Hair loss occurs in more than 60% of men and in approximately 10% of women. Although a lack of scalp hair can potentially increase the risk of actinic damage and skin cancer, male and female pattern baldness are conditions that are, with few exceptions, treated electively.
Balding is a major concern for many, and surgery to treat hair loss (ie, hair transplantation) is the most common cosmetic surgery procedure performed on men today. Yet, the market for hair transplantation is dwarfed by the immense market for products that treat hair loss without surgery.
These products, which include shampoos, hair-care cosmetics, scalp massagers, laser combs, and many more, have no proven efficacy except for their ability to temporarily increase the volume of existing hair, resulting in a denser appearance than before. Exceptions are the two medications the US Food and Drug Administration (FDA) approved: minoxidil (Rogaine, available over the counter in the United States) and finasteride (Propecia, available by prescription only for men), which have limited but definite benefit.
Interest in hair transplantation will probably increase as the knowledge that most modern hair-transplantation techniques can create virtually undetectable restoration spreads, as shown below. To this day, hair transplantation remains the treatment of choice for most patients with hair loss.
One of the most rapidly growing segments of hair transplantation is hair transplantation in women. Surgical hair restoration was developed for and has traditionally been used in males. Newer techniques are more adaptable to females.
Hair transplantation is used to treat various forms and degrees of permanent alopecia in both men and women. Intact hair follicles may be harvested from within the safe donor area (SDA) of a patient’s scalp by either follicular unit strip surgery (FUSS) or follicular unit extraction (FUE); each harvesting method has unique advantages and disadvantages. The refinement of follicular unit transplanting over the last decade has led to markedly improved hair survival and natural-appearing results (see the image below).
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