Medically reviewed by dermatologist Suneil Gandhi, MD What is it Effectiveness How does LLLT work How to use Types of …
Hair Loss Treatment
The treatment of hair loss has been a mainstream idea since the end of the last century when it was first noticed that minoxidil, a drug initially developed to combat heart problems, could cause hair to grow. Over the past few years, several effective treatments for hair loss have been made available for both women and men. Nowadays, you might be able to completely regrow your hair or at least slow down any further thinning using the treatment options available.
Medication for Hair Regrowth
The use of medication to treat hair loss is, by far, the most standard method. Currently, the hallmark of medication treatment for hair loss is a reduction in the amount of dihydrotestosterone (DHT) in the body.
Three main mechanisms achieve this: decreasing the levels of free testosterone, inhibiting the enzyme 5-alpha reductase reducing the number of androgen receptors. Why is this so? It is because DHT cannot be formed without free testosterone or the enzyme 5-alpha reductase. Moreover, DHT cannot exert its effect in the body if there are no androgen receptors.
All these mechanisms can be achieved by minoxidil and finasteride – the most common medications that are currently approved for the treatment of hair loss.
Minoxidil was the first hair loss medication to be approved by the Food and Drug Administration (FDA). It also goes by the name Rogaine and is sold over the counter for the treatment of both male and female pattern hair loss.
In a clinical trial using minoxidil 1 mg orally vs. minoxidil 5% topical (P. M. Ramos, R. D. Sinclair, M. Kasprzak, H. A. Miot, 2019) it was found out that the case for oral minoxidil is less reliable. Topical minoxidil was more effective.
Besides, topical minoxidil is not associated with severe side effects like those seen in the oral formulation of the medication. Currently, only the topical minoxidil formulation is approved for the treatment of hair loss.
Besides that, there is also nanoxidil – topical hair loss treatment product that is very similar to minoxidil, it only differs by its molecular weight. According to its manufacturer (D.S. Laboratories), it may be as effective as minoxidil but has a better penetration rate and no side-effects.
Finasteride is one of the favorite medications among hair loss enthusiasts. A comparative study on oral finasteride and topical minoxidil (E. Arca, G. Açıkgöz, H. B. Taştan, O. Köse, Z. Kurumlu, 2004) concluded that both drugs were effective in the treatment of mild to severe male pattern hair loss – though finasteride proved to be more effective than minoxidil.
According to the current guidelines, only the oral formulation of finasteride is approved for the treatment of hair loss. However, topical finasteride seems to offer similar effectiveness with a noticeably smaller possibility for side-effects.
Laser Treatment for Hair Regrowth
Laser treatment for hair loss, otherwise known as low-level laser therapy (LLLT), is a procedure that exposes your scalp to infrared light for therapeutic outcomes. It involves subjecting the scalp to infrared-emitting laser diodes in a therapy session that typically lasts between 8 and 30 minutes.
The therapy can take place at a doctor’s office, but usually, you can do that at home with a laser brush or laser helmet. The laser diodes used in LLLT emits infrared light in wavelengths between 630 and 670 nanometers. Comparatively, the sun emits natural wavelengths of between 250 to 2500 nanometers.
How LLLT triggers hair growth
Laser technology was first discovered in 1960. Since then, scientists have perfected the art of using it for therapeutic purposes. The outcome of hair regrowth following treatment with LLLT depends on several factors which must be carefully considered for better results.
Although wavelengths of between 630 and 670 nanometers are beneficial for hair regrowth, wavelengths to the tune of between 690 and 1100 nanometers can be harmful and slightly damage the hair shaft and surrounding tissue. Thus, parameters such as timing, power density, fluency, pulse structure, and wavelength of the applied light should be considered carefully.
When the parameters are not optimized, the effectiveness of the procedure may be low or may even impact the intended therapeutic outcome negatively. For this reason, it is common to find claims that LLLT doesn’t work – probably because of poor choices in the light source, wavelength dosage, and other parameters.
Microneedling for Hair Regrowth
Microneedling is a technique that is common among individuals who want to slow down the aging of the skin. The mechanism of this method is that it increases the production of collagen in the skin.
The method first gained popularity in the 1990s when it was used to treat scars. Since then, studies have been published detailing how micro-needling can help in treating thinning hair and hereditary hair loss.
How micro-needling works
This procedure is carried out by a certified practitioner or after a consultation with a doctor can be performed at home. The handheld device is carefully rolled along the area receiving treatment. The idea behind this technique is that the device creates small injuries in the scalp that extend to the deep layers of the skin. These injuries promote uptake of topical hair regrowth products.
Moreover, as the small injuries heal, the skin produces a lot of collagen fibers, which strengthens the skin and enriches the hair follicle leading to hair regrowth.
The procedure may be painful. Therefore, your doctor will apply an anesthetic agent topically at least 45 minutes before the procedure to help alleviate any unprecedented pain. The duration of treatment depends on the size or the area being treated – but can as little as 30 minutes.
Microneedling, as a procedure, has its own side effects, which may include irritation, development of wounds, and discharge from the wounds. However, the American Academy of Dermatology agrees that the side effects should resolve within five days after treatment.
Among the treatment options for hair loss, hair transplant could be the most expensive. The case for hair transplant dates back to about half a century ago in 1950. During this period, a researcher Dr. Orentreich conducted an experiment to understand the factors influencing baldness.
In his study that was first published in 1959, Dr. Orentreich devised a new and yet ingenious method to test his experiment. He was going to use hair transplantation. The bottom line for his study was to find out of bald hair transplanted onto a healthy scalp could continue balding or if healthy hair was transplanted to a balding scalp could stop the balding.
After observing his experiment for about 2 to 3 years, he concluded that:
- Balding hairs that are transplanted to non-thinning regions of the scalp will continue to bald at the same rate as balding hair at the area when samples were obtained.
- Non-thinning hairs that were transplanted to balding regions of the scalp ended up growing normally.
His conclusion summarized that scalp hairs would retain their characteristics regardless of where they are placed.
So, does hair transplantation work for hair loss? Yes, it does. But is it successful? That depends on how you view successful treatment. For some people, successful treatment involves the complete reversal of hair loss: regrowth, and reactivation of dormant hair follicles. However, transplantation does not stop the progression of hair loss – it only masks it.
There are excellent hair transplant surgeons with impressive skills in hair architecture who can help you to hide your hair loss cosmetically. The major downside for hair transplantation of the surrounding hair around the site receiving a transplant will continue to bald.
Although these surgeons will give you a thicker and fuller vertex, and a fabulous young hairline, you should be open to the fact that there is a possibility of future hair loss in areas that have currently not started balding yet.