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Introduction
Many people Email me asking about treatments - particularly
those available from private companies they have seen advertised
on the Internet and elsewhere. Unfortunately I cannot comment
on the suitability of specific products because;
- I do not have knowledge of all the pills and potions available.
- It would be illegal for me to advise on particular forms of
treatment for individuals as I am not clinically trained and
I do not know the specific details of your case history.
- It could be dangerous to recommend a treatment if you are
allergic to certain drugs.
- Manufacturers of the compounds may decide to sue me, or indeed
you may try to sue me if you decide I gave inappropriate information.
Even if the court action had no chance of success the cost would
be too much for me to bear - unlike clinical doctors I do not
have suitable insurance cover nor do I have a significant income
(too many PhDs - too few jobs!).
However, I can provide a general list of points you may wish
to consider when deciding on a course of treatment either from
your dermatologist or self treatment using alternative therapies
or other products commercially available. I hope you find the
outline below useful in arriving at your decision, but the
final decision must always be yours and yours alone.
Decide
your treatment course
1) Ask yourself if you really want to start ANY form of treatment.
Be absolutely sure that this is what you want. There are many
people with hair loss who would claim that attempts at treatment
or the use of scalp prosthetics is to avoid facing the issue head
on. We live in an image oriented society which proclaims hair, and
lots of it, is good. Great hair is part of that package the fashion
gurus try to sell us - and most of us seem to swallow. The fact
is 50% of the western world's population has thinning hair, mainly
as a result of androgenetic alopecia, which affects both men and
women - far more women than you might think. There are some individuals
who are strong enough to resist the expectations of our society
and prefer to go "au natural" are you one of them?
Today, scalp shaving is much more popular in the main stream of
society. Since coming into the field of hair biology, I have developed
a bad habit of walking around looking out for people with scalp
hair problems (hey, it's my job!). Thankfully no one has tried to
pick a fight with me yet and it is quite usual for me to see well
dressed gents, and a few ladies too, proudly displaying their bald
scalps. You may not yet feel able to join them but you may wish
to consider it in the future.
2) OK, so you have decided to try to regrow hair. There
are so many options you need to sort through. You have an enormous
list of dermatologists, suppliers and drugs to choose from. There
are many people out there who are happy to take your money and run.
There are more snake oil sellers now than ever before and many of
them can be found on the Internet with their highly polished web
sites.
Just because they use the high tech of the Internet to promote
their products or because they have big glossy adverts and brochures
does not mean they are reputable people or products.
3) Two key questions to keep uppermost in your mind. What's
in it for you and what's in it for the professional recommending
the treatment?
What's in it for you Daft question - hair growth right?
But what about the strings attached? The downside may include;
- It may not work.
- Cost of treatments can take a large portion of your income.
- The potential side effects of treatments.
- The time consumed with appointments and applying the treatment.
- The emotional stress involved. Will it work?
The upside may involve;
- It might work!
- A big boost to your confidence and self esteem. Whether it works
or not you feel you are at least doing something.
- No awkward questions or stares from friends, colleagues or strangers
if it works.
- If the people around you have not accepted your hair loss then
hair regrowth, or at least attempts to regrow it, will remove
many of their objections.
Many of these points are based on family and peer pressure. So
ask yourself just how important to you are the feelings of your
family and friends and do they have your best interests at heart?
What's in it for them? The person in charge of your treatment
also has risks and advantages to consider. The down side may include;
- If the treatment is unsuccessful you may find another treatment,
different supplier or dermatologist.
- If you feel you are poorly advised and badly treated you may
decide to file a complaint and/or take them to court.
- Loss of their self esteem if they fail to succeed in your treatment.
The advantages may involve;
- Profit!
- Improved self-esteem if they succeed in helping you.
- They gain experience and in some cases even new research and
treatment development.
- Furthers their careers, especially if they develop a high treatment
success rate.
- Hair biology has a bad name because of snake oil sellers and
dermatologists are very aware of this. They want to promote their
field of work to you as a serious and responsible profession.
Remember, when it comes to treatment for alopecia areata there
are some significant disparities between what you demand - nothing
less than guaranteed complete hair regrowth - and what a dermatologist/supplier
can provide - a chance of hair regrowth with no guarantee of success.
4) When choosing your dermatologist/supplier/product there
are several questions worth asking. Not all may apply in you
case.
- How much will it cost?! Just because a dermatologist charges
a high price does not necessarily mean his or her treatment will
be any more effective than dermatologists with more reasonable
charges. Charges vary widely and depend as much on a dermatologists'
prestige and political influence with their peers as how good
they actually are.
