You’ve probably seen them: television spots that promise a thick head of hair to the follicle-challenged. But offers that seem too good to be true usually are.

Among men losing their hair, the most common affliction is a progressive thinning known as male pattern baldness. The more hair lost, the less successful treatment will be, so specialists recommend action at the first sign of trouble.

Losing as many as 100 hairs a day is normal, but more substantial shedding is a red flag, says Pirooz Sarshar, cofounder of the Grooming Lounge, a men’s style sanctuary in downtown DC and Tysons Corner. Hair follicles are “like a mattress,” he says. “Fresh, firm springs loosen up with age.”

We’ve combed area experts for their advice on keeping what you’ve got.

Medical Marvels?

Hormones are to blame for most age-related baldness so the best solutions try to counteract chemical changes, says Dr. Thomas Nigra, chairman of Washington Hospital Center’s dermatology department.

Minoxidil, an over-the-counter medication sold in the United States as Rogaine, has shown promise in stopping hair loss. Rogaine, a topical treatment, stimulates follicles, says Nigra, who helped develop the drug more than two decades ago.

A prescription pill called Propecia also works; it blocks DHT, a sex hormone that causes follicle shrinkage. It’s faster and easier to use than minoxidil, which takes several minutes a day to apply. But Propecia is ineffective for all women and for men over 60, he says.

Many so-called “miracle” products marketed on TV are doctored-up trisaccharides, or sugars, that coat hair and give the illusion of thickness, Nigra says.

Transplant Trend

Interest in hair-replacement surgery has increased in recent years, as procedures now offer more natural results than the “hair-plug era,” says Dr. Richard Giannotto, with the Hair Restoration Group of Northern Virginia.

Depending on the procedure, a client can spend as little as $2,500 or as much as $20,000. Giannotto also offers laser-light therapy, a lesser-known treatment in the United States that has been “a mainstay in Europe for years,” he says. Scientists have found that low-level light exposure can slow hair loss, he says. Other physicians say there’s no evidence it works.

Researchers in Great Britain plan to conduct the first clinical trials with hair cloning, Giannotto says, adding that the procedure could reach this country by 2010.

But even a top-notch transplant is “still only a disguise,” says Nigra, who contends “there’s no substitute for a healthy head of hair.” Rogaine, which runs about $60 for a several-month supply, and $1-a-day Propecia stimulate hair growth and prevent the progression of baldness, he says.

Hair Myths

Here are a few falsehoods and half-truths about hair loss:

• Baldness is predetermined by your mother’s genes. “I think it’s time to stop blaming your relatives,” Sarshar says. “Hair loss does have a genetic component, but no one is sure what it is.”

• Vitamin deficiency causes hair loss. This is partly true—vitamins B and E as well as magnesium, copper, and zinc nurture the scalp. But, says Giannotto, there’s no supplement that can regrow hair.

• Regularly wearing a hat leads to hair loss. “Only if you’re destined to lose that hair in first place,” Giannotto says. Stress can also lead to thinning, but the loss is reversible, he says, merely through a decrease in stress.

• Baldness is caused by hair mites. Hucksters use this tactic to “scare people and sell special shampoo,” Sarshar says.

By Andrew Noyes. Andrew Noyes (andrew@andrewnoyes.net) is a senior writer for National Journal Group, where he covers technology and politics.