Dr. Jacqueline Gerhart: How Can He Stop Hair Loss?
Madison, Wisconsin - UW Health Family Medicine physician Jacqueline Gerhart writes a column that appears Tuesdays on madison.com and in the Wisconsin State Journal. Columns are re-published here with permission.
Dear Dr. Gerhart: I'm a guy in my 30s and I've been trying Rogaine for my hair loss. It's not working. What else should I try? I started having a receding hairline when I was 27. Does that mean I have bad genes?
Dear Reader: While turning gray or losing one's hair can be seen as a sign of wisdom, for many it can cause significant anxiety. There are many items on the market to treat hair loss, but first you should figure out what is causing you to have thinning hair.
Most often, baldness is related to genetics and aging. However, in some cases there can be an underlying medical reason, such as a hormonal imbalance or an infection. Check with your primary care provider to determine if you need further testing.
If your physician cannot find an underlying cause, you likely will be diagnosed with "male-pattern baldness." The medical term for this is "androgenic alopecia." About 95 percent of men with thinning hair have this diagnosis. They notice a receding hairline from both sides of the forehead or thinning hair at the crown of the head. Some people have hair loss in both areas, resulting in a "horseshoe" band of hair (think George Costanza on "Seinfeld").
Male-pattern baldness affects 35 to 40 million men in the U.S. About 25 percent will start balding before age 30, while 50 percent will be balding by age 50 and 75 percent will be balding by age 80.
This is mostly determined by genetics. People often say baldness is inherited from the mother's side of the family - if your mom's father (your maternal grandfather) is or was bald, then you will likely be as well. In reality, "baldness genes" can come from either side of your family. If your father is bald, it's possible your baldness is coming from one of his genes, but if your dad has a full set of hair, then it could be coming from your mom.
One gene specifically related to male-pattern baldness is the "androgen receptor" gene (AR gene), which you get from your mother. This gene allows your hair follicles to respond to androgens, or sex hormones, which stimulate hair growth.
So what to try? Rogaine's main ingredient is minoxidil. You rub it on your scalp and it stimulates the hair follicles. Unfortunately, it only works as long as you use it, and hair loss returns when you stop.
Another option is finasteride, also called Propecia or Proscar. This is a pill you take daily, which decreases the hormone dihydroxytestosterone (DHT), associated with hair loss. This medication also is used for prostate problems, and is prescription only.
Another option is hair transplants, where plugs of hair from other hair-bearing areas are removed and surgically attached to the head. Risks of this include scarring and infection, but the results can be very good.
There also is some evidence that vitamin deficiencies can cause worsening of hair loss. Be sure to eat a balanced diet, and consider taking a multi-vitamin daily.
Finally, if you can't beat 'em, join 'em. Embrace your hair loss. Accessorize with hats. Draw attention away from your scalp with facial hair.
Or shave your head. Numerous TV personalities, sports figures and musicians who are balding choose to shave their heads, which can provide a handsome and athletic look. Mr. Clean is rather dapper, if I say so myself. Perhaps try the look minus the large gold earring!
This column provides general health information and is not specific advice intended for any particular individual(s). It is not a professional medical opinion or a diagnosis. Always consult your personal health care provider about your concerns. No ongoing relationship of any sort (including but not limited to any form of professional relationship) is implied or offered by Dr. Gerhart to people submitting questions.
Date Published: 05/29/2012