August 15, 2019

What’s causing my hair loss doc?

One of the questions I get asked most by my male clients in my clinic is: “Doctor, what’s causing my hair loss? Is it my lifestyle? Is it the extra stress that I’m under at work, is it because I eat too much instant noodles or smoke too much?”

It is true that our lifestyle plays a critical role in our overall wellbeing. Hence we cannot over emphasize the importance of getting sufficient sleep, eating a balanced diet, managing stress levels and cutting down on cigarette smoking and alcohol. However, the 1 biggest thing that affects our hair, is not so much what we do, but rather it has to do with our genes. That’s right. Our genes have already programmed how our hair will grow and respond to hormones in our bodies. Unfortunately for some, their hairs react to a hormone called Dihydrotesterone (DHT). DHT can negatively impact the scalp hairs on the top of the head. Gradually over time, the hairs start to miniaturize and we start to experience male pattern balding. The affected hairs grow slower compared to our normal hairs, giving our head a flatter appearance up top or a receding hairline, but the side hairs grow faster, so our heads appear wider. So where does this DHT come from? It is originally converted from the male hormone testosterone by the enzyme 5-alpha reductase. If only there was a way to block DHT formation or at least to lower it, then logic follows that the hairs will stop thinning. And thankfully, there are 2 such medications that have been shown to do just that.

Introducing finasteride and dutasteride. These 2 medications are known as DHT blockers. They effectively reduce DHT by 70% and 100% respectively. This means that the DHT that is causing male pattern hair loss is no longer present or at least not as high a level as previously, giving hair a chance to regrow. As long as the hair follicles have not been permanently lost, there is a good chance the hair follicles will thicken back up to a certain degree. This is a great way to reverse early to moderate male pattern hair loss and a great way to maintain existing hair and prevent them from thinning further. Therefore, our advice is to seek treatment early before it is too late.

Propecia (finasteride, USA FDA approved for hair loss) or Avodart (dutasteride, KFDA approved for hair loss) are taken orally as a daily pill. It takes at least 6 to 9 months to see results: 3 months to slow any further hair loss, 3 months to grow new hairs, 3 months to show new thicker hair growth. So be patient and be consistent.

There are reports of men experiencing sexual side effects with this medication. In published data, the incidence ranges from 4 to 10%. The side effects are usually reversible, although a very small proportion of men report persistence of symptoms. In our clinical experience, the incidence of side effects is closer to 4%, with most patients having no side effects except for thicker fuller hair. Propecia or Avodart are not known to affect a pregnant partner so it is safe to continue taking the pill even when your partner is pregnant. Some patients choose to temporarily stop the medication and use an alternative like minoxidil until their partner have given birth. This is entirely up to them and do discuss this with your gynecologist or hair doctor.

After more than 20 years in the market, Propecia or Avodart remain the most effective way to combat male pattern hair loss medically. Apart from other options like minoxidil or a hair transplant, this is the most effective way to maintain your crowning glory. Speak to an experienced hair doctor for more information.

Think Hair, Think Dr. Harold

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