Male pattern baldness & Treatment Options
The information provided here is for educational purposes only and is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Individual health conditions and responses to treatment can vary greatly, and the potential uses of medicines as discussed should not be taken as medical guidance or a treatment recommendation. It is crucial to consult with your healthcare provider or a qualified medical professional to obtain advice tailored to your specific health situation. Always seek the advice of your doctor or other qualified health provider with any questions you may have regarding a medical condition or treatment and before undertaking a new health care regimen.
Male Pattern Baldness & Treatment Options
Male pattern baldness is an inherited (genetic) type of hair loss and thinning that is common in adult men. It is also known as androgenetic alopecia. Male pattern baldness involves hair loss that starts at the hairline above the temples and leads to a receding hairline. This is followed by hair loss on the top or ‘crown’ of the head, leaving behind a horseshoe-shaped pattern of hair. While it is commonly seen in older men, male pattern baldness can affect young adult men as well.
Hair loss occurs because of changes to the normal hair growth cycle. In the normal hair growth cycle, most hair stays in a growth phase (known as the anagen phase). This phase lasts for about 3 to 6 years before it falls out and new hair grows in its place. In male pattern balding, hair in affected areas of the scalp has a much shorter growth phase of weeks or months before it falls out. This process results in thinning and bald patches.
Most men can expect some thinning or change in their hair pattern as they age. Usually, hair loss is gradual, but sometimes it can occur in a sudden, dramatic, or otherwise abnormal way. This type of hair loss can sometimes signal an underlying condition or medical problem.
Other types of hair loss can be caused by:
hormone imbalances
autoimmune conditions
infections
radiation therapy
emotional stress
How is male pattern baldness treated?
Outside of hair transplants, shampoos and wigs, male pattern baldness can be prevented and treated through oral pharmacological treatments;
Finasteride:
Finasteride is a 5-alpha reductase inhibitor that targets the conversion of testosterone to dihydrotestosterone (DHT), the hormone responsible for miniaturising hair follicles. By reducing DHT levels, finasteride interrupts the underlying mechanism of hair follicle shrinkage, thereby promoting hair regrowth.
Efficacy:
Numerous clinical studies have demonstrated the efficacy of finasteride in treating MPHL. A pivotal trial spanning over two years showed that approximately 83% of men taking finasteride experienced either hair regrowth or no further hair loss, compared to 28% in the placebo group (Kaufman et al., 1998).
Side Effects:
While finasteride is generally well-tolerated, some men may experience side effects such as decreased libido, erectile dysfunction, and reduced ejaculate volume. These side effects are usually reversible upon discontinuation of the medication. Long-term safety data supports the use of finasteride for extended periods in men with MPHL (Gubelin Harcha et al., 2014).
Minoxidil:
Minoxidil, a vasodilator, was originally developed as an antihypertensive medication. Its exact mechanism in promoting hair growth is not fully understood, but it is believed to enhance blood flow to the hair follicles, prolonging the anagen (growth) phase of the hair cycle and stimulating the hair shaft's diameter.
Efficacy:
Numerous studies have demonstrated the effectiveness of minoxidil in promoting hair growth and slowing hair loss. A meta-analysis by Blumeyer et al. (2011) concluded that minoxidil was significantly more effective than placebo in increasing total hair count and improving subjective assessments of hair growth.
Side Effects:
Minoxidil is well tolerated, but some men may experience oedema (swelling), excessive hair growth on face and increased heart rate.
Combination Therapy:
Using Minoxidil and Finasteride together is the most comprehensive way to combat hair loss. In tandem, they cover two crucial elements in the fight against male pattern baldness: Finasteride tackles the fundamental cause of the condition, whilst Minoxidil boosts your follicular health from the outside.
Importantly, the two drugs are perfectly safe to use simultaneously – and studies have shown that chances of hair regrowth are higher as a result of their combined use.
What happens when you stop taking minoxidil & finasteride?
Both finasteride and minoxidil require ongoing use for sustained benefits, and discontinuing treatment may result in the reversal of the achieved outcomes. This means the level of hair loss will return to your normal biological state as if you didn’t take minoxidil or finasteride.
References:
Male pattern baldness | healthdirect
Hair Loss (Alopecia): Causes, Symptoms, and Regrowth Options (healthline.com)
Finasteride and Minoxidil: The Combo that Beats Hair Loss | Manual
Minoxidil and its use in hair disorders: a review - PMC (nih.gov)