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What Options Do I Have for Hair Restoration?

My hair is thinning, and I don't want to go bald. What treatments are available to stop hair loss and restore hair?

Doctor Answers (13)

Today, there are several options for hair restoration...

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Today, there are several options for hair restoration including surgical and non-surgical restoration.

One of the simplest options is simple wearing a hairpiece. There are many options for hairpieces available and some of them are quite natural appearing. The problem is that they are not permanent, will not grow, and have the possibility of detaching.

So what are the other options – medications and surgery.

Medications for hair loss
Topical minoxidil (Rogaine) and oral finasteride (Propecia) are the only treatments for male patterned baldness that have been approved by the US FDA. Their use is indicated in men older than 18 years with mild to moderate hair loss. Several well controlled studies have proven the efficacy of these medications. After 3-6 months of use, slowed hair loss, stabilization, or increased scalp coverage can be appreciated with either medication, and results are clearly evident by 1 year.

Dense regrowth is uncommon and neither medication can regrow hair in completely bald areas. Early intervention, when thinning is first noticed and hairs are incompletely miniaturized, produces the best results. Treatment must be continued indefinitely to maintain the benefits. Stopping treatment results in a return to pretreatment status by 6 months with minoxidil and by 12 months with finasteride.

For female pattern baldness, 2% topical minoxidil is the only FDA-approved medication. Its use is indicated in women older than 18 years with mild to moderate hair loss. As always, consult a physician before starting any medication.

Surgical Option for Hair Restoration
There are many different techniques for hair restoration. The plug look of yesterday is gone and hair replacement techniques can produce a natural looking head of hair which would be difficult for barbers to detect.

Before you decide to have surgery, think carefully about your expectations and discuss them with your surgeon. It is also important to realize that your hair loss will continue and the procedure you have should last a lifetime, not just 5 or 10 years. Once the hair is used for transplantation, that donor area is gone for good.

Using a surgeon who understands the aging process and not just the technical aspect of the hair transplantation procedure is very important. Hair replacement candidates must have healthy hair growth at the back and sides of the head to serve as donor areas. Donor areas are the places on the head from which hair is taken.

There are a number of techniques used in hair replacement surgery – from flap transfers to single follicular unit grafting. For best results, multiple techniques may be used.

Transplant techniques, such micro-grafts, follicular unit transfer, and single unit transfers are generally performed on patients who desire a fuller, thicker head of hair. These techniques produce a much more natural appearance than older techniques of plug grafting.

In follicular unit hair transplantation, a donor strip of hair is harvested by excising a narrow strip of scalp from the donor area—an area at the back of the head that is resistant to hair loss. This strip of hair is then divided into individual follicular units under a microscope. Each follicular unit from the donor strip contains one to four hairs follicles.

Follicular unit transplantation is an extremely efficient manner of hair restoration because several thousand hair grafts can be obtained from one small, thin donor strip. While follicular unit hair transplantation is very simple by principle, it takes an experienced surgeon, attention to detail, an artist's touch, and micro-surgical skills for the best implementation of this technique.


Dallas Facial Plastic Surgeon
4.0 out of 5 stars 13 reviews

Hair loss treatment Options for Men and Women

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Hair loss treatment options for men and women:

Men

  • Rogaine (topical medication, somewhat works)
  • Propecia (pill medication)
  • LEDs (laser treatment)
  • Follicular unit hair transplant (surgery)

Women

  • Rogaine 
  • Spironolactone (pill medication)
  • LEDs
  • Follicular unit hair transplant

Neil Sadick, MD
New York Dermatologist
5.0 out of 5 stars 1 review

Options for hair restoration - medications and FUE approaches

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Be careful on all the stuff you find on the internet. It is best to go with FDA cleared medications.  And the same for FDA cleared approaches like hair restoration using Neograft FUE or Artas Robot hair transplants.

