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  • Treatments for Male-Pattern Baldness
                Minoxidil
                Finasteride
                Hair Transplant
  • Treatments for Alopecia Areata
  • Treatments for Traction Alopecia and Trichotillomania
  • Other Kinds of Treatments




    Treatments for Male-Pattern Baldness

    There are three medical treatments for male-pattern baldness. The first two are FDA approved treatments: minoxidil and finasteride. Both drugs require living hair follicles in order to work. This means that a dormant or atrophied hair follicle can still be stimulated back into a growth phase. A hair follicle that is dead cannot be reestablished; hair regrowth will not occur from dead follicles.

    Minoxidil

    The first, a topical application of drug named minoxidil, sold in the name of Rogaine, when applied to thinning areas of the scalp on a daily basis, is thought to be effective in preventing further hair loss in many cases and in growing new hair in a much smaller proportion of cases. The mechanism of minoxidil's action remains unknown but is apparently related to the drug's ability to dilate blood vessels, thereby affecting the blood supply and the supply of circulating male hormones to those areas of the scalp that are losing hair.

    Minoxidil is the most widely recommended treatment, and is available as a generic, over-the-counter (OTC) medication. It was originally used to treat high blood pressure, but the drug was also found to stimulate hair growth. Now, minoxidil can be used in topical form for alopecia treatment.

    Minoxidil appears to work by gradually enlarging and lengthening hair follicles that have been shrinking due to the action of excessive amounts of the hormone dihydrotestosterone, or DHT. Minoxidil may also extend the growth phase of the hair follicle.

    Minoxidil must be used on a continual basis. Generally the drug must be used for 3 to 4 months before there is obvious hair regrowth in those individuals who will respond to the drug. Initially, new hair may be soft and colorless, but eventually it will attain its normal appearance.

    Clinical tests on minoxidil have been conducted by 27 US medical centers involving over 2,300 patients. The tests have been conducted on both a 2% minoxidil formulation and a 5% formulation. The tests indicated that after 1 year of 2% minoxidil use, 48% of the men had moderate to dense hair regrowth, and another 36% of the men had minimal hair regrowth. Two thirds of the women had some degree of hair regrowth. Use of the new 5% formulation appears to result in an additional 45% increase in hair growth when compared to the 2% formulation.

    The most common side effects of minoxidil are itching of the scalp and skin irritation. In general, these side effects disappear when treatment is discontinued.

    Finasteride

    The second is the systematic application of the oral prescription drug finasteride. This drug is taken in pill form on a daily basis and appears to be effective in preventing further hair loss in most cases and growing new hair in a significant minority of cases.

    Finasteride is an inhibitor of the enzyme called 5-alpha reductase. This enzyme causes the male hormone dihydrotestosterone (DHT) to be formed in the hair follicle. By inhibiting 5-alpha reductase, finasteride decreases DHT synthesis. Reducing the amount of DHT that can be synthesized thus reduces the destructive effects of excessive amounts of DHT on the hair follicle.

    Treatment with finasteride must occur for at least 3 months before regrowth begins to be apparent. After that, therapy must continue in order to maintain those effects. Approximately 83% of users have hair regrowth after 2 years. Finasteride is approved for use only in men. It is not recommended for use in women because of its high potential for causing birth defects.

    Two side effects are seen in 2% of finasteride users: impotence and loss of libido.

    The effects of both minoxidil and finasteride usually take 6 months or longer to be apparent. They may help to reduce hair fall but it is generally seen that when the application is stopped, regrown hair fall out.

    Hair Transplant

    The third treatment is hair transplantation. Hair transplant is a more permanent way to stop balding. This involves the transplantation of hair follicles from areas of the scalp where hair is still growing to areas where it is not--e.g., from the back to the front of the head. This carries a low risk for skin infections and may cause minor scarring in the donor areas.


    Treatments for Alopecia Areata

    Treatments for alopecia areata--patchy hair loss--is determined by the extent of hair loss, which is established by your physician. There are four main types of therapy:

    a   Topical or locally injected corticosteroids, usually used when there is less than 50% hair loss. Corticosteroids have a multitude of effects that lead to suppression of the inflammatory response. Topical minoxidil may also be effective in individuals with patchy alopecia areata.
    b   Oral corticosteroids, which may be used when there is greater than 50% hair loss.
    c   PUVA treatment--infrequently used. PUVA therapy involves oral administration of a light-sensitive drug psoralen, followed by short exposure to longwave ultraviolet light. PUVA therapy is also used to treat psoriasis.
    d   Immunosuppressive therapy, such as the application of cyclosporine, a powerful immunosuppressant with a specific action on T-lymphocytes. Immunosuppressive therapy is reserved for the more severe forms of alopecia areata, and it requires close supervision by your physician.


    Treatments for Traction Alopecia and Trichotillomania

    Traction alopecia and trichotillomania are caused by abnormal pulling or twisting of the hair, causing breakage of the hair shaft. In these conditions, the scalp is usually undamaged. When pulling and twisting are stopped, the hair regrows normally unless the follicle has been damaged.

    These conditions in children are usually caused by a nervous habit of playing with the hair. Traction alopecia can also be caused by certain styling techniques that pull excessively on the hair, such as straightening techniques.


    Other Kinds of Treatments

    A hairpiece can be custom made to cover a balding area. It is important not to neglect the scalp under the hairpiece, which should continue to be washed regularly.

    Another option is a weave, in which synthetic hair is sewn into existing hair.

    Cosmetic hair treatments that claim to thicken and straighten hair should be used with caution because most of the time they simply create an illusion of thickening, by building a layer of wax or oil.







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