Male Pattern Baldness - Detailed Facts And Information

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Everything You Need To Know About The Treatment Of Male Pattern Baldness
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Male Pattern Baldness - Detailed Facts And Information

Introduction

On average, there are 100,000 to 150,000 hairs on the human scalp. The hairs grow from hair roots, or follicles (saclike structures under the skin). Blood vessels at the base of each follicle provide the nourishment necessary for hair growth. Hair growth in each root occurs in a cycle independent of the other roots. At any time about 90 percent of the hairs on the scalp are in the growth phase, while the other 10 percent are in the resting phase. The growth phase lasts an average of four to five years, after which the follicle enters the resting phase, which lasts about two months to four months. At the end of the resting phase, the hair falls out naturally and is replaced by a new hair. Consequently, some hair loss is a normal part of the hair growth cycle. In fact, on a typical day, about 50 to 150 scalp hairs are lost. Baldness (or alopecia) results when hair loss occurs at an abnormally high rate; when hair replacement occurs at an abnormally slow rate; or when normal hairs are replaced by thinner, shorter ones.

What is male pattern baldness?

About 95 percent of all cases of hair loss are the result of androgenetic alopecia (also known as male pattern baldness in men). Androgenetic alopecia occurs much more frequently in men than in women. It affects roughly 40 million men in the United States. Approximately 25 percent of men begin balding by age 30; two-thirds begin balding by age 60.

While some types of hair loss are easily reversible, male pattern baldness is more permanent. It occurs in a characteristic pattern on the scalp: hair loss usually begins at the temples and at the top of the head toward the back, causing a receding hairline and a bald spot. Hair loss may continue until the two sections become joined, leaving a horseshoe-shaped area of hair on the sides and back of the head. Balding may begin at any age after puberty, even in the middle teens, and can range from partial loss to complete baldness. Male pattern baldness progresses slowly and is not associated with redness, itching, or pain. Currently, there is no way to prevent male pattern baldness from occurring.

What causes male pattern baldness?

The causes of male pattern baldness are thought to be complex and are not completely understood. However, as suggested by its medical name (androgenetic alopecia), male pattern baldness seems to involve both hormonal (androgen) and genetic factors. Many different types of hormones play roles in the regulation of scalp hair, but the hormones with the largest effect are the androgens. Testosterone and its more potent derivative dihydrotestosterone (DHT) are responsible for increasing the size of hair follicles in areas such as the beard and underarm during puberty, but can also cause hair follicles in the scalp to decrease in size later in life. These contrasting responses to DHT might be explained by genetic differences in the individual hair follicles. Similarly, in men who are balding, genetically determined characteristics of hair follicles in the scalp may cause the follicles to be more likely to degrade in the presence of androgens. Hair follicles become miniaturized, and the hair consequently becomes thinner and shorter. The growing phase of the growth cycle becomes progressively shorter, which means more hairs are shed. Although the follicles still have an adequate blood supply, they continue to shrink, and some eventually die.

Whatever the exact causes of male pattern baldness may be, it is a hereditary trait. There are multiple genetic factors that influence male pattern baldness. A tendency toward baldness in the men on either the mother's or father's side of a man's family indicates a genetic predisposition to baldness. The speed, pattern, time of onset and degree of balding are all influenced by heredity. Generally, the earlier the onset of balding, the more extensive the degree of hair loss will eventually be.

Contrary to popular myth, balding is not caused by wearing hats. Massaging or brushing the scalp will not help regrow hair, and excessive cleaning of the scalp will not "unclog" follicles and allow hair growth. While extreme psychological stress may contribute to a form of hair loss known as alopecia areata, normal everyday stress does not contribute to balding and is not a cause of androgenetic alopecia.

What are some other types of hair loss?

Aside from male pattern baldness, some of the most common types of hair loss include:

·	Alopecia areata, which leads to patchy hair loss on the scalp. While the causes of alopecia areata are not completely understood, the hair loss is thought to be the result of the body's immune system attacking the hair follicle. Alopecia areata often resolves without treatment.

·	Traction alopecia, which results from long-term pulling on the hair. This type of hair loss can be caused by certain hairstyles, such as tight braids. The hair loss is usually reversible once the cause of this pulling is eliminated.

Certain diseases, such as diabetes, systemic lupus erythematosus and disorders of the thyroid gland can also cause baldness. Sudden hair loss may be an early warning sign for some diseases and should be reported to a doctor.

Hair loss has many other causes, including illness, poor nutrition, skin damage, some medications, and certain medical treatments such as anticancer chemotherapy and radiation therapy. Ringworm, a fungal infection, may sometimes be the cause of balding in children, but is generally not a problem in adults.

How is the cause of hair loss diagnosed?

Because there are many potential causes of excessive hair loss, consult a dermatologist if you are concerned. Your doctor will ask questions about your family's history of baldness. He or she may also want to examine a few hairs under a microscope or check the scalp for signs of skin damage. You may be asked questions about your diet, hair-care procedures, medications (including vitamins and herbal supplements) that you take, and recent illnesses. In some cases, your doctor may order blood tests or a skin biopsy (taking a small sample of tissue for examination) to help make a diagnosis. He or she may also ask you to monitor the number of hairs lost during a day, by collecting and counting as many as possible.

