Male Pattern Baldness / Female Pattern Baldness

Androgenetic Alopecia accounts for 95% of all hair loss. It can affect both men and women although men experience a much greater degree of loss. In women, Androgenetic Alopecia appears as diffuse hair loss occurring over most of the scalp. In men however the pattern of loss usually starts with a receding hairline which then advances to thin the top of the head.

Causes of Androgenetic Alopecia

The male hormone dihydroxytestosterone (DHT), which is converted from testosterone by the enzymes 5 alpha reductase, contributes to Androgenetic Alopecia in those who are genetically predisposed. It is interesting to note that individuals with a deficiency in 5 alpha reductase do not develop Androgenetic Alopecia. This is because the body is unable to convert testosterone into dihydroxytestosterone.

When Androgenetic Alopecia occurs, large active hair follicles in specific areas begin to change to smaller less active ones that shrink slightly with each new growth cycle. This causes the hair shafts to narrow producing progressively finer hairs with each new growth cycle until eventually the hairs become transparent and stop emerging. If an individual has androgenetic alopecia the overall levels of testosterone may be normal; however, the activity of 5 alpha reductase is greater than normal leading to increased amounts of dihydroxytestosterone in the hair follicle.

Treatments for Androgenetic Alopecia

Minoxidil
Minoxidil is the most widely recommended treatment for Androgenetic Alopecia. In the United States topical Minoxidil is marketed under the brand name Rogaine. Minoxidil appears to work by gradually enlarging and lengthening hair follicles which have been gradually shrinking due to Androgenetic Alopecia. The growth phase may also be extended giving the hairs an opportunity to reach a longer length before they fall out. It is necessary to use Minoxidil for about 3-4 months to see evidence of regrowth and up to 6 months to get a proper estimate of whether Minoxidil will be helpful in a particular case. Minoxidil also requires continual use in order to be effective. Once application of Minoxidil is ceased the hair will return to the original state in about 3 months. The two main disadvantages of using Minoxidil is that first of all its use must be continued in order to maintain the results achieved and the second disadvantage is the expense.

Propecia (finasteride)
Propecia is a relatively new drug. It is a tablet which is taken once a day. At this present time, it is only approved for use in men. Propecia is not to be used by women and children. Propecia is a specific inhibitor of type 2 5 alpha reductase which is the enzyme that metabolizes the androgen testosterone into dihydrotestosterone (DHT). In this way Propecia helps to prevent the continued miniaturization of existing hair follicles and also assists in the recruitment of miniaturized hair follicles to become terminal hairs. Like Minoxidil, Propecia must be taken for a period of 3 months or more before any benefit is seen, and it must be continued in order to maintain any benefits gained. Propecia is also expensive to maintain.

Additional Treatments for Female Pattern Baldness

Cimetidine
Cimetidine is sold under the brand name Tagamet. It is commonly used to reduce secretion of acid in the stomach and to treat stomach and duodenal ulcers, inflammation of the esophagus and other digestive disorders. However, it also has a anti androgenic effect. Men however should not use Cimetidine to treat hair loss because of its feminizing effects.

Spironolactone
Sprironolactone is commonly used to treat high blood pressure. However it also acts as an anti-androgen.