hair growth. All of

UpToDate Patient information: Male pattern hair loss (androgenetic alopecia) Find on Page Where to get more info Printer friendly format Email this topic Outline of Topic INTRODUCTION WHAT CAUSES ANDROGENETIC ALOPECIA? WHAT AREAS OF THE SCALP ARE MOST COMMONLY AFFECTED? HOW IS MALE PATTERN BALDING DIAGNOSED? CAN MALE PATTERN BALDING BE TREATED? • Minoxidil (Rogaine) • Administration • Results • Side effects • Finasteride • Spironolactone • Surgery WHERE TO GET MORE INFORMATION REFERENCES Patient information: Male pattern hair loss (androgenetic alopecia) Beth G Goldstein, MD University of North Carolina at Chapel Hill Adam O Goldstein, MD, MPH University of North Carolina at Chapel Hill UpToDate performs a continuous review of over 330 journals and other resources. Updates are added as important new information is published. The literature review for version 13.3 is current through August 2005; this topic was last changed on March 20, 2005.The next version of UpToDate (14.1) will be releasedin February 2006. These materials are for your general information and are not a substitute for medical advice. You should contact your physician or other healthcare provider with any questions about your health, treatment, or care. Do not contact UpToDate or the physician authors of these materials. INTRODUCTION — A number of conditions can affect the hair follicle and cause hair loss, also known as alopecia. The most common type of hair loss, affecting 30 to 40 percent of men and women, is an inherited condition called androgenetic alopecia, also known as male pattern baldness [ 1 ]. For many people, losing their hair is a frustrating experience. Fortunately, research is helping us understand what causes male pattern balding and has yielded treatments that can be effective in some cases. WHAT CAUSES ANDROGENETIC ALOPECIA? — The hair follicle is a structure that encases the lower part of the hair shaft. Each follicle contains blood vessels that nurture new hair growth. All of our hair follicles are present at birth, and throughout our lifetime each follicle grows and sheds single hairs in a repetitive cycle. The growth phase for a single new hair lasts two to three years. At the end of this time, growth ceases and the follicle enters a resting phase. After three to four months in the resting phase, the hair is shed and the next growth cycle begins. On a normal scalp, approximately 80 to 90 percent of follicles are growing at any time. And each day, about 75 follicles shed their hair and the same number enter a new growth phase. Men and women experience androgenetic alopecia with equal frequency, although it may be camouflaged better in women. People who experience this type of hair loss have some hair follicles with a shorter than normal growth phase and produce hair shafts that are abnormally short and thin. These follicles are said to be "miniaturized." They develop because of a hormonal changes that occur in the hair follicle itself, although men with male pattern balding also may have higher levels of dihydrotestosterone (a byproduct of testosterone) in the blood. WHAT AREAS OF THE SCALP ARE MOST COMMONLY AFFECTED? — In men, androgenetic alopecia is characterized by gradual hair thinning that most often affects the crown and frontal areas of the scalp. In many men, the hairline around the temples regresses. As it moves back to the midscalp, an M-shaped hair pattern develops. The hair in areas affected by hair loss may be of various lengths and thickness, and the presence of uneven lengths and texture is a classic sign of male pattern balding. Women may have similar patterns of hair loss, although typically the hair loss is a little more diffuse than in men, and women rarely experience loss of all their hair. HOW IS MALE PATTERN BALDING DIAGNOSED? — Androgenetic alopecia can usually be readily diagnosed in men based on visual inspection of the scalp. A family history of similar hair loss also is suggestive of androgenetic alopecia. The diagnosis of androgenetic alopecia in women is similarly based on the history and visual inspection of the scalp. The scalp should be inspected carefully, however, for signs of hair disease such as scarring or follicular plugging. In addition, other causes of hair loss should be considered, including certain illnesses (such as hyperthyroidism, hypothyroidism, or iron deficiency) or medication side effects (such as anticoagulants, anticonvulsants, beta blockers, and antidepressants). Women may rarely experience hair loss due to an excess of male hormones (androgens). Typically these women have other signs of androgen excess, such as menstrual irregularities, acne, and excess hair growth in other areas. However, given the frequency with which androgenetic alopecia occurs in women, no extensive testing is necessary unless one of these other signs of androgen excess is present. CAN MALE PATTERN BALDING BE TREATED? — Two medications, minoxidil and finasteride, are available to treat male pattern balding in men; only minoxidil is used in women. A medication called spironolactone is also sometimes used in women. Surgical options may also be considered in some cases. Minoxidil (Rogaine) — Minoxidil promotes hair growth by lengthening the growth phase of hair follicles and causing more follicles to produce hair. The hairs that are produced tend to be larger and thicker. Minoxidil is a liquid preparation that is applied directly to the scalp. It is available in both 2 and 5 percent solutions, although the 5 percent solution has been shown to be more effective in men and is probably also more effective in women. It can be purchased over-the-counter without a prescription. Administration — Minoxidil