What are the treatment options available today?
Topical Minoxidil and oral Finasteride have very limited value. The impressions one sometimes has from reading advertising material is that they have a significant value. In my view this is not the case.
Hair Transplantation involves sharing hair follicles from the permanent ‘Friar Tuck’ rim of hair with the bald area.
The old technique of ‘punch grafting’ provided great density of hair but the hair had to be well groomed to disguise the ‘doll’s-head appearance’. The sizes of grafts have gradually become smaller so that eventually single follicles could be transplanted. This other extreme is called ‘follicular grafting’. These single follicles are denuded of all surrounding tissue which, in the view of one school of thought to which I belong, can compromise the vitality of some of the follicles. In addition, as opposed to the great density but questionable aesthetics of punch grafts, follicular grafting produces very limited density despite a refined appearance. It can be very expensive.
I strongly believe that a combination of acceptable density together with refinement is best achieved by grafts slightly larger then the follicular grafts but still very small.
This technique of 1, 2 and 3 hair grafts is known as mini/micro grafting and is one which I favour.