiandrogens such as finasteride or dutasteride cannot be prescribed to women, there are other antiandrogen medications that can be effectively used to treat female pattern baldness. Spironolactone (trade name Aldactone) and cyproterone acetate (used in contraceptives such as Ginette 35, Diane 35 and Diane 50) are antiandrogens most commonly used to treat female pattern hair loss.

Another treatment with seemingly high rates of success is topical estrogen solutions such as Crinohermal, which use a female hormone, estradiol, as their main active substance. Estradiol is capable of inhibiting the conversion of testosterone into follicle-harming DHT. Hormone replacement therapy is another hormonal treatment suitable for women at menopause, with estrogens and progesterone pills and creams being the most common forms of treatment. Estrogen levels in the body decline with time. As women enter the menopause, estrogen levels decline and, therefore, more of the male hormone testosterone is then available to be converted into follicle-harming DHT.

This list of treatments for female pattern baldness is not exhaustive. A variety of other existing remedies are claimed to help promote hair growth in women, such as ketoconazole, fluridil, flutamide, alfatradiol, as well as various substances of natural origin. Despite the fact that there are female patients who will swear by some of these alternative treatments, none of them has ever been sufficiently clinically tested, let alone approved by any major national health supervisory authority as a treatment for female hair loss and the claims of their guaranteed effectiveness should be taken with a grain of salt.

It pays to have some basic understanding of the existing hair loss treatment options before you decide on your treatment. The hair loss treatment options can be, in the first place, divided into surgical and non-surgical therapies. There are only a few surgical techniques currently used but the non-surgical spectrum is wide and confusing. There seem to be thousands of non-surgical treatments available to those who wish to avoid hair transplant surgery. Propecia and Rogaine might be the best known medicinal hair loss treatments, while dried fruits of saw palmetto and a Chinese herb, He Shou Wu, also known as Fo-Ti, are the natural ingredients most frequently found as the main active ingredients in alternative hair loss remedies.

The non-surgical hair loss therapies can be in principle divided into medicinal and alternative treatments, whereas when considering methods of application, they can be administered as oral treatments, topicals and others, such as LaserComb. Irrespective of the aforementioned breakdowns, hair growth treatments work either by blocking the activity of dihydrotestosterone (DHT), also called anti-androgens, or by stimulating hair growth.

DHT is a biologically-active metabolite of the male hormone testosterone and it is held to be the main cause of both male and female pattern baldness. DHT causes hair miniaturization as the hair becomes finer and thinner with every new hair growth cycle until the hair follicles refuse to produce another hair and die. The exact mechanism by which DHT acts on hair follicles is not known, though. Finasteride, better known under its trade name Propecia, is the only clinically-proven and FDA-approved anti-androgen used for treating male pattern baldness. It acts by preventing the creation of harmful DHT in the scalp. Since the introduction of Propecia, many other drugs and natural therapies have emerged claiming anti-androgen activity. Some of them are thought to work by a different mode of action than Propecia, such as preventing DHT from binding to the receptor sites in the hair follicle or blocking activity in the androgen receptor itself.

Minoxidil, also known under its trade name Rogaine (Regaine in Europe), is the best-known hair loss medicine amongst hair growth stimulants. It is assumed that hair growth stimulants work by stimulating epithelial growth of hair follicles and some of them may also counteract the hardening of the hair follicles but the exact mechanism of their action has never been described. One thing that all hair growth stimulants appear to have in common is their ability to increase the length of the hair growth cycle, thus improving the ratio of hair in the growth phase and to increase the hair’s thickness.

The natural hair loss remedies are assumed to work by the aforementioned modes of action and are often presented as safer alternatives than medicinal treatments. There are not too many hair loss treatments out there that have been clinically proven and independently verified to be effective in treating baldness. Of those few existing, all happen to be medicinal drugs. Natural hair loss remedies have still to live up to their originator’s claims.

When deciding about the most suitable hair loss treatment option, you should consider approaching the problem from different angles. It is best advised to use a combination of anti-androgen and hair growth stimulant, such as a Propecia/Rogaine combo. Alternative, hair loss treatments, for instance herbal remedies, should largely be considered as a method of fine-tuning this basic regimen in order to achieve additional benefits.

