What is male pattern baldness?
Male pattern baldness, scientifically known as androgenetic alopecia, is the most common type of hair loss in men, characterized by a distinct pattern that begins above both temples or at the crown of the head. Over time, the hairline recedes to form a characteristic “M” shape, with hair thinning at the crown often progressing to partial or complete baldness. This condition is influenced by a combination of genetics and hormones, particularly dihydrotestosterone (DHT), a derivative of testosterone. DHT affects hair follicles by miniaturizing them, leading to shorter, finer hair strands until, eventually, these follicles cease producing hair altogether. The genetic predisposition can come from either side of the family, and while it’s more prevalent with age, male pattern baldness can start as early as in one’s late teens or early twenties.
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What are treatments for male pattern baldness?
Treatments for male pattern baldness include minoxidil (Rogaine), an over-the-counter topical solution or foam that promotes hair growth by increasing blood flow to hair follicles; finasteride (Propecia), an oral medication that reduces hair loss by inhibiting the conversion of testosterone to DHT; dutasteride (Avodart), similar to finasteride but potentially more potent; and hair transplant surgery, where hair follicles are moved from areas of abundance to balding areas. Other options include low-level laser therapy, microneedling combined with topicals to enhance absorption, and lifestyle changes like improving diet and reducing stress. Each treatment has varying degrees of efficacy, side effects, and requires ongoing use to maintain benefits.
At Vigor Health Clinics, we focus on treating male pattern baldness with oral medications which are discussed in further detail below:
These medciations work by blocking the 5-alpha-reductase enzyme, which is responsible for converting testosterone into dihydrotestosterone (DHT), a hormone that contributes to hair follicle miniaturization in male pattern baldness; by reducing DHT levels in the scalp, these inhibitors help to halt hair loss and can promote hair regrowth. Two of these medications are currently approved by Health Canada:
5-alpha Reductase Inhibitors:
- Finasteride (Propecia):
- Usage: Specifically approved for male pattern baldness at a lower dose (1 mg daily under the name Propecia).
- Effectiveness: Studies have shown finasteride can halt hair loss in about 80-90% of men and promote some regrowth in approximately 66%. Its effects are most pronounced at the crown and mid-scalp.
- Dutasteride (Avodart):
- Usage: Although primarily approved for treating BPH, it’s also used off-label for hair loss due to its ability to inhibit both types (I and II) of 5-alpha reductase enzymes, whereas finasteride mainly inhibits type II.
- Effectiveness: Some studies suggest it might be more effective than finasteride because it inhibits more DHT production, but this also potentially increases the risk or severity of side effects.
5-alpha Reductase Inhibitors, like finasteride and dutasteride, can cause side effects including decreased libido, erectile dysfunction, and less commonly, depression or breast tenderness. These effects are mostly tolerable and diminish over time. These treatments require indefinite use to maintain benefits since discontinuation leads to resumed hair loss within months. Combining these inhibitors with topical Rogaine (minoxidil) can enhance efficacy, as they work differently; minoxidil promotes blood flow to follicles while inhibitors reduce DHT. Before starting any prescription medication, it’s essential to have a thorough assessment with your doctor about your medical history to identify any contraindications and to understand the potential side effects. This ensures you can give informed consent for the treatment.