Health & Fitness

Scalped

There are now more treatments than ever for balding—some even work—and a cure is on the horizon

Log on to the forum at hairlosstalk.com and you’ll find men with screen names such as Sheddy Kreuger, Diffusion Guy, and DamnThis venting about going bald. Their anger is understandable. For the 2,000 years between Julius Caesar’s comb-over and Ted Danson’s toupee, men have fought a losing battle against the body’s senseless hormonal war on its own hair.

The outlook has improved slightly in recent decades with Rogaine and Propecia, the first and only FDA-approved drugs to treat baldness. Used consistently, they can stop or delay balding and sometimes regrow hair. But they’re treatments, not cures. The next decade, however, will bring peace to the men at hairlosstalk.com, as more effective treatments and even a permanent cure for baldness move from the lab to clinical trials. “The cure will come from gene therapy, and it’s coming at a rapid clip,” predicts Douglas Altchek, MD, a professor of dermatology at New York’s Mount Sinai School of Medicine.

If your bathroom mirror shows that you can’t wait for a cure, Propecia and Rogaine should be your first option. “Start both medications as soon as your hair begins to thin for the best results,” advises Robert Bernstein, MD, a clinical professor of dermatology at Columbia University. We asked the experts how the latest baldness treatments measure up.  

PHARMACOTHERAPY
Finasteride and Minoxidil
Rogaine’s active ingredient, minoxidil, improves blood flow to the scalp, and Procepia’s finasteride blocks dihydrotestosterone (DHT), a hormone that causes hair loss. Many men triple-treat by using both Propecia and Rogaine—they call it “fin and foam” (finasteride and foaming minoxidil)—plus Nizoral A-D, an antifungal medication used to fight dandruff that has been shown in studies to regrow hair.

OFF-LABEL THERAPY
Dutasteride
Sold as Avodart to men with enlarged prostates, this drug is more powerful than finasteride because it blocks both types of the enzyme that synthesize DHT. “The reproductive side effects—decreased libido and ejaculation disorders—may be persistent, so I don’t usually recommend this medication for younger patients,” says Dr. Bernstein.

SURGERY
Hair Transplant
The leading method today is follicular unit transplantation. It involves moving clumps of up to four hairs from the back and sides of the head to balding areas. “Hair transplants are most appropriate for people who have not responded to medical treatments,” says Dr. Bernstein.

NATUROPATHY
Saw Palmetto and Pumpkin-Seed Oil
Saw palmetto extract has been shown in several small studies to shrink the prostate, working like finasteride to block DHT. Likewise, pumpkin-seed oil is believed to help break down DHT in the liver. “Men reluctant to try drugs are good candidates for these natural treatments,” says Dr. Altchek, “but there is a tremendous placebo effect.”