Options for Hair Regrowth
One of the few things that a male-to-female crossdresser can do to help them pass is to grow their own hair out. I can't overstate how much wearing my
own hair has helped me. Although there are some distinct advantages to wearing a wig, in my not-so-humble opinion, wearing you own hair is better.
Not everyone can grow their hair out because of baldness or a receeding hairline. There is not much that can be
done if you are completely bald, but you do have options if you only have thinning hair or a receeding hairline. Unfortunately, the vast
majority of hair loss treatments being marketed today are nothing but "snake oil" and do not work. Unless the a hair loss treatment is approved by the
FDA or recommended by the American Hair Loss Association, chances are you are wasting your time and money.
Basically, you have only a few proven approaches for addressing hair loss:
- prevent the hair loss before you loose it;
- regrow lost hair with drugs;
- transplant the hair.
Prevention of hair loss
There are several drugs available on the market that can help prevent your hair from going away. These drugs do not cause hair to regrow, per se, but
prevents the hair from thinning and falling out. As always, before taking any medication, you should consult with a qualified medical professional.
Avodart, Propecia and Proscar are the most widely used drugs for preventing hair loss. They are is considered to be "5-alpha reductase inhibitors." These
drugs help block the production the "5-alpha-reductase" enzyme that converts testosterone into dihydrotestosterone (DHT). It is
DHT that shrinks or miniaturizes the hair follicle, which eventually leads to baldness. By eliminating the DHT, you hair is less likely to fall out.
In short, taking these drugs do not regrow hair but it allows you to keep what you have.
Throughout my thirties, I noticed a slow recession of my hairline. By the time I was 35, the hairline had receeded at least an inch and a half and was probably
closer to two inches. Even though I started growing my hair out, having the tell-tale "M" pattern hairline made me feel self-conscious. I would hardly wear my
hair up for fear of exposing too much of my ever increasing forhead.
So, I started taking Propecia. After a few months it appeared that the recession slowed down a lot but it had not stopped. Since Propceia only reduces
the amount of DHT produced rather that eliminate the DHT, I looked around for other options.
One thing that I found was Nizoril shampoo. This comes in two strengths - the 2% strength requires a perscription, but the 1% is available over the counter
in the USA. Nizoral is a anti-dandruff shampoo but its active ingredient, ketoconazole, is an androgen production inhibitor. In other words, it helps block
DHT production. This is a good thing!
Early in 2006, I was chatting with a TS friend of mine who passed along the name of a relatively new drug, called Avodart, that has been shown to reduce
DHT levels dramatically better than Propecia. I talked about this with a pharmacist and my doctor and they agreed that, for me, Avodart was a better choice.
Since I started using Avodart, the hair loss has either stopped or slowed down nearly to a stop. It is hard to tell after only a fairly short period of time
but I feel pretty satisfied.
You should be aware of some of the possible side effects with these 5-alpha reductase inhibitors drugs. These side effects may include decreased sex drive,
increased ejaculatory dysfunction, and difficulty getting an erection. If you are TS, then these side effects are probably not an issue. If you are not TS,
then proceed with caution. Another interesting side effect is possible gynecomastia (breast enlargement and tenderness). Again, this may or may not
be an issue for you. Avodart is not for everyone, especially if you have liver problems or prostate cancer, so make sure that you check with your
doctor before beginning to use Avodart. (Gee! This
is starting to sound like a commercial you might see on television!)
You can read what the FDA has to say about Avodart from their website at
http://www.fda.gov/cder/consumerinfo/druginfo/avodart.HTM and
http://www.fda.gov/cder/foi/label/2002/21-319s1lbl.pdf/. By the way, as of the time of this writing, the makers of
Avodart, GlaxoSmithKline, was offering a free month's trial of Avodart on their website at
http://www.avodart.com/.
The last note about these drugs is that you will be on them for the long haul. Unless you do something to prevent your body from producing testosterone
(such as get an orchiectomy or chemically castrate yourself through other drugs), once you stop taking the "5-alpha reductase inhibitors", the DHT will
start getting produced again and your hair will again become susceptible to its damaging effects. Still, it may be worthwhile going on these medications if
only for a few years because they will delay the onset of male pattern baldness or slow down your current hair loss rate.
Regrow lost hair with drugs - Minoxodil (Rogaine)
There are very few drugs on the market that have been proven to regrow hair. Minoxidil (sold as Rogaine) is the only real option that I am aware of.
