Surgery and drugs are giving new hope to the balding
Vanity, thy name is woman? A bald lie if you ask doctors. For one of the most common cosmetic procedures in the world is usually requested by men: hair transplants. In recent years, medical efforts to reforest bare scalps have become increasingly sophisticated. A combination of new surgical procedures can now mask baldness so faithfully that "only the patient and his doctor will know for sure," according to Dermatologist Theodore Tromovitch of San Francisco. At the same time, research on a new drug treatment suggests the hair-raising possibility that baldness can be prevented in the first place, even for those fated by heredity to lose their hair.
Many of the new methods of treating sparsely covered scalps are based on a transplant technique developed in the 1950s: about 50 "plugs," each consisting of twelve to 15 hairs with follicles intact, are removed from the back of the head and implanted in the bald spots. But the process is tedious and expensive. Transplanting each plug costs $25, and three to four sessions may be necessary. Moreover, not everyone has enough hair to provide sufficient plugs.
A solution is scalp-reduction surgery, which can shrink a bald spot the size of a palm to the width of a finger. The procedure, developed about eight years ago in Canada, is performed in a doctor's office under local anesthesia. The plastic surgeon or dermatologist makes an incision in the crown and then tugs firmly on the scalp, pulling hair-covered areas from the sides of the head toward the bare area on top (see diagram). A section of the bald scalp is cut away, and the incision is closed with stitches. The 60-min. procedure may be repeated to reduce further the size of the bald spot, which is eventually filled in with transplanted plugs. The approximate cost of surgery each time: $1,200. However, says San Francisco Dermatologist Alan Gaynor, in one out of four cases the patient's scalp is too tight to be stretched.
Another new procedure has made it possible to avoid the artificial-looking hairline left by transplants. Using a Danish technique, doctors can now insert plugs of just one or two hairs in front of an implanted area to simulate a natural hairline.
The latest hope in treating baldness is a drug originally designed to combat hypertension: minoxidil, made by Upjohn. It proved to have the bizarre side effect of promoting hair growth everywhere on the body, probably because it increases blood supply to the hair follicles. Trying to make a virtue of necessity, Upjohn began a number of studies in which minoxidil ointment was rubbed onto the scalp. In Washington, D.C., early this month, Dr. Hideo Uno, of the University of Wisconsin, reported that "minoxidil stopped the natural process of balding" in monkeys that normally lose their hair. So far, results in humans have been less clear-cut. "There is no question that minoxidil can stimulate growth in some patients," says San Francisco Dermatologist Vera Price, but the yield is often nothing more than a fine peach fuzz. It may be that minoxidil will be most effective as a preventive measure, applied at the earliest signs of balding. Researchers are also investigating a dozen other chemicals, including hormones, all of which require further testing. One thing is certain: there will be no shortage of volunteers.