Hair Loss Treatment for Men
The most reliable and effective form of hair restoration known to mankind. No other form of treatment even comes close. Hair roots that exist in over abundance in the back and sides of the scalp are removed and placed into the thin and balding areas of the front and top. After about 4 months these transplanted hairs begin to grow in the new location. Because it is your own body there is no chance of “rejection”. The hair will usually continue to grow for a lifetime just as it would have it were not moved from the back. This hair may be styled, washed, and cut just like regular hair because it IS regular hair. Most hair transplant procedures are performed in one or two sittings. It is considered a minor in-office procedure performed under local anesthetic. There are two different hair transplant procedures available: The first is Follicular Unit Transplant (FUT) also called the “Strip Method. This is the gold standard of hair transplant procedures. The second is Follicular Unit Extraction (FUE) now called Follicular Unit Excision. This is a secondary type procedure that should only be considered IF the FUT procedure is not an option. Some of the worst results coming out on the internet are due to improper use of the FUE procedure. At Feller and Bloxham we are recognized leaders in the field for both procedures.
The “hair pill”.
First of its kind
The first truly effective pill to treat hair loss is called Finasteride, and it has an interesting history. Like so many drugs it was not created to address hair loss, but rather to reduce the size of enlarged prostate glands in men. It’s hair enhancing property was only discovered incidentally, but it didn’t take long for the company to repackage and rebrand the product to serve a huge market. There is no doubt that this drug has efficacy in reducing or slowing the hair loss process in some young patients who still possess most of their hair. We have noticed this ourselves in patients who have visited our clinic over the past 24 years. However, we have found Finasteride to be of very limited value in patients who have already lost a significant amount of hair- from a Norwood stage 4 and higher.
We do not give this drug to just anyone who visits the office. Like all drugs there a risk to benefit analysis must be made to determine if it is right for each individual. If it were fine for just anyone to take at anytime it would have been marketed as an over the counter drug rather than by prescription. Finasteride works because it is a hormonally active drug. It blocks the formation of DHT which is responsible for hereditary hair loss. The problem is: DHT is also needed for normal healthy function of the body. So when it is decreased there are going to be some unpleasant side effects. In the case of this drug is the loss of sexual drive and the possibility of impotence. Unfortunately, we have had several patients visit for consultation who tried this drug and experience sexual dysfunction. If it were only a few men making such claims over the years I would have written it off to other likely causes, but so many different men have made the claim that I believe firmly it is a side effect of this particular drug- independent of other possible causes. At least two of these patients had hired attorneys to bring lawsuits against the manufacturer for their sexual dysfunction and asked us to provide medical information for their lawyers.
How we use this Finasteride
- If a patient visiting us for surgery has already been on the drug for over a year with no complications then we recommend they stay on the drug for as long as they or the prescribing doctor feel comfortable continuing it.
- If a patient visits us for surgery and wants to start the drug afterward we give them a prescription with enough refills for six months. Thereafter we recommend patients go to their primary care physician and inform them they are on the drug. A blood test to check liver function should be performed at least once prior to taking the drug to make sure the liver isn’t impaired. Thereafter, further prescriptions can be given by the patient’s own physician who can properly supervises its use.
How we don’t use Finasteride
Many doctors put all their post hair transplant surgery patients on Finasteride. This makes no sense considering, by definition, transplanted hair follicles do not have DHT receptors and therefore are not affected by DHT. So why put them on a drug that will reduce systemic levels of a needed hormone ? One may make this argument if there is a lot of weak native hair around the transplants, and perhaps that is a valid reason, but in reality any hair that is that thin (miniaturized) and weak is likely too far gone to respond to Finasteride. The possibility of side effects, known and unknown, do not make it a good gamble in our opinion.
And yet other doctors put almost all patients who just visit for consultation on the drug. Unfortunately, we believe this is done for marketing reasons.
This drug was going to be marketed as an improved competitor to Finasteride. It was hoped that since it blocked two pathways of DHT creation rather than just one that it would act as a better hair pill. The drug was offered off label by some doctors and it was found to indeed work better than Finasteride did. However, while approved to treat enlarged prostate, it has not yet received FDA approval. At Feller and Bloxham we do not recommend the use of this drug.
This hair medication was also discovered inadvertently. Originally it was used as an anti-hypertensive medication, but some patients started noticing an increase in body hair and scalp hair over time. It didn’t take long for the company to re-brand and repackage the drug for sale in the hair loss market. At Feller and Bloxham we have noticed over the years that this drug, applied topically, is not very effective. In fact, it seems to cause more hair loss through chronic irritation of the scalp. We do not recommend the use of this drug.