The causes of hair loss are many

Karan Dhumal, 46, combed his hair each morning, he became increasingly _dis-
mayed at what he saw: more ind more hair sticking to his comb. “As director of a company, my life is stressful.” he says. “And stress was steadily thinning my
hair” On the advice of his doctor,
Dhumal* underwent transplant surgery in November 2007 to counteract the baldness. The cost: Rs120,000. Now he has virtually a full head of hair. “It was certainly worth it.” says Dhumal. “My new
crop is coarser than my original hair, but that difference is obvious ‘only to me” [*All asterisked names
changed to protect privacy.)

After being rejected by many prospec tive brides, Manoj Kumar, 27, a Surat financial consultant, 100, decided to get transplant surgery done in April. Before that he tried improving his condition
with a drug called minoxidil, and
“vitamin therapy” Today, hair has started growing on Manof's scalp, indicating re-growth in the bald-
ing areas. “It is promising" he says, “I hope to fully recover my lost hair, although it's a slow process. I have to be patient” Even after surgery, he continues with vitamin therapy.

Though no actual figures are
available, younger people in their
late teens and twenties are experi-
encing alarming hair loss. The in-
cidence increases with age. Mean-
while, the market for hair-loss
remedies—surgeries, hairpieces,
cosmetics and drugs—has grown
exponentially over the past few
years. The good news is that the
success rate is much greater today
than ever before. The bad news
is that there is much hype amid
the hope. While some methods of
restoring hair have proved their
worth, others have not. If you are
considering one of the many op-
tions, you need to know the facts.

Complicated chemistry

Hair loss can be triggered fections, drugs, diseases, diet and oth-
er factors, but most of the time its
a result of genetic predisposition.
The genetic trait, which can be
passed on by either parent, deter-
‘mines not just if, but when, we will
lose hair. The condition is called
androgenetic alopecia because it
is an androgen (a male hormone)
that causes the problem.

Researchers believe that in those
predisposed to hair loss, the folli-
cles start to produce the enzyme
5-alpha-reductase, which grabs the
male hormone testosterone from
the blood and converts it to DHT,
or dihydrotestosterone. DHT at.
tacks the hair follicles, which then
weaken and shrivel. For men, hair
usually recedes along the hairline
or falls out at the crown—or both.
For women, hair loss tends to be
more diffuse, thinning all over the
scalp. Female hair loss is usually
less severe because, it's believed,
women produce an enzyme called
aromatase, which can turn DHT
into estrogen and lessen follicle
‘withering.

‘The chemical reasons for hair
loss are complicated, so it's not
surprising that many products
promising they can make hair grow
back don't work. Among them are
special hair nutrients, herbal rem-
edies, oils, amino acids, proteins and hair “restorers” containing chemicals which are supposed to encourage new hair growth by unclogging follicles the way floor cleaners cut through built-up dirt.

However, a number of methods are proving effective in fightinghair loss:

“Volumizers”

tis illegal to sell non-prescription
products that claim to prevent
baldness or regrow hair. But many
shampoos, conditioners, mousses
and gels contain “volumizers,”
‘which—though they can't replace
hair—can at least make what's left
Took thicker by anti-static-coating
each strand and preventing them
from sticking together. They also
contain “humectants” that absorb
and retain moisture making the
hair seem fuller, temporarily.

Thinking

Hairpleces and wigs can be expen-
sive and costly to maintain. They
also wear out. Worse, though it's
rare, they can shift at embarrass
ing moments. But these hair additions supply an instant head of hair and can also buy time for people considering surgery.
          Newtechnologieshaveimproved
hairpieces, making them look natural. Human or artificial hair (or a mixture) is sewn into finely netted nylon or polyur ethane or silicone, all of which are pliable, mould to the skin, and allow air, water and perspiration to circulate aroundthe scalp. One hair at a time is
attached to the base in the direction it would normally grow. Andthe customer's own hairline, hair density and curl can be matched.

 

Many hairpieces can be washed,blown dry, coloured and permed  just about anything you'd do with your own hair. Most weigh very little, and are attached with double-face surgical adhesive tape,

combs or clips. A taped-on hairpiece can be left attached for a couple of days or removed whenever desired; hair extensions that are bonded to natural hair with acrylic or polymer glue, or woven to a braid of existing hair, can be

left in place for several weeks.

Yoga and head massage

The yogic practice of pranayam

increases the efficiency of oxy-

gen utilization thereby improving

blood supply to the scalp. Consult

a yoga teacher to learn about more

benefits through yoga. Regular

ayurvedic head massage using

specific oils can increase blood

supply to the scalp and stimulate

healthy growth, though i's unlike-

Iy to reverse baldness.

Drugs and ers

‘When it was noticed in the 1970s

that minoxidil, a drug devel

oped originally as an oral treat-

ment for hypertension, produced

hair growth on foreheads, upper

cheeks and arms, researchers

began testing it in a two-percent

solution applied to balding scalps.

Today that solution, the only drug

approved for hair growth, is avail-

able in India.

“Minoxidil isn't for everyone.

And those for whom it does work

see different gains” explains a

spokesman for The Upjohn Com-

pany, minoxidil's major US seller.

A study conducted by Upjohn

found that when more than 300

women with hereditary hair loss

were treated with minoxidil, 60

percent showed some regrowth

and 55 percent noticed a decrease

in hair shedding. In another study,

2300 men who suffered hair loss

but were not completely bald

tried minoxidil. After one year,

39 percent had moderate to dense

growth at the top of the head.

