hairline

A Brief History of Hair Systems

The urge or need to cover heads with hair that is not our own is as old as civilization. The reasons and methods have changed – and newer technologies are amazing.

Today we call them hair systems. In an earlier era, they were known as toupees. The term “wig” is still used, although those are generally something women wear or what are used in theatrical settings. Today, nonsurgical hair systems have become popular hair loss solutions for men and women.

But over literally thousands of years, hair that in some way landed on peoples’ heads was everything from a way to keep cool, to be rid of lice, to address hair loss from sexually transmitted disease, or as a sign of social status. It’s not at all new to put human, animal, or synthetic hair on one’s head.

Reportedly, the Egyptians shaved their heads to alleviate the heat of North Africa, donning wigs for social and burial occasions (wigs are found in sarcophagi, and not just the royalty but also in commoner graves). When syphilis landed in Europe in the 16th century – thanks, Columbus! – wigs of human or animal hair were used by those who lost hair to their affliction (this is all pre-penicillin, of course). During the great plague of the 17th century, fear of infected hair from the dead being used in wigs led to greater use of horse and goat hair.

The fad of European royalty wearing outrageously big hair began with King Louis XIV of France, whose thinning hair in his late teens prompted him to do this with elaborate tall wigs. Both women and men copied him, a fad that is seen in early American colonists of high status. The term “big wig” comes from the fact that richest and most powerful people also had the biggest hair system. Powdering of these wigs was a means to deter lice.

But the American and French revolutions diminished those trends (although four of the first five American presidents still wore wigs, George Washington being the exception). That’s when going natural, hair loss or not, became the norm.

Modern use of toupees rose from the 19th to the 20th century as a means to inconspicuously cover bald spots. The sophistication of hair types, the base, how it is woven into a cap, and the adhesives used gradually progressed. Beginning in the late 1990s, with the FDA approval of the adhesive cyanoacrylate, a medial grade product, a better hair replacement system was born. This adhesive allows the skin to breathe and adjacent hair to continue growing. It sticks, allowing greater physical activity and less maintenance for the wearer.

Other new systems include membranes that are grafted to the wearer’s skin, a permanent solution that is non-invasive (it is merchandised under different brand names including SensiGraft and Folligraft). It works best with pattern and irregular hair loss, and is used by both men and women.

So modern hair replacement systems have come a long way from hot Egyptian deserts, the royal courts of Europe, and the pestilences of the Medieval and Renaissance eras. But what hasn’t changed is the drive to have a full head of hair, come what may.

Do Hats Cause Hair Loss?

Head coverings of any kind might make a hair loss situation worse, however wearing a hat, helmet or scarf is generally not the main cause.

Look around. Hair loss is everywhere. Every city has a hair loss treatment clinic filled with both men and women – younger and older – seeking hair loss solutions for traumatic hair loss conditions.

There are many causes of hair loss. They include genetics, stress, infection, traction (pulling), and accidents involving blunt trauma or chemical burns. But can wearing a hat – or a helmet for that matter – create or make worse a hair loss condition?

In and of themselves, hats and helmets do not directly cause hair to fall out. But it’s possible that such head coverings can make an existing hair loss condition worse. That can happen in a variety of ways:

Hats that cause a hygiene problem. Whether or not you are experiencing hair loss, it’s possible that excessive wearing of headgear of any kind – hats, helmets, even scarfs – can trap bacteria that then causes a skin infection in the scalp. Most commonly seborrheic dermatitis can cause temporary hair loss. It is characterized by scaly, sometimes oily skin inflammation that is itchy and painful. Other fungal skin infections, or bacteria (including but not limited to syphilis) can have a similar effect. Persistent infection should be treated medically.

Causing a traction (pulling) problem. Traction alopecia is a very real and very permanent type of hair loss that comes from pulling the hair tight. In people who wear tight ponytails or braids (e.g., cornrows), this is fairly common. Conceivably, a hat or other head covering might accompany a tight pull on hair, however it’s more about a combination of the two. This is reversible hair loss unless it persists long enough to permanently damage the hair follicles.

Covering up a genetic condition. The vast majority of hair thinning and hair loss in both women and men is genetic in origin. Wearing a ball cap, wigs and hair extensions, or other head coverings might be a way for some to ignore the problem when in fact there are solutions through medications (minoxidil and finasteride are chief among them) that can stop it before it becomes irreversible. Early treatment is most effective!

