Hairloss
Men
You know, thinning hair really doesn't look so bad in a guy.
You ought to come to terms with this idea, at least to a point, because frankly, there isn't a huge amount you can do about hair loss. That's not to say you can't do anything at all, but modest expectations are a key to minimizing disappointment.
Where'd my hair go?
The first time a man notices he's thinning, he assumes it all happened the week before and he'll be bald in a year. In fact, balding is gradual and unpredictable. Hair loss is not transmitted just through the mother's side. Looking at your family gives only a general idea of what you'll look like and when; you will not necessarily get bald at the same rate as your Dad or older brother. Balding continues throughout life, and even people (men and women) with “full heads of hair” have less at 70 than at 20.
Because the rate of balding varies so much, it's all but impossible to tell whether treatment is working or not. You can very easily fool yourself into thinking hair is coming out more or less than it used to. Here are some points to keep in mind:
- You lose up to 100 hairs per day normally, some days a lot more, others less. These hairs have finished their 3-year life span and are ready to be shed, then replaced. Finding hair on your comb or in the sink therefore does not necessarily mean you're going bald.
- Hats and headgear do not throttle the follicles and make you lose hair.
- Shampooing does not accelerate balding; the hairs you find are just the ones ready to come out, and these will be replaced.
- Sometimes acute stress to the system (such as high fever, sudden weight loss, etc.) produces a sudden, rapid shedding of hair, where you find clumps of hair all over the place. Although this syndrome (called telogen effluvium ) is alarming, it actually is good news, because the body readjusts itself and most if not all the hair grows back. People who lose hair genetically notice they're thinning without seeing very much actually come out.
What if you really are balding?
Because hope springs eternal, there are many products which claim to slow hair loss, but there's only one available over-the-counter which really helps, if only a little: Minoxidil. Originally introduced as a drug to combat high blood pressure, Minoxidil may work by increasing blood flow to the scalp. Used consistently for 4-6 months, studies show that this drug can slow the rate of loss somewhat, and even grow a little hair in some people. Minoxidil is safe, nonirritating, and quite inexpensive (as little as $5/month in the generic form.) But there are drawbacks:
- Minoxidil mainly works on the crown, not on the frontal scalp, which is where baldness really bugs most men.
- You have to keep it up indefinitely (in other words, forever.) If you stop, whatever hair the drug has helped you hold onto will fall out and leave you where you would have been without it. Putting something on twice a day forever is very hard to do, especially when you rarely see spectacular improvement. Instead, your hair continues to thin, and you have to keep on believing that it would be worse without treatment. The only way to prove that, of course, would be to stop and watch more fall out.
Original minoxidil comes in a 2% formulation. Other forms available include 2% minoxidil with added tretinoin (Retin-A), or 5% minoxidil (“extra-strength”), with or without additives. Some studies suggest that these preparations are a little more effective than the original formula, but it's hard to say if they're worth the additional cost, which can be substantial (up to $50 month, not covered by insurance of course.)
Hairpieces, etc.
You can always choose one of the time-honored ways to add hair temporarily: hairpieces or hair weaving, in which a mesh is attached to your remaining hair and artificial or human hair is woven to blend with your own. Either method can produce quite pleasant results, but quality varies considerably and depends a great deal on how much you want to spend. Also, hair pieces and weaves stretch, oxidize, and loosen, requiring you to refresh or replace them (or in the case of hairpieces buy 2 or more at a time, to have on reserve.) Also, some stay on more securely than others during swimming and other activity. (How's that for a delicate euphemism?)
What can your Doctor do?
- The Medical approach: Propecia is a low-dose version of a drug used for several years to treat enlarged prostates in middle-aged men. It has a good safety record, although it hasn't been on the market very long (about a year as a treatment for hair loss.) Studies show that Propecia slows down the rate of hair fall, and may grow some additional hair as well. Taking one pill a day is easy, but some men prefer not to take something oral for an indefinite period (forever.)
- Surgical approaches include various versions of hair transplantation (taking hair from the back and putting it near the front) or scalp reduction (cutting away bald areas and stitching the rest together.). Check credentials carefully when consulting about these, since skill varies widely. If the doctor has limited experience, a poor esthetic sense, or if he or she transplants hairs which are destined to fall out anyway, results can be unnatural and unfortunate.
Women
Women lose hair on a genetic basis too, only not as much and not as fast. Also, women tend not to have big bald spots; in general women's frontal hairline sticks around even to the bitter end. Thinning in women tends to be general, distributed throughout the scalp. Like men, when women first notice that their hair is thinner than it used to be (which can be in their early 20's in some families), they assume the process will gallop along and leave them bald in no time, but in fact it usually takes many years for thinning to become evident to others.
Treatments for women are more or less the same as for men, with the following exceptions:
- Minoxidil can't be used during pregnancy.
- It's harder for women to apply minoxidil, because their pattern is more diffuse; in other words, there isn't an easy “bald spot” to put the medicine on.
- Propecia cannot be used by women of potentially childbearing age, because of the risk of birth defect.
|
Medical online consultation with qualified doctors
Copyright © 2004-2005