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Non Surgical Options - Medications
 Throughout history numerous treatments have been advocated to try to deal with hair loss. Hair transplants provide a permanent solution and from the multitude of products that are available (shampoos, creams, herbal treatments, ointments, drugs) only two medications have been proven to have some benefits.
Minoxidil is a topical application that comes in 2% solution that can be used by both men and women and 5% solution (for use by men only) , and is typically applied twice a day to the area of the scalp being treated. The exact mechanism by which topical Minoxidil works is not yet fully understood. Used over a period of time, in some cases the rate of hair loss has been slowed down and a small percentage of patients have shown new hair growth. However the quality of new hair growth promoted by Minoxidil is somewhat disappointing. Also the light "fuzz" that appears is usually restricted to only the crown area, and if the patient decides to stop using Minoxidil, any gains from the therapy are lost rather quickly. The main side effects include a low incidence of skin irritation and itchiness that are generally well tolerated.
Used by itself as a single treatment, the results of Minoxidil are not what most patients hope for. However lately many hair transplant doctors have noticed an increase in the rate of hair growth when Minoxidil is used as a complimentary treatment after hair transplantation.
Finasteride comes in the form of oral medication and is available only through a prescription. This drug treatment is only safe for use by men. The results of therapy can be fully judged only after one year of use. It works by inhibiting the ability of the 5-alpha-reductase enzyme to convert testosterone into DHT (dihydrotestosterone) thus lowering levels of DHT in the scalp (DHT acts as the catalyst in the balding process). Recent studies (conducted over a 5 year period) have shown that use of Finesteride over an extended period of time may slow or stop hair loss, with some men showing substantial growth of quality thick, strong and full length hair. However the new hair growth is limited to the crown area, while in the frontal area its effectiveness has not been proven..If the patient decides to stop using Finasteride any gains from the therapy are lost within a year. Propecia has an excellent safety profile, the main side effects, experienced by approximately 3% of men, are decreased libido and impotence.
Used as a single treatment it seems that Finasteride is more beneficial to most men than the single use of Minoxidil. It should be mentioned that lately it has been advocated that the combination of Minoxidil topically and Finasteride orally produces a synergistic response. This means that the benefits of combining the two can be greater than sum total of the benefits obtained when these products are used individually.
Hair Transplants are a proven treatment for restoring hair where it has been lost, and both Finasteride and Minoxidil have made real contributions toward stopping the advancement and sometimes even reversing hair loss. We now have more tools in planning a strategy to combat the effects of genetic hair loss.
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