Another argument against hats, helmets and other hair coverings is that fresh air is good for hair. In a sense, they are right in that getting fresh air generally means getting outdoors for exercise and a little healthy sunlight (sufficient to help your body produce its own vitamin D). It’s true that general good health translates into better hair health as well. But a hat that protects you from overexposure to the elements – the sun, and the drying effects of cold winter air – is a good idea, too.

Types of Alopecia: An Overview

While male pattern baldness (androgenetic alopecia) is most common, there are many different types of hair loss that affect men, women, and children.

Hair loss is rarely something one chooses. But it’s extremely common, more for men but lots of women and children experience it as well. What’s less known is that there are many types of hair loss, the bulk of it due to genetics, some to trauma and medical treatment, and some of it due to behaviors and emotional illness.

Knowing the different types of hair loss and what causes it is a first step in addressing them and, in many cases, reversing the loss. It’s a good idea to be armed with as much information before picking up the phone and calling the local hair loss treatment clinic. When you finally do, you’ll want to be certain the clinic provides hair loss solutions for women and men.

Start with the medical term, which is alopecia. The word itself derives from “alopex,” the Greek word for fox. Evidently, the animal is often afflicted with mange, which includes balding in patches. Alopecia is the umbrella term, but the specific types of hair loss comes under the following names (grouped by general causative factors):

Genetic causes of hair loss

Androgenetic alopecia – This is a generalized, diffused thinning of the hair over most of the scalp. It includes male and female pattern baldness, although it is expressed differently between the genders.
Alopecia areata – This is balding in patches, perhaps due to an autoimmune disorder (the body attacks the hair follicles, treating them as foreign).
Alopecia totalis – This is hair loss where almost all scalp hair is gone (causes are various and sometimes idiopathic, of unknown origin).
Alopecia Universalis – While rare, it is the most extensive form of hair loss: All hair on the scalp and body – even eyebrows and eyelashes – falls out.

Environmental/external causes of hair loss

Telogen effluvium – Sudden and diffuse loss of hair attributed to childbirth, major surgery, severe stress, and chemotherapy.
Scarring alopecia (aka cicatricial alopecia) – When there is trauma to an area where there is natural hair growth (the scalp, eyebrows, facial hair or elsewhere on the body), the scar tissue does not support hair follicles.
Anagen effluvium – Exposure to certain chemicals and radioactive substances that fracture the hair shafts at the scalp, including chemotherapy and radiation applied in cancer treatment. This condition is temporary.

Patient-caused hair loss

Traction alopecia – Unfortunately for people who tug tightly on their hair to achieve a particular hairstyle (braids, dreadlocks, pigtails, ponytails), this irritates the skin and hair follicles. The result is redness, itching, pus-producing ulcers and infections,
Trichotillomania –A self-inflicted (conscious and subconscious), continuous pulling of the hair. It typically occurs with children, adolescents, and women.

While the loss of hair in ancient Greece might have been simply accepted as one’s fate, the modern understanding of different types of hair loss and various forms of treatment now mean that baldness need not be destiny.

Hair Transplant Surgery: Does it Work for Women?

Yes, hair transplant surgery for women with hair loss can provide noticeable improvements. But it’s not the same thing as treatment for male baldness.

There are a variety of means for women to combat hair loss – which, it should be noted, is far more common than people realize.

Part of the reason women who are losing their hair feel alone is because other women do a good job of concealing their hair loss. A recent famous example is Congresswoman Ayanna Pressley of Massachusetts, who ran successful for the US House of Representatives in 2018 wearing wigs styled into Senegalese twists. Only in early 2020 did she appear in her natural state with a completely shaved head.

“I think it’s important that I’m transparent of this new normal and living with alopecia,” she told NBC News. Her condition is known as alopecia areata, which affects body hair as well as leaving random, asymmetrical bald patches on the scalp.

Pressley seems to have settled into a shaved head look – the attractive representative has the bone structure for it – but that, and wigs, don’t work for everyone. For the woman considering hair transplant surgery, a few points should be considered:

Treat underlying health issues first. In some cases, conditions such as anemia and thyroid problems lead to temporary hair loss because they affect the scalp itself. If resolved, natural hair growth most often resumes.

Women have different types of hair loss. Most women do not lose their hair in the way that men do. There is some variation in male pattern baldness, but with women the differences are significant and come in five general types:

Generalized thinning with some patches of alopecia
Global diffuse thinning without patches
Frontal temporal recession (forehead rising)
Scarring alopecia, which often is the result of infections caused by abuse of some kind (tight braids, compulsive hair pulling, traumatic injury)
Medical and hormonal causes

How each is treated requires different approaches, best evaluated by a hair loss specialty dermatologist.

