For patients with male or female pattern baldness and select other medical conditions, there are options for hair restoration. As with any other medical condition, patients with hair loss must have an evaluation by a trained physician to ensure that an underlying medical condition is not the cause of their problem. Once it is determined that treatment is merely cosmetic, there are several options which can be examined:
· Hair replacement systems
Often referred to as wigs or toupees, hair replacement system are artificial replacements for lost hair. There are many types of systems with widely varying quality. All will require some form of maintenance, will need replacement at some point, and have limitations. For patients with temporary hair loss due to medical treatment such as chemotherapy or patients who want a quick result, these are good options. Costs vary depending on the quality of the system but can easily rival or exceed surgical hair restoration over the long term.
· Scalp Reduction Surgery
While not considered state of the art, scalp reduction surgery is aimed at reducing the amount of bald scalp. There are limitations but for patients with small areas of baldness due to alopecia areata or scarring, this can be a good option. It is also a viable option when used in combination with other hair replacement techniques.
· Hair plug surgery
An older technology which has generally fallen out of favor, hair plugs tend to produce an unnatural hairline which is easily discernible as being operated.
· Follicular unit grafting
Considered the current gold standard of hair restoration surgery, follicular unit grafting relies on placing toupee individual hair follicles, the part which grows the hair shaft that everyone sees, in a natural appearing fashion. The results are generally quite good and produce hairlines which are so natural that a barber will often not know that anything was done.
· Follicular unit extraction
A subset of follicular unit grafting techniques, follicular unit extraction or FUE, relies on taking out follicular units from the donor area using individual punches instead of a continuous strip. Though there are advantages in some patients, the technique significantly increases the time or procedure, cost, and can thin the donor site.
· Medical treatment
There are three medications approved to treat hair loss in the United States by the FDA. These include finasteride, minoxidil, and brimtamoprost. Finasteride and minoxidil are the only ones approved for scalp hair. Though a complete discussion of the medications is beyond this article, consider that these medications are aimed at preserving what a patient has left and not necessarily increasing hair density or causing hair growth, though this may be an added bonus.