Baldness is probably the most rampant of plastic surgical problems, and indeed is the most common consultation in males in a Plastic Surgeon’s office. We know the reasons for baldness, and it should not come as a surprise to learn that baldness is also present in females, evidenced by hair thinning and then patches of baldness, particularly in the perimenopausal and post- menopausal women. Various surgical and non surgical procedures like hair transplant, hair weaving and bonding, wigs, medical therapy like minoxidil and finasteride are in use and present a confusing array of treatment for the bald patient

So what are the choices

Hair loss and thinning is a direct effect of the role of testosterone on the its receptors in the scalp, and the hair region in the back of the head is usually fairly resistant to the effects of testosterone, and thus maintains hair for longer periods. It is these facts that are the basis of various treatment modalities.

Role of Medical therapy

Finasteride is a testosterone receptor blocker, and blocks the effect of testosterone. Thus it allows a decrease in hair fall and probably gets back a few of the faller hair, in that the nano hair, that are there, probably get thicker. It is a drug, used primarily in older patients with prostate problems. In baldness the dosage that is prescribed is very small from 1 mg daily to alternate days; at this dose there are virtually no side effects

Minoxidil is an agent that increases the blood supply of the scalp, and indirectly increases the density of the hair, and a small reduction of hair fall. However, less than half of the people who actually use it, have a tangible benefit. Both these drugs need to be taken for prolonged periods, often the life time.

Hair transplant – this is the only true solution to baldness. The surgical procedure which is a single day job, done under local anesthesia, and hardly any discomfort, is the only natural procedure available. The hair that is implanted, almost never falls, can grow to any length, and do not require maintenance. There are almost no precautions to be taken after a hair transplant. It is possible to repeat the procedure after 6 months gap for almost 3 times. However we have to know that hair transplant requires 6 months for effect to show, as the hair has to pass through a natural phase. Also, we cannot assure a density, that was present in younger ages, and for one to achieve that kind of density, repeat procedures are required.

Hair weaving, bonding – these are artificial procedures, in which someone elses hair is used to cover the head. The hair is fixed to the head with silicone adhesives, or with clips or sutures to the remaining hair. The advantage is that it is a fast procedure, painless, instant, and gives a great density. However low costs should not influence the decision, since one has to go the beauty parlour every 2 weeks to get it refixed, adding to the costs. Also one cannot go out in a strong wind or heavy rainfall, cannot swim, or airdive, or perform any exertional outdoor activity or physical contact sports. Sever allergies are known to occur with the adhesives, and hair gets loose from the constant traction of the clips that is used to fix the patch.

HAIR TRANSPLANT IS THE BEST !!!!!!!!!!!