Androgenetic alopecia (AGA), the most common cause of hair loss (alopecia), requires both a genetic predisposition and the presence of androgens to manifest.
This type of hair loss is also called male pattern hair loss and causes loss of hair on top of the scalp and a receding hairline in affected men. It usually begins in men in their 20’s and the incidence increases by 10% for every decade. Men who start balding at an early age are more likely to lose more hair. Up to 25% of men start balding before the age of 30, and almost 70% are completely bald by the age of 60.White men have as high as an 80% chance of going bald.
It has been noted that castrated men do not become bald. A balding scalp contains miniaturised hair follicles and increased amounts of dihydrotestosterone (DHT) compared to a hairy scalp. This suggests that it is the excess presence of DHT in the scalp tissue that causes AGA in those patients genetically predisposed. DHT gradually shrinks the length and caliber of genetically programmed hair follicles – this is called miniaturisation.Each hair cycle, the hairs get smaller and finer.
Testosterone is broken down by an enzyme called 5 alpha reductase to the more potent DHT. Men with male pattern hair loss have higher quantities of 5 alpha reductase in their scalp follicles.
So the aim should be to reduce the breakdown of testosterone to DHT, to reduce hair loss. Here are the options:
1.DHT Inhibitors work to inhibit the binding of Testosterone and 5-Alpha Reductase. These include Finasteride, Dutasteride, and Progesterone creams. Dutasteride and Finasteride are used to treat Benign prostatic hyperplasia (BPH/Prostate enlargement) in men. Men who suffer from BPH, also have increased levels of DHT and 5-alpha-reductase Dutasteride inhibits the activities of two types of 5-alpha-reductase enzymes, Finasteride only inhibits one type. Dutasteride is more powerful and faster-acting for hair loss than Finasteride.
Dutasteride should not be used by women and chidren, and pregnant women should not even touch the medicine in case it is absorbed through the skin. Men who use it should not donate blood until 6 months after they have finished, to prevent pregnant women from being exposed to the medicine through a blood transfusion. If you have liver disease, you need to talk to your doctor before taking Dutasteride.
Dutasteride’s side effects include sexual adverse experiences. It also affects PSA levels, which is the screening indicator for prostrate cancer
2.Some vitamins inhibit the activity of 5 alpha reductase – zinc, vitamin B6, and azelaic – combined use causes a 90% inhibition of 5 alpha reductase activity.
3.Antiandrogens stop DHT from binding to the Androgen receptor. Saw Palmetto extract is an effective herbal anti-androgen that blocks 5 alpa-reductase and the receptor sites required for cells to absorb DHT. Saw Palmetto is also used in the treatment of benign prostatic disease. Saw Palmetto can be taken with zinc, vitamin b6, and azelaic acid for a synergistic effect.
4.Growth Stimulators artificially stimulate growth.
5.Super Oxide Dismutase (SODs) have anti-inflammatory properties, that stop the hair from falling out, as well as growth stimulation properties. Other anti-inflammatories reduce the inflammation, itching, and flaking which can make hair loss worse, if not controlled.
It takes years for hair to thin. It can take months before you notice an improvement. Areas that are completely bald may not grow hair, if the follicles are dead. The aim is to prevent the hair loss from getting worse.
Have you or the man in your life suffered from male pattern baldness? Please share your experiences with other readers, especially about any of these medications below.
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