A Gentlemen's Guide On Navigating Hairloss

Male pattern baldness, also known as androgenetic alopecia, affects approximately half of all men by the age of 50.

It's estimated that about 30% of men experience it by the age of 30, 40% by age 40, and so on.

The distress and anguish caused by hair loss can lead to significant mental health problems for some men, yet the issue is often not discussed openly due to societal stigma and perceptions.

It's important to recognize that while many men might adapt and embrace their hair loss, others might find it more challenging. For those men, here are a few options:

1. Ketaconazole Shampoo: It works by causing a mild reduction in DHT (Dihydrotestosterone), the primary hormone that contributes to hair loss. The exact mechanism isn't clear but it's known that using Ketoconazole shampoo 2-4 times per week with a scalp contact time of about 3-5 minutes can maintain hair that would otherwise be lost.
   

2. Microneedling — involves causing micro damage and micro levels of inflammation to the scalp, which can stimulate growth. This is because all cells in our body can respond to both chemical and mechanical cues. The micro-damage and inflammation caused by microneedling can remind the cells in the area that they need to stay alive to replenish whatever is lost.
   

3. Minoxidil, originally developed as a hypertension drug, helps with hair loss by increasing blood flow to the hair follicles. his increased blood flow delivers more oxygen and nutrients to the hair stem cells, which are crucial for hair growth.

   
   Specifically, minoxidil extends the anagen phase of hair growth, which is the active growth phase. This is why it's often used to slow rates of hair loss, particularly in people who are just starting to experience hair loss.

   
   However, it's important to note that minoxidil alone may not be sufficient for those who are losing their hair quickly or have already lost a significant amount of hair.

   
   The dosage of minoxidil is also crucial, with ranges for oral minoxidil from 0.25 milligrams to 5 milligrams per day, and topical solutions typically at a 5% concentration used once or twice daily.
   

4. PRP Therapy

   
   PRP involves drawing a person's blood, spinning it to separate different components within the blood, and then taking the platelets and reinjecting those in a solution back into the scalp.

   
   When PRP injections are made into the scalp, they can potentially support hair growth. This is because the platelets are rich in growth factors that can stimulate the activity of the hair follicles and promote new hair growth.

   
   However, it's important to note that the success of PRP treatments can be transient and the treatments can be expensive. There are not sufficient clinical data to suggest PRP as a universally effective treatment for hair loss.
   

5. Finasteride

   
   Finasteride helps with hair loss by inhibiting an enzyme called five alpha-reductase, which is responsible for converting testosterone into dihydrotestosterone (DHT).

   
   DHT has a negative impact on hair follicles, leading to hair loss. Finasteride reduces DHT, and in doing so, it can increase hair count by as much as 20% and reduce hair loss in 90% of all people who take it.

   
   It's also known to increase hair thickness by about 20% to 30% overall. However, it's important to note that finasteride can have significant side effects if not dosed properly, and these side effects can be more pronounced in certain populations.
   

6. Dutasteride

   
   Dutasteride is a molecule similar to finasteride, and it works by inhibiting the five alpha reductase enzymes, which in turn reduces DHT, a hormone that negatively impacts hair follicles.

   
   Unlike finasteride, which mainly inhibits one type of this enzyme, dutasteride inhibits all three types, making it more potent. As a result, dutasteride can work two to five times faster than finasteride at inducing hair regrowth and can reduce DHT by up to 95%.

   
   However, it's important to note that dutasteride is associated with a number of side effects related to the DHT pathway, such as a reduction in sex drive and overall drive, and it can also impact other hormone pathways.
   

7. RU58841

   
   RU58841 is an experimental drug that acts by binding to the androgen receptors in the scalp and competing with DHT.

   
   Unlike systemic treatments that affect the entire body, RU58841 is applied topically, which means it less minimal systemic side effects.

   
   However, it's important to note that it is not FDA-approved and its long-term safety and efficacy has not been established through extensive clinical trials.
   

8. FUE Hair Transplant

   
   FUE hair transplants involve individually extracting hair follicles from a donor area of the scalp, usually, the back or sides where hair is more resistant to balding, and transplanting them to areas that need more density.

   
   The goal of FUE is to create a hairline and hair density that looks natural. The results are permanent, as the transplanted hair follicles retain their resistance to the DHT hormone responsible for hair loss.

   
   However, FUE does not prevent any future loss from occurring so using it in combination with other treatments is ideal.

In conclusion, while each of the treatments discussed offers its own set of benefits, it's crucial to understand that there is no one-size-fits-all solution. The reality for most men facing androgenetic alopecia is that a combination of treatments may be necessary to achieve the desired results.

Whether it's integrating a daily regimen of Minoxidil with periodic PRP sessions, combining the hormonal impact of Finasteride with the mechanical stimulation of micro needling, or following up a FUE hair transplant with maintenance treatments, the key lies in personalizing the treatment plan. It's essential to consult with healthcare professionals to tailor a combination that suits your specific condition, lifestyle, and goals.

Ultimately, the journey to managing hair loss is as unique as the individuals experiencing it. By staying informed and open to a range of therapies, men can navigate this path with greater confidence and a higher chance of success.