Best Treatments for Receding Hairline in Men

In today’s post, we will discuss on receding hair line in men, what causes this and the best treatments to treat receding hairline.

Receding Hairline in men can start any time after puberty. It is one of the first signs of male pattern baldness and can be caused by a variety of factors like:

  1. Age: Most men in their 30’s have a receding hairline. But for some men, it can start very early and can be the first sign of male pattern baldness.
  2. Family History: The Genes play the most important role in male pattern baldness and receding hairline.
  3. Hormones: Dihyrotestosterone, in short DHT is the main hormone responsible for causing the follicles to shrink or miniaturise them initially and then it completely kills the follicles and no hair can grow in them anymore. More than DHT hormone, the sensitivity of hair follicles to DHT is the major concern which is again genetically determined.

Let’s discuss the treatment options for a receding hairline. There is no instant cure for receding hairline and baldness. The medical treatment aims at reviving the shrunken hair follicles back to normal, but cannot revive the hair follicles that are already dead!

On #1: Changing Hair Styles or growing longer hair in the frontal region can be a temporary solution to make your feel confident and positive!

On #2: Minoxidil: This is an over-the-counter scalp solution to help slow the rate of hair loss. The effects typically last as long as a person uses the treatment, but baldness will return once a person stops using it. You can start with 2% or 5% minoxidil solution once daily or twice daily depending on the severity of hair loss.

On #3: Finasteride, 1 milligram daily is the best medical remedy to block DHT and hence can bring back a shrunken hair follicle back to life. But remember, It may not work if the hair loss is more than an year old, because the follicles in the bald patch have no life.

On #4: Laser therapy using a red light or laser at a wavelength of 660 nanometers may also increase hair growth in some people.

On #5: Hair Transplantation: This is a permanent solution to solve the problem of receding hairline. Before you undergo this procedure, you have to opt for either FUE or FUT method and also choose the best possible clinic with sophisticated robotic surgical device like the ARTAS system for best results.  We have discussed Hair Transplantation in detail in another post.

 

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Body building and Hair loss | Creatine and Baldness

In today’s post we will answer two frequently asked questions on hair loss in men – Does body building cause hair loss and do creatine supplements for body building lead to baldness.

Having done so many episodes on DHT and hair loss, most of you may develop misconceptions that DHT – Dihydrotestosterone is some evil androgen hormone that serves no purpose in the body but to make our prostates bigger and cause baldness. But infact the actual situation is much more complex. For some people, reducing or eliminating DHT may be the only concern but for some other people keeping DHT levels under control may be the best option.

To understand whether body building causes premature baldness, You need to know the differences in the functions of DHT – dihydrotestosterone and its precursor Testosterone.

To quickly sum up DHT is biologically important for:

  1. Sexual differentiation into a male foetus during embryogenesis,
  2. Maturation of the penis and scrotum at puberty,
  3. Growth of facial and body hair after puberty.
  4. Development and maintenance of the prostate gland and seminal vesicles.
  5. Lastly the negative one: That’s Receding Hairline and Male Pattern Baldness by gradually miniaturizing the hair follicles.

DHT – Dihydrotestosterone is produced from the prohormone testosterone by the action of enzyme 5α-reductase in selected tissues, like in the genitals, prostate gland, seminal vesicles, skin, and hair follicles.

Now, Let’s quickly sum up the Functions of the hormone Testosterone. It’s important for:

  1. Sperm production and Male Fertility
  2. Muscle and Bone development – Remember this.
  3. Voice Deepening from puberty onwards
  4. Acne and sebum production
  5. Libido and Erections.

You can clearly see Testosterone is important for Muscle and bone development function. It is also important to understand that even though testosterone is the active androgen in muscle, and DHT exhibits relatively little direct anabolic effects on muscle in men, DHT is still very important for the full performance enhancement effects from testosterone. What I specifically mean here are the effects of DHT on the central nervous system that lead to increased neurological efficiency (strength or power of muscles), and it’s also important for increased resistance to psychological and physical stress and finally for optimal sexual function and libido. Hence you notice adverse effects of DHT blockers like finasteride on long term use in a small percentage of hairloss patients.

Now let’s Answer the question – Why do most body builders get bald early?

There are bodybuilders who do not use steroids or exogenous testosterone and build muscle naturally, And then there are professional bodybuilders who use a muscle building drugs that are high in testosterone.

Natural ways of body building like lifting heavy weights and weight training programs increase the circulating testosterone levels and help in muscle development. But anything in excess is converted to DHT and may cause some hair loss. But according to studies High levels of testosterone specially the exogenous formulations or steriods can cause increase in levels of DHT (Dihydrotestosterone) which can induce premature male pattern baldness in body builders.  But remember, baldness is multifactorial, the most important factor being your genes.  Remember those with DHT sensitive hair follicles and not everyone will go bald and this is genetically programmed.

Now, the next question: Do Creatine supplements for muscle building cause hair loss?