Transplanted hair should be strong and healthy. “Donor scalp” is the hair harvested from the back of the head just above the neck (the occipital region, under the nuchal ridge, to be technical). This can be done by different techniques, with a multi-blade knife or via “strip harvesting.” But the transplanted hair will not increase in thickness once moved; this is why the quality of the hair selected will affect the outcome.

Manage expectations. As one patient who had a successful transplant said in a New York Times interview, “There are people who think they’ll look like Cinderella when they are finished,” she said. “Help is here, but it’s not going to make them look like they did before they started to lose their hair.”

That said, the most advanced techniques have been around for more than a dozen years and the skills of the medical people performing hair restoration surgery make for the best, appreciated outcomes.

Learn Which Medications Have Hair Loss Side Effects

Every patient reacts differently to prescriptions. While many drugs can cause hair loss, it’s usually not permanent – and nutrition might mitigate the loss.

It’s common knowledge that individuals undergoing chemotherapy treatment for cancer experience significant, if temporary, hair loss. Less known is how several other types of medications, administered for a variety of conditions and diseases, can cause hair loss as well.

Unlike chemo hair loss – which not only is temporary, but often regrown hair comes in with a thick wave, even with individuals who previously had straight hair – sometimes the loss from medications is long term. Doctors and pharmacists should discuss this with patients in advance. Seeking hair loss treatments after the fact can be tricky.

What kinds of medications can literally make your hair fall out?

According to dermatologists – the medical specialty that typically treats hair loss – various types of hair loss (thinning, shedding, complete fall-out) can be caused by a variety of medications:

Accutane (used for acne)
Antacids (cimetidine or Tagamet, an over-the-counter medication for acid reflux)
Antiarrhythmic drugs such as Amiodarone
Anticoagulants, such as warfarin (Coumadin)
Antidepressants such as Celexa, Lexapro, Prozac, Paxil, Pexeva and Zoloft, all selective serotonin uptake inhibitors (SSRIs)
Birth control medications containing progestin, as well as Depo-Provera injections, skin patches (Xulane), implants (Nexplanon), and vaginal rings (NuvaRing)
Blood pressure medications, such as captopril and lisinopril)
Cholesterol lowering drugs, such as statins (atorvastatin and simvastatin, but not rosuvastatin)
Colchicine, taken for acute gout attacks
Steroids (testosterone, progesterone, Depo-Provera, Provera, Prometrium)

IMPORTANT: Not all of these prescriptive drugs will cause hair loss in women and men. With some pharmaceuticals, hair loss is experienced by as few as 1% of patients taking it.

What determines if medication-induced hair loss is short-term or forever?

Physicians and medical societies always stress that with almost every medication, side effects as well as the efficacy of the medication will vary. Genetic medicine is changing that, although its primary applications at present are in identifying types of cancer treatments that work best for people with similar genetic makeups.

For birth control medication hair loss, for example, family histories of hair loss are considered a contributing factor. A mitigation strategy is to lean toward medications that contain more estrogen than progestin (which might also stimulate more hair growth).

In some instances, the hair loss is temporary even if the individual continues taking the medication.

It’s important to remember that nutrition plays a role in hair health, with or without medications. During times of illness the appetite can wane, leading to nutritional deficiencies. At least one study found that increasing intake of iron, biotin, and zinc might make up for a deficiency. That study, a randomized controlled trial published in the French journal J Cosmet Dermatol (Le Floc’h, Cheniti, et al., Laboratoires inneov, R&D, 2015), found that significant gains were experienced by women taking omega 3 and omega 6 supplements along with antioxidants.

The study subjects were healthy women, not taking any medications, so translating this to medication-induced hair loss is an imperfect comparison and therefore inconclusive. But it suggests nutrition can play a role in hair health. Consult with a doctor any time you plan to mix over-the-counter supplements with prescriptive medications.

You Can Prevent Hair Loss by Reducing the Stress in Your Life

Stressors such as the pandemic (Covid-19), surgery, and other trauma can lead to hair loss. The key is to manage stress as best you can, come what may.

Stress can cause hair loss in several ways – including how Covid-19 fevers might result in sudden, diffuse hair fall about six weeks after onset of the disease.

The facts are that fever of any kind from any illness can lead to hair falling out. According to Johns Hopkins All Children’s Hospital website, “Sometimes teens lose their hair … having a serious illness or high fever can temporarily cause shedding of large amounts of hair.”

