There are two main approaches -- hair transplantation or medications such as Rogaine and Propecia -- but the best choice for an individual man depends on his age and the speed and degree of hair loss.

     

In general, it¹s best to start with a drug treatment, said Dr. Sandy Tsao, a dermatologic surgeon at Massachusetts General Hospital. When rubbed on the scalp, Rogaine also known as minoxidil, helps hair regrow. The trouble is, significant hair re-growth only occurs in 3 to 5 percent of users, Tsao said, though the drug can stabilize hair loss.

     

A more effective drug is Propecia, a pill that is a low (1 milligram) version of another drug, Proscar, that is used to treat benign prostate enlargement.  Both Propecia and Proscar block the conversion of the hormone testosterone to its evil cousin, DHT, or dihydrotestosterone, which ³shrivels hair follicles,² said Dr. William Rassman, medical director of the New Hair Institute in Beverly Hills, Ca.

     

Propecia works best in younger men and in those whose hair loss is moderate and recent, though it doesn¹t help men whose hair loss is in the front part of the scalp. It also takes about a year to determine if the drug can stimulate significant hair regrowth.

     

Hair transplantation, a form of surgery that can cost $5,000 to $8,000 and is not covered by insurance, is a good option for men who are dissatisfied with results from drugs and whose hair loss is gradual. In the old days, doctors used to take ³punch biopsies² -­ little plugs of hair ­- from the back of the head and insert them in the front and top of the scalp, where balding is most common. Now, they transplant tiny grafts containing one to four hair follicles each, which yields better results cosmetically.

     

For men whose hair loss is extensive or rapid, the best option is often combination therapy -- some transplantation, plus drugs to slow further loss.