MALE PATTERN HAIR LOSS
Androgenic Alopecia or Male Pattern Hair Loss (MPHL) is responsible for the vast majority of balding in men. While there are many possible reasons people lose their hair, including serious disease, reaction to certain medications, and in rare cases extremely stressful events, most hair loss in men (over 90%) can be blamed on heredity.
What MPHL sufferers are actually inheriting are hair follicles with a genetic sensitivity to Dihydro testosterone (DHT). The number and location of these susceptible hairs is determined by inherited genetics from both or either parents. Hair follicles that are sensitive to DHT begin to miniaturise, shortening the lifespan of each hair follicle affected. The hair follicle has a life cycle. In simple terms, this cycle consists of a growing phase and a resting phase. Before hair loss sets in, the growing phase lasts up to seven years and the resting phase lasts three to four months. Genetic hair loss causes the life cycle phases to go in reverse (i.e. the growing phase becomes shorter and shorter and the resting phase longer). Eventually, these affected follicles stop producing hair that is visible.
MPHL is generally characterised by the onset of a receding hairline and thinning crown. Hairs in these areas but also in the temples and mid-anterior scalp appear to be the most sensitive to DHT. This pattern eventually progresses into more extensive baldness throughout the entire top of the scalp, leaving only a rim or horseshoe pattern of hair remaining. For some men even this remaining rim of hair can be affected by DHT.
Dihydro testosterone is a derivative or by-product of testosterone. Testosterone converts to DHT with the aid of the enzyme Type II 5-alpha-reductase, which is held in the hair follicles oil glands. While the entire genetic process of MPHL is not completely understood, scientists do know that DHT shrinks hair follicles, and that when DHT is suppressed, hair follicles continue to thrive. Hair follicles that are sensitive to DHT must be exposed to the hormone for a prolonged period of time in order for the affected follicle to complete the miniaturisationÂ process. Today, with proper intervention this process can be slowed or even stopped if caught early enough.
Typical MPHL is usually diagnosed based on the appearance and pattern of the hair loss, along with a detailed medical history, including questions about the prevalence of hair loss in the patients family. An experienced medical hair loss expert will often examine the scalp under magnification (preferably with a device called a densitometer or folliscope), in order to assess the degree of miniaturisation process of the hair follicles. This assessment can be very important when recommending the proper course of treatment.
In the past few decades, medicine has made tremendous strides in the treatment of mens hair loss. With the advent of 5-alpha-reductase inhibitors such as Finasteride (Propecia) and the evolution of surgical hair restoration, for many, living with noticeable hair loss is no longer inevitable. It is now possible to stop or slow the progression of hair loss and to replace lost hair through surgery with completely natural results.
Finasteride is the generic name for the brand name drugs Pro scar (5mg Finasteride) and Propecia (1mg Finasteride). Finasteride was originally developed as a drug to treat enlarged prostate glands. During the trials on men with prostate problems an intriguing side effect of hair growth was observed.
Finasteride works due to its ability to specifically inhibit Type II 5-alpha-reductase, the enzyme that converts testosterone into a more potent androgen dihydro testosterone (DHT).
1 mg of Finasteride taken daily can effectively lower DHT levels by as much as 60%. It is DHT that shrinks or miniaturises the hair follicle, which eventually leads to baldness. This 60% reduction in DHT has been proven to stop the progression of hair loss in 86% of men taking the drug during clinical trials. 65% of trial participants experienced what was considered a substantial increase in hair growth.
Minoxidil (Reginae) was the first drug approved for the treatment of MPHL. For many years, Minoxidil, in pill form, was widely used to treat high blood pressure. Just like with Finasteride, researchers discovered a very interesting side effect of the drug. People taking the medication were growing hair in unexpected places like on their cheeks and the back of their hands, some even grew hair on their foreheads.
Some enterprising researchers had the idea that applying Minoxidil topically, directly on the scalp, might grow hair in balding areas. They found it did this to varying degrees depending on the extent of the hair loss.
While Minoxidil has been clinically proven to slow the progression of hair loss and regrow some hair, most informed experts see it as a relatively marginally effective drug in the fight against hair loss. Since Minoxidil has no effect on the hormonal process of hair loss its positive effects are likely to be temporary but might be a useful option for men who do not want to take Finasteride.