is a scalp treatment, not a hair treatment. One milliliter of the solution should be applied twice a day to the affected areas of the scalp using a dropper or pump spray device. The solution should be lightly spread over the affected area with a finger, and does not need to be massaged into the scalp. People using minoxidil must have a normal, healthy scalp since cuts or openings can allow the solution to be absorbed into the bloodstream. Results — Minoxidil must be used twice a day for at least four months before the initial response to treatment can be gauged. When it is effective, people usually begin to shed less hair within two months after the start of treatment, and by four to eight months hair begins to grow. The effects of minoxidil usually stabilize after 12 to 18 months of use. Treatment must be continued indefinitely. If minoxidil is discontinued, any hair that has been maintained or regrown as a result of the medication will be lost. Not all people benefit from minoxidil. Best results are obtained when baldness has been present for less than 5 years, when it affects the crown of the head (the vertex), and when it is less than 10 centimeters in diameter. Studies have shown that up to one-half of men and women with vertex hair loss experience cosmetically significant results with minoxidil [ 2,3 ]. Side effects — Minoxidil causes few side effects. Occasionally, the skin may become irritated. Systemic side effects are possible if minoxidil is absorbed through cracks or cuts in the scalp. Patients with a history of heart disease, in particular, should watch for systemic side effects such as an increased heart rate, edema or swelling (for example in the hands or feet), or weight gain. Women treated with 5 percent minoxidil may occasionally develop increased facial hair. Finasteride — Finasteride decreases dihydrotestosterone levels, resulting in an increased amount of hair covering more of the scalp [ 4 ]. It cannot be used in women of reproductive age because of concerns regarding abnormal genitalia development in male fetuses. One study that evaluated the use of finasteride in postmenopausal women with androgenetic alopecia found that finasteride did not improve hair loss [ 5 ]. Thus, finasteride is not currently recommended for women at any age. Finasteride is taken orally in men at a dose of 1 milligram (mg) per day. Higher doses of finasteride (such as those used to treat some prostate conditions) can cause side effects including sexual dysfunction and decreased sex drive. However, such side effects are rarely seen with the 1 mg dose used to treat hair loss. A small study suggested that finasteride worked better than 2 percent minoxidil and there may also have been a benefit with combination therapy. Studies comparing finasteride and 5 percent minoxidil have not been performed. However, clinical observations suggest that finasteride is easier to use. Because of this, men may be more apt to take it consistently and it may yield better outcomes. Spironolactone — Spironolactone blocks the action of the hormone aldosterone. Women with androgenetic alopecia who do not respond to minoxidil may benefit from the addition of spironolactone. A typical dose would be 100 to 200 mg per day. Surgery — For some patients, surgery may be a preferred form of treatment. Surgical options include hair transplantation, in which healthy follicles from other parts of the scalp are transplanted to areas affected by baldness. Scalp reduction is another procedure sometimes performed. In scalp reduction, bald patches of the scalp are removed and the remaining skin is sutured together. WHERE TO GET MORE INFORMATION — Your doctor is the best resource for finding out important information related to your particular case. Not all patients with hair loss are alike, and it is important that your situation is evaluated by someone who knows you as a whole person. This discussion will be updated as needed every four months on our web site ( www.uptodate.com ). Additional topics as well as selected discussions written for healthcare professionals are also available for those who would like more detailed information. Some of the most pertinent include: Professional Level Information: Chemotherapy-induced alopecia A number of sites on the internet have information about hair loss. Information provided by the National Institutes of Health, national medical societies, and some other well-established organizations are often reliable sources of information, although the frequency with which their information is updated is variable. National Library of Medicine ( www.nlm.nih.gov/medlineplus ) National Alopecia Areata Foundation ( www.alopeciaareata.com/ ) American Academy of Dermatology ( www.aad.org ) Use of UpToDate is subject to the Subscription and License Agreement. REFERENCES 1. Olsen, EA. Androgenetic alopecia. In: Disorders of hair growth: Diagnosis and treatment, Olsen, EA (Ed), McGraw-Hill, New York 1994. p.257. 2. Price, VH, Menefee, E, Strauss, PC. Changes in hair weight and hair count in men with androgenetic alopecia, after application of 5% and 2% topical minoxidil, placebo, or no treatment. J Am Acad Dermatol 1999; 41:717. 3. DeVillez, RL, Jacobs, JP, Szpunar, CA, Warner, ML. Androgenetic alopecia in the female. Treatment with 2% topical minoxidil solution. Arch Dermatol 1994; 130:303. 4. Kaufman, KD, Olsen, EA, Whiting, D, et al. Finasteride in the treatment of men with androgenetic alopecia. Finasteride Male Pattern Hair Loss Study Group. J Am Acad Dermatol 1998; 39:578. 5. Price, VH, Roberts, JL, Hordinsky, M, et al. Lack of efficacy of finasteride in postmenopausal women with androgenetic alopecia. J Am Acad Dermatol 2000; 43:768.