What are the treatment options for male pattern baldness?

Male pattern baldness is not a medical disorder. Whether treatment is desirable is a personal decision. Many men decide to let the process run its course. However, baldness can be a source of anxiety for others and can have a negative effect on self-image. If you decide that you are not comfortable with your hair loss, you may want to consider the treatment options described below.

Prescription medications

Minoxidil - Rogaine
Originally used to treat high blood pressure, minoxidil is now widely used as a topical solution applied twice daily to treat male pattern baldness. Studies have indicated that it may help grow hair in 10 percent to 20 percent of those who use it, and it may slow the rate of loss for 90 percent. It is not clear exactly how minoxidil works, but when it is effective, it seems to somehow prolong the growing stage of the hair growth cycle, enlarge the follicles, and cause follicles at rest to grow. Minoxidil is generally more effective for young men and those whose onset of hair loss is recent.

Minoxidil may take four months or longer to show results. The treatment is relatively expensive and must be applied indefinitely; when application is stopped, regrown hair falls out. Newly grown hair may also not be as long and thick as normal hair. As with most medications, side effects are possible, including irritation of the scalp. The solution was originally available only in a 2 percent solution, but the Food and Drug Administration has recently approved a 5 percent solution, which has shown better results in some cases.

Finasteride - Propecia
Originally used for the treatment of enlargement of the prostate gland, finasteride was recently approved by the FDA to treat male pattern baldness. It is taken daily in pill form. Finasteride works by inhibiting the conversion of testosterone to DHT, decreasing the levels of DHT in the blood and scalp. In this way, finasteride helps to block androgen-dependent degradation of hair follicles. In a recent study, nearly half of the men who took finasteride grew hair on the scalp, and the drug was even more effective at halting hair loss. A significant percentage did, however, continue to report hair loss.

Side effects associated with finasteride are mainly related to sexual function, such as loss of sex drive, reversible impotence and a decrease in the quantity of semen. These side effects were experienced by approximately 2 percent to 5 percent of patients in clinical trials. Finasteride is not approved for use by women, because it may cause birth defects. Broken or crushed tablets should not be handled by women who are or may be pregnant.

Currently, minoxidil and finasteride are the only medications approved by the FDA for use in the treatment of male pattern baldness. Nonprescription preparations are not effective and were banned by the FDA in 1989.

Surgical treatments

Hair transplantation
In hair transplantation, productive hair follicles are removed from a donor area on the scalp and transplanted to a balding area. The follicles are commonly taken in plugs of one hair to two hairs (called micrografts) from the sides or back of the head and moved to the front and/or top, with the hairline being slowly reconstructed. Larger plugs of up to 10 hairs are also sometimes used. Donor sites with full hair make transplants more successful. In the flap technique of transplantation, areas of hair are removed from the sides and back of the scalp and transplanted to the top.

Some scarring in the donor site may result. Transplanted follicles may be permanent, or they may last only for a few years. The implantation of synthetic hair fibers has a high rate of infection and has been banned by the FDA.

Scalp reduction
Balding areas of the scalp may be surgically removed to decrease the appearance of baldness. Scalp reduction is usually used in conjunction with grafts or flaps. Devices may be used to stretch the scalp, expanding areas where hair grows. The effectiveness of scalp reduction depends on the degree of hair loss and the elasticity of the scalp.

As with any surgical procedure, hair transplantation and scalp reduction present certain risks, including scarring and infection. If you are considering one of these treatments, discuss the risks with your doctor.

Cosmetic treatments

Synthetic hair
A hairpiece (or toupee) can be custom made to cover a balding area. Hairpieces may fade and loosen over time. Certain organizations specialize in cleaning, coloring and tightening hairpieces. It is important not to neglect the scalp under the hairpiece, which should continue to be washed regularly. Another option is a weave, in which synthetic hair is sewn into existing hair.

·	Hair products Be wary of hair-care products that claim to thicken and strengthen hair. This is accomplished simply by waxes or oils that build up on hair, creating the illusion of thickening.

While male pattern baldness presents no physical risks, your emotional well-being is an important part of your complete health. If hair loss causes you anxiety and negatively affects your self-image, treatment can be beneficial. Consider the treatment options and discuss them with your doctor.

Treatment Of Male Pattern Baldness With Propecia Prescription Medication Propecia is a prescription medicine available from online pharmacies taken in tablet form that partially blocks the effects of the male hormones which cause male pattern baldness. Propecia is used in a higher dose to reduce the size of the prostate gland in men with benign prostatic hypertrophy. Propecia has been shown to halt further male hair loss and promote re-growth of scalp hair in approximately 80 per cent of men after three to six months use. Treatment with Propecia must be continued to sustain the improvement in hair growth.

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