KANSAS CITY, Mo. - Just when you thought bald was cooL or at least benign now comes a deluge of late-night infomercials with eye-popping before-and-after photos.
Over here, bald. Then, next to it, are mounds of hair, seemingly sprung right out of baby-bottom-smooth scalps.
There are still three basic options for people who want to combat hair loss: drugs, hair additions and hair transplant surgery.
All have drawbacks: the cost, for one. But while the methods haven't changed, they certainly have grown sophisticated. Hair additions are more artful now, and transplant surgery has been fine-tuned from plugs to micrografts, a procedure that moves hair-growing follicles In tiny numbers.
An oft-repeated survey claims that the number of hair transplants has dropped precipitously in recent years. But Kenneth A. Buchwach, a Kansas City area facial plastic surgeon and author of two textbooks about hair loss, says that's just not so. The surveyors polled the wrong people, he said.
"My business has doubled over the last five years," he said.
In typical hereditary hair loss, hair-growing follicles get smaller and smaller, at first producing thinner hair and eventually, in some people, no hair at all. The chief Culprit is testosterone. The skin of the scalp changes testosterone to dihydrotestosterone, or DHT. Heredity makes some pea Ie sensitive to DHT, causing follicles in the usual balding areas to shrink.
Here is an outline of what works. For more information, check out these Web sites: www.aad.org (American Academy of Dermatology) and www.ahIc.org (American Hair Loss Council).

HAIR TRANSPLANT
WHAT: hair-bearing skin from the back and sides of the head is surgically moved to balding areas.
PROS: Considered a permanent solution; hair from that part of the scalp is resistant to the hormone that brings on hair loss.
CONS: The usual risks of surgery, the cost, the possible need for time off work, the potential need for follow-up surgeries.
Cost: Can range from $4,000.

PROPECIA
WHAT: A pharmaceutical option, Propecia is a pill, a 1-milligram dose of finasteride, taken
once a day to inhibit the production of a hormone that contributes to hair loss.
PROS: Slows hair loss and, for a few, may promote some growth.
CONS: Approved for men only; side effects could include a reduction in sex drive and erectile dysfunction. Results can take several months, and hair loss resumes if the drug is stopped.
Cost: About $50 a month.

ROGAINE
WHAT: A solution of 2 percent to 5 percent minoxidil applied directly to the scalp, often twice a day, to combat hair loss.
PROS: Slows hair loss.
CONS: Results may take several months. Side effects can include itching and scaling of the
treated areas, and hair loss continues if treatment ends.
COST: About $12 a month.

HAIR ADDITIONS
WHAT: Non-surgical hair restoration includes hairpieces, wigs and hair additions achieved by adding real and synthetic hair.
PROS: No risks from surgery or side effects from drugs.
CONS: Additions anchored to existing hair may require reattaching or tightening as the existing hair grows. Additions attached to the skin can be cumbersome and can need reattaching and blending when existing hair is trimmed
COST: $750 to $2,500, but the cost of maintenance and new hairpieces can reach $10,000 or more over a decade's time.