Hair loss • Sweating

Hair loss International Edition | Member Center: Sign In | Register Home Page World U.S. Weather Business Sports Politics Law Technology Science & Space Health Entertainment Travel Education Special Reports Video Autos CNN Pipeline E-mail Newsletters Your E-mail Alerts Podcasts RSS CNNtoGO Contact Us In association with: WOMEN'S HEALTH Hair/Nails/Skin • Corns and calluses • Nail fungus • Ingrown toenails • Moles • Acne • Skin cancer • Psoriasis • Hair loss • Sweating and body odor • Rosacea • Hives and angioedema • Athlete's foot • Dermatomyositis • Dermatitis/Eczema • Cold sore • Scleroderma • Lice • Common warts • Melanoma • Cellulitis • Scabies • Anal itching • Dandruff • Impetigo • Boils and carbuncles • Psoriatic arthritis • Ringworm of the body • Jock itch • Plantar warts • Folliculitis • Dry skin • Actinic keratosis • CREST syndrome • Vitiligo INFORMATION CENTERS: Pick a category Health Centers =========== Family Health Men's Health Women's Health Children's Health Seniors' Health Fitness & Nutrition Working Life Pain Management Condition Centers ============= AIDS/HIV & Immune System Allergy Alzheimer's Arthritis Asthma & Respiratory System Brain & Nervous System Cancer Cold, Flu & Viruses Diabetes & Endocrine System Digestive System Heart and Blood Infectious Disease Mental Health Note: All links within content go to MayoClinic.com Diseases and Conditions Hair loss From MayoClinic.com Special to CNN.com Overview Your hair loss may have started with a few extra hairs in the sink or in your comb. But now you can't look in the mirror without seeing more of your uncovered scalp. Baldness typically refers to excessive hair loss from your scalp and can be the result of heredity, certain medications or an underlying medical condition. Anyone — men, women and children — can experience hair loss. The medical term for hair loss is alopecia. The most common type is pattern baldness (androgenetic alopecia). It accounts for about 95 percent of hair loss from the scalp. It's typically permanent and can be attributed to heredity. Another type of alopecia, alopecia areata, can be temporary. It can involve hair loss on your scalp or your body. Its specific cause is unknown. Some people prefer to let their hair loss run its course untreated and unhidden. Others may cover it up with hairstyles, makeup, hats or scarves. You may also choose one of the medications and surgical procedures that are available to treat hair loss. Before pursuing any of these treatment options, talk with your doctor about the cause and best possible treatments for your hair loss. Signs and symptoms Having androgenetic alopecia may mean you experience hair loss as early as during your teen years. For men, this type of hair loss is typically characterized by hair loss that begins at the temples and crown. The end result may be partial or complete baldness. Women with androgenetic alopecia usually have hair loss limited to thinning at the front, sides or crown. Complete baldness rarely occurs in women. With alopecia areata, hair loss usually occurs in small, round, smooth patches. You may lose only scalp hair, or you may lose body hair as well. Causes About 90 percent of the hair on most people's scalp is in a 2- to 6-year growth (anagen) stage at any given time. The other 10 percent is in a 2- to 3-month resting (telogen) phase, after which time it is shed. Most people shed 50 to 150 hairs a day. Once a hair is shed, the growth stage begins again as a new hair from the same follicle replaces the shed hair. New hair grows at a rate of approximately 1/2 inch each month. Hair loss may lead to baldness when the rate of shedding exceeds the rate of regrowth, when new hair is thinner than the hair shed or when hair comes out in patches. Androgenetic alopecia is caused by heredity. Although it's most common among men, it can also affect women. A history of androgenetic alopecia on either side of your family increases your risk of hair loss. Heredity also affects the age at which you begin to lose hair and the developmental speed, pattern and extent of your hair loss. Alopecia areata is classified as an autoimmune disease, but the cause is unknown. People who develop this type of hair loss are generally in good health. Some scientists believe that some people are genetically predisposed to develop alopecia areata and that a trigger, such as a virus or something else in the environment, sets off the condition. A family history of alopecia areata makes you more likely to develop it. Unlike androgenetic alopecia, hair generally grows back. But you may lose and regrow your hair a number of times. Other causes of temporary hair loss include: Disease. Diabetes, lupus and thyroid disorders can cause hair loss. Poor nutrition. Having inadequate protein or iron in your diet or poor nourishment in other ways can cause you to experience hair loss. Fad diets, crash diets and certain illnesses, such as eating disorders, can cause poor nutrition. Medications. Certain drugs used