Grasping at strands for baldness remedies

Matt Leavitt, a dermatologist who specializes in hair-loss treatment, has had more than one taste of his own medicine:

He has used his entire tool kit, including drugs, surgery and a laser comb device, to restore and maintain his own hair.

Leavitt runs Medical Hair Restoration in Orlando, and he is a paid adviser to the makers of HairMax, a laser comb that just received marketing clearance from the Food and Drug Administration.

He says each of the treatments "has a unique mode of action, and they are all complementary to each other."

That's one way to look at it.

Another:

There's still no cure for baldness — but if you are losing your hair and are willing to spend a lot of time and money on multiple, lifetime therapies, you might avoid ever looking like Britney Spears on a bad day.

Treatment "is a lifelong process" because hair loss is, too, especially for men who have typical male pattern baldness, says Robert Bernstein, a dermatologist in Manhattan who runs Bernstein Medical Center for Hair Restoration.

Specialists differ somewhat on the usefulness of various treatments. Some are especially skeptical about the laser comb.

And although all agree that the most effective method, by far, is costly hair transplant surgery, few advise it as a first choice.

Instead, the mainstays of treatment are two FDA-approved medications:

•Propecia, a drug that reduces levels of a hormone that shrinks hair follicles as men age, is the only pill approved for male pattern baldness.

•Rogaine, also sold as generic minoxidil, is a topical treatment — applied directly to the scalp — and is approved for men and women who have thinning hair.

The latest version is a foam.

The drugs have drawbacks: Propecia causes reduced libido in a small number of men; minoxidil can cause scalp irritation and must be applied twice daily.

"You have to do it for the rest of your life," says Amy McMichaels, a dermatologist in Winston-Salem, N.C. "That's the big downfall for a lot of patients.

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And the results? Anyone who expects miracles will be disappointed, doctors acknowledge.

In the best case, about one-third of men in the early stages of hair loss regrow some hair with Propecia, Bernstein says.

Both medications primarily slow down hair loss and improve hair quality, he says.

"With both of these drugs, stopping hair loss is a Hair Loss run," Leavitt says. "Growing more hair is a grand slam."

And in later innings, doctors agree, the benefits decline. "You do continue to lose hair, no matter what you do," McMichaels says.

Leavitt says, "That's the point when we talk about surgery."

So where does the laser comb fit in? Leavitt points to the six-month study reviewed by the FDA that shows men who used the comb grew an average of 19 more "terminal" (thick, rather than thin) hairs per square centimeter than those who used sham devices.

That's a "medically significant" amount, he says, though the average healthy scalp has 160 to 260 hairs per square centimeter.

The results make the comb — which is for use three times a week and is sold online in versions that cost $395 and $545 — a good add-on treatment or a choice "for anyone who doesn't want to take a pill or rub something on their head every day," Leavitt says.

Bernstein says the comb "clearly does something," but a six-month study is too short to be meaningful.

McMichaels says she is "very skeptical. … My concern is that patients will spend money and put their faith in something that has not undergone rigorous study."

Though the three doctors may quibble on the comb, all agree that no vitamin or herbal supplement has been proved to promote hair growth.