The available medical options for reversing hair loss hair in people suffering from hereditary forms of baldness are limited to relatively few products with most of them being effective only in the early stages of baldness. Once you have lost a big portion of hair due to hereditary factors or an accident, such as a burn, the only remaining option is to replace the missing hair. Your options can be either of a temporary nature, such as the use of hair pieces and hair loss concealers, or a permanent surgical solution. Hair transplantation happens to be the most effective way of surgical hair replacement and the only permanent solution that offers satisfactory results.

Hair transplantation consists in transplanting patient’s own hair from the back of his scalp to the frontal, balding area. The main limiting factor of hair transplantation is the shortage of donor hair and, therefore, many patients do not make a good candidate. The suitable hair transplant candidate should have a high hair density in the back of the scalp, his hair should be thick and wavy, his scalp flexible and the contrast between the colour of his hair and scalp should not be too great, and he must be in good physical condition. Women largely suffer from a diffuse form of hair loss and, therefore, do not make very good hair transplant candidates. Hair transplantation also cannot be performed on patients suffering from unpredictable forms of hair loss such as alopecia areata.

Given the limited supply of donor hair, the hair transplant surgeon must be able to utilise the little hair he can use to create the optical illusion of a full head of hair. This represents the biggest risk in hair transplantation, as it can sometimes happen that the patient does not like the final result. Although you can usually arrange for another hair transplant procedure, some damage can be irreparable. Other risks and side effects occurring during and after hair transplant surgery include excessive bleeding and scarring, the lengthy healing of wounds, the transaction and eventual death of many implanted hair follicles, post transplant shock hair loss, which, though only temporary, can affect your newly-implanted hair as well the hair in the donor area, scalp numbness and tension and the further progression of hair loss post surgery, which can lead to unnatural patterns of baldness. In one recent study, which examined the experiences of 425 hair transplant patients who had undergone 533 hair transplant procedures in total, it was determined that about 5% of the patients experienced complications either during or after surgery.

Hair transplantation can cost more than ten thousand dollars, depending on the technique used, the location and reputation of the clinic, the extent of hair loss and the number of hair transplant sessions needed to achieve the desired change in density. However, sometimes it is impossible to estimate the final cost, which represents another risk you take when deciding on hair transplant surgery. Given the pain, time and cost involved, it pays to educate oneself prior to signing up for hair transplant surgery. The hair transplant industry is a fast-growing area and the quality and affordability of hair surgeries are improving, so do not let anybody push you into hasty uninformed decisions.

When it comes to combating hair loss, it is medicinal pills and topicals that spring to most peoples’ minds as the options holding the greatest promise. There also happen to be other available treatment options, such as surgical as well as non-surgical hair replacement, but to date only oral and topical medicinal treatments have been proven to reduce and reverse hair loss naturally. Hair transplantation, though providing the best cosmetic results, cannot slow or reverse hair loss. Natural and herbal hair loss treatments seek to mimic medicinal treatments in their mode of action but their effectiveness in treating hair loss has never been confirmed in any significant clinical study and many of them are associated with hair scams.

The two medicinal treatments that have been approved by the FDA (Food and Drug Administration) in the US for treating hair loss are topical minoxidil (trade name Rogaine/Regaine) and oral finasteride (Propecia). These two hair loss drugs have been also approved by national health supervisory authorities in many other countries. Topical minoxidil is suitable for both sexes, whereas finasteride can only be prescribed to male patients. Minoxidil is a vasodilator, originally used to treat high blood pressure, which was later found to stimulate new hair growth when applied topically to the scalp. Its exact mechanism of action is not known, though.

Finasteride (better known as Propecia) is an antiandrogen that was initially applied to treat benign prostatic hyperplasia (BPH), also known as prostate enlargement. It acts by inhibiting conversion of the male hormone testosterone to the follicle harming didydrotestosterone (DHT). The discovery of finasteride’s positive influence on hair growth led to finding the true cause of hereditary baldness, which are the harmful attacks of DHT on our hair follicles. Since making this discovery, a quest for other alternative DHT inhibitors has begun, especially amongst antiandrogen drugs and herbs that have, in the past, been used to treat urinary problems.

Dutasteride (trade name Avodart) is a drug similar to finasteride and has been studied extensively for treating hair loss. It is currently undergoing phase III clinical testing. It has been approved for treating BPH and is therefore available in pharmacies in many countries around the world. Although it has not yet been approved for treating hair loss by any national health supervisory authority, it is being prescribed by some clinics and doctors to male patients who no longer respond to finasteride. Dutasteride is believed to be a more powerful hair loss drug than finasteride but also with more severe side effects.

