MALE PATTERN BALDNESS
What is Male Pattern Baldness?
Male pattern baldness is a typical pattern of loss of hair in men, caused by hormones and genetic predisposition.
Baldness occurs when there is a progressive miniaturization of the follicle resulting in shorter and finer hair. The end result is a miniature follicle with no hair. The cause of the failure to grow a new hair is not well understood, but it is associated with a genetic predisposition and the presence of endocrine hormones (androgens---male sex hormones), especially dihydrotestosterone, which is converted from testosterone. The follicle, however, remains alive, suggesting the possibility of new growth.
What are the Symptoms of Male Pattern Baldness?
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absent hair or hair loss
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receding hairline
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hairline recedes from the front toward the back over time
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thinning of hair
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loss of hair at the crown of head
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progression of hair loss in a typical "M"-shaped pattern which eventually results in a loss of hair over the top of the head, and a horseshoe ringshape to remaining hair
How is Male Pattern Baldness Diagnosed?
Classic male-pattern baldness is usually diagnosed based on the appearance and pattern of hair loss. Hair loss that occurs in an atypical manner may be caused by other medical disorders.
A skin biopsy or other procedures may be needed to diagnose other disorders that cause loss of hair. Hair analysis is not accurate for diagnosing nutritional or similar causes of hair loss.
How is Male Pattern Baldness Treated?
The hair loss of male-pattern baldness is permanent. No treatment is required if the person is comfortable with the appearance.
There are two drugs/medications approved by the United States
Food and Drug Administration (FDA) to treat male-pattern baldness, minoxidil and propecia (finasteride).
Minoxidil is used topically on the scalp. It may help hair to grow in 20 to 25% of the population, and in the majority it may slow the loss of hair. Treatment is expensive, however, costing about $600 per year for the recommended twice a day use. The higher concentration minoxidil works better. Hair loss recurs when its use is discontinued.
Propecia (Finasteride) is the only oral medication that is approved by FDA for male pattern baldness. It inhibits the production of the hormone that contributes to male pattern baldness. About 50% of the men who take this drug have increased hair growth in one year. In general, it is more effective than minoxidil. It has no major effect on testosterone level in the body. Only about 1.8 percent of the men who take this drug may experience sexual dysfunction.
Hair transplants consist of removing tiny plugs of hair from areas where the hair is continuing to grow and placing them in areas that are balding. This can cause minor scarring in the donor areas, and carries a low risk for skin infection. The procedure usually requires multiple transplantation sessions and may be expensive.
Suturing of hairpieces to the scalp is not recommended as it can result in scars, infections, and abscess of the scalp or brain. The FDA banned the use of hair implants made of artificial fibers because of the high rate of infection.
Hair weaving, hairpieces, or change of hairstyle may disguise the hair loss. This is usually the least expensive and safest treatment for male-pattern baldness.
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