Most men—and some women—experience some degree of hair loss as they grow older.
In the normal cycle of hair growth, it is natural to lose up to 100 hairs per day. If you are losing more than that, or if
your hairline becomes more prominent, it could be a sign of excessive hair loss.
The medical term for hair loss is alopecia.
The most common type of hair loss in men is male pattern baldness, or androgenic alopecia.
This is an inherited tendency to stop producing new hairs.
Each hair follicle produces a single hair that normally grows
about a half inch per month for about 4 to 6 years. It then goes into a resting phase and loses the hair before growing a
new one. The number of hair follicles entering the resting phase is equal to the number of hair follicles starting the growth
phase, so the number of hairs on the head remains the same.
With androgenic alopecia, an increasing number of hair follicles
never recover from the resting phase, resulting in a scalp with less hair. This loss of active hair follicles may take place
over months or years before it is noticeable.
The hair follicles that usually stop producing new hairs are located along
the frontal part of the scalp and along the crown of the head. This results in a receding hairline and/or balding at the top
of the head.
Other causes of hair loss include:
- Alopecia areata, an autoimmune disorder
that attacks the hair follicles, shrinking them and inhibiting hair growth (can also lead to bald spots of facial hair)
- Stressful
events, such as major surgery
- Medications that can damage hair follicles, such as chemotherapy or blood thinners
- Fungal infections (tinea capitis)
- Chronic illnesses, such as diabetes or lupus
What Are Some
Treatments for Hair Loss?
Although the vast majority of hair loss isn’t life-threatening, many men are dismayed
enough by a balding appearance to seek treatment.
Some hair loss will resolve on its own once the underlying cause is
eliminated. For example, hair that falls out during chemotherapy usually grows back when treatment is finished.
Hair
loss due to androgenic alopecia does not go away on its own and cannot be cured. But the following treatments may slow hair
loss or promote hair growth:
- Minoxidil (Rogaine). This topical, over-the-counter medication has
been shown to regrow hair and prevent further hair loss in some people with alopecia areata and male pattern baldness. It
is rubbed into the scalp twice per day. Minoxidil only works while you are taking it, so any new hair will stop growing if
you discontinue use of the medication. Results may not be seen until after 6 months of use.
- Finasteride (Propecia).
This prescription medication is taken by mouth once a day and is designed to treat male pattern baldness. It works by decreasing
the growth of DHT, a hormone that shrinks hair follicles and inhibits hair growth. As with minoxidil, the benefits of finasteride
stop if you stop using it. Results may not be seen until after 6 months of use.
The effectiveness of these medications
depends on the cause and extent of hair loss and each person’s individual response. Usually, the more recent the hair
loss, the more effective the treatment will be. Extensive hair loss probably won’t respond well to medications.
One
other option for treating hair loss is hair transplantation, where tiny plugs of hair-growing skin are removed from one part
of the scalp and re-implanted on the balding areas.
Hair Transplantation
Hair transplantation
transfers hair follicles from areas of thick growth (“donor” sites) to balding areas (“recipient”
sites).
Hair transplantation is commonly used for the treatment of male pattern baldness and female pattern hair loss
(androgenic alopecia). It may also be used to treat other forms of hair loss.
The hair that grows from transplanted
follicles will have the same color and texture it had before it was moved.
How is it performed?
Donor
site
Healthy hair follicles are identified with the help of a magnifying scope. Donor areas are selected based on
the density of hair follicles and how well the hairs match the hairs of the recipient sites. The donor area is then sterilized.
The
hair follicles are then removed in one of two ways. A strip of skin (about a quarter inch wide) with the hair follicles is
removed. Alternatively, a small round punch may be used to remove individual groups of hair follicles. This is known as follicular
unit extraction (FUE)
Your doctor will recommend a procedure based on several factors, including your tendency to scar,
the quality of skin at the donor site, and his or her clinical experience.
If a strip of skin is removed, sutures are
used to close the wound. The wound takes about 7-10 days to heal and a small scar remains. This scar is usually covered well
by the surrounding hair.
Recipient area
The recipient area is sterilized. Then multiple small incisions
are made in the recipient area to receive the hair follicles.
The incisions made at a precise depth and angle to make
sure that there is an adequate blood supply for hair follicle and lead to a proper cosmetic result.
Then a small piece
of skin with a cluster of hair follicles is carefully inserted into the incision. Each inserted section contains as many hair
follicles as possible.
Hundreds or thousands of follicles may be inserted in a single session.
Your doctor may
offer some form of pain medication for the first 2 to 3 days following the procedure.
What to expect
Small
crusts form on the skin at the recipient site as the wounds heal. These fall off after 3 to 10 days.
The transplanted
hairs will fall out in the first few weeks, but the hair follicles remain healthy and ready to grow new hair in another 2
to 3 months.
In most cases, over 90% of transplanted hair follicles will go on to grow hair for as long as they were
naturally destined.
Complications
There may be mild-to-moderate swelling of the forehead that arises 2
to 3 days after the procedure and lasts for 3 to 7 days. In some cases, the swelling may be accompanied by bruising around
the eyes that lasts for about a week.
Although uncommon, there can be post-operative bleeding or infection. If too many
follicles are transferred at one time, or the follicles are placed too densely together, a greater percentage of transplanted
hair follicles may not grow
Is Hair Loss Preventable?
In general, androgenic alopecia cannot be avoided. However,
you can prevent additional hair loss by not wearing your hair in ways that can pull on it (ponytails, cornrows, or tight rollers)
and avoiding hot oil treatments or perms, which can scar the hair follicle.
This information is for general educational
uses only. It may not apply to you and your specific medical needs. This information should not be used in place of a visit,
call, consultation with or the advice of your physician or health care professional. Communicate promptly with your physician
or other health care professional with any health-related questions or concerns.
Be sure to follow specific
instructions given to you by your physician or health care professional.
