Tag: hair loss

Treatment of Male Pattern Hair Loss

Treatment options for Male Pattern Hair Loss are quite limited. With more men seeking treatment, and plenty start suffering from hair loss at quite young ages, more research is being placed on reversing or slowing this frustrating condition.

Treatment of Male Pattern Hair Loss are mainly divided in to three: Topical, Oral, and Surgical

Topical Treatment of Male pattern Hair Loss

Topical Minoxidil

This is the mainstay of treatment for Male Pattern Hair Loss. Studies have shown that 5% Minoxidil prolongs the anagen phase and thickens the hair fibre. The exact mechanism by which it does this is still unknown. It takes 4-6 months before results can be seen. It is up to 60-70 % effective in the crown and 30-40% effective in the front of the scalp. The brand is Rogaine and it comes in 2 forms- solution and foam. There are many generic brands available and quite a few countries that provide it OTC.

In  Europe, OTC caffeine based products are available in shampoo and lotion form. Caffeine has been shown to increase the anagen phase. The studies have been found to be encouraging.

Oral Treatment of Male Pattern Hair Loss

The two main medications used are Finasteride and Dutasteride. Both are used off-label from their intended use, which is for the treatment of Benign Prostatic Hypertension.

Finasteride (Propecia or Proscar) help to stop the conversion of Testosterone to Dihydrotestosterone by the enzyme 5 alpha reductase. Fiansteride takes up 4 months before results can also be seen. It has a slightly greater efficacy compared to Rogaine. Together with Minoxidil, there is increased benefit to the patient. Most persons can start off with Minoxidil and Finasteride added to see if there is any more improvement.

Dutasteride (Avodart)  is a more potent form of Finasteride because it acts on the many forms of the enzyme. It is 95% effective compared to the 50-70% seen with Finasteride. However, it has 5 times more the effects of side effects compared to Finasteride. The main concerns for both Finasteride and Dutasteride include: decreased libido, decreased power of orgasm/ejaculation,  erectile dysfunction, and depression. For Finasteride, this is quite low, but much higher in Avodart. The side effects usually go away after cessation of the medication, however, it should note that many men who start this medication are already at risk of having these issues.

Surgical Treatment of Male Pattern Hair Loss

The ultimate treatment of this condition is Hair Transplantation. It involves permanent removal of hair from the back of the scalp, which is less likely to be affected by the condition. These are then transplanted to the front of the scalp and will take and grow keeping their inherent properties from where they are coming from.  There are two main types: Follicular Transplant (strip harvesting that leaves a visible scar) and Follicular Unit Extraction (individual harvesting of hair follicles). Hair growth is not immediate. It takes about 4-6 for the transplanted hairs to start growing, and up to a year for it to be noticeable.

Surgical treatment is limited to how much hair is present in the donor site. There are many factors that can cause decreased hair growth. However, up to 99% of the hairs transplanted usually grow.

 

Treatment of Male Pattern Hair Loss is limited but promising as there are many new treatment therapies such as Stem Cell Therapy are actively being investigated.

 

 

Male Pattern Hair Loss

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Male Pattern Hair Loss or Androgenetic Alopecia is the most common type of hair loss found in men. Up to 80% of men will experience some level of hair loss by their 70s. Most will discover their hair loss in their 30s and 40s however, quite a number may start long before in their teens.

So what causes Male Pattern Hair Loss?

Male Pattern Hair Loss is due to the activity of a hormone Dihydrotestosterone, a potent androgen (male hormone). The hair follicle in affected men is more sensitive to this hormone. There are several genes responsible for the condition and they can be inherited from either the mother, father, or both.   This hormone is made from Testosterone under the action of the enzyme, 5-alpha reductase. Dihydrotestosterone latches onto the receptors in the hair follicle and causes a decreased anagen (hair growth) along with  reduction in the size of the hair follicle. The hairs become progressively thinner and more vellus-like.

Stages of Male Pattern Hair Loss

There are several stages of Male Pattern Hair Loss.  The main staging system used is the Norwood Hamilton Scale for Hair Loss in men.

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Which stage do you fall under?

Next month: Treatment options

 

 

 

May’s QOM- Which hair growth serum should I use?

