Beyond Comb-overs
What you need to know about hair restoration  

Pam Harrison

Bald may be beautiful, but many men don’t suit the “bad biker” look, says Dr. Thomas Nakatsui, a clinical lecturer in dermatology at the University of Alberta in Edmonton. And while the old saying has it that eunuchs never go bald, for some folks, a lack of hair still raises a virility issue: if you don’t have what it takes to keep a full head of hair, what else don’t you have?

“I guarantee you that if men had a choice, virtually 100% of them would want to retain their hair,” says Dr. Michael Sheps, an associate professor of dermatology at the University of Manitoba in Winnipeg. Here's what a man can do to restore his crowning glory. 

Drug therapy

Minoxidil (Rogaine), applied to the scalp daily, helps prevent hair from falling out, as opposed to stimulating new growth, says Sheps. No one's exactly sure how it works, but some suggest that it may revitalize shrunken hair follicles, producing longer, stronger, thicker hair. Company studies say minoxidil stimulates moderate hair growth in about 25% of men. When it works, it seems to affect the hair growing mainly on the crown and at the back of the head, not at the hairline, Nakatsui says.

Finasteride (Propecia) is taken orally and blocks the effects of the androgen dihydrotestosterone, the male hormone involved in hair loss. Like minoxidil, this drug is better at stopping further hair loss than stimulating new growth, and it is considered the more effective of the two drugs. And at $75 a month versus about $60, finasteride is also more expensive.

Rug therapy

A well-fitted, high-quality toupée, wig or weave can be cosmetically quite acceptable — not like the phony-looking “rugs” of old. If a man has any locks left, human-hair or synthetic weaves can be tied to these vestiges. But hairpieces need regular care and can trigger further hair loss because of the stress of retying. They also need to be regularly replaced, so over time they’re not necessarily cheaper than hair restoration, Sheps notes. According to the Hair Prosthesis Centre of Toronto, high-quality men’s hairpieces start at $750 and can go as high as $2,000, depending on their base.

Plug therapy

Follicular unit grafts (FUGs) are proof of how much hair transplantation has been refined since the early days of painful-looking plugs. Though hair is still harvested from the back and the sides of the scalp, each strip is now meticulously processed into follicular units, which contain a complement of one, two or three hairs. These tiny grafts are then inserted into equally tiny slits in the scalp. The units can be quite densely packed as well to create a realistic, non-transplanted look.

“Results can look so natural that even hairdressers don't know for sure,” says Nakatsui. “But while the concept is very simple, doing it is technically difficult.” So he advises men to ask for high-quality close-up photos of patients who’ve had hair transplants at the clinic they’re considering and to make sure the facility is using FUGs and not older techniques that are less cosmetically refined.

Depending on the degree of hair loss, the number of grafts required and the expert performing the procedure, hair transplantation costs between $3,000 and $10,000. It can cost significantly more, however, and further transplants may be needed as the hairline continues to recede. The procedure takes two to six hours, depending on the number of grafts needed.

For more information on hair restoration, go to www.shepshair.com or www.hairtransplantedmonton.com. But if you’re bald and proud and would rather look like Yul Brynner than Donald Trump, check out this site: www.baldrus.com.