Male pattern baldness is a common type of hair loss which typically affects men from middle age. Its medical name is androgenic alopecia and in some men it can cause significant distress, especially if it occurs earlier in life or very rapidly. In men the hair loss generally starts at the front and sides of the head and moves backwards. It is caused by a response of hair follicles to testosterone and it often runs in families. Around a third of men are already affected by the age of 30! The diagnosis is normally very easy to make and we do not generally do blood tests or other investigations unless we suspect there is an underlying condition causing the hair loss.
Of course, male pattern baldness does not necessarily require treatment but I am often asked by patients if there is anything they can do to reverse or slow down the process. Here we’ll separate fact from fiction and outline the main options.
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Topical treatments
There are a number of topical creams, oils and shampoos which purport to fix the problem of male pattern baldness. Minoxidil is the active ingredient in most of the well-known brands and these can usually be bought without a prescription. Minoxidil is a very safe medicine and side-effects are rare. One of the downsides of this approach is that it can take 6-12 months to notice any difference. Minoxidil is also less effective than the commonly used oral medication at reversing hair loss.
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Finasteride
Finasteride (Propecia) is taken in tablet form. In higher doses it is used to treat an enlarged prostate but the dose we use for hair loss is much lower. Side effects at this dose are rare, but are still more common than in topical treatments. Finasteride is more effective than Minoxidil and around two-thirds of men will see noticeable hair regrowth as well as much less hair loss. Noticeable changes can take 3-6 months to appear, and the medication is only available in Singapore with a doctor’s prescription.
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Hair transplant
Hair transplant is an option in men who have more extensive or longstanding baldness. It is a minimally invasive surgical procedure where hair follicles from a donor site on another part of the body are transplanted onto the head. Like any surgery, there are potential complications and these should be discussed in details before proceeding. Unlike Minoxidil and Propecia, hair transplants can be a permanent solution (the effects of Propecia re lost if one stops taking the medication).
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The Future
Research into the use of ‘platelet rich plasma’ and other stem cell treatments which are injected into the scalp to create new hair growth is ongoing, and it is inevitable that more advances will be made over time.
Treatment is often more effective if started earlier. If you’d like to discuss your options, come in to see us.
