As hair loss is so closely linked to personal confidence, self-esteem, and our expectations of ageing, it is not surprising that a whole industry has grown up dedicated to selling you the ultimate cure that will provide hair restoration.
As far back as ancient Egypt, people have been duped by ‘miracle cures’ for baldness, ranging from pigeon droppings to black cow blood, and nettles to dog claws. Remarkably, there are still many ‘snake oil’ cures around today, as men and women desperately seek to turn back time and restore their youthful head of hair. But that doesn’t mean that all hair restoration treatments are shams.
Two chemical hair restoration treatments have been clinically proven to be effective at both slowing or stopping hair loss and promoting new growth. These two treatments are known as minoxidil (often sold as Regaine®) and finasteride (often sold as Propecia®). These two treatments work in different ways and it is worth getting expert advice to see which will provide the best hair restoration solution for you.
Minoxidil as a hair restoration agent
Minoxidil is a happy accident of medicine, as it was originally developed as a blood pressure medication. Patients taking it for hypertension noticed that their hair grew thicker as a result, and before too long, hair restoration became the primary purpose of the treatment rather than a curious side effect.
Perhaps as a result of its unusual route to market, no one quite understands how minoxidil actually works in hair restoration. One theory is that it causes hyperpolorisation of cell membranes, while others think that its effect is due to dilation of blood vessels around the hair follicles.
However it works, minoxidil has been shown to slow or stop hair loss in as many as 80% of both men and women, while also promoting new growth. Minoxidil is an effective hair restoration treatment when used in the early stages of hair loss, although the effect reduces in the later stages. It is unlikely to have much effect at all on patches of scalp that are totally bald.
Where it is effective, minoxidil shows results rapidly, within around four months, although continued use is required to maintain hair restoration. If the treatment is discontinued, you may experience hair loss at a more rapid rate than before you began.
Minoxidil comes in two strengths, 5% for men and 2% for women, and is applied directly to the scalp as a foam or lotion twice a day. No treatment is without potential side effects but minoxidil is considered relatively safe, although, because of the treatment’s original medical use, it is not recommended for people with heart conditions. You should consult your GP before commencing hair restoration treatment with minoxidil if you are in any doubt.
Finasteride as a hair restoration treatment
Unlike minoxidil, the mechanism by which finasteride acts as a hair restoration therapy is well understood. Finasteride works by preventing the body from converting the hormone testosterone into dihydrotestosterone (DHT) by inhibiting the production of the enzyme type II 5-alpha reductase. It is DHT that causes hair loss in male pattern baldness (as well as in females) by destroying vulnerable follicles. Reducing DHT also shortens each follicle's rest cycle, causing a further hair restoration effect.
Finasteride can be a very successful hair restoration agent in men with male pattern baldness and will prompt fresh growth and thickening in up to 30% of cases. Finasteride is most effective at the crown of the head and has least effect at the hairline. As with minoxidil, the effect will only continue while the treatment is ongoing and normal hair loss will resume within a year if treatment is stopped.
Unlike minoxidil, finasteride does have some side effects when used in hair restoration, including a loss of libido, erectile dysfunction, and reduced ejaculate in around 0.5% of cases. However, these will return to normal very quickly once you stop the treatment.
While finasteride can be just as effective for hair restoration in female pattern baldness, it does not work for post-menopausal women. It is vital that women taking finasteride also take birth control precautions as the drug can cause birth defects if taken during pregnancy. Women who may become pregnant should avoid any hair restoration treatment.
Choosing your hair loss restoration treatment
As the two main hair loss treatments work in different ways, it is important to get expert help when choosing the right hair restoration treatment for you. It is also worth considering the fact that once you begin a treatment, you are committed to continuing with it in order to obtain the best results. This is especially true with minoxidil.
A long-term commitment to hair restoration treatment involves a significant financial outlay, and it may work out cheaper to consider a hair transplant for hair restoration rather than chemical treatments. Hair transplants, although an intensive treatment at the time, do not require follow-up scalp applications on a regular basis to achieve hair restoration.
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