Creatine is one of the most widely used bodybuilding supplements. It’s naturally found in animal products like red meat, but can be easily purchased as a supplement from any drug store. Many studies have shown creatine to increase muscle strength and athletic performance.
A 2009 study published in the Clinical Journal of Sports Medicine says that creatine may increase the conversion of testosterone to dihydrotestosterone (DHT) and may accelerate male pattern baldness in genetically predisposed individuals. Remember, Creatine in addition to hair loss can cause kidney failure in many body builders.

 

References:

https://www.ncbi.nlm.nih.gov/pubmed/19741313

https://academic.oup.com/edrv/article/38/3/170/3861397s

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10 GOOD AND 4 BAD Functions of DHT Hormone (Di-Hydro-Testosterone)

In today’s post we will look into the positive and negative effects or functions of DHT – Dihydrotestosterone in our body.

We have done so many posts and videos on DHT and hair loss and most of you may develop misconceptions that DHT is some evil androgen hormone that serves no purpose in the body but to make our prostates bigger and cause male pattern baldness

Let’s First look into the 10 Positive effects of DHT and lastly the Negative effects. All research article links related to this topic are provided in the description link below.

  1. During Embryogenesis or Foetus development, DHT is needed for sexual differentiation into a male foetus.
  2. During Puberty, DHT is critical to the development of the penis and prostate in men.
  3. After Puberty, DHT is essential for development of male features like body hair,facial hair, pubic hair, muscle growth, and a deep voice.
  4. In Adults, DHT is essential for the development and maintenance of the prostate gland and seminal vesicles and contributes to the volume of semen.
  5. Libido and Erections: Here there are lot of controversies that the primary hormone needed for the drive and erections is testosterone and not DHT. But the fact of the matter is DHT is also important due to its effects on the central nervous system that provides increased neurological efficiency (strength), and increased resistance to psychological and physical stress. Hence we notice depression and loss of libido in a small percentage of patients treated with DHT blockers like finasteride for hair loss.
  6. Blood Sugar Control and Obesity: According to a study, it may lower blood sugar levels in type 2 diabetes in males with improved insulin-sensitivity and reduces the body fat and controls obesity.
  7. Improves Memory: A study showed Men between the ages of 34 and 70 showed improvements in memory when treated with DHT skin patches.
  8. Muscles and Bones: Studies have shown that DHT levels correlate with the Muscle Power as well as muscle mass, though the main hormone responsible for muscle and bone development is testosterone. And increased DHT levels are associated with higher bone density in men.
  9. Heart and DHT: Increased levels of DHT were associated with lower amounts of fat deposits in the hearts and coronary arteries of men and hence lesser chance of a coronary artery disease.
  10. Depression and Anxiety: The anti-anxiety effect of DHT and testosterone are due to the actions of DHT on the central nervous system. This is the reason why DHT blockers like finasteride may induce depression in as small percentage of hair loss patients on long term use.

Now let’s List out the Negative or Harmful effects of DHT on our body.

  1. Male Pattern Baldness or Androgenetic Alopecia. Yes as discussed in our previous episodes, its proven that Higher levels of DHT act on the DHT receptors located on hair follicles in scalp and cause miniaturization of the hair follicles and ultimately kills the hair follicle. Of course this depends on the sensitivity of hair follicles on DHT and your genes.
  2. Acne and excessive sebum production is due to increased levels of DHT.
  3. Prostate Enlargement and Cancer: Many studies have proven this. Though DHT is required for the normal development and maintenance of the prostate gland and the seminal vesicles, it’s also responsible for benign enlargement of prostate (BPH) and also prostate cancer.

REFERENCES:

https://www.ncbi.nlm.nih.gov/pubmed/28472278

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2096617/

https://www.ncbi.nlm.nih.gov/pubmed/27133133

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3433349/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2701485/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4364836/

https://www.jstage.jst.go.jp/article/endocrj/62/9/62_EJ15-0196/_pdf

https://www.ncbi.nlm.nih.gov/pubmed/20043171

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3158152/

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STAGEWISE MEDICAL TREATMENT OF MALE PATTERN BALDNESS

In Today’s post, we will help you locate your stage of baldness on the international Norwood’s scale and suggest medical hair loss treatments for every stage for reversing baldness stage-wise backwards!

Will will not go into the science and mechanism of male pattern baldness in this video. We have discussed all these in our previous episodes.

Let’s get started!

Baldness is staged commonly using the International Norwood’s scale, the hair loss stages are described with a number ranging from 1 to 7 depending on the severity of hair loss.

Let’s start with:

Norwood Stage 1: This type describes the least amount of hair loss with an adolescent type of hair line. You can consider this normal unless you have a family history of male pattern baldness.  If you have a family history closely monitor your hairline to determine if your hair loss develops into stage 2.  And No Treatment is necessary at for stage 1.

