By Marta Ustyanich
The cure for hair loss is hidden in a complex sequence of more than 25 genes, limiting treatment to medical, surgical, and cosmetic procedures, which millions of men have nevertheless turned to for over two decades. And while next-gen treatments like Scalp MicroPigmentation (SMP) are becoming more popular worldwide, traditional hair-loss treatments have actually progressed very little over the last decade. Of course, this doesn’t make them ineffective, but the success of the treatment option you choose will depend on several factors, including your age, the extent of hair loss, and your ability to keep up with the treatment long-term. In fact, not all treatments are suited to everyone — still, some may be able to try several options, even combining them, to help improve results. We’re taking a closer look at some of the most effective options you’ll be given when you first step into a hair-loss clinic or meet with a dermatologist.
Rogaine or Minoxidil
Type of treatment: This over-the-counter topical treatment is available as a liquid or foam, and should be gently applied to a dry scalp (not the hair) using the fingertips, twice daily.
Cost: Approximately $40 to $50 per month.
Best suited to: Early stages of hair loss to maintain or improve thinning hair.
Efficacy: Eight to 30 per cent of those who start using minoxidil (generic name) or Rogaine (trade name) will notice an improvement.
Time to results: Six months.
Available formulations: 2% liquid minoxidil; 5% liquid minoxidil (extra strength); 5% Rogaine foam — 5% minoxidil is significantly better for men than 2% minoxidil, according to the Canadian Hair Loss Foundation.
Known side effects: Potential to irritate the scalp, an increase in daily hair shedding during the first two months of use, and other rare side effects such as headaches, dizziness, heart palpitations, and swelling of the hands and feet.
Contraindications: Those with heart or cardiovascular disease, high or low blood pressure, or an irregular heartbeat should consult with their doctor before starting treatment.
Things to note: Once you start treatment, you’ll need to continue using it in order to maintain your results. Once you stop, any progress will diminish over a period of six to nine months. You can also pair minoxidil with oral hair-loss treatments to maximize your results.
Finasteride or Propecia
Type of treatment: Also sold under the name Proscar, this is an oral medication taken daily.
Cost: Approximately $50 per month.
Best suited to: Younger men with hair loss in the crown, with some improvement in frontal hair loss.
Efficacy: Forty-eight to 90 per cent of men will stop losing their hair completely, and 42 per cent will improve their hair density.
Time to results: Three to five months.
Available formulations: 1 mg Propecia pill or 5 mg Proscar pill — consult with your doctor to determine which dose is right for you.
Known side effects: A lower sex drive in 1.8 per cent of men; impotence in 1.3 per cent of men (more common in older men); testicular pain; depression and mood changes; breast enlargement in less than two per cent of men; other rare side effects.
Contraindications: Finasteride is not suitable for those with liver problems or a history of depression.
Things to note: Finasteride works by blocking the production of the dihydrotestosterone (DHT) hormone, an androgen responsible for androgenetic hair loss. You can improve your results by combining Finasteride with a topical treatment. Once stopped, the effects of the treatment will wear off in six to 12 months.
Type of treatment: This permanent surgical cosmetic treatment is an outpatient procedure that lasts three to 16 hours, and involves removing hair from the back of the scalp and transplanting it into balding, thinning, or scarred areas under local anesthesia.
Cost: $6K to $12K, depending on the extent of hair loss.
Best suited to: Younger men in the early stages of hair loss with strong, dense hairs at the back of the scalp so removal can be easily disguised.
Efficacy: Ninety to 100 per cent of hair follicles will survive transplantation.
Time to results: Hair will begin to grow out at three months, with significant changes observed at six months; it generally takes nine to 12 months for the full effects to appear, and hair can even continue growing 15 to 18 months post-treatment.
Variations on treatment: The “strip method” involves removing a strip of skin with a high hair density from the back of the scalp — also called the “donor site” — from which individual hairs are extracted for transplantation. Follicular unit extraction (FUE) involves shaving the back of the head to extract as many as 2,000 to 3,000 out of over 30,000 total hair follicles one by one.
Known side effects: Occasional swelling and bruising post-surgery around the forehead and eyes; temporary numbness on the back of the scalp; temporary hair loss in the first few months post-surgery in 20 per cent of men; scarring on the back of the scalp; infection in 0.05 per cent of patients; post-surgical bleeding.
Contraindications: Those with bleeding problems and other medical conditions should consult their doctor to determine if they are good candidates for surgery. You should discuss which medications to avoid prior to surgery, and avoid smoking and alcohol before and after the procedure.
Things to note: It can take about a week for swelling and redness to subside, so book some time off. You’ll also want to avoid physical activity post-surgery. If you’re using Rogaine or minoxidil, discontinue its use before your surgery, but making it a part of your maintenance plan post-procedure can actually help. Keep in mind that you may require two to three sessions; a second hair transplant can be performed nine to 12 months following the initial session. Ongoing research at Bosley Hair Restoration is currently looking into making stem cell therapy a viable option for growing an unlimited number of healthy donor hairs within a cell culture.
Platelet-Rich Plasma (PRP)
Type of treatment: A newer, 45- to 60-minute non-surgical procedure that involves injecting the growth-promoting components of a patient ’s own blood, which is rich in numerous growth factors that stimulate hair follicles, into the scalp, which is numbed with local freezing medications.
Cost: $1K to $2K per treatment.
Best suited to: All forms of male pattern balding.
Efficacy: Half of all patients will experience some degree of improvement.
Time to results: Three to six months.
Known side effects: Tenderness in the scalp and swelling in the forehead for one or two days.
Contraindications: Consult your physician for a list of conditions that may preclude you from undergoing treatment.
Things to note: To maintain your results, you’ll need to under go additional treatments two or three times a year.
Scalp Micropigmentation (SMP)
Type of treatment: “Scalp pigmentation works by camouflaging your scalp to look thicker, with a realistic hairline,” says SMP technician Milena Pagano, who practises at Raro Tattoo & Piercing in Woodbridge. “We use specially designed pigments to replicate hair follicles in your scalp.” This non-invasive treatment requires no surgery, and while it is suitable for all hair-loss candidates, Pagano suggests that those with shorter locks who prefer the buzzed look are the ideal customers.
Cost: $3K to $4K, depending on the extent of hair loss.
Best suited to: All types and stages of hair loss, for all ages, colours, and skin types.
Efficacy: One-hundred per cent — that’s right. The procedure results in a permanent “buzzed” look, but doesn’t actually affect hair growth.
Time to results: Five to 12 hours over two or three sessions.
Known side effects: Temporary, mild discomfort during treatment.
Contraindications: Forehead botox. (Yep.)
Things to note: Already a popular option in Europe and the US, SMP is a permanent way to restore the hairline or camouflage any type of hair loss or scarring, and can even boost the visual effect of a hair transplant. The procedure will take place over the course of three treatments, notes Pagano. “The first treatment is the longest, lasting about four hours, depending on the area that needs to be covered and the colour-matching process. The follow-up procedures are shorter, lasting approximately two to three hours.” Pagano also identifies the importance of choosing the right technician. This treatment requires different needles and inks from regular tattoos to prevent your head from taking on a blueish tinge.