Hair loss is a
major concern for men and women the world over. Unfortunately, many
consumers answer ads for hair replacement products and procedures
before getting the facts about hair loss. While some cases of hair loss
are inherited, others are caused by disease and poor diet and may also
result as the side effects of some medical treatments.
In some cases, people with hair loss conditions can
re-grow hair through correct diagnosis and medical treatment while
others may decide to seek alternative hair replacement options.
Dermatologists specializing in treating diseases of the hair and skin
may evaluate patients’ hair problems to determine what, if any,
treatment may be right for that patient. Before spending hundreds of
dollars on products and procedures, it is important to get a
professional opinion on whether or not the problem will respond to
medical treatment.
Types of Baldness
There are numerous types of baldness (or "alopecia"); all types are
divided into two categories: "scarring" and "non-scarring" baldness.
"Scarring" baldness occurs after any infection, inflammation, or trauma
severe enough to destroy hair follicles. Included in this category are
chemically-caused baldness (e.g., baldness due to acid) and
physically-caused baldness (e.g., baldness due to burns or x-rays). It
is important to remember that since the hair follicles are destroyed in
cases such as these, baldness considered to be permanent and incurable.
The most common form of "non-scarring" baldness is
"hereditary" or "male-pattern" baldness, which accounts for as much as
95% of all cases. Its genetic causes are not known, but there is
usually a strong history of this type of baldness in the families of
men who are affected by it early in life. This type of baldness is
evidenced by a gradual loss of hair over a period of years. Usually,
the hair loss occurs as a gradually receding hairline which becomes
more severe until the front and top of the head are left bald, with
hair relatively thick around the sides and back of the head. This hair
loss is considered normal with age for men, although it may also occur
in older women. The bald areas of the head may not be totally bald, but
may contain some of the almost-visible "vellus" hairs. In this type of
baldness, the follicles waste away; since the follicles cannot be
regenerated, this type of baldness is permanent.
Treatments For Baldness
Currently, the only drugs approved by the Food and Drug Administration
for hair loss are Minoxidil and most recently, Finasteride. Minoxidil
can be found in the popular topical solution Rogaine. Although Rogaine
cannot completely prevent hair loss, it does have some positive
effects. According to the FDA, it is estimated that Rogaine stimulates
hair growth in 10 to 14 percent of the people who try it. It generally
works better on men who have been bald less than ten years and who
still have fine hairs left in balding areas.
Finasteride was originally approved in 1992 as Propecia, a
medication used to treat prostate enlargement. This product has proven
to stimulate hair growth in areas of male pattern baldness. Finasteride
has been approved only for men since it is yet to be safely established
for use by women and has shown to cause birth defects.
Product Scams
In 1989, the FDA banned all nonprescription hair loss products. The FDA
has specific labeling requirements for products claiming to change the
structure of hair. According to these guidelines, product labels may
only claim to thicken hair, but not make it grow or prevent it from
falling out. Since some products get away with “hinting” that they can
regrow hair, it is important to be wary of these scams.
- “Thinning hair supplements,” oils, and special shampoos or
conditioners
will not increase hair growth or thicken existing hair.
Instead, they temporarily make the hair appear thicker by coating it
with products.
- “Vasolidators,” “hair tonics,” and other mixtures that are
intended for massage into the scalp
are not known to increase hair
growth or prevent baldness.
- Scalp "Foods" are external preparations designed to "feed"
the hair at the follicles. They
cannot grow hair in cases where the
follicles are damaged. The Food and Drug Administration considers the
phrase "scalp food" as a typical example of a "false or misleading"
cosmetic claim.
- Devices, such as "vacuum" caps or pressure helmets use
infra-red radiation or positive and negative pressures to increase
circulation to nourish the hair. These "treatments"
cannot grow hair in
cases where the follicles are damaged.
- Sprays and other products meant to cover up bald spots are usually noticeable to anyone standing near a person wearing it.
Hair Replacement Techniques
There are several methods or hair replacement and a number of
variations of these methods, but they generally fall into these
categories:
Hairpieces
Wigs are available which may cover the whole heads of both men and
women. Quality and price of wigs may vary depending upon the fiber
used. An important disadvantage of wigs is that they are not
permanently attached to the head; however, their advantages include the
fact that they cover large areas of scalp. Toupees are like wigs,
although toupees are meant to cover only the bald areas of the scalp.
Toupees (also called Fusion, hair extension, hair bridging, hair
linking, etc.) may be of different materials depending if the piece is
custom- or ready-made. Toupees may be attached to the head in several
ways, including tapes and clips. Various attachments may differ in ease
and comfort. Toupees are not service-free, as adjustments, dyeing, etc.
is often necessary for their upkeep. Of course, toupees are not
permanent methods of hair replacement; the pieces can slip and are
supposed to be removed periodically. Also, periodic cleaning is
necessary.
Hair Weaving
Hair weaving is a non-surgical technique in which the client's own hair
is woven or braided tightly, enforced by synthetic fibers. To these
braids, synthetic or natural hairs are woven or "wefted", creating the
illusion of natural hair. This procedure may be performed by a
cosmetician or beautician. The quality of the weave may depend upon the
beautician's skill and the materials used. This method is a temporary
method to conceal partial baldness only. Its advantages include the
fact that it is not a surgical technique. Maintenance of a hair weave
is necessary; as the client's natural hair grows, the weave must be
re-adjusted and tightened. Regular cleaning is needed, as may be
dyeing. Some discomfort may be caused by a hair weave, although medical
complication is improbable.
Hair Transplants
This method involves taking the hair of one part of the head and
replacing it in another part of the same head. Transplanting is a
surgical procedure and must be performed by properly certified medical
personnel. The physician removes a part of the bald scalp with a
"punch" of about 3 or 4mm. He/She then repeats the procedure, removing
a portion of the scalp, which includes growing hair (hair, follicle,
and all); this portion is called a "plug". The two portions of scalp
are then switched, so that the plug with hair is "planted" in the bald
area. Disadvantages of the method include its expense and its
discomfort (including temporary scarring and irritation following the
procedure). There is no guarantee of success, and the body may even
reject the transplanted plugs. However, there are advantages to the
method, including the fact that it is usually performed on an
out-patient basis and that once successfully completed, the results are
considered to be permanent. Both the physical condition of the client
and the experience of the doctor should be taken into consideration.
Another implantation technique involves placing one or two
hairs into a needle and shooting it into a person’s scalp. This
procedure can help produce a thin but visible hairline, but requires a
lot of hair to create the desired effect.
Hair Implants
This procedure, too, is a surgical one and appears in two forms. In the
first, "sutures" (surgical threads) are placed under the scalp in the
bald areas of the head. Real hairs are then attached to the implanted
sutures, creating the appearance of growing hair. In the second form,
synthetic fibers are themselves planted in the scalp to "create" hair
in the bald area. In both forms, the results may not be permanent, as
the hair may be rejected, causing infection.
It is important to note that the FDA has banned the use of
artificial hair fibers in implantation because of their high risk of
infection and other adverse reactions.
Scalp Reduction
This procedure involves a doctor cutting out the bald part of the
patient’s scalp and suturing or stapling the scalp back together. While
this procedure can be a permanent treatment, there is a risk of
infection, scarring and thinning of the scalp’s skin.
For more information, you may contact the Food and Drug Administration in the following ways:
Department of Health and Human Services
5600 Fishers Lane
Rockville, MD 20857
1800-INFO-FDA
www.fda.gov
