Male Pattern Baldness
(Androgenetic Alopecia)

This article is published for general information. Professional advice should be sought.

Androgenetic Alopecia (termed 'Male Pattern Baldness'). This familiar permanent baldness located within the hat line in males is associated with the conversion of the androgen testosterone into di-hydro-testosterone (DHT) by the enzyme 5 alpha reductase. This is a multi-factorial condition in which genetic predisposition + DHT are the key factors in initiating a cyclical reduction of the anagen (hair growing) phase with progressive miniaturisation of follicles and their encumbent hairshafts. Follicles effectively 'shrink' and produce only fine vellus hairs.
In some patients, regional hair characteristics change also. Previously long straight hairshafts at the scalp’s occipital and auricular margins become short wavy and wirey - similar to beard/pubic hair.

Caucasoids have a higher susceptibility than Afroids or Mongoloids.
The Eunuch (post-pubertal castrated male) does not suffer this form of alopecia.

Over the years, many ‘treatments’ for this condition have emerged. Indeed rarely full a year passes without the announcement of more miraculous hair re-growth pills/potions/gadgets.
To date the best have been less than edifying, the majority have been useless.

However science moves on and we live in hope that the next 'cure' will be efficacious.

Research is currently reconsidering the existing anti-androgen medication Spironolactone administered topically.
This drug possesses the following properties:
It is a potent anti-androgen but does not apparently interfere with proper testosterone levels.
Applied topically it apparently does not have systemic side effects.
It is a potent competitive inhibitor of DHT at receptor sites and therefore effectively prevents DHT from attaching to the receptor sites in the hair follicles.
It is anticipated that follicular anagen may increase thereby allowing terminal hair growth to resume without decreasing the circulating levels of DHT.

Current Treatment Options:

Medicines which may assist some people - not everyone !
I)   Finasteride (Propecia).
2)   Minoxidil.
3)   Dutasteride (Avodart™)

Hair Restoration Surgery performed by the right expert remains a practical option.

This surgical redistribution of scalp hairs currently offers the best overall prospect for patients fortunate enough to have generous numbers of donor hairs.
Surgically implanting the individual's 'cloned' hair follicles will be an option within a few years.

Hair Restoration Surgeons will be recommended at consultation.
Wigs and hairpiece suppliers will be recommended at consultation

The Norwood-Hamilton Scale (categories numbered 1-7) is used below to describe the level of development of MPA.

Male pattern hairloss may or may not travel through each of these stages, the development may stop at any time.

 

© B Stevens FTTS    Contact the author