For this sort of hair loss condition, hair loss treatments may not be necessary. Hair will grow back as one moves further from the stressful event. If hair continues to shed or does not recover, speaking with a physician about the available hair loss solutions is advisable.

The site also says that several types of traumatic events – childbirth, surgery, psychological trauma, chemotherapy of course, or serious illness – are also capable of leading to hair loss, in men and women. With illnesses such as the coronavirus, an extended period of fevers is the culprit, and given the nature of this particular infectious disease, not something easily in control of the patient.

But what are the ways one can control stress? And how does stress work physiologically?

It helps to know a few things about the biological components of hair. Hair growth can be broken down into mostly three phases, the anagen (growth), catagen (a brief, 2-3 week phase) and telogen (dormancy or resting). All hair begins in anagen and lasts 2-7 years. It then transitions through the short catagen phase, then on into the telogen phase, which is where it stays for up to 120 days. In the teleogen phase the existing hair shaft is in a resting period, a time when a new shaft emerges from the root to replace it.

A pronounced fever or other traumas speed up this process in a phenomenon known as telogen effluvium.

This condition, telogen effluvium, can also be stimulated by psychological stress. The fact that rapid hair loss accompanies such things as divorce, job loss, a medical diagnosis, or other major, stressful events essentially creates a nasty feedback loop where the patient cannot help but to become more stressed and, often, hopeless.

Fortunately, telogen effluvium is not permanent. With time, emotional counseling, taking up physical exercise or meditation (yoga covers several bases) and healthy life habits of proper diet, sleep, and the removal of environmental toxins (e.g., banning smoking from the household and moving away from areas of heavy vehicular traffic), the condition can be overcome. Hair loss will return, albeit slowly as the follicles return to the anagen phase.

How to Get Insurance to Pay for Cancer Wigs

Most health insurance providers consider “cranial prostheses” to be an essential part of chemotherapy treatment. Coverage may be partial, however.

Treatment for cancer does not necessarily involve hair loss. Certainly not as much as it used to. But breast cancer patients undergoing chemotherapy almost all have some degree of hair loss. When it happens, it’s good to know which local hair loss treatment clinic has expertise cancer-related hair loss solutions.

For some, the chic bravery of a shaved head makes a statement. That may be due to the patient having great facial features that might even stand out better with a shaved head. Actresses with shorn tresses for important roles include Sigourney Weaver (Alien 3), Natalie Portman (V for Vendetta), and Cate Blanchett (Heaven). Portman actually kept her look for a long time after the movie was made and released.

For when a full head of hair matters

But that particular look is not for everyone – not every day for all occasions, at least. Does a mother-of-the-bride want her daughter’s big day to include a focus on her shaved head? Under some circumstances, a full head of hair not only changes the social dynamic but also helps the patient leave the concerns for her health in the background. Cancer doesn’t have to be a 24/7 topic of conversation.

The cost of a wig can range from fifty to thousands of dollars. The differences are about quality of construction, whether or not human hair is used (there are healthy humans who sell their hair), and even the hairstyle (as one might expect, longer and fuller hair styles cost more). One characteristic of better-constructed wigs is if the outer edge of the cap has one to two inches of fine lace fabric. That creates a more natural appearance.

So who needs the expense of a wig when other healthcare costs and a possible reduction of income is part of cancer treatment? Fortunately, there are ways to reduce and even eliminate the cost of wig when undergoing chemotherapy – including by reimbursement from your health insurance provider.

Insurance and cancer support groups to the rescue

First, ask your doctor to provide a prescription for a “cranial prosthesis” or “hair prosthesis.” Yes, it sounds clinical. But this has to do with not only your mental health, but if having a full head of hair means getting up and going places, that increases your physical activity and sense of wellbeing. Importantly, those are the words that most insurance plans recognize.

Next, you probably will need to buy the wig on the promise from your insurer that you will be compensated in part or in whole. It helps to call first, and if so keep a written record (perhaps with a follow-up email, if possible) that confirms what the customer service person at the insurance company says. Importantly, keep all paperwork (prescription, receipts, completed insurance claim form, all related correspondence) in case there is pushback on your claim.

Any amount not paid for by your insurance company might become an insurance deduction. Current tax codes allow medical deductions when out-of-pocket expenses exceed 10% of your adjusted gross income.