Flutamide (trade name Eulexin) is an extremely powerful antiandrogen used to treat prostate cancer. It works by binding to the androgen receptors and thus competing with DHT. Oral use of flutamide can cause serious side effects but it is believed that topical applications might have less adverse side effects and could be, in the future, used to combat hereditary hair loss. More research is needed to verify such claims.

Spironolactone (trade name Aldactone) is another antiandrogen that works by binding to androgen receptors, competing with DHT. It is used in women to treat acne, excess body hair and hair loss and although there are some generic topical applications designed for treatment of male pattern baldness containing spironolactone, it has never been approved to treat hair loss in men and should better be avoided.

Aminexil, was developed by L’Oreal to treat baldness in men and women and its molecule is very similar to that of minoxidil. Its mode of action is not exactly known and it is believed to be a less powerful weapon in the fight against hair loss than minoxidil.

NEOSH101 is one of the most promising novel hair loss drugs under development. It is in phase II clinical trials and is supposed to be a hair growth stimulant, distantly related in its actions to minoxidil. Although not expected to become an ultimate cure for baldness, it could improve the chances of many hair loss sufferers of regrowing some of their lost hair.

The above list of medicinal treatments for hair loss is not exhaustive. There are also other drugs though to help treat hereditary baldness, such as superoxide dismutase, fluridil, ketoconazole, alfatradiol, etc. but none of them has ever been proven in any serious clinical study to promote hair growth and further studies will be needed to evaluate their actual effects on hair loss. Therefore, for the time being, minoxidil and finasteride remain the main weapons in the fight against genetically-determined hair loss conditions in male patients.

Men have been seeking an ultimate cure for hair loss for thousands of years but until very recently with relatively little success as most available cures were either cosmetic cover-ups or unsophisticated vitamin/mineral pills and herbal lotions, with quite many of them just being scams. It was only with the advent of finasteride and minoxidil and improvements made in hair transplantation techniques in recent fifteen years that the new era began, enabling hair loss patients to halt the further progression of the balding process and replace the missing hair on top of their head using the hair left at the back of their scalp. However, to this day no ultimate cure for hereditary hair loss exists. There are presently several promising drugs and techniques under development but none of these new therapies is expected to hit the market before 2013.

NEOSH101 is being developed by the US company Neosil and it is currently undergoing phase IIb clinical testing. It has been shown to be a more potent and faster-acting hair growth stimulant than minoxidil and it only needs applying once daily. Though considerably improving the current hair loss treatment options, NEOSH101 is unlikely to become an ultimate cure for hereditary hair loss. The clinical trials seem to be advancing slower than most hair loss sufferers would like to see and, hence, do not hold your breath for it hitting the market anytime soon. NEOSH101 is mainly expected to replace minoxidil and other currently available hair growth stimulants.

Another promising area of development is genetics research, especially the telomerase research. Telomerase is an enzyme that puts natural caps on telomeres and thus protects them from shortening. Telomerase thereby maintains the genomic integrity. Shortened telomeres are associated with the premature aging processes. However, the uncontrolled activation of telomerase can cause cancer growth. Cancer research is the main focus of the telomerase study but scientists are also looking for other applications, such as anti-aging drugs and drugs against hereditary hair loss and premature grey hair. Although still under development, there are already some generic products available on the market that seek to emulate the mechanism of telomerase action but they have no scientific backing and should better be avoided. Telomerase research could really change the world of medicine but its commercial application might be a good decade away.

Hair multiplication, often called hair cloning, is the next hopeful treatment approach being developed. This technique involves extracting the healthy hair follicles from the back of the patient’s scalp, culturing and multiplying them and injecting the newly-grown hair cells into the bald scalp. Among several teams of scientists on three continents researching hair multiplication, the UK healthcare firm Intercytex appears to be the frontrunner. Intercytex reported results of the latest stage of the clinical phase II study of ICX-TRC (a suspension of a patient’s own dermal papilla cells) in March 2008 and they were positive. The next release is expected by the end of 2008. However, since the aforementioned data release no substantial progress has been reported and the company seems to be struggling, having serious difficulties to secure financing for its ongoing projects. This therapy might hit the market in 2013 at the earliest. The main benefit of hair multiplication would be solving the shortage of donor hair that is the main limiting factor in hair transplantation.

