Developed in the 1950s as a tablet to treat high blood pressure, minoxidil was found to produce hair growth. Re-invented as a lotion applied directly to the scalp, it was launched in the United States in 1988 and soon became popular around the world.
Minoxidil is TGA-approved and available over the counter in pharmacies for between A$15 and A$60 per month, depending on the brand.
No prescription or trip to the doctor is required, but talk to your pharmacist if you are taking any other medicines, especially high-blood-pressure medication.
Low doses of minoxidil, can still grow hair with minimal effect on blood pressure and no need to put anything in your hair.
Minoxidil is good at stimulating new growth as well as preventing progression of hair loss. A bit like the bank manager who lends an umbrella when the sun is shining, and wants it back when it starts to rain, minoxidil works better before you go bald. Men who still have hair regrow more hair than men who have lost it all.
Hair transplant surgery
Men whose hair is too far gone to be saved by tablets and lotions might consider hair transplantation surgery, a cosmetic surgical procedure that has improved dramatically in recent years.
Various techniques are available, but all involve taking hair-bearing skin from one part of the scalp and grafting these pieces of skin onto bald or thinning areas of the scalp.
The main down side, apart from the cost (A$10,000 to A$15,000, depending on the number of grafts required) is the linear scar left behind on the back of the head locking men into long hair styles.
Another option is follicular unit extraction. Rather than a strip of skin and a scar, donor tissue comprises multiple tiny punch grafts that heal invisibly by wound contraction. Further dissection of these grafts releases single hair follicle units that can be implanted one by one into the bald scalp to recreate a natural hair line.
The only limiting factor for follicular unit extraction is whether there is enough remaining donor hair to transplant. While chest and body hair have been used when donor hair is poor, artificial hair implants, also TGA-approved, remain the last resort. Artificial hairs cover the scalp, but do not grow and grey and regenerate like hair transplants.
What about other suggested treatments such as vitamins, dietary supplements, lasers, stem-cell therapy and platelet rich plasma? At this stage the most generous interpretation of the available data is that they are unproven, expensive and poor value compared with the TGA-approved treatments.