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Doc, which hair growth serum should I use?

 

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I’ve been asked this question so many times in so many different ways. Everyone wants the next great hair potion. Most persons are bombarded by a myriad of hair growth serums on the market. However, what should the discerning customer use to gauge what product she should purchase?

All are not created equally and all do not address ALL types of hair loss. Most non-medicated hair growth serums contain carrier oils such as coconut, olive or jojoba oil. Additional reported active ingredients include essential oils such as rosemary, nettle, and cinnamon oils.  The essential oils help stimulate the scalp through various undetermined mechanisms resulting in hair growth. Other ingredients that have been included in non-medicated hair growth serums are:  Saw Palmetto, (to help those with Androgenetic Alopecia), Caffeine, Capsicum, and Castor oil. The latter has received so much attention in recent years that virtually everyone has a bottle of it. Please see my blog post on it: http://askthehairdoc.com/athd-investigates-castor-oil/.

So how does one choose the right product? First of all, remember that the only topical product proven to grow hair for Androgenetic Alopecia is Minoxidil. All others, except caffeine, have not been extensively proven to grow hair. Other hair loss disorders such as Traction Alopecia and Central Centrifugal Cicatricial Alopecia may not necessarily respond to topical products and may need oral medication to halt hair loss.  Unfortunately, I cannot specifically say which is the best product to use. Even Minoxidil (Rogaine), has been shown to not work in everybody.  So my advice is to try one product at a time, and if after 4 months there is no improvement, then move on. If after two products, there is no improvement, consider getting a consultation. Don’t try to purchase every product out there, because the efficacy of some of the products have not been extensively studied and so most consumers have to rely on anecdotal reviews. Hopefully, as hair research increases, more effective products will be available on the market.

 

Pattern Hair Loss

First in our series on non-scarring hair loss is the ever pervasive Pattern Hair Loss or Androgenetic Alopecia. It is mostly an inherited condition affecting up to 40% of women by menopause, and up to twice that amount in men by age 50.

Pattern Hair Loss presents differently between men and women. Women tend to have generalised thinning to the top and sides, whilst men start off with thinning at the temples eventually ending with the “horse shoe” shape that is often dreaded.

The cause of Pattern Hair Loss, though largely known, is still being determined. In men it is due to excessive sensitivity to the male hormone dihydrotesterone. In women, male hormones are not seen as a major factor, however, the exact mechanism is yet to be determined. In fact, it has been postulated that there are other non-hormonal factors which may contribute to Pattern Hair Loss in both men and women.

As it is a genetic disorder, there is no permanent cure for Pattern Hair Loss. Gene therapy, ideally the perfect treatment,  has not been developed for the condition. The best that is available today is hair transplantation. In the near future, stem cell therapy will likely lead the way. For most, topical Minoxidil is the best option in addition to oral therapy with Finasteride and other anti-androgen medications are useful.

Next month: Male Pattern Hair Loss- Cause and Staging

Hair Loss Disorders

So, after discussing the basic properties of hair, the next in the blog series will be on Hair Loss Disorders. There are two main types:

1. Non Scarring

These hair loss disorders may be due to hormonal or inflammatory processes which causes hair loss with hair follicles not being affected. Once the process resolves, or is treated, the hair will grow back. Examples of non-scarring hair disorders include: Female and Male Pattern Hair Loss (Androgenetic Alopecia), Alopecia areata, and Telogen Effluvium. Traction Alopecia is also non-scarring in its early stages.Extremely inflamed Psoriasis, Seborrhoeic Dermatitis and Contact Dermatitis have been causes of temporary non-scarring hair loss.

 

2. Scarring Alopecia

Scarring type alopecias usually result from an inflammatory process whereby the body, for whatever reason, attacks the hair follicle, destroying it in the process. The hair follicle is replaced by scar tissue, and as such, hair will not grow back. Most of these scarring hair loss disorders, if treated from very early, can have favourable outcomes with the hair growing back. Examples include: Traction alopecia, Lichen Planopilaris, Central Centrifugal Cicatricial Alopecia, Dissecting Cellulitis, Folliculitis Decalvans, Chronic Discoid Lupus Erythematosus.