Rashid M. Rashid, PhD, MD
Houston Dermatologist
5.0 out of 5 stars 6 reviews

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Options for hair restoration

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In the last few months studies have shown that non surgical hair restoration can be assisted by PRP. If you have tried propecia and minoxidil, a course of treatments with PRP may help.Thanks

Jeffrey Rapaport, MD
Englewood Dermatologic Surgeon
3.5 out of 5 stars 7 reviews

Options for Hair Restoration

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There are surgical and non surgical options for hair thinning and they differ slightly in men and women. It's important to determine accurately the cause of the hair loss as treatments are markedly different for different types of hair loss

For male and female thinning (androgenetic alopecia), the options include

MEN - SURGICAL

1. follicular unit extraction (FUE) hair transplant surgery
2. follicular unit strip surgery  (FUSS) hair transplant surgery

MEN - NON SURGICAL

1. minoxidil (ie. Rogaine and generics)
2. finasteride (ie Propecia)
3. low level laser therapy
4. platelet rich plasma
5. pumpkin seed oil (now on my list via recent study 2014)


WOMEN - SURGICAL

1. follicular unit strip surgery (FUSS) hair transplant surgery
2. follicular unit extraction (FUE) hair transplant surgery

WOMEN - NON SURGICAL

1. minoxidil (i.e. Rogaine and generics)
2. spironolactone (ie. Aldactone)
3. low level laser therapy
4. platelet rich plasma



Jeff Donovan, MD, PhD
Toronto Dermatologist

Here are your options...

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As many of the other doctors have mentioned there are different options for hair restoration, the surgical approach and the non-surgical approach. Frequently, I recommend the non-surgical items first such as Propecia or topical Minoxidil, like Formula 82M. You may notice differences in a few weeks, months or even up to a year. However, the medications must be continued to maintain the steady growth. Then there is the surgical approach of hair transplantation.  Most likely, the donor area of hair to be excised will come from the back of your scalp.   Than each follicle will be carefully dissected and placed in the areas that need to be treated. Hair transplants are the most efficient and permanent way of hair restoration. However finding the appropriate doctor is essential. Look for a doctor who has specialized in this particular area of facial plastic surgery, and can give you the best experience! Best of luck!

Yael Halaas, MD
Manhattan Facial Plastic Surgeon
4.5 out of 5 stars 25 reviews

Options for Hair Restoration

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Medications are available like Propecia and Rogaine. They can be employed to help prevent further hair loss. And they can also help encourage hair growth in the crown area. However, they are not very effective for growing hair in the hairline area.

You might want to speak to a hair transplant surgeon to see if you are a candidate for a restoration procedure. Results would be permanent.

Sanusi Umar, MD
Redondo Beach Dermatologic Surgeon
5.0 out of 5 stars 23 reviews

Treatment for hair restoration

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The best science around is the drug propecia which reduces the amount of hair loss in patients.  The drug does not always grow new hair but is highly effective in controlling hair loss.  There are many other products on the market but the only one that has science is rogaine.

Jack Fisher, MD
Nashville Plastic Surgeon
5.0 out of 5 stars 3 reviews

Medical and Surgical Options for Hair Restoration

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I would set up an evaluation or consultation to discuss your concern with a physician who specializes in hair loss.  They will evaluate the severity of your hair loss and formulate treatment options.  I always recommend Propecia (for men) to prevent further hair loss and to stimulate new hair growth.  However, if the hair loss is severe enough medication alone won’t take care of the problem.  In that case, hair transplant surgery may be a good choice.

Timothy Jochen, MD
Palm Springs Dermatologic Surgeon
5.0 out of 5 stars 3 reviews

There are many treatments available for hair thinning including both surgical and non-surgical

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There are many treatments available for hair thinning including both surgical and non-surgical hair restoration options. A board-certified dermatologist should first evaluate the cause of your hair loss to determine the best treatment for your unique case.    Non-surgical treatments may include red light therapies, topical or oral medications including finasteride and minoxidil, or compound prescriptions. Some of these treatments may provide additional hair growth; all of these are a good way to maintain the hair you currently have. There are also surgical techniques which can be used that present very natural –looking results including follicular unit grafting, follicular unit extraction, and NeoGraft with follicular unit extraction. Call a board-certified dermatologist who specializes in hair restoration to set up an initial consultation and determine the best hair replacement strategy for you. With every surgical consult, a discussion is presented to each patient regarding preventing further balding as the patient grows older.  Now with the present medications at least 90% of patients can halt their progression.

Edmond Griffin, MD
Atlanta Dermatologic Surgeon

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.