Initially, Minoxidil was taken as a tablet and was intended to be used for the treatment of high blood pressure. Hair growth was an unexpected side effect
of the drug. People would find hair growing in unexpected places like the back of their hands and on other body parts. By administering the drug as a liquid
that is applied to the scalp, researchers were able to limit the hair growth just to the treated area.
Although Minoxidil has been shown to cause some hair regrowth, most people find it to be a disappointment. Minoxidil's effects take several weeks (if not months)
before they become noticeable and disappear soon after you stop using it, many people consider Minoxidil to be just a temporary solution. Also disappointing was
the fact that the hair that grows back is often just "peach fuzz." Finallly, Minoxidil appears to work fairly well with bald spots but does little for a
receeding hairline.
If you do decide to try Minoxidil, go with the 5% solution rather than then 2% since the higher percentage is relatively much more effective.
Hair Transplants
One sure-fire way of getting hair back is through hair transplants. It works and the improved techniquies of recent years can provide you with
a natural look. And the best thing about haor transplants is that they are permanent!
Regardless of who you use for hair transplants, the process is essentially the same. They first cut out a thin strip of skin from the back of your head. Typically,
this goes from just behind one ear to just behind the other and is perhaps one inch wide. This donor strip is then chopped up into groupings of hair that
may contain one to four follicles. It is this grouping that is called the "graft." A series of punctures are made on your scalp and the grafts are then
inserted into each puncture.
What is important in this process is the skin that is transplanted and not the hair. At the base of each hair is a small structure, called the papilla,
that actually produces the hair. If you relocate the papilla to a new location then it will grow hair in that new location. It should be noted that not all the
hair on your body is susceptable to damage by DHT. Pubic hair is not, the hair in your eyebrows is not, nor is the hair found at the lower back of your head.
That is why the donor strip is taken from the back of your head. Even if this hair is moved to the forehead or to the top of your head, it will not be
damaged by DHT. This means that the transplanted hair will stay.
The only bad thing about having this procedure is if you don't use an 5-alpha reductase inhibitors drug to prevent additional hair loss, then you could end up
with a strip of full hair around your forehead but still have a big bald spot. I have seen a few people who had hair transplants when fairly young and
years latter lost all of their hair except at the back of their head and whatever had been transplanted. It just looked bad.
I went through a hair transplant procedure in January of 2007 and have been please with the results (although I was disappointment with how long the discoloration
of my skin lasted, which was nearly three months). The process took about six hours to harvest the donor area, chop up the grafts, and
then insert the 1984 gratfs into my scalp. They used a series of shots of some sort of novacane-like pain killer, so it was not especially painful - although
it was not pain free. For me, the most uncomfortable aspect of the procedure was when the doctor was puncturing the scalp. Not because I felt a lot, but
rather because I "heard it." It was kind of like crunching popcorn inside my skull. It was gross.
As expected, within a few weeks, most of the transplanted hair fell out but they slowly returned over the months that followed. I was told that I should
expect anywhere between 6 to 18 months before everything comes back. After six months, it is "So far, so good."
Although prices may vary, you will probably pay on a per graft basis and may get "volume discounts." Initially, I went to see one plastic surgeon about this
and he told me that I would end up getting a better deal at one of these places that specializes in hair transplants. A plastic surgeon will end up charging
a lot for their services because what they do is often highly speciallized and requires a great deal of skill and experience. The process for hair transplants,
although requiring skill and experience to do it correctly, does not require the same level of expertise as a plastic surgeon. So why pay a high priced
plastic surgeon to do something he does once in a while when you can go some place that specializes in hair grafts and charges less?
Some hair transplant specialists have got into hot water over the years because of pricing. One very prominent hair transplant service had a bunch of people sue them
because the patients expected one price but ended up getting charged something much higher. The issue had to do with the contract having a clause that say something
like "the technician will be authorized to apply more grafts than was estimated if they judge that the additional grafts are needed to properly do the job." From
what I read, the amount charged ended up being twice what was estimated.
The place that I went to,
DiStefano Hair Restoration Center, did give me an
estimate. Actually, they gave me a low-end estimate and a high-end estimate of 1200 to 1500 grafts. To their credit, they ended up with nearly 2000 grafts from the donor area,
put them all in, but did not charge me for anything over the 1500. They are good people.
