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Hair today, transplants,
or drugs tomorrow?
NEW YORK, Aug 2 - Hair gets us into tangles. When it's full, we flaunt it. When it sheds, we lose it.
Youth, vigor, sex drive and power are attributes we see in this asset, so crucial in a service economy where looks sell. Hairstyling woes are a mere indulgence for the hirsute. It's when locks are lost for good that the issue really hits home.
"We get up every day and go into denial about our mortality. But hair loss screams in the mirror 'You're getting old,'" said Dr. Michael Reed, attending physician at NYU Medical Center's Hair Transplant Clinic in New York. "For men it's less severe. A man can declare hair independence or at least pretend to. For women it's a catastrophic event."
About 50 million men in the United States have androgenetic alopecia, the most common form of hair loss caused by heredity, hormones and age. Surprisingly, though, one in four women -- or nearly 30 million -- also have this problem, according to the Women's Institute for Fine & Thinning Hair.
Some, like actor Yul Brynner, may choose to flaunt a beautifully sculpted pate with a shine, but most men -- and especially women -- shy away from highlighting their dwindling fortunes. Desperate and embarrassed, most people turn to the back of magazines and surf the Internet for solutions.
Unfortunately, most "miracle" drugs and "secret" formulas make dubious promises. The "scientific proof" they claim is mostly based on foreign studies that U.S. authorities would probably dismiss as miserably inadequate.
"People are often so desperate to do something about their hair that they can be taken advantage of by people selling snake oil. Historically, products that have not been tested generally don't work," Dr. Reed said.
Instead, experts recommend first going to a dermatologist to trace the root cause of any hair loss. Don't assume it's hereditary. It could be temporary, caused by allergies, stress, illness, dieting, anesthesia, pregnancy, or chemotherapy.
Only two medical treatments have been approved by the U.S. Food and Drug Administration. Minoxidil, sold under the brand name Rogaine, is a liquid that's applied to the scalp twice daily. Finasteride, sold as Propecia in tablet form by Merck & Co. Inc., is taken daily, by prescription for men only.
Far from being miracles, these drugs may stop hair loss or regrow hair over time. But the success rate varies. Also, Rogaine may irritate the scalp, and Propecia could harm a male fetus and is therefore not approved for women.
Surgery offers the only guarantee. Thankfully, unlike the Barbie doll-style
corn rowed hair plugs of the past, hair follicles are now transplanted in mini- and even
micro grafts of two to three strands each so that the hairline will look perfectly natural.
"I've had people compliment me and were flabbergasted that it's a transplant," said "John," an actor in Los Angeles, who spent about $16,000 on six or seven transplant sessions over eight years. "It's worth every penny."
As a result of the technical and aesthetic advances, women now make up 35 percent of hair transplant patients, compared with just 5 percent 10 years ago, according to Dr. Reed.
Under "twilight" anesthesia, surgeons remove a hairy strip, 1/8-inch to 1/4-inch deep, from the back or side of the scalp -- which is genetically programmed to never grow bald, or at least remain hirsute for many more years. The strip is then microscopically dissected into clusters, which are planted into tiny holes made in the needy areas.
About 2,000 grafts can now be made in a $3,000 to $5,000 session. In the cornrow days, only 100 to 200 grafts were possible. And now, patients can even wash, or rather, pour shampoo over their hair the next day.
Hair surgery is painless, but the continuous discomfort afterward can be "maddening," said John. "You need medication to sleep until the stitches come out. It's like having a rock in your shoe. But I've gone back to work the next day."
And results don't show until four to 12 months later. The hair follicles, traumatized during the transplant, go to sleep and shed before they wake up again to grow hair 3 months later. Even neighboring follicles may be shocked and go dormant, so patients may end up balder before they get hairier.
People who want hair NOW should just get a hairpiece. If stares don't bother you, $100 to $250 will buy you a rug-on-your-head look, manufactured with inexpensive Asian hair that's dyed or permed to match your image.
But for about $2,500 every 3 to 4 months, "hair systems" will pass close scrutiny. Such hairpieces, which are glued on, are made of very fine materials that must be replaced every few
months.
"Wayne," a 33-year-old New Yorker, started using a hair system when he was 26. But the cost, irritation from the glue, monthly restyling sessions, and worry made him give it up.
"If I was 26 again, I would shave my head," he said. "No matter how good it looks on you, there's some stress at the back of your mind about whether people can tell or not," added Wayne, who is now quite bald.
"When you get older, instead of doing a comb over, shave it, be a man. Be cool, shave it off."
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