Male Hair Loss Treatments

Most people think of hair loss as a distinctly male health problem and associate it with the typical horseshoe balding pattern. Women also lose their hair but they seldom develop completely bald areas like men do. Hereditary form of hair loss, also known as male pattern baldness, affects about one third of men (40% according to some statistics) at some stage in their lives. Its onset and severity are individual but the cause is always the same. It is dihydrotestosterone (DHT), a natural metabolite derived from the male hormone testosterone. DHT is biologically much more active than its precursor - testosterone. DHT binds to the receptor sites at hair follicles, causing damage to genetically susceptible follicles. In men it is usually only hair follicles in the frontal and midscalp area and in the crown that are susceptible to these attacks. The result is a gradual miniaturization of affected follicles and their eventual decay. Affected hair follicles start producing thinner and shorter hairs until they cease producing hair at all. The most effective hair treatments address this problem either by reducing the amounts of DHT in the body through blocking the conversion of testosterone into DHT or by binding to the receptor sites in hair follicles and thus competing there with DHT.

FINASTERIDE: The best known hair loss drug from the category of DHT blockers is finasteride. Finasteride was in the late 1990s approved by the FDA for treating hair loss in male patients under the trade name Propecia. This antiandrogenic drug was originally used to shrink enlarged prostates affected by benign prostatic hyperplasia (BPH) as this condition is also caused by the harmful activity of DHT on certain cells in the prostate. Propecia was clinically proven to reduce hair loss in about 80% of balding men and it was shown to spur renewed hair growth in about one third of balding men. Although thousands of male hair loss patients buy finasteride online, Proscar and Propecia (the drugs using finasteride as their sole active substance) are in most countries only available at prescription from urologist. Due to its androgenic properties finasteride can cause some feminizing side effects in about 1.5% of male patients. It has to be taken once daily for as long as you wish to keep your hair. Some patients take only half a pill a day in order to avoid negative side effects as several recent studies indicated that a dosage of 0.5mg daily can reduce the levels of DHT in the body almost as much as 1mg while significantly reducing the risk of negative side effects. Topical application of finasteride has not been approved for treating hair loss yet as no conclusive proof of its effectiveness exists.

DUTASTERIDE: Another DHT blocker which has been clinically tested for treating male pattern baldness is dutasteride. It went through all three phases of clinical testing but its originator has not submitted the application to the FDA to this date. Nevertheless, some hair restoration doctors prescribe dutasteride off-label to those patients who do not satisfactorily respond to finasteride. Dutasteride (trade name Avodart) is an antiandrogen drug similar to finasteride and it is currently only approved for treating BPH. Preliminary results of its clinical study showed that it is more effective in protecting hair follicles from DHT attacks in the frontal scalp area than finasteride but the biggest worry are its side effects. Dutasteride stays much longer in the human body than finasteride and thus it is assumed that its side effects might be longer lasting and possibly also more severe. The clinical study, however, has not confirmed this assumption, judging by the available preliminary data.

NATURAL DHT BLOCKERS: Since the discovery of finasteride's protective effects on hair follicles, herbalists started looking for natural substances that have been in the past used in the folk medicine to treat enlarged prostates and examining their effects on hair loss. The best known amongst the herbal substances for being used not only to treat prostate problems but also hair loss is saw palmetto. Extract from saw palmetto berries has been studied extensively for its effects on enlarged prostates but no conclusive proof exists that it helps shrink them. Therefore, it is even less well proven to protect hair follicles from shrinking. Despite that saw palmetto is often mentioned as the most powerful ingredient in numerous natural DHT blockers used for treating hereditary baldness in men. Other natural substances that are believed to act as DHT blockers and thus often used in natural hair loss cures are pygeum africanum and nettle root extract. As is the case with saw palmetto, no scientific proof exists confirming their positive protective effects on hair follicles.

The second possible mechanism through which an antiandrogen drug can protect hair follicles from DHT attacks is by binding to the receptor sites at hair follicles. By doing so, it can crowd out DHT and thus prevent it from interacting with hair follicle cells and damaging them. There are several antiandrogen dugs that can do this such as flutamide, spironolactone or cyproterone acetate but these drugs posses very strong feminizing effects and their oral use by male patients for treating hair loss should better be avoided. However, spironolactone (generic Aldactone) is sometimes recommended to male patients who cannot take Propecia in the form of topical cream to treat hair loss.

Another type of drugs used to treat baldness are the so-called hair growth stimulants. They do not protect hair follicles from DHT like antiandrogen medications mentioned above, they promote new hair growth by various other mechanisms.

MINOXIDIL: The best known hair growth stimulant and one of the most popular hair loss drugs is minoxidil (trade name Rogaine) which is applied twice daily topically to the balding scalp areas. Minoxidil was the first drug ever to get approved by the FDA for treating hereditary form of baldness in the early 1990s. To this date minoxidil is considered to be the most powerful hair growth stimulant available and the most effective topical hair loss treatment. Minoxidil is a vasodilator, originally used in oral form to treat high blood pressure that was later found to promote new hair growth. However, its exact mechanism of action on hair follicles is not known. It is available as a lotion and foam, with foam being easier to use and a more effective form of treatment. Concentration of minoxidil that was approved by the FDA for treating hair loss in men is 5% but generic lotions containing up to 20% of minoxidil exist.

There are a couple of other possible hair growth stimulants which have been studied for treating hair loss recently but none of them was proven to be superior to minoxidil. Ketoconazole 2% (it can be found in the antidandruff shampoo Nizoral) and aminexil 1.5% (developed by L'Oreal is a similar chemical to minoxidil) have been shown to promote new hair growth with about the same effectiveness as minoxidil 2% so they are relatively weak hair growth stimulants and are usually only recommended to patients who for some reason cannot use minoxidil.

As regards other popular substances that one can find in hair loss treatments today such as fluridil (Eulexin), procyanidins or beta-sistosterol, it is hard to say how they work and classify them either as DHT inhibitors or hair growth stimulants. However, these substances, though being quite popular now, are not believed to be nearly as effective as the hair growth stimulant minoxidil and DHT blockers finasteride or dutasteride.