Hair Loss Advice

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Male Pattern Baldness

Male pattern baldness was once thought to be an inevitable, unavoidable part of aging for about a third of the male population.

It typically begins with a receding hairline, your hair recessing backwards from your forehead, then a bald patch on top of the head (the “Al Gore”), to sometimes all bald in the middle with racing stripes and finally the Cue Ball. Baldness is common today and has been for hundreds of years. Walk into any large crowd, say a hockey game or a mall and you’ll see balding, somewhat bald or totally bald men. Still it might surprise you that there are tribes in the world where baldness is unknown. All the men in these groups keep their hair from childhood until death, with some exceptions due to local diseases.

The prevalence of male baldness, and the fact most men and women say they don’t like it, either to look at or to have, has made bald or balding men one of the most promising market segments for pharmaceutical companies hoping to develop treatments. Huge dollars to be made! And there are now medications. The first and perhaps best-known of these, Rogaine (minoxidil), was wildly successful in sales after its introduction in 1988, despite its relatively high cost and omission from most health insurance coverage. You can now buy Rogaine over the counter (OTC) in shampoo or lotion form, and it comes in 2% or 5% Extra Strength versions. It’s OTC because Rogaine seems to have virtually no side effects and is now thought to cause new hair growth in about one-third of users. Minoxidil was originally developed for the treatment of high blood pressure, and the mechanism by which it produces new hair growth is not understood.

Rogaine’s success was not missed by the other pharmaceutical giants. They redoubled their efforts to find new drugs, as well as started examining their existing drugs for signs of growing new hair as a side effect. The first one they came across was Proscar. Its chemical name is finasteride, and it was originally a prostate medication designed to mitigate the effects of BPH, or in plain English, make you stop having to visit the bathroom several times a night after turning 40. But Proscar also grew new hair on bald or balding men, primarily on the crown of the head. This is why Merck “relaunched” Propecia, a “new” hair growth medication, while continuing to sell Proscar.

The mechanism by which Propecia grows new hair IS understood. It blocks an enzyme necessary for a hormone to (a) enlarge your prostate, (b) switch off hair follicles. Normal hair growth involves all your hair follicles but with some in a “switched-off” state from time to time. Baldness, you might say, is when they’re ALL switched off. Propecia blocks any switchoff at all. In a five-year controlled study completed in 2001, 75% of Propecia users reported increased hair growth.

Proscar and Propecia are chemically identical, but differently marketed and priced. The smart patient will discuss this with his doctor, because prescriptions for Proscar sometimes are covered by insurance and even if out-of-pocket payment is required, Proscar is fairly cheap. Propecia, mucho dinero. But the dosages for the two drugs are different: despite being the exact same stuff, Proscar is 5 mgs/day for BPH, Propecia 1 mg. per day for alopecia so you will need to talk to your doctor about this. But there can be the chance to save money here. The fact Propecia and Proscar are the exact same chemical, finasteride is not widely known.

Finasteride does carry side effects, but the FDA has determined all of these are fully reversible upon cessation of use. Consult the official Merck website for Propecia) for specific details.

There are other ways to deal with male pattern baldness of course, ranging including surgical options. Put an end to your hair loss suffering using modern hair restoration methods.

You can also try haircuts and styles to minimize its visibility, embrace baldness via shaving your head, or just ignore it. One thing is sure however; male pattern baldness is progressive. You keep getting balder if you do nothing.