to treat gout, arthritis, depression, heart problems and high blood pressure may cause hair loss in some people. Taking birth control pills also may result in hair loss for some women. Medical treatments. Undergoing chemotherapy or radiation therapy may cause you to develop alopecia. After your treatment ends, your hair typically begins to regrow. Recent high fever, severe flu or surgery. You may notice you have less hair three to four months after events such as an illness or surgery. These conditions cause hair to shift rapidly into a resting phase (telogen effluvium), meaning you'll see less new hair growth. A normal amount of hair typically will appear after the growth phase resumes. Infancy. Newborns often lose hair during the first several months of life. This baby hair (vellus) is eventually replaced by more permanent hair. It's also common for babies to lose a patch of hair on the back of their heads from rubbing against mattresses, playpens and car seats. Hair will grow back once a baby begins to spend more time sitting up. Childbirth. Some women experience an increase in hair loss several months after delivering a baby. This is because during pregnancy the hair is shifted into an active growth state that then goes back to baseline soon after delivery. This increased hair loss usually corrects itself. Hair treatments. Chemicals used for dying, tinting, bleaching, straightening or perming can cause hair to become damaged and break off if they are overused or used incorrectly. Excessive hairstyling or hairstyles that pull your hair too tightly also can cause some hair loss. This is known as traction alopecia. Scalp infection. Infections such as ringworm can invade the hair and skin of your scalp, leading to hair loss. Once infections are treated, hair generally regrows. Ringworm, a fungal infection, can usually be treated with a topical or oral antifungal medication. Type 1 diabetes Lupus Hypothyroidism Eating disorders Gout Depression High blood pressure (hypertension) Fever Influenza (Flu) Treatment Baldness, whether permanent or temporary, can't be cured. But treatments are available to help promote hair growth or hide hair loss. For some types of alopecia, hair may resume growth without any form of treatment. Medications The effectiveness of medications used to treat alopecia depends on the cause of hair loss, the extent of the loss and individual response. Generally, treatment is less effective for more extensive cases of hair loss. The types of drugs for treatment of alopecia that are approved by the Food and Drug Administration include: Minoxidil (Rogaine). This over-the-counter medication is approved for the treatment of androgenetic alopecia and alopecia areata. Minoxidil is a liquid that you rub into your scalp twice daily to regrow hair and to prevent further loss. Some people experience some hair regrowth or a slower rate of hair loss or both. Minoxidil is available in a 2 percent solution and in a 5 percent solution. New hair resulting from minoxidil use may be thinner and shorter than previous hair. But there can be enough regrowth for some people to hide their bald spots and have it blend with existing hair. New hair stops growing soon after you discontinue the use of minoxidil. If you experience minimal results within six months, your doctor may recommend discontinuing use. Side effects can include irritation of the scalp. Finasteride (Propecia, Proscar). This prescription medication to treat male-pattern baldness is taken daily in pill form. Many people taking finasteride experience a slowing of hair loss, and some may show some new hair growth. Positive results may take several months. Finasteride works by inhibiting the conversion of testosterone into dihydrotestosterone (DHT), a hormone that shrinks hair follicles and is an important factor in male hair loss. Rare side effects of finasteride include diminished sex drive and sexual function. As with minoxidil, the benefits of finasteride stop if usage is discontinued. Finasteride is not approved for use by women. In fact, it poses significant danger to women of childbearing age. If you're a pregnant woman, don't even handle crushed or broken finasteride tablets because absorption of the drug may cause serious birth defects in male fetuses. Corticosteroids. Injections of cortisone into the scalp can treat alopecia areata. Treatment is usually repeated monthly. Doctors sometimes prescribe corticosteroid pills for extensive hair loss due to alopecia areata. Ointments and creams can also be used, but they may be less effective than injections. Anthralin (Drithocreme). Available as either a cream or an ointment, anthralin is a synthetic, tarry substance that you apply to your scalp and wash off daily. It's typically used to treat psoriasis, but doctors can prescribe it to treat other skin conditions. Anthralin may stimulate new hair growth for cases of alopecia areata. Surgical procedures Hair transplants and scalp reduction surgery are available to treat androgenetic