Medical treatment of hair loss due to Male Pattern Baldness has until recently been completely unsuccessful. Nonetheless a range of “cures” and “treatments” with no scientific evidence continue to be promoted in advertisements in the press by non-medical clinics and many people continue to try them in the hope that they might have some effect. A popular misconception is that “natural” remedies (i.e. one’s that haven’t been developed by medical scientists but occur naturally in nature) are both effective and safe. The fact that new “natural remedies” are promoted every year suggests that the older remedies haven’t been too successful. The proper place to start investigating the treatment of hair loss and baldness is the doctor’s surgery. Two medical treatments- Finasteride (Propecia) and Minoxidil (Regaine) have revolutionised the treatment of baldness and created a new era where, for many men and women, hair loss (including baldness) is an option rather than a necessity.
Finasteride (Propecia) a new oral medication by prescription only, has been recently released to the market. Scientific studies over the last 5 years have shown that it can re-grow hair in up to 66% of men (of which 36% would be regarded as significant re-growth) and that it can stop hair loss in over 80% of cases. Finasteride is an enzyme-blocking agent that prevents the conversion of testosterone (the principal male sex hormone) to dihydrotestosterone (DHT). The amount of the enzyme 5 alpha reductase that occurs in the hair follicles in the scalp seems to be genetically determined and influences both the amount of hair loss and the age at which this occurs. It is remarkably safe having been used on men with enlarged prostate glands for over 11 years with no serious side-effects. Less than 1% of patients report any sexual performance side effects which are mild, often only transient, and can be reduced by taking the drug on an intermittent basis (e.g. taking the tablet every 2nd or 3rd day). Finasteride (Propecia) works best for early or moderate hair loss with all the scalp hair responding to prevention of balding. Reversal of hair loss works best in the crown, probably because hair is lost earlier in the frontal region and is more advanced here by the time treatment begins.
All patients who may benefit from this treatment are offered Finasteride (Propecia) at the initial consultation. A combination of this medicine and hair replacement surgery may provide the best outcome in many patients.
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