MALE HAIR LOSS TREATMENT
Male pattern baldness, or androgenetic alopecia, is very common in adult men. It is caused by genetic traits that are passed down through a person’s inherited DNA. The genes can come from either parent.
Depending on the age of the patient and the stage of his hair loss, the baldness can typically be classified in one of twelve classes of patterned hair loss described in the Norwood Classification.
The diagnosis of male pattern hair loss is initially made by observing the distribution of hair loss and by discussing the patient’s family history of baldness.
Miniaturization — the progressive decrease in hair shaft diameter and length — is a process that is only seen in genetic balding, so the presence of miniaturized hairs indicates a diagnosis of androgenetic alopecia.
Thinning and hair loss can cause huge distress to men and it is possible to reverse or stop further hair loss with medication.
The oral medication Finasteride (trade name Propecia) and the topical medication Minoxidil (Regaine) — are approved for the treatment of common baldness in men (androgenetic alopecia). Finasteride which inhibits DHT, is particularly helpful in reversing genetic baldness in its early stages.
Finasteride is a type II 5α-reductase inhibitor, an enzyme that converts Testosterone to DHT (dihydrotestosterone).
This type of Testosterone is not associated with libido and so it would be very rare (probably less than 1% of men) who would suffer erectile or sexual problems after taking Finasteride. If you do experience this, it is usually psychological and due to worrying about it.
If your hair follicles are sensitive to DHT they will begin to shrink, and each time they fall out they will become thinner and thinner until they become so small, they become virtually invisible. This is how male pattern baldness operates.
Finasteride can suppress as much as 70% of DHT and can do any of the following: slow, halt, or even reverse hair loss in some cases.
Regaine (minoxidil) directly stimulates hair growth, but is significantly less effective than finasteride when used alone. The best results are noted when it is used in conjunction with finasteride tablets.
Finasteride is significantly more effective than Regaine in treating hair loss, but they have additive effects when used in conjunction with one another. When both are used, over 1/3 of patients can expect visible amounts of hair regrowth. In over 90% of patients, these medications can significantly retard further hair loss.
Since both finasteride and minoxidil were approved for use in the crown (the back of the scalp), there is a common misconception that these drugs only work in this area. The fact is that both Rogaine and Propecia work in the front and top parts of the scalp. This makes sense, since the process of hair loss is the same in both locations. Both medications thicken fine, miniaturized hair, but both are unable to grow hair in areas that are completely bald.
Since the crown usually has hair in the thinning phase for longer periods of time than the front part of the scalp, there is often a longer window of time for the medications to be useful in re-growing hair in this location. This helps to explain the relatively better response to medication in the back part of the scalp (the crown) compared to the front. That said, for prevention of further hair loss, the medications are equally important in all parts of the scalp, front and back.
Continued Use
Medications take time to work and it usually takes six months to a year to see the results. In the first few months they may cause shedding, so one needs to be patient and continue to use the medication. The effects will wear off if the drugs are discontinued and the patient will soon revert to the degree of hair loss they would have had if they had not used the medications at all. Medication must be applied consistently and regularly or hair loss will recur and any advantages gained will be lost.
It is also beneficial to have microneedling treatments in which fine needles are rolled across the scalp to stimulate extra blood flow which has been shown to help strengthen and stimulate the hair follicles.
If hair loss is excessive and does not respond to the above treatments due to having gone too far or not responding well, then we can refer you to a reputable hair transplant surgeon who can assess your suitability for transplant.
All treatments have associated risks and complications which will be discussed with you in detail at your medical consultation. Any illnesses you have, medications you take or previous problems with treatments will be taken into consideration. We want you to be totally informed, not rushed and happy to go ahead before you have any treatments.