Generating hair follicles in wounds of hair-free skin is a completely new approach to growing new hair. It was discovered accidentally as wounded skin in mice started producing new hair. This technology is currently being developed by the US medical device company, Follica, which licensed this technology from the University of Pennsylvania. Though this technique may sound weird it is said to use only common instruments and drugs that have already been medically approved and thus it should not take too long for it to become commercially available.

This is the list of the main promising lines of research and development in the area of treating hereditary hair loss that are being currently developed but some others seem to be in the pipeline. It appears that becoming bald will one day be by choice rather than destiny.

The best known and the most frequently prescribed medications for male pattern baldness are Propecia, or some other form of finasteride, such as Proscar, and Rogaine, or its generic form - minoxidil. Some doctors will also recommend you to use supplementary vitamin and mineral pills, some anti-dandruff shampoos, such as Nizoral, and a laser comb. But very few dermatologists and hair loss clinics will recommend their patients buy herbal hair loss treatments. But there are so many of them out there and most of them claim that they work better than Propecia or any other medicinal treatment prescribed by your doctor, while being free of potential negative side effects so typical of prescription medicine. And some of the manufacturers seem to be so much convinced about the effectiveness of their product as to offer you a full money back guarantee. Or is it a catch?

First, one needs to differentiate between medical practice and the pharmaceutical industry on one hand and the cosmetics industry on the other. The medicinal and pharmaceuticals industries are strictly regulated in any civilised country in the world, ensuring patient’s safety. Doctors can only prescribe certain medications for certain conditions and the safety and efficacy of such medications has to be approved by the national health supervisory authorities. Such products are considered safe and clinically proven to help treat the given condition. If your doctor recommends you some other, unproven herbal hair loss remedy, they will be taking the risk of supporting a treatment that has not been subjected to any rigorous clinical testing. Most doctors would not do that since they have no guarantee that such a product would be beneficial to their patients and recommending a bad treatment could hurt their reputation and lead to withdrawing their licence.

Although some of the active ingredients in herbal hair loss products may pose a health risk, despite the common belief that they are safe, this is not their main controversy. The principal question is whether the herbal hair loss remedies are effective in treating baldness. They might be effective to a certain degree since many of them also contain generic minoxidil, the only existing, clinically-proven and FDA-approved topical medicine for treating hereditary hair loss. Additional components, besides herbal extracts, usually include minerals, vitamins, essential fatty acids and amino acids. Most of these substances are either essential to ensuring healthy growth of hair and skin or they have been shown to promote hair growth, mostly in small studies conducted on rodents. They have never been clinically tested for treating hereditary baldness and thus their effectiveness and mechanism of action are unknown. They may or may not help promote hair growth but since no clinical proof of their efficacy exists, the only way to find out is to buy them and try for yourself. And should they fail to work as promised, you may find out that the generous money-back guarantee, after deducting the marketer’s incurred costs, only applies to a small percentage of the original price. This is the way some herbal hair loss product manufacturers and their distributors earn their money.

In summary, no herbal hair loss remedy has ever been clinically proven and independently verified to treat hereditary baldness. This does not necessarily mean that all herbal hair loss remedies are ineffective as they might work for some of us. However, they are usually overrated and should at best be expected to maintain your existing hair rather than grow new hair from a bald spot.

As there are bad hair loss products, there are also bad hair loss patients, too. Obeying certain basic rules is necessary if you want your hair loss therapy to be successful. The first thing you should do before you start looking for a suitable hair loss treatment is to determine whether you are a hair loss patient at all and what type of hair loss you are suffering from. For male patients who have already lost a noticeable amount of their hair on the top and front of their head, it is easy to self-diagnose. But if you are suffering from diffuse hair loss or your hair loss began only recently, you need to go and see a dermatologist and have a miniaturisation test done. It would be senseless to treat a condition that does not exist. It is very common for hair loss sufferers to skip the doctor’s consultation while many others simply deny their condition. This often leads to hair loss progressing too far for it to be treated successfully. In order to re-grow lost hair you must have fine miniaturized hair left in your bald areas. Once your hair follicles have died and there is no baby hair left, no miracle can rejuvenate them.