alopecia. During transplantation a dermatologist or cosmetic surgeon takes tiny plugs of skin, each containing one to several hairs, from the back or side of your scalp. The plugs are then implanted into the bald sections. Several transplant sessions may be needed as hereditary hair loss progresses with time. Scalp reduction, as the name implies, means decreasing the area of bald skin on your head. Your scalp and the top part of your head may seem to have a snug fit. But the skin can become flexible and stretched enough for some of it to be surgically removed. After hairless scalp is removed, the space is closed with hair-covered scalp. Doctors can also fold hair-bearing skin over an area of bald skin in a scalp reduction technique called a flap. Scalp reduction can be combined with hair transplantation to fashion a natural-looking hairline. Surgical procedures to treat baldness are expensive and can be painful. Possible risks include infection and scarring. If you're interested in these procedures, consider only board-certified dermatologists, plastic surgeons or cosmetic surgeons, and check local and state medical boards for a record of patient complaints before choosing a doctor. If you would like an alternative to medical treatment for your hair loss or if you don't respond to treatment, you may want to consider wearing a wig or hairpiece. They can be used to cover either permanent or temporary hair loss. Quality, natural-looking wigs and hairpieces are available. Coping skills Chances are that the greatest challenge of losing your hair is coping with the change in your appearance. You may be frustrated or upset by other people's reactions or after trying various treatments with little success. If you're having difficulty coping with baldness caused by heredity, a medical condition or medical treatments, you may find some of the following suggestions helpful: Learn about the cause of your baldness and treatment options. Be wary of alternative treatments that have no proven track record or may cause dangerous or unpleasant side effects. Educate those near to you. Your family and friends can be more sympathetic if they understand the cause of your baldness or your concerns about your looks. You may also learn that they are less concerned about changes in your appearance than you are. Consider joining a support group. While support groups aren't for everyone, they can be sources of information and comfort. Talking with people who experience the same challenges or medical conditions and learning how they cope can be reassuring. Hair loss: Cancer-related causes and how to cope March 12, 2004 © 1998-2005 Mayo Foundation for Medical Education and Research (MFMER). All rights reserved.  A single copy of these materials may be reprinted for noncommercial personal use only. "Mayo," "Mayo Clinic," "MayoClinic.com," "Mayo Clinic Health Information," "Reliable information for a healthier life" and the triple-shield Mayo logo are trademarks of Mayo Foundation for Medical Education and Research.  Terms of Use . © 2001 Planetree, Inc. All rights reserved. International Edition Languages --------- Arabic Japanese Korean Turkish CNN TV CNN International Headline News Transcripts Advertise with Us About Us © 2005 Cable News Network LP, LLLP. A Time Warner Company. All Rights Reserved. Terms under which this service is provided to you. Read our privacy guidelines . Contact us . External sites open in new window; not endorsed by CNN.com Pay service with live and archived video. Learn more Download audio news | Add RSS headlines

Hair Extentions

Skin Laser Dubai Dermatoloy Laser and Laser hair removal in Dubai UAE arabian gulf We thank you for visiting our site . Dr.Mehta has been practicing Dermatology and Dermatology Surgery for past 28 years in several countries and on different positions such as consultant dermatologist , on faculty position in teaching hospitals and in Armed Forces Medical unit on military position as head and consultant Dermatologist in Doha Qatar ( Arabian gulf ) , Bahrain , India and now in private practice in Dubai united Arab emirates and treated thousand of patients from approximately one hundred nationalities mainly Saudi Arabia ( K.S.A. ), Kuwait , Muscat Oman , Doha Qatar , India , Pakistan , USA , UK , and Dubai United Arab emirates ( U.A.E. ) . Our medical center is situated in Heart of Dubai , Al Ghurair Center and equipped with most modern state of art equipment's like latest Revolutionary break through of this century in medical science Like Non surgical , non invasive skin tightening using safe light based technology Called Titan , Which tightens the skin on most parts of body without any down time which gives better result than Thermage but without pain and discomfort. Extrac Excimer Laser for Vitiligo and Psoriasis is One of the First of its kind in UAE which is going to make traditional PUVA and other photo-therapy completely obsolete and now we can treat Vitiligo and Psoriasis without systemic side effects of drugs and , UV side effects on normal skin and at a faster rate , Light sheer Laser hair removal , Laser resurfacing and Laser skin surgery , Non ablative Laser rejuvenation , Laser treatment for leg veins and spider veins , AHA and TCA chemical and fruit acid peel and several other equipments and treatment of skin and cosmetic such as skin fillers Like collagen , Restylane , Perlane , for facial lines and scars and for Lip enlargement and shaping , PUVA therapy ,Broadband UVB , narrow band UVB for Vitiligo and psoriasis etc., Botox injection / Dysport injection for treatment of frowning , horizontal and vertical facial lines , Neck bands , Crows feet etc. details of which is available on our site. I and my staff assure you of highest standard of medical care. Please Use Our Contact Page For any suggestions or inquiries, Your suggestions are very important to us. Or call us directly on Tel : +9714-2282444 , Fax : (+9714) 2219292 641-B , Al Ghurair Center P.O. Box: 14477 Dubai - United Arab emirates Thank You e mail: drmmehta@emirates.net.ae We are pleased to announce that Dr. Mahaveer Mehta has been invited to participating at the annual meeting of American Academy of Dermatology to be held in San Francisco and he will not be available for consultation from 2nd march 2006 to 9th march 2006.Dr.Mehta is recipient of Physician recognition award from American medical association and continuing medical education award from American academy of Dermatology several times . Several new procedures are added in our medical center . For further information please use our contact form or call directly on Tel.+9714-2282444 . Dr.Mehta with Prof Dr.Lawrance field of Stanford university during annual convention at ISDS congress live work shop Dr.Mehta with prof. Dr.Rex Past president of American Academy of Dermatology , Past president of American Society of Dermatologic Surgery and Prof Dr.William Hanke Prof. of Dermatology , Author of Several books on Cosmetic Surgery , President of American Academy of Cosmetic Surgery , Past president of ISDS and one of the founder of International society of Dermatologic surgery , Past president International society of cosmetic Laser surgeons . Dr.Mehta's profile on AMERICAN ACADEMY OF DERMATOLOGY WEBSITE Dr.Mehta's Link on International Society of Dermatologic Surgery Web site Our affiliation with top Middle East Health portal GulfMD.com Dr.Mehta is an Founder Expert panelist on Dermatology and Cosmetic Laser Surgery for NRI World.com- Platform for global NRI [Skin Laser Dubai] [ Profile ] [ Laser Hair removal ] [ Titan ] [ Laser Skin Surgery ] [ Laser Resurfacing ] [ Vitiligo Psoriasis Laser ] [ TCA peel ] [ Acne ] [ Acne Scars ] [ Skin Cancer ] [ Sexual Dysfunction ] [ Sexual diseases ] [ Plastic Surgery ] [ Skincare tips ] [ Comments ] [ Contact us ]

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Malehealth – fast, free, independent men’s health info Asthma Back pain Bowel problems Cancer Coronary heart disease Dementia Depression Diabetes Hair loss Hernia Infertility Mid-life crisis Peptic ulcers Penis problems Prostate problems Sexual problems Sexually transmitted infections Skin problems Sleep problems Sports injuries Stress Testicle problems Vasectomy Weight problems Hair loss What is it? What are the main symptoms? What's the risk? What causes it? How can I prevent it? Should I see a doctor? What are the main treatments? How can I help myself? What's the outlook? Who else can help? What's it like? (real comments from real people) Have your say about hair loss What is it? Most men don't need to be told – it's the loss of hair resulting in decreasing coverage of the scalp. Top of Page What are the main symptoms? Male pattern baldness (also known as genetic hair loss or alopecia androgenetica) is the most common form of hair loss in men. It usually develops very gradually, typically involving the appearance of a bald spot on the crown of the scalp accompanied by thinning at the temples. Although this problem can strike any man at any time, many first become aware of it as they approach their thirties. Other causes of hair loss Top of Page What's the risk? Two-thirds of all men will eventually be affected by male pattern baldness – in the UK, this means that 7.4 million men are losing their hair at any one time. There are racial differences, however, in the incidence of male pattern baldness. The highest rates are found among Caucasians, followed by Afro-Caribbeans. Chinese and Japanese men have the lowest rates. For some unknown reason, this form of hair loss is does not occur among Native Americans. Male pattern baldness runs in the family. If your grandfather, father or brothers went bald early, the chances are that you will too. The strongest influence is on the mother's side: if your maternal grandfather went bald, that's probably a better indicator that you will too than if your father's father lost his hair. Top of Page What causes it? There is only a tiny grain of truth in the myth that bald men are more virile