Keep your hair on

There is, in the pursuit of hirsuteness, a bewilderingly long menu of treatments, with results that range from the near miraculous to the nightmarish.

Navigating the various options, knowing which is best suited to you, and who best to perform it, can make the difference between appearing deliciously and naturally younger — or looking ripe for a Channel 5 documentary. It is that stark.

The first option is the hair transplant — much improved in recent years. Long gone are those procedures that called to mind thatching, rugs, or East Anglian crop rotation. Instead, with developments in every aspect of the techniques and tools used, a natural-looking, refined result is perfectly achievable.

There are two types: FUT, follicular unit transplantation; and FUE, follicular unit extraction. The former is the older method and involves slicing a strip of hair several inches long off the back of the head near the nape of the neck. Individual hairs, or groups of hairs, are then transplanted with their root into the front or crown. Though more invasive, FUT can produce better results if you have more advanced hair loss, as the strip gives the surgeon access to more hairs to implant into the bald area.

By contrast, FUE involves removing tiny clusters of one to four hairs from all around the sides and back of the head before transplanting them in the same way as FUT. The difference, therefore, is in the extraction, not the transplantation. Both are good for those in the early-to-mid stages of male pattern baldness. The treatment can last anywhere from a few hours to two days, depending on the size of the job. It is uncomfortable and at times painful, with a succession of anaesthetic injections into the scalp. Steroid pills are prescribed to speed up the healing process and avoid infection. You can’t exercise or fly for a month, and it is advisable to take at least ten days off work.

When it comes to the actual operation, research is essential, say those in the know. Make an appointment, ask to speak to the surgeon (not an administrator), examine closely their photographs and ask to talk to at least one former patient.

If you can’t face needles or invasive procedures, there are always wigs. Or ‘hair replacement systems’ as the industry and its customers prefer to call them. As with hair transplants, the technological innovations over the last few years have been extensive, creating staggeringly natural-looking results. And as with most hair loss treatments, you get what you pay for. Off-the-peg toupées sprouting synthetic hairs will generally look awful. Custom-made ‘systems’ using human hairs, fitted and cut into your own hair with the latest ‘membrane’ (the cap from which the hairs sprout) can look as if your own barnet has grown back overnight.

Although the cost is a few hundred pounds in the first place for the wig itself, an annual spend of around £1,500 is typical, once changes of system and haircuts are factored in to keep it looking good.

As with most human problems, there are pills. The footballer Wayne Rooney admitted that his two hair transplants were boosted by his use of Propecia, and many surgeons advise this dual approach. The brand name for the drug finasteride, it was developed from a prostate cancer drug whose users reported it slowing and even reversing the balding process. It is available on private prescription only and works by blocking the conversion of testosterone to dihydrotestosterone, the hormone responsible for male pattern baldness.

The latest innovation in baldness cures isn’t hair at all — it just looks like it: the scalp tattoo. It’s not a blue/black spider’s web, nor anything that makes you look like an escapee from America’s toughest jail, but numerous tiny dots on the scalp to mimic the stubble of a shaved, rather than bald, head. Known as MHT (micro hair technique) this, of course, is desirable only if your face and head suit the zero-crop look. But to those who do, it’s the quickest and most permanent solution — although as with all tattoos, the colour will gradually fade. This is also not something any tattooist can offer as it requires finer needles and specialist ink without the classic blue tinge of tattoos. The HIS clinic (www.hishairclinic.com) was the first to develop it and is recommended. It costs around £2,000.

Finally, there are the over-the-counter hair-loss products: lotions, hair-building fibres and thickening shampoos. The first of these, a masking lotion, looks a bit like boot polish, but is a cream, in various colours, dabbed on to the scalp to conceal the bald patch poking through. Although the colour is fixed into the cream, some users complain it can still rub off. However, it also coats existing hairs, thickening the shaft by about half, and can be used in conjunction with the hair-building magnetic microfibres. These are shaken on to thinning hair and form what look like hairs attached and around actual existing hair, beefing up what you already have.

There’s nothing new about volumising shampoos, but the latest innovation is hair shaft-expanding shampoos, such as the Millefolium hair expander. The theory is that the protein in these products penetrates each follicle and reacts with heat, causing the shaft of each hair to expand and thus swelling a thinning thatch. From around £10 per bottle, they too will work best on those in the early stages of hair loss.

The message from customers of all treatments for baldness is clear: over-the-counter remedies can be tried on a whim, but for any permanent or semi-permanent solution, take your time. Equally, if anything goes wrong, don’t panic. It can usually be fixed. In other words, keep your hair on.