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Balding? Here is a FAQ

What is male pattern baldness?

Male pattern baldness is a chronic condition which involves and thinning and gradual disappearance of hair on the scalp.  Male pattern baldness is controlled by a combination
of genetics and hormones also known as androgenetic alopecia.  No hormones = no hair loss.
Under the control of  your genes, certain enzymes turn on with age that convert testosterone to dihydrotestosterone. Dihydrotestosterone goes to the hair and causes it to diminish in caliber, ie. get thinner and eventually disappear.  This enzyme is typically found on the top of the scalp but versions of it are also found in the prostate.
  • Can hair growth products for men actually work?
Yes, hair growth products for men can actually work.   But the caveat is to a degree and not for everyone.  The most well studied product, finasteride has been studied in thousands of patients and we now have over 20 years experience.   Finasteride is a 5-alpha reductase inhibitor that blocks the conversion of testosterone to dihydrotestosterone. Studies showed more success with the vertex of back top of the scalp more than the frontal hair line.  This is essentially true for all hair loss products.
Minoxidil topically used for many years as a solution know as Rogaine seemed to slow hair loss and in a minority of cases regrow some hair. More recently, oral minoxidil, initially approved by the FDA and used as a blood pressure agent, is now used off label in a very low dose to cause hair regrowth. While the topical form has few side effects such as rashes and itching, the oral form has many side effects
Can they assist in preventing further hair loss.
 All of the above agents seem
to slow and in some cases prevent further hair loss.  After 3-6 months, many patients notice less shedding.  It is not clear if this effect  wears off in time,  for example will it still prevent further hair loss after 5 years of use.
  • How would you recommend preventing further hair loss if a reader is currently experiencing it? What are some tactics to keep in mind?   
Thats a great question because for many patients who still most of their hair,   maintaining or stabilization of their hair line may be their goal and they can accept a lack of regrowth.
Hair growth comes from the base of the hair follicle under your skin. Its important to keep your skin of your scalp healthy. with regular washing. While i think a well balanced diet is important, it is rare to find nutritional deficiency at the present time.  Many people take supplements with items like Biotin which has never been shown to be beneficial in male pattern hair loss but only in a tiny number of patients who have a genetic biotin deficiency.
  • Which ingredients would you say are paramount in hair growth products? Rosemary oil was shown in one small study to be equivalent to topical minoxidil so the evidence is limited. Saw palmetto can theorectically help inhibit production of DHT but this has not been shown to cause hair regrowth.
  • Items that keep the stress on your hair to minimum can be benefiical. So oils or detangling agents can decrease the stress from brushing. This can help with hair loss related to traction or breakage