because they have more of the male sex hormone testosterone. This idea probably grew from the observation that eunuchs never became bald and, having being castrated, they didn't, of course, produce very much testosterone. Yes, testosterone is involved in male pattern baldness, but its relationship with hair loss is complicated and not completely understood. Testosterone is naturally converted in the body to a related sex hormone, dihydrotestosterone (DHT). This stimulates the growth of facial and body hair, as well as acting on the prostate gland. There is good evidence that male pattern baldness results from an over-sensitivity of scalp hair follicles to DHT, rather than raised levels of either sex hormone in the blood. Smoking and balding Top of Page How can I prevent it? You cannot prevent male pattern baldness, although there may be ways of slowing down the process or disguising the problem. Top of Page Should I see a doctor? To get advice and treatment for hair loss, you should always start with either your GP or a professionally qualified trichologist. Until very recently, male pattern balding was seen as a natural process and you may find your doctor to be neither sympathetic nor helpful if you consult him/her about it. But things may be changing. An increasing number of doctors realise that hair loss can have psychological consequences that significantly diminish quality of life, especially for younger men, and they may be more willing to take the problem seriously. If you are lucky enough to have an enlightened GP, by all means seek their advice – at the very least, you'll get a referral to a reliable trichologist (although you'll probably have to pay for any treatment you receive). A trichologist, by the way, is a hair specialist whose training covers both the cosmetic and the medical aspects of the subject. Some trichologists are also trained hairdressers, but they are not usually medically qualified. The Institute of Trichologists keeps a register of properly qualified people: look for the letters AIT (Associate), MIT (Member) or FIT (Fellow) after their name. Other types of hair loss, such as alopecia areata, are taken seriously as medical conditions and you should seek your GP's advice as you would for any other medical problem. Top of Page What are the main treatments? There is no cure for male pattern baldness, but there are both drug and surgical treatments available which may lead to some improvements. Minoxidil (sold as Regaine) This is the only topical treatment (one that you rub into the skin) which is actually licensed for the treatment of male pattern baldness in the UK. It was originally developed (in tablet form) as a drug for high blood pressure. Doctors noticed that people on minoxidil sometimes grew new hair, so the drug was reformulated for this purpose. Regaine comes as 2% or 5% lotions which you rub, daily, into your scalp. It is best to start with the 2% lotion and after three months, if you have not seen significant growth of hair, upgrade to the 5% lotion. It is a Pharmacy Only medicine, which means you can obtain it from a pharmacy without a prescription, but only when a pharmacist is on the premises. The pharmacist should check that Regaine is appropriate for you before selling it (for instance, you shouldn't use it without medical supervision if you have high blood pressure). Regaine cannot work miracles. About one-third of men using it get good hair growth on the bald patches, one-third get a fine, downy regrowth, while the rest will get little or no response. The majority of men using it find that at least they don't lose much more hair – but as soon as you stop using it, hair loss resumes its course. Expect to wait up to four months before you get any response from Regaine (be patient), but if nothing happens after, say, a year, you may as well give it up. Incidentally, never pay large sums of money to a private trichologist or over the Internet for Regaine – the usual price is around £30 for a month's supply. Top of Page Finesteride (marketed as Propecia) This is a treatment for male pattern baldness which is licenced in the UK but only on private prescription, not on the NHS. It is one of a class of drugs called 5-alpha-reductase inhibitors. Since 5-alpha-reductase is the enzyme which causes the conversion of testosterone into DHT, inhibiting this with finesteride should, in theory, stop hair loss. In fact, finesteride was originally developed for the treatment of benign prostatic hyperplasia (BPH), a condition in which the prostate gland becomes enlarged through the action of DHT. Although there have been no clinical studies directly comparing low dose finesteride and Regaine, the data suggests that the two products may be similarly effective as a treatment for hair loss. Finesteride can lead to side effects in up to 2% of users such as impotence, reduced sex drive and reduced semen volume. (These side-effects are reversible when the treatment stops.) Propecia can be obtained from your GP or