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HAIR LOSS TREATMENTS
 
HAIR PROSTHESES        
 
Full hair replacements (wigs) are available for people either temporarily or permanently unable to grow scalp hair. Non-surgical hair additions include hair weaving, hair extensions, hair fusions, hair pieces and synthetic hair.
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MEDICAL TREATMENTS
 

Products that claim to stop hair loss have been around almost as long as concern about hair loss. Only two medical treatments have FDA-approval:

Finasteride 1MG Oral tablet (brand name Finpecia)        


Finasteride is an oral tablet, available only with a prescription, and is taken once daily. Its mode of action is well understood thanks to research that documented the hormonal cause of hair loss in androgenetic alopecia. Finasteride inhibits the enzyme that converts testosterone to dihydrotestosterone (DHT) in the follicle.

Finasteride has proven to be highly effective in clinical trials and in medical practice for slowing hair loss in almost all men and for reversing hair miniturisation in some men. It can be used alone or in conjunction with other hair loss treatments, including surgery.

Advantages:

Convenient pill form administration - one pill taken once a day.

Effective in most men - the vast majority of men using finasteride experience some benefit from its use.
Stops hair loss from progressing.
Beneficial side effects such as the shrinking of the prostate gland in men susceptible to an enlarged prostate.

Disadvantages:

Finasteride is not a cure for hair loss. It will only work over the long term if you continue taking it. If you stop taking finasteride, you will likely lose any hair you have gained within 12 months of stopping treatments.
Finasteride is not approved for use by women.
May cause sexual side effects such as decreased sexual desire(less than 0.5% decrease).
Finasteride is only available by prescription.


Minoxidil (brand name Regaine®)

Minoxidil is available over-the-counter and applied topically to the scalp skin in areas of hair loss. Minoxidil is available in SA in only the 2% strength. The 5% strength, which is only available when made up by a pharmacist to a doctor’s prescription, has been shown to be more effective in both men and women in slowing hair loss and promoting new hair growth.... unfortunately the 5% solution also has a significantly higher incidence of side-effects(such as contact dermatitus and other allergic reactions). Results of minoxidil's effectiveness in slowing or halting hair loss to some degree in men have ranged from 50% to 80% of men treated.

Only about 20% of patients have reported new hair growth. Minoxidil is ineffective for some men and women who continue to lose hair.

While it is available without prescription it is used most effectively in a physician-guided program of hair restoration, after the cause of hair loss has been diagnosed. Minoxidil's mode of action is not completely understood. It appears to prolong the anagen (growth) phase of the hair follicle.

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SURGICAL TREATMENTS
 
• Hair Transplantation        

Gone are the days of the Barbie-doll hair "plugs" of the old days.
Hair transplantation today is a natural and undetectable procedure performed under local anaesthetic. The results are totally natural and undetectable. This look is made possible by better understanding of the scalp and hair biology, refined surgical techniques and ever-improving surgical instrumentation.

For further information see www.medhair.co.za

• Alopecia reduction         

Alopecia reduction surgically removes bald scalp skin in areas of hair loss and pulls adjoining hair-bearing scalp skin together to eliminate the bald spot.

This procedure is rarely done these days.

• Scalp expansion (Tissue expansion)        

Scalp expansion is a modification of alopecia reduction. A balloon-type device is placed under the scalp and slowly expanded for several weeks to create a "dome" or "bubble" of stretched scalp skin.

A series of surgical procedures reduce the area of hair loss, remove the scalp expansion device and complete closure of hair-bearing scalp to achieve complete alopecia reduction. This procedure is most commonly used when plastic surgeons are attempting to restore an area of scalp that has been badly damaged during some form of trauma (for example burns). This procedure can only be done by highly experienced and trained cosmetic surgeons.

• Hair bearing scalp flap transfer

A flap of hair-bearing scalp tissue is surgically raised from underlying tissue and transferred to a prepared scalp site with hair loss. This procedure was extremely popular a number of years ago, but suffered from the problems of unnatural and very strong hairlines. It also had the major problem of necrosis of the flaps that resulted in massive scarring and loss of hair. There are very few surgeons who still practice this form of hair relocation.
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