After you have determined which type of hair loss you are suffering from, the journey can begin. Whether you intend to follow you doctor’s advice or be experimental, you must have realistic expectations. False hopes necessarily lead to frustration, no matter how effective the treatment is. Do not believe that there is a hair loss remedy that can re-grow all of your lost hair. You will be lucky to find a treatment to arrest your balding process and if you manage to re-grow a few hairs, take it as a bonus. Keep in mind that the ‘before and after’ pictures on promotional websites are forged. The best possible improvement one can expect from any treatment is to re-grow the hair you have lost in the previous three years.

Many patients fail to follow professional advice and use proven treatments and instead opt for allegedly safer alternative natural remedies, as they get scared off by the potential negative side effects of medicinal drugs. This is a common trick used by the marketers of hair loss scams - to spread stories exaggerating the harmful side-effects of medicinal drugs. They lure you into buying their own concoction, which is most likely a waste of your time and money. Starting with unproven remedies deprives you of the opportunity to test some of the best hair loss treatments available today.

The key to a successful treatment is, besides picking the right remedy, adherence to the prescribed daily regimen. Many people, in their impatience, fail to follow their doctor’s instructions and start experimenting with multiple treatments simultaneously. This often leads to them abandoning certain treatments before they have started producing results. Any hair loss treatment requires a minimum of four months to kick in and you should allow it at least six months to bring measurable results. Overdosing will not speed up or improve results.

And lastly, do not overreact to shedding. Shedding is a common occurence in any effective hair restoration therapy. If you start a new treatment, such as Rogaine, you will first have to shed the old hair. Rogaine stimulates hair follicles, resulting in an increase in the thickness of your miniaturized hair. But this will not happen overnight. First, the old thin miniaturized hair must be shed, and then the hair follicles rearrange themselves in order to start producing thicker hair. Typically, the first sign that the treatment is working is accelerated hair loss.

Conquering baldness and restoring lost hair is to many of us a distant dream. However, there are existing options for replacing lost hair and some of them may seem surprisingly effective even to the most sceptical hair loss sufferer. The three principal methods of hair restoration include surgical hair restoration, non-surgical hair replacement and therapies for regrowing hair using pills and topicals. The main technique of surgical hair restoration today is hair transplantation, whereas wigs, hairpieces, hair thickeners and hair loss concealers are the most popular aids used to replace the lost hair by non-surgical means. The non-surgical cover-up is obviously the quickest and the least expensive method of replacing lost hair, though not tremendously popular, as many people believe that wigs and concealers cannot withstand rain and wind and do not look natural. In spite of this common belief, some of them are extremely resistant to external influences and can appear very authentic. Wigs and concealers are usually the only option of restoring lost hair for people suffering from non-hereditary forms of hair loss such as unpredictable alopecia areata.

Surgical hair restoration is the most expensive method of restoring lost hair but also the most elegant solution. It can only be used in people suffering from hereditary forms of baldness and burn patients. Candidates are required to have sufficient hair density at the back of their scalp and many women suffering from female form of hair loss with its typical diffuse balding pattern do not meet this condition. Hair restoration surgery has made great strides in the past twenty years with the introduction of the two main techniques used today - follicular unit transplantation and, more recently, follicular unit extraction. These advances in hair transplantation techniques enable the grouping of hairs very close together, which gives modern hair transplants an entirely natural look. The main weakness of hair transplant surgery, besides the cost and the pain involved, is the limited supply of donor hair and the need for multiple surgeries to achieve the final improvement. Furthermore, patients have to commit themselves to the use of finasteride or any other adequate medicinal hair loss therapy for the rest of their lives to prevent further loss of hair.

Hair loss pills and topicals do not, despite significant scientific advances and the discoveries of recent years, provide satisfactory hair restoration results yet. The two most frequently prescribed hair loss drugs, finasteride and topical minoxidil, can be effectively used to reduce hair loss but their ability to regrow lost hair is relatively poor. Their effectiveness typically declines sharply in the later stages of the balding process. There is no existing medicinal or natural hair loss remedy that can deliver adequate visual results comparable to either hair transplantation or non-surgical hair replacements such as wigs and hair loss concealers. Although there are some promising medicinal hair loss drugs currently being developed, especially in the area of genetic research, the ultimate pill for baldness is not expected to become commercially available within the next fifteen years. Other advances in hair science, such as hair cloning or the generation of new hair follicles in wounds, also hold out some promise but it appears that hair transplant surgery will in the next ten to fifteen years remain the most complete method of hair restoration.