“Once a root dies, no medica-

tion can help grow the hair back,

not even minoxidil.” explains

Dr Bishan Mahadevia, plastic sur-

geon and head of the Mahadevia

Clinic in Ahmedabad. “Minoxidil

acts by increasing the blood supply

Ayurvedic head massagecan increase

blood supply to the scalp and stimulate healthy growth, but it’s unlikely toreverse baldness to the scalp and by directly stimulating the hair roots. If you start

‘minoxidil, you cant stop. When ‘you stop, your genes will take over, and the minoxidil supported hair ‘will soon start shedding.”

‘Women seem to respond to minoxidil slightly better than men do; men appear to benefit most from the drug when they begin treatment in the early stages of

hair loss. Though long-term side

effects of the treatment are not

known, short-term ones include a

risk of dry, itchy scalp, even aller-

gic reactions (rare). People with

known or suspected coronary ar-

tery disease or heart failure are advised to avoid the drug in case it has internal effects. Minoxidil is also a pricey commitment—a 60ml bottle can cost up to 2400, depending on its concentration.

Never take it without your doctor's

advice. Since hair loss resumes after you stop it, i's not seen as a permanent solution.

Diet and nutrients

Dr Rajesh Rajput, a hair restora-

tion expert at the LH. Hiranan-

dani Hospital, Mumbai, will tell

you that when the body senses an

abnormal change, either in diet

or lifestyle, the roots of the hair

that are weaker start shedding. In

some cases, the body's protective

‘mechanism causes your hair roots

to “sleep.” This prevents hair fol-

licles from dying out completely.

Dr Rajput believes that hair can

be made to grow again by re-acti-

vating such dormant roots. So he

treats his patients with a particular

combination of oral vitamins, anti-

oxidants, calcium and aminoacids

in regular cycles every three days

for three to four months. There

are no side effects, maintains

Dr Rajput, in this “vitamin thera-

py” as he calls it and he claims it

succeeded in several cases.

Shweta Sharan, 29, is a freelance

writer from Chennai who experi-

enced severe hair fall in her early

20s. “I had hardly any hair left on

‘my head. It was embarrassing,” she

says. A visit to a trichologist—hair

specialist—revealed that her poor

diet was the underlying cause. As

a college student, Shweta often

‘went on crash diets, once losing as

much as 19 kilos in three months.

Soon she was underweight, with

a deficiency of iron and protein,

two vital ingredients for healthy

hair. “My dieting was unhealthy”

she says. “Id work out for about

three hours a day and eat only

Marie biscuits or brown bread.

From being obese at 90 kilos,

became severely underweight"

Shweta also had dandruff and a

fungal infection on the scalp, which

she blamed on a bad dye job. Her

doctor recommended that she cor-

rect her diet immediately and also

asked her to wash her hair with a

medicated shampoo every other

day for a year. Shweta also took up

‘yoga and used only wooden combs

that were gentler on her hair. In a

year, she went from virtual bald-

ness, to a full head of hair.

Scalp and scalpel

In some cases the only alterna-

tive would be transplant surgery.

Miriam Baptist, 51, who works at a

Mumbai computer firm, has been

juggling a demanding career and

home for the past 30 years. “T've

‘worked long hours every day, nev-

er managing more than six hours

of sleep” she says. “Finally the

stress began to take its toll. Td al-

‘ways had a thick head of hair but

1 noticed a bald patch above my

forehead a few years ago” When

the patch kept growing, Baptist

tried out a few popular hair recov-

ery centres but without results.

She finally decided on a follicular

hair transplant in August 2007. Bap-

ist was satisfied with the results.

Her bald patch has disappeared.

Duringa follicular hair transplant,

a naturally occurring follicular unit

which may contain two or three

hairs or hair-roots is pared from an

area of thick and more permanent

growth in the scalp and transplant-

ed to the bald region. The surgeon

‘makes tiny pores in the bald part

of the head and the healthy hairs

are delicately placed in the pores.

During a single treatment session,

hundreds or even thousands of in-

dividual hairs may be transplanted.

After about four months, these

hairs begin to grow normally.

Thanks to new techniques,

hair transplants look more natu-

ral today than they did years ago.

But transplants, however, almost

never totally eliminate baldness.

Like any surgical procedures, they

may also leave residual scarring.

Hair in the donor area may look

100 thin if too many transplants

are taken from it. Some initial

hair loss after the transplantation

surgery isn't uncommon and is no

cause for alarm.

Be sure to choose a surgeon with

a proven track record and don't be

afraid of clarifying all your doubts

before the surgery. And postpon-

ing any potentially irreversible

surgeries until balding patterns

can be more accurately predicted

might be the best approach. And

be cautious! Says a patient who

was left with a visible scar from

a previous transplant, “The ques-

tion to ask before any surgical

procedure is ‘What is the price for

achieving this?’ And I'm not talk-

ing just about money”

A bit of prevention

Sensibly taking care of the hair

you have can help prevent need-

less hair loss and camouflage thin-

ning areas. If your hair is thinning,

experts suggest these methods:

® Shampooing too frequently

may reduce surface sebum—the

fatty matter secreted by glands

under the scalp—and aggravate

hair loss.

® Pat or blot washed hair instead

of rubbing it with a towel—wet

hair is more vulnerable to dam-

age if it's pulled. If you blow-dry

your hair, set your dryer on a low

temperature.

® Brush and comb as gently

as possible without tugging on

tangles. Use a conditioner after

shampooing to let you comb your

hair more easily.

® Eat well. Nutritional defi-

ciency such as that of iron may

speed up the genetic hair loss and

therefore such a deficiency should

be detected and corrected by

nutritional supplements.

‘These simple measures can give

you time to decide if more drastic

procedures are needed. Perhaps

the best remedy for thinning hair

is not worrying about it. For men,

at least, a bald head can be a style

statement—as actor Yul Brynner

proved for a generation ago. Ben

Kingsley, Sean Connery and An-

upam Kher are carrying the bald

admired look forward.