48-year-old Luis has battled hair loss since he was young. Here he shares his story with Vita Health Media’s Stephanie Arndt. His responses have been edited for clarity and conciseness, and his name has been changed to protect his privacy.

Hair is a big issue in our family. All the men have very thin hair and go bald sooner or later. The cause is genetic and has nothing to do with stress, improper care or a poor diet. It is because our hair follicles react hypersensitively to male sex hormones, known as androgens. As a result, the natural growth phase of the hair shortens, it becomes even thinner, eventually falls out and does not grow back. 

It was always clear to me that I couldn’t imagine life without hair. That is why I have been actively combating it since I was young. There is probably no product on the market that I haven’t tried: tinctures, foams and sprays. What’s more, my dermatologist recommended decades ago that I stop my hair loss with medication.

Since then, I have been taking one prescription tablet containing one milligram of finasteride every day. Put simply, this active ingredient lowers the level of the androgen DHT (dihydrotestosterone) in the scalp, to which my follicles are so sensitive. This has enabled me to significantly reduce my hair loss. At the same time, every day I use a tincture containing the active ingredient minoxidil, which improves the hair structure. 

The meticulous research begins 

Despite all my efforts, the top of the back of my head became increasingly thin and eventually went bald: I ended up with a receding hairline, which really bothered me. 

So I started looking into hair transplants. I compared five to ten clinics and read countless reviews to find out how satisfied customers were with the results. 

Primarily, it was important to me that the doctors were well-trained and experienced. If the extracted follicles are implanted with the wrong growth direction, you’ve got a problem. I also wanted to undergo treatment using the FUE (follicular unit extraction) technique, in which individual hair follicle units are extracted from the scalp.

FUE is state-of-the-art these days. The older and cheaper method, in which a whole strip of hair is removed, leaves scars. There are also significant differences in cost.

On average, costs are highest in Germany and lowest in Turkey. There is a proper hair transplant industry there. As I spend half my time in Germany and half in Spain, I decided on Barcelona.

The clinic impressed me and the costs were only slightly higher than those in Turkey. I arranged a free consultation and a doctor used a camera to examine my hair structure and assess how many follicles he would need to fill the gap. The follicles are taken from the back of the head, where there is usually enough material available, even for people with hair loss issues. 

The transplant process took hours 

A few days later, the transplant was carried out. The donor site at the back of my head was shaved and numbed so that the follicles could be extracted more easily using a hollow needle.

I was given a mild sedative beforehand and lay face down on a couch. The process took so long that I even fell asleep in between. In total, around 2,700 follicles were extracted and, after a break, transplanted into the bald area. I was then sent home with my head bandaged. 

On the first night, I had to sleep fairly upright and with the bandage on so as not to pull out the fresh follicles whilst sleeping. I was given painkillers, which were necessary as my scalp burned when their effect wore off. At first, I had to spray my scalp very often to aid the healing process.

I also took antibiotics for a week to prevent infection. It has to be said that I looked terrible for a week; the back of my head was bald and everything was scabbed over. Consequently, I only left the house for follow-up appointments to have the bandages changed at the clinic. 

Better, but not perfect 

And then all the transplanted hair fell out. Fortunately, the doctor had pre-warned me that this often happens as a shock reaction. Nevertheless, it takes trust and patience.

You only see the results after about three to six months, but it takes up to 18 months for the full result to become visible. Today, three years on, I can say that the overall density could be better.

However, this probably also has to do with the location of the transplant. For various reasons, the crown tends to be a difficult area for a transplant. For me, though, it was €2,600 well spent. I feel much more content today than I did before and would have no hesitation in doing it again.