If that doesn’t work, there are many cancer non-profits that provide wigs and wig exchanges for free or at steep discounts. This is a laudable effort in the circular economy, where people who no longer need the wigs they bought during their treatment then donate them to the organization, which then cleans and preps them for the next person to use. Contact the American Cancer Society, Susan G. Komen Foundation, Wigs and Wishes or other similar organizations for more information.

What is Laser Hair Therapy and How Does it Work?

Low-level laser therapy has been found to be safe and probably effective in treating some kinds of hair loss.

There are several reasons why people, men and women alike, lose their hair. It might be due to genetics (as is generally the case with pattern baldness, which is the most common cause), due to medication use, physical pulling (due to a tight braid hairstyle, or a psychologically illness called trichotillomania), nutrient deprivation, or infections.

And for that reason there are different therapies to reverse or at least stop the loss. Male and female pattern baldness being the most common, the medical and cosmetic industries have come up with several solutions that include the invasive (finasteride medication and hair transplant surgery), the less invasive (monoxidil topical hair loss treatment) and the non-invasive therapies (low-level laser hair therapy). Each has some measured degree of efficacy when used correctly.

Laser hair therapy is safe

Laser light therapy, or LLLT, has not been tested for efficacy in clinically controlled trials and therefore is regarded with some degree of skepticism. But it is lab-tested, it is not regarded as dangerous, and users report satisfaction with their results.

Importantly, the medical establishment has determined there is no health risk in use of LLLT. As published in Lasers in Surgery and Medicine, the official peer reviewed journal of the American Society for Laser Medicine & Surgery, searches of PubMed and Google Scholar revealed the following:

“LLLT mediated by a laser comb was approved by the FDA [in 2007 and 2011] as a safe treatment for male and female pattern hair loss respectively. Laser phototherapy is assumed to stimulate anagen re-entry in telogen hair follicles, prolong duration of anagen phase, increase rates of proliferation in active anagen hair follicles and to prevent premature catagen development. The exact mechanism of action of LLLT in hair growth is not known; however, several mechanisms have been proposed. Evidence suggests that LLLT acts on the mitochondria and may alter cell metabolism through photodissociation of inhibitory nitric oxide (NO) from cytochrome c oxidase (CCO).”

Because LLLT devices emit a cool-temperature laser, overexposure is not likely to cause burning or other harm.

How laser light therapy works

To be clear, men and women with androgenetic alopecia – the pattern baldness that affects the majority of men and some women over the age of 40 – are the best candidates for LLLT. And the earlier in their hair loss that they receive the treatment the better the results, as reported by individuals who have used the technique.

Individuals using LLLT also seem to fare better with twice-weekly use of either an LLLT head cap or hand-controlled comb. Overuse of therapeutic laser light is less effective.

To identify one’s propensity to benefit from LLLT, consult first with a dermatologist (a medical doctor) to rule out skin diseases or other causes of hair loss.

Can Vitamins Prevent or Reverse Hair Loss?

There are nutrients that contribute to healthy hair. The biggest problem is nutrient deprivation, and the best strategy is a healthy, balanced diet.

Most hair loss for men and women is due to factors beyond their control. Largely based in genetics, androgenic alopecia – the term for male and female pattern baldness, although it generally happens in different ways for men vs. women – is largely programmed into the DNA. Hair loss treatments aren’t going to help much with pattern baldness, though some hair loss clinics have developed certain therapies that work for some people.

But there are behaviors, particularly with eating patterns and habits, which can cause or contribute to certain hair loss conditions. The reason for that is our bodies are smart enough to compensate for deficiencies. When an individual fails to take in adequate amounts of nutrients, in particular those that contribute to the production of a protein known as keratin, the first body part to be sacrificed is the hair.

Keratin and yo-yo diets affect hair health

Keratin is important to the structure and health of skin, which is the protective layer for the entire body. When there is insufficient keratin in the diet (or in the case of bulimia, it is not allowed to be digested), the body allocates it away from hair to the more important epidermal layers.

So called yo-yo dieting, involving significant weight losses then gains then losses again, can trigger much of the same effect.

But it’s conceivable that circumstances such as a nutrient-poor diet, without the intention to lose weight, can cause hair loss (high-calorie diets can easily be low in essential nutrients, as one finds in processed foods). So it makes sense that some people experiencing hair loss are just eating the wrong things.

