Hair Replacement & Hair Loss Products: What Works, What Doesn't

by Larry Hanover

When the advertising slogan "Be Like Mike" caught America's fancy, it wasn't because every man decided to go for the Michael Jordan look by reaching for a razor and shaving his head.

Sure, men like Jordan, Charles Barkley, and "Star Trek's" Patrick Stewart are part of a small minority who are proud of their baldness. But combating and covering up hair loss hasn't turned into an estimated $1 billion-a-year industry because Americans like the idea of hair collecting in the shower drain.

"It probably represents aging," says Ken Washenik, M.D., director of dermatopharmacology at New York University Medical Center. "I think our concept of a bald person is of an older person. I think anything that reminds us in the mirror every day of the inevitability of aging is less than optimal."

When you talk about restoring hair, you're essentially looking at three different approaches. The first is to medicate, using a 2 percent solution of minoxidil found in Rogaine (and other brands since Pharmacia & Upjohn's patent expired in February 1996). Minoxidil is the only drug approved by the Food and Drug Administration for regrowing hair.

That doesn't mean minoxidil is by any means the panacea that men have been searching for since at least 1150 B.C., when Egyptians covered their baldness with a mixture of fats from ibex (a mountain goat), lion, crocodile, serpent, goose, and hippopotamus.

Surgical procedures, including hair transplants and scalp reduction, are another modern-day approach. And, finally, there's the solution that Julius Caesar, according to legend, used in ancient days--cover it up. The most powerful man in the Roman Empire is said to have turned to the ceremonial wreath of laurel leaves to hide his ever-emerging scalp. The modern alternative is the hairpiece.

The Thick and Thin of Hair Cosmetics

While Rogaine and other minoxidil-based products are giving consumers hopes of regrowing hair, another part of the hair-care industry has been jumping into the fray.

Drugstore chains, beauty shops, and salons are offering a number of products claiming to make hair appear thicker or fuller. While they won't solve baldness, such products can help women in particular by giving the appearance of more hair--if, and only if, the products are used regularly.

"The reality is," says Anthony Santangelo, president of the American Hair Loss Council, "[the products] just build hair for the day."

A quick walk down the store aisle shows a multitude of shampoos, conditioners, gels, mousses, and volumizers competing for your dollars. Many labeling claims target people with thinning hair, while others hint they can regrow hair, creating controversy about whether such a claim constitutes going too far. Any product claiming to regrow hair would have to file a new drug application. The Food and Drug Administration has approved only one product, the drug minoxidil, for regrowing hair.

"It's marketing; it's puffery," Santangelo says. "They'll take it as close as they possibly can without crossing the line, and they'll run with it."

Many of these products seem to thicken hair by coating it with chemicals called polymers. Hair has a negative charge, and the polymers' positive charge causes the polymers to adhere to the hair shaft, says Charles Fox, a Fair Lawn, N.J., consultant to the cosmetics industry. That results in better hair manageability and shine, he says. The hair also retains moisture, causing the shaft to swell and its diameter to expand slightly.

Also, says Stanley Milstein, Ph.D., special assistant to the director of FDA's Office of Cosmetics and Colors, some products coat the hair with various oils, waxes and silicone, claiming to restore moisture balance as they thicken hair.

Clarence Robbins, vice president of advanced technology for Colgate-Palmolive Co. and author of Chemical and Physical Behavior of Human Hair, says that if the products work, it's because they keep hair shafts from sliding past each other (think of the fly-away hair you get after blow-drying on a winter day.) In that way, hair volume appears greater.

If you're one to use bleach (peroxide) occasionally, he says, the bleach can achieve that sliding effect. Perms also make your hair wavier and fuller looking.

Many promoters of these products say their pro-vitamin B5 (panthenol) formulas can lead to fuller hair. Experts say don't bet on it, and according to the agency, the claim has never been proved.

By the way, there are products that simply color your scalp to create the appearance of hair. "But get any closer than 20 feet from an individual, they're gonna see your head's been spray-painted or covered with powder," Santangelo says.