Hair Loss

The first hair transplants were conducted in Japan back in the 1930s. In the old days of hair transplant surgery relatively large strips of skin of four millimetres in diameter, the so called punch grafts, were transplanted from the back of the scalp to the frontal balding area. Hair transplantation techniques have evolved enormously since then and today’s hair transplants can give you a very natural look. This is due to the miniaturisation of hair transplants, which now contain only one hair follicle (holding between one and four hairs) and are less than one millimetre in diameter. These tiny, single follicular unit grafts are then implanted into the needle-made incisions in the balding area. Today’s technology enables dense packing of hair follicles, which gives you a completely natural-looking frontal hairline. Gone are the days of pluggy grafts that made you resemble a toothbrush.

The two main hair transplantation technologies that are used today are called Follicular Unit Transplantation (FUT) and Follicular Unit Extraction (FUE). The main difference between them is in harvesting hair follicles. The FUT is the older method, using the so-called strip harvesting, when a linear strip of skin of up to 20 centimetres long and 1.5 centimetres wide is extracted from the back of the scalp and the opening is then sewn closed. This strip is then placed under series of microscopes and dissected into small grafts, containing just one follicular unit each and measuring max one millimetre in diameter. Such follicular grafts are then implanted into the balding area. The advantage of this method is its high yield, measured as a percentage of the follicles that are successfully transplanted into the bald area. This yield is around 98%. The greatest weakness is that it leaves the patient with a linear scar at the back of his head. The FUT is less expensive than the FUE and is used when a large area needs to be filled with transplanted hair in one single session.

The FUE method uses a micro-extraction technology to harvest individual hair follicles that can be directly implanted into the small needle poke holes in the bald area. The FUE technique is the latest technology, introduced in 2002. Its greatest benefit is the fact that it leaves the patient with only tiny scars at the back of the head, which are visible only after very close inspection, and the healing time is much shorter than with the FUT, due to the small size of the wounds. However, this method is not suitable for covering large areas in one session and it is more expensive. Additionally, its yield is significantly lower, due to the transaction of many follicles, and since the supply of donor hair is limited, it cannot be used in patients whose hair loss has progressed above NW4 level.

Potential future surgical hair restoration technologies, such as hair multiplication and the generation of new hairs in wounds, should solve the problem with the limited amount of donor hair. It seems that hair implantation will in the long future only be used for creating frontal hairlines and, therefore, the follicular harvesting should manage to provide a sufficient number of hair implants. However, none of the aforementioned potential future techniques is expected to become commercially available before 2012. Therefore, the immediate future probably lies in improving the harvesting techniques of the FUE technique in order to improve its yields and make it financially more affordable. The FUT with its strip harvesting, which sparked a revolution in the hair transplant industry less than two decades ago, may become history in the not too distant future.

Propecia, or generic finasteride and Rogaine, or its generic form - minoxidil are the most frequently prescribed treatments for hereditary pattern baldness by dermatologists and hair loss clinics around the world. Some doctors may also recommend you to use supplementary vitamin and mineral pills, some special shampoo, such as Nizoral, and a laser comb. But very few dermatologists and hair loss clinics will recommend their patients to buy natural hair loss treatments despite the fact that many of them out there claim that they work better than Propecia or any other medicinal treatment, 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 fields are strictly regulated in almost every country in the world, ensuring patient’s safety. Doctors are only allowed to prescribe certain medications for certain conditions and the safety and efficacy of such medications has to be evaluated and 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 cosmetic hair loss product, they will be taking the risk of prescribing 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 product could hurt their reputation.

Although many of the active ingredients in natural hair loss remedies 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 natural hair loss remedies are effective in treating hereditary forms of hair loss. They might be effective to a certain degree since many of them contain minoxidil, the only existing, clinically-proven and FDA-approved, topical medicine for treating hereditary baldness. Additional components usually include minerals, vitamins, proteins, essential fatty acids and herbal extracts. 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 baldness in men and thus their effectiveness and mechanism of action remain 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 by trial and error, hence you have 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 their incurred costs, only applies to a small percentage of the original price. This is the way some natural hair loss product manufacturers and their distributors earn their money.

Despite all the aforementioned claims no natural hair loss remedy has ever been clinically proven and independently verified to treat hereditary baldness. This does not necessarily imply that all natural hair loss remedies are ineffective as they might work for some of us. However, they are usually overpriced and should at best be expected to maintain your existing hair rather than grow new hair from a bald patch.