Dealing With Balding

Hair loss can inflict such trauma on those who experience it that an entire industry has sprung up to do battle with baldness: An estimated $1 billion a year is spent on efforts to re-grow hair.

Hair replacement surgery, which averages more than $7,000, is one of the more costly options. But experts say that it’s gotten a lot more sophisticated.

In the old days, surgeons would remove small circles of tissue from the back of the head, where hair growth is stable. Then to transplant those clumps of up to 30 hairs, the surgeon would remove a matching circle of tissue from the top of the head and put in the graft.

The procedure worked, but the results looked unnatural. Still, surgeons were on the right track.

“The hair transplant is really extraordinarily successful,” Dr. Robert Bernstein, medical director of New Hair Institute, told Good Morning America.

“In fact that has always been the problem," he said. "The grafts that were done 25, 30 years ago are still around. So really the idea is not to get the hair to grow. That’s the simple part. The problem has been to do it in a way that it looks natural.”

Today, hair replacement surgery involves single follicular unit transplants.

The surgeon removes a strip of hair-producing tissue from the back of the head, and dissects it under the microscope into units of one to four hairs, the way hair grows naturally. The surgeon uses a needle to make tiny incisions at the exact place and angle where the hair will grow.

A Gift to Themselves There are many reactions to losing one's hair.

Some men let nature take it's course, and adopt the motto that bald is beautiful.

Others head for the drugstore to get the latest lotions and pills. Some take a pre-emptive strike and shave their heads clean. And still others look for surgical alternatives.

Greg Morrone, a 50-year-old probation officer from Philadelphia, started losing his hair about five years ago. It wasn’t too much of a surprise, since his dad was bald, but he wanted to do something about it.

He tried minoxidil (sold in drug stores as Rogaine), but it didn’t work for him.

Two years ago, he made the decision to go to Bernstein for hair-replacement surgery.

“I started noticing in pictures of myself and home videos that there was a dramatic difference in my hair,” Morrone says. “It’s bad enough getting older without worrying about losing your hair too.”

In Marrone’s case, he was experiencing what is known as "class 6 male pattern baldness," with loss of hair in the front of the head, and a large bald spot toward the back of his head.

After the surgery, his hair grew back so gradually that his co-workers couldn’t quite put a finger on what was different. (Some even asked him if he’d lost weight.) His wife, who thought he looked good the way he was, enjoys the new look.

Usually it takes about six months after the surgery to really see a difference.

“I feel great — more like I used to feel,” Marrone says.

Like most patients, he had two procedures done. The first surgery is more dramatic, the second is more filling-in type work. Though it was costly, Marrone considers it wise purchase — and an investment, like buying a house, which appreciates in value as the years go by.

Trying to Look as Young as They Are A 40-year-old mechanical engineer who lives just outside New York City also visited Bernstein nearly two years ago. He had started losing his hair when he was 19 and as the problem got worse, he felt less and less attractive.

“Premature balding makes you look older for your age,” said the engineer, who requested anonymity. “Especially after I got divorced, I didn’t want this. After I got the procedure done, I had women coming up to me in bars and introducing themselves.”

He had tried the old-style surgery when he was 25, but was unhappy with what he described as “plug-y” results. The newer procedures, which transplant the hair one at a time look much more natural, he said. He had about 1,700 grafts done, which works out to be about 4,000 hairs.

“Because it’s an individual follicle transplant, you can’t come up to my forehead and look at it and say that’s a transplant,” he said. “I think it makes a huge difference in my appearance.”

As with any surgery, there can be problems, or mishaps.

It can be painful, even though patients are given a local anesthetic and a painkiller for the procedure. Patients also run the risk of bleeding, swelling and infection, and they often wear a bandage for a day, just after the procedure, then a hat for a few days while the bleeding and swelling go down.

How Balding Happens Baldness occurs when there is a progressive miniaturization of the hair follicle, resulting in shorter and finer hair with each cycle of hair growth, loss and re-growth, according to the American Academy of Dermatology. The hair on the head grows as fine as the hair on legs and arms, and gradually disappears. The end result is a miniature follicle with no hair.

Baldness is blamed on a combination of genetics and an increased sensitivity to the male hormone DHT, which is believed to shorten the time it takes for hair to fall out. If shedding or thinning begins quickly, people should seek medical advice, since it could be indicative of such conditions as thyroid disease, lupus or diabetes.

By far, the most common form of hair loss is male-pattern baldness, which is either a receding hairline or balding at the crown of the head. It affects about half of men by age 50. Contrary to popular belief that baldness passes from the mother’s side of the family to the son, experts say the genes from both the mother and the father are responsible.

Mainstream and nontraditional clinicians agree that it’s best to address hair loss early, and that therapy works if a person sticks with it for at least several months.

Other Treatments There are other, less expensive treatments out there for men and women who don't want to live with hair loss. Rogaine, the first FDA approved drug to treat hair loss can be purchased over the counter. The liquid solution is applied with dropper directly on the scalp. It produces hair growth of 15 to 50 percent in men after several months, according to the American Academy of Dermatology.

Propecia is the first pill approved to treat male pattern baldness. The doctor prescribed pill is not an option for women. The pill had a high success rate during its clinical trials.

Hair pieces are a completely safe, traditional option. Today hair pieces range in price from under $100 to several thousand dollars. Obviously, the more expensive the piece, the more natural the appearence in most cases.

"As-seen-on-TV," cover-up products often claim to hide bald spots with a quick and easy spray. If you have very little hair loss, they can be effective. Cover up products include hair building fibers made from keratin to scalp makeup that reduces the contrast between balding scalp and hair.