Male Pattern Baldness — All that I found out about it.
This is Dev. I am a 27 year old. I have been suffering from hairloss for quite sometime. It started when I was 21. I wasn’t sure of the cause then, but eventually I realised that I was losing hair very fastly and if I don’t do something about it, I might go bald very soon.
I consulted a few trichologists. Read experiences of other balding guys. Followed medical journals that dealt with hairloss and male pattern baldness. Treatments that are available for hair loss and are FDA approved. What possible treatments might be available in the near future. I was obsessed with it. I spent a lot of time over it over these years.
So, I want to share my knowledge I accumulated so that you understand what’s happening within your scalp. With this knowledge you could consult a trichologist or a dermatologist and decide what is the best option for you.
How does it start?
Hairloss is common. Everyone loses hair everyday. 50 hairs every day is common. But if you observe any of the follwoing, you are probably balding.
1. the hair lost is not growing back
2. you observe your hair thinning
3. if your scalp is more visible than before
4. your hairline is receding.
Hairloss happens with most of the men sooner or later in their life. Even though there are multiple types of hairloss, the most common one is androgenic alopecia. It is also known as Male Pattern Baldness, MPB in short. Men suffering from MPB, lose hair aggressively on the top of their head. Generally, sides and hair on the back isnt affected much in case of MPB.
What causes Male Pattern Baldness?
Men have testosterone hormone which is responsible for male characteristics. So, testosterone is partially converted to Dihydrotestosterone(DHT) by human body. DHT is responsible for your sex drive. It’s an effective mood booster. Also responsible for muscle growth and strength.
So, DHT has a side effect also. It gets accumulated around the hair follicles on your scalp . Even though the hair on your back and sides is not susceptible to hair loss, but the ones on top of your head and crown and temples are.
DHT accumulated suffocates the hair follicles from receiving nutrients from blood and thins them out and eventually killing them.
But not everyone loses hair at the same age or with the same speed. It really depends on your genetics. Our genes decide if our hair follicles are susceptible to DHT. If your father and grand father has good hair you most probably wont have to bother about MPB.
How to treat MPB — Finasteride!
One way to do that is to completely eliminate DHT from our body. So, how would we do that. Lets get into a bit of biology here. Human body generates testosterone and a body enzyme called 5-alpha-reductase converts testosterone to DHT. So, what happens if we remove 5-alpha reductase from our body ? DHT concentrations will be significantly reduced and no longer will be affecting hair follicles.
That’s what finasteride does. It blocks 5-alpha reductase and therefore reduces DHT. Doctors generally prescribe 1mg dose and it generally takes 4–6 months for visible results. There might be some unwanted side effects initially when your body is getting used to finasteride but they generally subside eventually in most of the people. It is an FDA approved drug for combating hairloss.
Hair wont regrow on the complete bald spots but you can observe your hair density in other areas increasing and also less hairfall.
Very few people have side effects which in most people’s cases will go away once you stop using the drug.
How to treat MPB — Minoxidil!
What if we try to make sure the hair follicles get more blood flow to them so that they get enough nutrients?
So, minoxidil is a drug which was initially used to treat high blood pressure. It dilates blood vessels and thus increasing blood flow. Well, there’s one side effect — which is users observed abnormal hair growth all over their body. Thats what we want to happen.. only on our heads but.
So, FDA approved topical minoxidil solution for this purpose. 2% and 5% minoxidil solutions are available which when applied on the balding areas, it results in widening of hair follicles and also prolonging the phase of hair growth. This also takes 4–6 months to show results.
What happens when you discontinue usage of finasteride or minoxidil ? When you stop using finasteride, DHT will again resume accumulating around follicles and you will slowly begin to lose hair again. Its as if a pause button. What about minoxidil then!! This works differently. Whatever hair that was restored or that was supposed to be gone hadn’t you used minox will slowly be lost in 4–6 months post discontinuation of minoxidil.
How to treat MPB — Ketaconazole!
Generally, hair loss is also associated with itching and tingling sensation. It’s not always the case but it happens. The itch means that your hairloss is significantly faster. Why does it itch?? So, androgen receptors are something that are present in our body and also around hair follicles. They get activated by male hormones like DHT. So, they are responsible for hair follicle miniaturization. and when that happens, it itches. So, you can tackle your hairloss by focusing on these too. Thats what ketoconazole does. Ketoconazole is an anti fungal medication and is generally available as a topical cream used to treat fungal infections. It is available as a shampoo under trade names like nizoral which is used to treat dandruff and scalp itching. What it does is clears dandruff and blocks androgen receptors. This reduces inflammation on your scalp and there by your hairloss.
Other treatments.
Finasteride, Minoxidil and Ketaconazole shampoo. These three are the big daddies that are used to control male pattern baldness and are used by people across the world. Thats what generally dermatologists prescribe depending on the patient’s condition
What ketoconazole does, another medication called topical spironolactone also does more effectively.
Oral spironolactone is used to treat oedema and hypertension. But topical spironolactone does is blocks androgen receptors in your scalp efficiently and there by stopping your hairloss.
Also make sure you have a good diet. Diet plays a major role in your hairloss. Stop eating junk food. Eat more green vegetables. Take a vitamin supplement. Increase protein intake. Decrease trans fats and fried foods.
Hair Transplantation
So, what if you have already lost too much of hair or have bald spot over your crown. Well, there is a costly solution but a permanent one. It is hair transplantation. What is it? It is nothing but surgically removing hair and ‘planting’ on bald spots on your scalp. Well, you could use any hair on your body and transplant to your scalp but not someone else’s hair. Unlike heart and liver transplantation, hair transplantation is not possible from one person to other unless it’s from your identical twin.
So, the only option is to transplant hair that is resistant to DHT and placing them onto your balding spots. This hair is permanent. Hair on the back of your head can be used for this. Or your beard hair. or your chest hair. Or pubic hair. :)
The best option is from back of your head which gives a complete natural look. But the issue is there are only limited hair on the back which can be transplanted and they may not be enough to cover your bald spot completely. There are very improved technologies that can give you a natural look even with transplantation. The only issue is its costly. Either you have to wait until you no longer are losing hair or have to get multiple sessions of transplantations as you keep losing hair.
There are 2 most popular hair transplantation techniques.
What else?
Dermatologists recommend not to wash your hair with strong shampoos too frequently. Better wash with plain water and use shampoos once or twice a week.
Well there are lots of other treatments that are available on the internet. One is saw palmetto. This is similar to Finasteride. It blocks DHT production but it’s not FDA approved.
Then there are laser combs. The concept here is laser combs increase circulation of blood and thereby strengthening hair follicles.
Future Research
Even though hairloss is an age old problem, there isn’t a permanent cure to it. Aggressive research has been undertaken but the results are not yet there. I will go through the most promising research that might possibly cure it in this decade or the the next.
1. Stem cell research.
2. Histogen.
Histogen is under clinical trials and waiting FDA approval.
3. Replicel
Replicel’s optimistic about it’s availability to everyone by 2017