- Have you heard of this person/product before and did you first
hear about them/it from an unbiased source?
- Was the dermatologist/product personally recommended to you?
Recommendations by someone you know and trust are one very good
way of sorting the wheat from the chaff.
- Does the recommender have personal, and successful, experience
of the product/doctor?
- Do you know the track record of the dermatologist/supplier?
find out their basic curriculum vitae. If they refuse they may
have something to hide. Worse, there have been one or two cases
of dermatologists practicing without training or full qualifications!
- Is there published evidence to demonstrate this treatment can
work?
- Were the treatment trial(s) conducted by an investigator independently
of the drug manufacturer or was the trial paid for by the manufacturer?
In other words is it possible that the treatment trials were biased
in favor of the manufacturer to keep the money supply flowing?
- How long has this treatment been around and how wide spread
is its use?
- What kind of success rate has the dermatologist/supplier had
with this treatment?
- What is the specific active ingredient? Reputable dermatologists/suppliers
will usually be happy to divulge this information. If they tell
you it is a trade secret ask yourself why? It may be because the
producers do not have a patent do not want their competitors to
cash in and start selling the same compound after all their expensive
research and development (a reasonable argument). It may be because
the compound is already available elsewhere at a considerably
cheaper price (not such a reasonable argument). It may be because
there is no active ingredient at all.....(no argument - they're
a bunch of snake oil sellers).
- How does the treatment work? The actions of many classic treatments
for alopecia areata are not fully understood but the dermatologist/supplier
should be able to provide a brief overview or their ideas on how
it works. For alopecia areata it may act on the immune system
or directly on the hair follicle.
- Does the dermatologist/supplier openly explain any potential
side effects. Most, if not all classic treatments for alopecia
areata have some potential side effects and many alternative treatments
also carry a risk. If any drug or treatment is powerful enough
to regrow hair then it is strong enough to be harmful.
You
decided to try an alternative treatment
I am amazed how naive people can be about alternative treatments.
The assumption always seems to be that if it is alternative it must
be harmless and it is more likely to work because it is not derived
from western medicine. This is a very naive viewpoint.
Alternative treatments have the same potential for side effects
as any other product. Natural herbs are the obvious case in point.
Around 25% of prescription drugs were first found in plants. Some
of the most potent drugs used in western medicine today are plant
derived. The drug Digoxin used to treat heart failure patients is
derived from the digitalis plant. Although beneficial when care
fully administered, it is fatal in larger doses. A recent drug developed
in the war against cancer is Tamoxifen. This drug is a pure plant
extract and a potent anti-estrogen. Herbs and plant extracts can
be very powerful drugs. Use them wisely and with care!
Some suppliers of alternative treatments explain that you may
not have heard of their product before because it was rejected and
suppressed by mainstream dermatologists. They may say it was suppressed
because dermatologists knew it was so good it would put them out
of a job - or because the developer rebelled against the dermatological
establishment and is being punished! It is tempting to believe that
someone with a different approach to a problem can come up with
an answer and this has certainly occurred in the past. However,
far more frequently, the establishment rejects a claim for a product
because it is quite simply rubbish. Advertisers know that
playing the underdog or acting the outsider appeals to your sense
of fair play and puts their product in a more favorable light. You
must make your own decisions but bear in mind if someone recommends
a particular product to you ask yourself if they have anything to
gain?
The alternative medicine industry is worth $14 billion in the
USA alone (source; American Association for the Advancement of Science
conference 1997). Health food companies and alternative medical
suppliers make a big profit from you. The industry has lobbyists
in governments around the world seeking a more favorable environment
to sell their product. Do not believe that they are doing you a
favor. This is business so treat them as you would any other commercial
company and ask questions about suppliers and products until you
have all the information in front of you to make a fully informed
decision. There are many alternative practitioners who firmly believe
in their products and what they do. There are many more who firmly
believe they can make a big profit in a poorly regulated commercial
sector.
There is potential for alternative treatments to work. We have
much to learn about or bodies and how they function. There are many
forms of alternative medicine some of which may have an answer.
However, when deciding on a treatment, traditional or alternative,
the bottom line is never rush into a decision and never feel
pressured by those around you - friends, relatives, dermatologists,
fashion models or medical advertisers. Make a decision on what
is best for you, not what is best for others. Good luck - I hope
you succeed whatever you goals are!
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