Men concerned with hair loss and baldness usually go through a series of more and more aggressive steps before he will proceed with the most invasive procedure - a hair transplant. They first try grooming agents -- shampoos, lotions and conditioners -- some of which give the illusion of a thicker head of hair. The next approach is personal grooming: growing the ponytail, combing over the remaining hairs or getting a permanent wave, which curls the hair to give a fuller appearance.
When scarcity of hair no longer creates a sufficient illusion, medical remedies are sometimes sought. Some medical treatments keep hair from falling if hair loss is at an early stage, but only five percent of people have been able to grow cosmetically beneficial hair; another 30 percent will grow a peach-fuzz type of covering. The vast majority may try this approach for a year, but then give up.
Then men might start with a hair system, or essentially a wig to cover their balding. Hair systems have improved and look more natural now, but they can be costly to keep up. The pieces themselves vary in price, from $600 to $2,000, but maintenance can cost up to $100 to $200 a month. Men need two pieces, one to wear and one that gets cleaned. Or they might take a prescription drug that blocks the formation of 5 dihydrotestosterone, or 5 DHT, which otherwise accumulates in the follicles and prevents the hair from growing. This achieves cosmetically beneficial hair in over 60 percent of cases. One potential side-effect, in around two percent of cases, is some sexual dysfunction, such as impotence or reduced sperm volume.
Finally there is cosmetic surgery. The state-of-the art hair transplants is follicular transplants, in which groups of one-, two-, three- and four hairs from hairy areas on the head are implanted into tiny holes in the balding area. Single hairs are used to create a hairline. The extent of the baldness determines how many grafts need to be performed, from around 1,000 to 3,000 grafts for a receding hairline to 4,000 to 10,000 grafts for a more exposed scalp. Groomable hair usually sprouts in six months, with the full benefit accruing in nine months to 12 months.