dermatologist on private prescription. Anti-androgen therapy Another way of tackling male pattern baldness is to directly block the action of DHT using a variety of hormonal drugs. Some of these are similar to oral contraceptives and female hormone replacement therapy. They should only be applied under the supervision of an endocrinologist (hormone specialist) or a dermatologist with expertise in hormone therapy. Top of Page Hair transplant surgery Surgery offers the possibility of a longer-term solution to your hair loss problem. But it doesn't come cheap and it can be hard to find a skilled and reputable surgeon. Put simply, hair surgery involves rearranging your scalp skin so as to minimise the bald areas and maximise those where hair is still growing. In the UK most hair surgeons use grafts, which involves transferring skin from the hair-bearing area at the back of the head to the bald parts at the front. Hair grafts work because the section of skin transferred retains its own characteristics (i.e. hair grows) rather than acquiring those of the place it is transferred to (where hair does not grow). The most natural results come from transferring plugs of skin bearing 3–6 hairs (minigrafts) or just one hair (micrografts). The surgeon makes tiny slits or pinholes in the recipient area into which the plugs are inserted. A new hairline can be built up by using rows of micrografts at the front and minigrafts a few rows further back. When considering surgery, you must remember that your hair loss could well continue around the reconstructed areas. This may look unsightly unless you're prepared to invest in further surgery in a few years time. Hair surgery usually involves considerable financial investment and you are also involving yourself in a medical procedure. So choose your surgeon carefully, preferably via personal recommendation or through the Institute of Trichologists . He or she should carry one or more of the following qualifications: FRCS (Fellow of the Royal College of Surgeons) BAAPS (British Association of Aesthetic Plastic Surgeons) BACS (British Association of Cosmetic Surgeons) Remember, a good hair surgeon probably doesn't need to advertise. Other treatments As far as other treatments are concerned, be very wary. There are many bogus operators out there who are only too keen to exploit people with hair loss. What treatments don't work Top of Page How can I help myself? Making changes in your hair care routine and overall lifestyle may help minimise the appearance of hair loss. Treat your remaining hair with a bit more respect. Most people are too rough with their hair. It's better to use a comb, not a brush, and to avoid tightly fitting caps or hats. Hair is more fragile when it's wet, so handle it with care. Some shampoos and other hair cosmetics can make your hair look thicker and fuller. Ask your hairdresser for advice. Short hair minimises the contrast between balding and non-balding areas. Long hair has the reverse effect and is very ageing. It shouldn't need saying, but combing hair over a bald spot is not a good idea. Include sufficient protein in your diet, especially if you are vegan or vegetarian (hair loss sometimes starts when people give up meat). Ensure that you do not become anaemic by eating plenty of iron-rich foods like liver, eggs and green vegetables. Find out about a healthy diet. Top of Page What's the outlook? There's no cure for male pattern baldness, although other forms of male hair loss are often reversible. Top of Page Who else can help? Hairline International: The Alopecia Patients Society Web site: www.hairlineinternational.com Lyons Court 1668 High Street Knowle, Nr Solihull West Midlands B93 0LY Institute of Trichologists Web site: www.trichologists.org.uk Tel: 08706 070602 E-mail: admin @trichologists.org.uk Two other interesting sites: For those who, like the eagle, are bald and proud, BaldRUs puts the case compellingly for letting it all fall out while head of hair is a pro-transplant site put together by a man who had one (and has since worked as a PR for the clinic that did it.) Top of Page Back to A-Z of Health By Dr Susan Aldridge, a freelance medical writer and editor who contributes to many publications and websites including Focus, Nature Biotechnology and healthandage.com. Her new book Use Your Brain to Beat Addiction is published by Cassell in July 2005 . Updated by malehealth for 2005. Have your say about hair loss Have you been affected by hair loss? If so, we'd like to hear about your experience and to post it on the malehealth.co.uk site. This could be useful to other men who are also affected by this problem. Please note, we cannot answer any queries posted here . If you would like to ask a question about hair loss that will be answered by our panel of experts, please go to Ask the Doctor . Read about other men's experiences of tackling hair loss problems Your Comments Page last updated: 01/01/2005 Designed by Anytime After 9 Ltd

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