There’s no cure, but there are ways to counter hair loss.

Baldness isn’t an issue that affects only older men. By age 30, in fact, 25 percent of Canadian men will be losing their hair, according to Kendall Beleshko, president of the hair-restoration firm SIR 101. For many men, hair loss is a sensitive issue, not to mention a source of anxiety and embarrassment. Jerry Shapiro, clinical professor with the department of dermatology and skin science at UBC’s faculty of medicine, says that thinning hair can affect men’s self-confidence. But men with thinning hair need not suffer: the hairpiece of yesteryear and patchy hair-transplant surgery are no longer the only solutions.

Androgenetic alopecia, also known as male-pattern baldness, is the most common form of hair loss, Beleshko says. Contrary to popular if age-old myths, thinning hair has nothing to do with brushing hair too much, poor nutrition, or excessive stress. But there is a genetic component: Androgenetic alopecia can be passed from your mother’s or father’s side, skip generations, and even affect one sibling and not another. Beleshko describes androgenetic alopecia as an autoimmune disorder. “It is a disease,” he says. Hair follicles are irritated by dihydrotestosterone, an androgenic hormone. DHT flows in the blood and in an attempt to thwart the irritation, the body restricts the blood going to those follicles.

“The Catch-22,” Beleshko says, “is [hair] needs that blood flow to continue in its growth cycles.” The result? Gradual hair loss. When it comes to compensating for hair loss, options fall into three categories: replacement, restoration, and treatment.

Replacement refers to the use of wigs, “hair systems” (the PC term for hairpieces), and prosthetic attachments to mask thinning. And unlike the divotlike hair pieces of the past—think ABC’s Sam Donaldson—modern hair systems, which are made from real human hair or synthetic hair, are more natural-looking than ever. “The application of a piece or a system can look like your own hair even on close inspection,” Beleshko says.

Treatments include products like the vasodilator minoxidil (Rogaine), an ointment that supposedly revitalizes hair follicles and causes them to shift from a dormant phase to a growing phase, and the antiandrogen finasteride (Propecia), a pill that is said to inhibit the formation of DHT in your scalp.

“They’re not cures,” Beleshko cautions. “The results are limited.” Treatments need to be used for life. And they can have side effects. The Mayo Clinic says Rogaine can yield skin rash and, in rare cases, burning of the scalp, soreness at the roots of hair, and reddened skin. MedlinePlus states that Propecia can lead to skin rash and occasionally abdominal pain, decreased libido, and headache.

Another option is laser light therapy, in which a cool laser is applied to the thinning area. The light promotes wound healing and tissue regeneration. Restoration or surgery is one more approach.

Surgery doesn’t give you more hair but rather redistributes what you already have. It involves taking a strip of hair-bearing tissue (usually about 2.5 centimetres wide) from the back of the head and attaching it to areas where thinning has occurred.

“We then divide it into small grafts containing one to three hairs each so it looks natural,” Shapiro explains, “then we would make a thousand-plus tiny slits all over the top of the scalp and then we would put the grafts into these slits.”

Potential side effects include a small risk of infection, numbness, and facial swelling. “Surgery, in most cases, is not a one-time thing,” Beleshko notes. “Most men get two to three sessions over a lifetime” at a cost of $5,000 to $10,000.

Beleshko doesn’t recommend surgery for men in the initial stages of hair loss. It’s best to start with other treatments. If those don’t work, the next step depends on how much hair you want—or think you need.