Hair Transplants vs Hair Loss Medication – or both?

Hair loss is a very common condition, affecting about 49% of young men in Ireland before the age of 30, according to a report by a transplant clinic. Even though it’s so widespread, experiencing hair loss can leave men feeling self-conscious and stressed. Thankfully, there are lots of treatment options available if you want to do something about your hair loss. Two options probably come to mind first: hair transplants and medication.

But which option is right for you? Here’s some pros and cons for both to help you come to a decision.

Hair Loss Medications

Finasteride

Finasteride is one of two licensed treatments for male pattern baldness. It works by inhibiting the enzyme 5α-reductase which converts testosterone into the hormone dihydrotestosterone (DHT) – the hormone responsible for shrinking hair follicles. When DHT binds to receptors on hair follicles, it causes them to miniaturise, so hair grows shorter and thinner over time until it stops growing altogether. By lowering DHT levels, Finasteride protects the hair against its harmful effects.

Finasteride has been shown to stop further hair loss in around 90% of men, with a further 60% also seeing an increase in hair density. It’s available in both topical and oral forms, with visible results typically appearing after 3-6 months of consistent use.

As with any medication, Finasteride comes with a risk of side effects – most commonly reduced libido and changes in seminal quality. These side effects are typically reversible and tend to subside once the medication is discontinued. If you’re concerned about side effects, the topical version may be an alternative option for you. Because it’s applied directly to the scalp and not absorbed into the bloodstream in the same way, the risk of systemic side effects is generally thought to be lower.

Dutasteride

Dutasteride is also a DHT-blocker, working similarly to Finasteride by blocking the enzyme 5α-reductase. Dutasteride may reduce DHT levels more than Finasteride, because it blocks both type-I and type-II of the enzyme, whereas Finasteride primarily blocks type-II only. For this reason, Dutasteride may be better for hair growth: in one study, participants saw a greater increase in hair count with 0.5mg Dutasteride tablets than those using Finasteride.  Dutasteride shares a similar side effect profile with Finasteride with a longer half life (meaning potential for prolonged side effects), so topical versions may offer a safer alternative to the oral route.

Minoxidil

The other licensed treatment, topical Minoxidil, boosts blood flow to the scalp which helps revitalise dormant hair follicles. It supplies vital oxygen and nutrients to hair follicles damaged by DHT and extends the growth phase (anagen) of the follicle, so hair can grow thicker and longer. Studies show Minoxidil 5% Spray is effective in 84% of men with androgenetic alopecia at stopping hair loss. Minoxidil is also available as an oral capsule, for those who experience side effects from the spray or find it difficult to keep up with the twice-daily application.

Hair Transplants

There are two main types of transplant:

Follicular Unit Transplantation (FUT): a strip of skin is removed from the donor area and cut into individual grafts, which are inserted into tiny incisions in the transplant area.

Follicular Unit Extraction (FUE): individual hairs are removed from the donor area one by one and placed into tiny incisions in the transplant area.

FUE is generally less expensive and involves a shorter recovery time compared to FUT. That’s because FUT is a more invasive procedure requiring a larger surgical team. One noticeable difference is scarring – FUT can leave a more visible linear scar, which may need longer hair to conceal, whereas FUE typically results in tiny dot-like scars that are usually easier to hide. That said, FUT might be the better option if you need a higher number of grafts.

Regardless of the method used, results take time. A shedding phase usually occurs 4-6 weeks post-transplant, after which the transplanted hair will begin to grow as normal – but it could be 12-18 months before you get the full benefit of transplanted follicles.

It’s also worth noting that a hair transplant isn’t an option for everybody. You’ll need a consultation with a clinic to verify there are enough thick, healthy donor hairs to provide the coverage and density required.

To make it simple, here are the pros and cons:

Can you combine medication with a hair transplant?

Many hair clinics recommend combining medication with a transplant – both before and after the procedure. This approach can improve the overall look of a transplant by encouraging regrowth of your native (aka original) hairs, making it look fuller and more natural. Using medication for up to a year before deciding on a transplant may mean you decide a transplant is not necessary for the time being if you regain enough density. But if you do go ahead, continuing medication can support thicker, more even coverage and help maintain your results long-term.

Male pattern baldness tends to get worse over time if you don’t treat it. So even though your transplanted hairs are permanent, the rest of your natural hair can still thin out. That might leave you with patchy spots around the transplanted areas – which probably isn’t the look you were going for. That’s why it can be a good idea to keep using hair loss treatments after a transplant. They can help slow down further thinning and might even encourage some regrowth.

If you are interested in hair loss treatments, take our free consultation for personalised recommendations of the best plan.

All of our blog articles are reviewed for medical accuracy by our Medical Director before publication.

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