It is a common misconception that a hair transplant is a one-and-done procedure, rather than part of a process to address a progressive condition. Maintaining the health of existing hair through medical therapy can help maximize the long-term results of a hair restoration procedure. An easy way to think about it is that hair transplantation addresses existing baldness, while medical therapy serves to preserve and strengthen the hair that remains. For those on the hair restoration journey, medical therapy is an important aspect in achieving—and maintaining—a natural-looking head of hair for many years to come.

Dr. Marco Barusco—Founder and Chief Medical Officer at Tempus Hair Restoration—is often asked about the need for medical therapy when he counsels his patients.

“One of the questions I get is that if I can have surgery to replace the hair I’ve lost, why would I worry about treating my hair loss with medications? My answer to that is, if you’re not doing medical therapy, you’re missing out on a lot of benefits.”

What Causes Hair Loss?

Knowing what causes hair loss can put the role of prescription hair loss medications into perspective.

Dihydrotestosterone (DHT) is the primary driver of male pattern baldness (androgenetic alopecia). DHT binds to androgen receptors in the hair follicles, triggering a shrinking process called miniaturization. Over time, this causes the follicles to produce progressively thinner, shorter hairs until they stop producing hair altogether.

Understanding this mechanism allows for targeted treatment options. Finasteride (an oral pill, brand name Propecia) works by inhibiting the 5-alpha reductase enzyme to reduce DHT production. Minoxidil helps stimulate and widen shrunken hair follicles. While finasteride handles the hormonal defense against further hair loss, minoxidil acts as a growth stimulant. Topical minoxidil is sold under the brand name Rogaine; oral minoxidil is prescribed off-label.

Although a hair transplant redistributes existing donor hair from areas of the scalp that are typically more resistant to the effects of DHT, it does not stop the progression of loss of your existing so-called “native” hair. Without treatment, native hair surrounding the transplanted grafts will continue to thin over time, creating what’s known as a “halo effect”—an unnaturally dense patch of transplanted hair at the front of your head, separated from the rest of your hair by a growing ring of baldness.

Benefits of Medical Therapy for Hair Loss

As with any prescription treatment, hair loss medications are not appropriate for every patient, and may cause side effects. Treatment should be prescribed and monitored by a qualified physician after reviewing the patient’s diagnosis, age, sex, medical history, current medications, and individual risk factors.

For those who are approved, medical therapy can offer the following benefits:

Hair loss may be slowed or stabilized — A surgeon may recommend starting medical therapy before planning a hair transplant procedure in order to stabilize hair loss and improve baseline hair thickness. This allows the surgeon to better predict future hair loss progression in order to recommend a procedure that will provide the best possible long-term outcome.

“By stabilizing hair loss progression, medical treatment can convert a patient that’s a marginal candidate for hair transplant surgery into a good candidate,” says Dr. Barusco.

Moreover, following medical therapy on an ongoing basis post-surgery may serve to slow hair loss progression, delaying the need for a subsequent procedure.

Enhances the results of a hair transplant procedure — Dr. Barusco was a coauthor of a randomized, double-blind, placebo-controlled clinical study evaluating the use of finasteride in men undergoing hair transplantation. At the conclusion of the study, the finasteride group demonstrated significant improvements in the surrounding non-transplanted hair and overall hair density compared with the placebo group.

Dr. Barusco also refers to his case study of one patient who received a hair transplant to the front and top of his scalp, but not for his balding crown area. Dr. Barusco prescribed finasteride and minoxidil for the patient, who over the year following surgery experienced hair growth around the periphery of his crown.

“It’s subtle, but the medication actually improved his hair and decreased the zone of baldness around the sides and the lower area,” says Dr. Barusco. “I see this quite a bit in my practice.”

To see Dr. Barusco discuss his clinical study work and see this patient’s before-and-after photos, click here to watch his video—“Medications and Surgery for Optimal Treatment of Hair Loss”—which is on his YouTube channel, Hair Loss Medical Advice.

Hair Loss Medical Therapy for Those Who are Not Good Candidates for Surgery

Not everyone is an appropriate candidate for a hair restoration procedure. However, only a qualified hair restoration surgeon can determine this during a consultation that includes questions about your medical history, as well as your past and current medications, and several other factors. Our blog post—“The Importance of Consultation Before Hair Restoration Treatment”—covers this topic in greater detail. Consider the following a general guideline.

For example, Dr. Barusco is generally cautious about recommending hair transplant surgery for men under age 25. If performed too early, the donor hair may be distributed too heavily in one area, leaving too little to be transplanted later, when needed on another area of the scalp as hair loss progresses. Fortunately, such individuals could be ideal candidates for medical therapy. Our blog post—“When Should You Have a Hair Transplant Procedure?”—covers this topic in detail.

Another common situation is an insufficient supply of donor hair or diffuse thinning throughout the scalp. Medications do not create new hair follicles, but they thicken existing, miniaturized hairs across the entire scalp, which can improve overall visual density.

Addressing a Common Concern About Hair Loss Medical Therapy

As a hair transplant patient himself, Dr. Barusco addresses a common concern he hears from patients: that the benefits of medical therapy may diminish after treatment is discontinued.

 “Some patients say they’re reluctant to start medical therapy because they don’t want to be taking medications the rest of their life. I am going through the process of restoring my hair, and I take medications every day. The same thing I prescribe to you, I take myself. These medications have been used for many years, so we know a lot about them. They are considered safe for many patients when properly prescribed and monitored.”

Choose Your Hair Restoration Surgeon Wisely for the Best Result—Now, and Over the Long Term

Medical therapy provides numerous benefits for those seeking hair restoration—either as a powerful augmentation to optimize the long-term outcome of a hair transplant procedure, or as a treatment for situations in which a hair transplant is not—or not yet—appropriate. Regardless of the circumstance, choosing the right hair restoration surgeon is essential.

At Tempus Hair Restoration, Dr. Barusco combines extensive experience in surgical hair restoration with an individualized approach to treatment planning—emphasizing physician involvement, patient education, and natural-looking results.

Dr. Barusco conducts virtual consultations in English, Spanish and Portuguese. He conducts every consultation himself, giving you the opportunity to learn your options in the comfort of your home—or any location, on any internet-enabled device. 

Out-of-town patients traveling 100 miles or more to our Port Orange, Florida, surgical center may qualify for a complimentary two-night hotel stay. No matter how far the distance, we welcome the opportunity to help you on your hair restoration journey!

Contact us today to schedule your free consultation with Dr. Barusco.