Also see our other health topics on Normal (hereditary) hair loss and Temporary hair loss.

For normal hereditary hair loss, caused by androgenic alopecia, there is no cure as such, although some treatments are available to slow or halt the hair loss. Early treatment works the best, to prevent further loss. If hair loss is caused by a temporary situation such as medication, stress or insufficient iron, however, the hair loss will stop when the cause of the hair loss is removed.

Medications for hair loss

Treating hereditary hair loss with medications is more successful when started early, at the first signs of hair thinning. Treatment must be continuous to maintain hair regrowth. If the treatment is stopped, regrowth ceases and hair loss will start again. The effectiveness of treatment may not be measurable for up to 12 months.

Hair loss medications for treating hair loss are classified as either pharmacist-only or prescription-only medicines. These medications have a small risk of causing side effects, and you should make sure your doctor or pharmacist satifactorily explains to you what these are before starting treatment.

There are several medications available for hair loss in New Zealand. The results differ from person to person, but on average three out of five who use these medications find hair loss is slowed or stopped - and some may even get increased hair growth.

Finasteride (Propecia) is available on prescription from your doctor for the treatment of hereditary hair loss in men only (male pattern baldness). It is taken as a single tablet each day - the recommended dose should not be exceeded. Finasteride acts on 5-alpha reductase, an enzyme present in your scalp that controls the production of the hormone dihydrotestosterone, which is involved in regulating hair growth. Taking this medication will not affect the hair on the rest of your body.

Minoxidil topical lotion (Rogaine, Headway) is available over-the-counter from pharmacies and is rubbed directly onto the scalp and can be used by both men and women. It usually works best for hair loss at the top and back of the scalp, where there is still some remaining hair. It can slow progressive balding in hereditary hair loss, but not all hair will grow back.

The lotion needs to be applied twice daily to the scalp while it is dry. You should not exceed the recommended dose, as overuse will not achieve better or faster growth. The most common side effect is an itchy scalp.

You should always wash your hands thoroughly after applying the lotion, and avoid getting it in your eyes, nose or mouth. When taken in tablet form, minoxidil is used to treat high blood pressure and, if accidentally swallowed, could potentially affect normal heart function and blood pressure. This product should not be used by women during pregnancy or breastfeeding.

Hair transplantation

Hairstyles can often be effective in hiding thinning hair. In some men, hair transplants can redistribute the remaining hair. Hair transplantation is often less satisfactory in women than in men. Partial hairpieces or wigs are recommended for women if the hair loss is severe.

Surgical hair replacement can give you back a head of your own hair. Available since the 1950s, surgical hair replacement is a low risk procedure. Tiny plugs (grafts) of your hair-bearing skin are surgically removed and transplanted into tiny holes made in the scalp where your hair is thinning. These plugs are removed from the band of hair extending from above your ears and around the back of your scalp.

During one hair transplant session, up to 60 or 100 hair plugs are transplanted. Local anaesthesia and mild sedation minimise discomfort during surgery. Hospitalisation usually is unnecessary. A few days after the operation, tiny scabs form around each hair graft. When the scabs disappear, the transplanted hairs usually fall out. New hairs generally start to grow within a few months.

If the baldness and thinning is extensive, one should not expect to walk out of the first surgery with a full, natural-looking head of hair. Even after the transplanted hairs begin growing, these widely scattered clumps may look conspicuous. Additional surgical appointments may be needed to fill the bald spaces. It may take a year or two before you will be pleased with your new appearance. The quest for a new look may be expensive for each round of surgery. Typically, it takes three or four sessions to cover a bald area.

Material adapted from myDr Australia and HealthScout. Reviewed in New Zealand by Dr Garsing Wong, February 2005.