Science Gives That Natural Hair Look

Bosley Hair Restoration courtesy Bosley

A scourge has afflicted mankind for eons. It is a harsh genetic disease, mercilessly attacking generation after generation. It is baldness. There was a time when the only cure for this affliction hawked on late night TV was Ron Popeil's Hair In a Can. Look how far we've come. Nowadays, the undisputed heavyweight champion of baldness cure commercials is Bosley's hair "restoration" (read: transplantation) surgery system. Sure, Bosley has celebrity endorsements from megawatt superstars like American Idol reject Matt Rogers, but does it really work? And if so, how?

The Bosley system for hair replacement is a common surgical procedure known as Follicular Unit Transplantation (FUT). FUT usually costs between $10,000 and $15,000 and involves five steps. First, the doctor plans out the new hairline. Then the doctor surgically removes a strip of scalp from the back of the head. Using a microscope, technicians then remove the individual hair follicles from the strip. Finally, the team pokes holes in the bald scalp and inserts the hair follicles into the holes. The common side effects are itching and inflammation in the scalp, as well as possible pain and infection associated with all surgery.

"You're not getting new hair, you're just moving hair around," said David Alpeter, a doctor at the New York Bosley clinic. "The key to this is that the density of hair is so great that you can take from the back of the head without any evidence of loss there whatsoever."

Dermatologist developed FUT to overcome the problems associated with older forms of hair transplantation. Those older methods involved either implanting single hairs in uniform rows or grafting small chunks of scalp from the back of the head to the top. These procedures could not transplant large quantities of hair per session and left the patient with thin, uniformly distributed hairs. Obviously, few patients found hair transplants worth the money for the procedure (although the Vice-President-elect was an early adopter of the technology).

"People used to be afraid of getting the procedure because they would end up with what looked like doll hair," said Amy McMichael, associate professor of dermatology at the Wake Forrest University School of Medicine in Winston-Salem, North Carolina,

Then, in 1994, B.L. Limmer, a dermatologist from San Antonio, Texas, published the seminal paper in the field. His paper illustrated how hair grew in little patches, with a couple of hairs rooted to the same follicle. Limmer demonstrated how that those single follicles could be dissected out of a strip of scalp by using a microscope. Soon Robert Bernstein, a clinical professor of dermatology at Columbia University, took the next step and actually implanted those separated follicles back into the top of the scalp, essentially reseeding the head with hair. Thus FUT was born.

"FUT allowed us to transplant thousands [of hairs] in a single session. And by using the body's natural unit of hair, it looks more natural. It was a seismic change," said Bernstein.

The doctors at Bosley use the FUT techniques pioneered by Limmer and Bernstein in the mid-1990s, and, according to Alpeter, are the world's largest hair transplant group, with about 22 surgeons in the U.S. However, while the technique works, Bernstein worries that the advertising sends the wrong message.

"Not everyone is a good candidate for the surgery, and you have to be careful about people who advertise a lot overprescribing the procedure," said Bernstein.

Funny, no one ever complained about overprescription of Hair In A Can, and they advertised that all the time.