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Male pattern hair loss is the most common type of hair loss in men. It is caused by increased sensitivity in certain parts of the scalp to male sex hormones (androgens). This results in men losing their hair in a very predictable pattern. Hair that remains on the scalp also becomes finer and does not grow as quickly as it used to.
The hormones make the hair follicles from which hair grows shrink or miniaturise. Each time the hair follicle goes through the hair cycle it reduces in size, producing a shorter and finer hair shaft to the previous one. The follicles remain alive, but over time the hair shaft becomes so small that it does not protrude above the level of the skin in the scalp.
The condition usually starts in men aged 20 to 30.
Treatment
There is treatment available that may either arrest or reverse the process of miniaturisation. This means the process of male pattern hair loss can be stopped and in some patients regrowth of hair can be achieved.
Medications
- Minoxidil lotion (Regaine regular strength or Regaine extra strength) is applied twice daily to the scalp. It is not available on NHS prescription, but can be purchased over-the-counter. About 60% of patients benefit from it to varying degrees, however, its effects start to wear off as soon as its application is stopped.
- Finasteride (Propecia) partially blocks the effects of the male hormones (an 'anti-androgen'). It is taken in tablet form. Propecia has been shown to halt further hair loss and promote re-growth of scalp hair in approximately 80% of patients after three to six months. Treatment must be continued to sustain the improvement in hair growth. It is only available on private prescription and a month’s supply costs around £30.
Plastic surgery
Plastic surgery may be the only reliable way to replace lost hair, and techniques for restoring hair growth are constantly improving. The result is very much dependant upon the skill of the surgeon. It is advisable to discuss this with a dermatologist with a particular interest in hair loss.
Hair transplantation
A surgical method of management, where some hair is moved from genetically unaffected donor sites, where the hair is thickest, to the thinning area of the scalp. Micro-grafts may be carried out under local anaesthetic. It is very expensive and time consuming and carries the normal risks of infection and scarring. Factors that determine whether a person is a suitable candidate include age, hair colour, the nature of hair loss, and whether the hair type is straight or curly.
Scalp reduction
A technique that is most suitable for men with a small, well-defined bald spot on the top of the head.
Flap surgery
This involves making the part of the scalp that still contains hair larger. This is a possibility in cases of hair loss over a small area.
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