Keratin, biotin, Vitamin A and Vitamin D for hair loss

So which nutrients are best for hair health? As one can easily deduce about keratin, a diet with adequate protein can address that problem. Note that these are foods that enable the body to produce keratin, that it’s not in the foods themselves. Quality proteins include fish, red meat (beef and pork), chicken, eggs, and dairy (milk, yogurt, cheese). Plant foods can also provide the protein necessary for keratin production. Some of the better choices are nuts, beans, nut butters, and quinoa.

Biotin, a B vitamin, helps the body metabolize amino acids that help aid the production of keratin. Beef has the highest concentration of biotin, followed by eggs (yolk and white), salmon, pork, sunflower seeds, sweet potatoes, almonds, tuna, spinach, and broccoli.

Vitamin A is another nutrient that helps synthesize keratin, among other essential biological functions. It’s somewhat easy to know which foods are good sources of Vitamin A because they tend to be the orange fruits and vegetables: sweet potatoes, pumpkin, raw carrots, cantaloupe, and butternut squash. Also, non-orange foods including kale, collards, and spinach have Vitamin A.

Vitamin D has a role in keratin production as well. Rich sources are fatty fish (salmon, tuna, mackerel, sardines), beef liver, mushrooms, dairy and all the foods that are fortified with it (milk, yogurt, breakfast cereals, and milk substitutes such as soy, almond, and oat milk).

One dietary habit that counter-intuitively can lead to hair loss is the overconsumption of uncooked egg whites. Indeed, some people eat this in the mistaken belief that this protein minus the fat in egg yolks is beneficial for fitness. If uncooked, the avidin in egg whites prevents biotin absorption. For better health and hair, eat the whole omelet.

Effective Non-Surgical Hair Loss Solutions for Men and Women

Hair loss is the problem with many solutions, in part because the causes and people it affects are so numerous. Smart patient-consumers consider all options.

The mid-career male pattern hair loss patient is accustomed to comparison shopping for everything from cars to cans of beans. His boss, age 50 and seeing her hair generally thinning all over, is perplexed with her situation and knows no other women who have this problem. And the guy in IT, fresh out of college, thinks he’s too young to face getting bald like so many others in his family.

The blessing each of them has is that hair restoration solutions are in more abundant supply than ever before. Surgical solutions get a lot of attention, and for some they are the ideal (if expensive) option. But for many other people, non-surgical solutions might be a better choice.

What are those non-surgical solutions? Some are proven and approved by the US Food and Drug Administration (FDA). Others don’t fall under the FDA, as they don’t need to be, and are considered safe but experimental. The major non-surgical solutions are in four categories:

Topical, FDA approved: Minoxidil, sold under the brand name Rogaine (including Rogaine Women’s), is a foam treatment derived from a common prescriptive treatment for high blood pressure. Requiring a daily application, it works best for people in the early phase of hair loss. Importantly, it poses no danger to women who are pregnant and their developing fetuses.

Take internally, FDA approved: Finasteride, sold under the brand name Propecia, is effective at restoring hair growth: In a widely-cited clinical trial, 83 percent of men taking it saw a cessation of hair loss, and 65 percent saw new hair growth. A DHT blocker, Finasteride has been on the market since 1997. Importantly, it’s not a medication that should be around women in their childbearing years, as so much as touching a broken pill (the dust thereof) can have a profound effect on a developing fetus. Finasteride is sold to women who no longer can get pregnant, and it is effective for them as well.

Light therapy, experimental: Generally called LLLT, for “low level laser hair therapy,” this is a treatment that increases blood flow to the scalp, where the root follicles are located. While it sounds somewhat hocus-pocus, the respected website WebMD has this to say about LLLT: “What they do is boost blood flow to your hair roots, bringing nutrients and energy that your hair needs to grow … When LLLT works, you should see thicker, fuller hair in about 6 months — the same amount of time other treatments take. But LLLT won’t help if you’re completely bald … We still need more research to figure out the best way to use it and how long the effects last.”

Plasma injections, experimental: Anecdotally, this type of treatment works although there are no studies to indicate how well and how long. And while it doesn’t involve surgery, an injection (15-20 injections, actually) is technically invasive. The process involves taking the blood of the patient, putting it into a centrifuge and separating out the platelet-rich plasma (PRP) cells. Platelets have growth factor proteins that are used to medically treat wounds, and the general idea with hair loss is it helps stimulate follicle growth as well. Tellingly, PRP is also used in conjunction with hair transplants. There are no long-term studies on how long the treatment remains effective.

So middle-aged and younger men, as well as women, have many options for treating various forms and age-of-onset hair loss. Add to that hats and wigs – but importantly, those are not the only choices available to them.