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.
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.
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 **** 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 ***ual function, such as loss of *** 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.
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.
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.
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.
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.