Baldness: It's What's Inside (Not on Top) That Counts

What is it?

The medical term for baldness is alopecia. Many causes of hair loss are rare and related to unusual diseases or high risk treatments for life-threatening conditions such as cancer. This article concerns itself only with male pattern baldness, a very common progressive loss of scalp hair from the top and the front of the head. The condition affects one-third of all men and many women. It generally worsens with age.

What causes it?

Male pattern baldness results from hindering of hair growth by male hormones. Some hair, particularly that on top and in front of the head, has an inborn sensitivity to male hormones. This sensitivity causes the hair follicles, which hair grows from, to shrink. The shrunken follicles produce thinner hair and eventually none at all. This tendency is definitely hereditary, so look at those ancestor pictures in your family album for answers.

What can I do about it?

In the past, toupees (wigs) were the only available answer. However, there are some medical approaches that can help.

Surgery

Originally done with a punch a few millimeters in diameter, it can now be done using a few hairs at a time, giving very natural-looking results. Although transplantation is expensive, it lasts forever and looks as good as never having grown bald in the first place. It uses hair from your body that is not sensitive to male hormones. Sessions take one to three hours and are spaced four months apart. Good results are often achieved after three sessions. It takes another year for the hair to grow. Hair transplant specialists advise you to select a doctor who is board certified as a "hair transplant surgeon." It is a good idea to look further into the doctor's qualifications. Talk to the physician in person, ask about complications and success rates, look at before and after photographs and check the local regulatory authorities for complaints. Plastic surgeons also can relocate the pieces of your scalp that still make hair. This involves much more extensive surgery.

Medications

Rogaine® (minoxidil) was originally developed to control high blood pressure, but it also can stimulate hair growth in a certain percentage of men. You must continue using it to maintain its effects. Results begin to become apparent within one to two months.

Propecia® (finasteride) is a prescription medication that inhibits the ability of male hormones' ability to suppress hair growth. It has received FDA approval for men but has not been approved for women. Women should not use Propecia and women who are or may become pregnant should not even handle Propecia because it could cause birth defects. Propecia may take more than a year to get results and you must continue to take it. Possible side effects include difficulty getting an erection and decreased desire for sex.

Rogaine and Propecia have proven to stimulate hair growth, although each person's response varies.

Points to remember:

• Ordinary balding can be treated effectively and safely in several ways.
• Do your homework. The more informed you are, the better choice you will make.
• If you choose to have a hair transplant, carefully check out the provider to make sure he or she has a good record.

Related Articles Hair Transplantation in Men: Is It Right for You?

External Source American Academy of Dermatology. Hair restoration. Accessed May 11, 2007.

This article was reviewed and updated June 2007.

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