Norwood Stage 2: This stage means a small amount of hair loss with progression to the adult type of hair line.  Here there is slight recession of hair line around the sides or temples.
Regarding Treatment for this stage. If you have family history, first consult a doctor to verify that your hair loss is caused by male pattern baldness. There is a good chance that, with treatment, you can regain most of your lost hair and prevent progression into stage 3. You can start with simple treatment like 2 percent topical minoxidil application at this stage or start rolling a 0.5mm derma roller once a week with or without minoxidil solution. You can check out my detailed post on derma roller for hair loss.

Norwood Stage 3: This stage describes a mild to moderate amount of hair loss. This is the earliest stage of hair loss considered cosmetically significant enough to be called “baldness” according to Norwood scale. At this stage, most men show a deep bilaterally symmetrical recession of hairline at the temples that is sides, which are either completely void of hair or only sparsely covered with hair.  This resembles letter M, U, or V shape. The vertex figure here shows the additional thinning of the hair at the crown of the head.
This is the most important stage of norwood, because you must start treatment as early as possible to prevent progression into stage 3. Remember, The higher the stage, the more difficult the treatment is.

Well, the treatment options at this stage, you may require a combination therapy like minoxidil 5 percent twice daily plus finasteride 1 mg tablet. This stage is stubborn for most people. If you are able to control or grow back hair at this stage, the baldness progression is generally slowed down in later part of your life.
Also the other treatment options you can consider at this stage are PRP and mesotherapy along with minoxidil. You can watch my detailed post on this PRP mesotherapy.

You can also consider Hair transplantation treatment at any stage from stage 3 onwards.

Norwood Stage 4: This stage describes a moderate amount of hair loss. At this stage there is further deepening and recession at the front of the head as well as the temple areas. Hair loss at the crown is also prominent now and a thick bridge of hair will separate hair loss at the front of the scalp from that at the vertex or the crown of the head.  To differentiate this from stage 3, you can draw an imaginary vertical line tangential to the front margin of the ear. If hair loss crosses behind this line, then is stage 4.
Regarding the treatment options at this stage, there is no guarantee that using all the treatments including finasteride, minoxidil or a combination therapy will bring back all your lost hair. But the good news is if you start early treatment, the miniaturized hair will come back to normal and you can switch back to stage 3. You might have to use minoxidil in a higher concentration like 10 percent plus finasteride 1mg daily indefinitely.  Please check my article on DHT to understand this miniaturization and the mechanism of hair loss.

You can also treat this stage with PRP and mesotherapy plus Stem cell therapy and consider hair transplant option at this stage too.

 

Norwood Stage 5: this stage marks the beginning of severe degree hair loss. In this stage, there remains only a thin separation between the loss of hair at the hairline and the loss of hair at the crown, the band of hair between the two is much thinner and narrower. Hair loss at both the crown and the temporal regions are larger and more distinct.   The treatment options at this stage are same as that in stage 4.

 

 

Norwood Stage 6: In this stage there is a large amount of hair loss. The bridge of hair that once separated the front of the head from the crown is now almost fully lost, only a few sparse strands may remain. The remaining hair now forms a horseshoe shape around the baldness concentrated in the center of the scalp. Hair loss on the sides of the head will also extend further at this stage.
At this level, a hair transplant may be the only option.

 

Norwood Stage 7:  The most advanced stage of hair loss, Here, only a wreath of thin hair remains on the sides and back of the scalp. This stage has the least chance of regaining your hair with any treatment.

 

 

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5 BEST TOPICAL MINOXIDIL COMBINATION HAIR LOSS TREATMENTS

In Today’s article, we will discuss on the best combination treatments for hair loss in both men and women. We will also list out the 5 best topical minoxidil formulations with no side effects. We will also discuss on how to use and which formulation to use depending on your stage of baldness and also briefly discuss on how these medications work to promote hair growth.

Topical Minoxidil solution is the only non-prescription, over-the-counter hair loss treatment, clinically proven and FDA approved medication for female and male pattern hair loss.

Minoxidil belongs to a class of medications known as VASODILATORS, that means those medications dilate the blood vessels.

Minoxidil was actually discovered in the clinical trials for high blood pressure treatment. During the trials, oral use of minoxidil showed unexpected increase in scalp and body hair. These incidental findings led to the development of topical minoxidil for the treatment of androgenetic alopecia.

Now lets quickly discuss on the Mechanism of action by which minoxidil works:

Minoxidil is a potassium channel opener which dilates the blood vessels of the skin around the hair follicles and this allows more entry of oxygen, blood, and nutrients to the hair follicles. This increases follicular size and hair shaft diameter and prolongs hair growth and keeps hair in anagen phase for a longer time. This brings back miniaturized hair follicles back to normal. Miniaturized follicles are those that are weakened by the action of DHT – dihydroxytestosterone.

Minoxidil may cause follicles in the telogen phase to shed – that is why you experience hair loss for intial few days after minoxidil application!  These hair are then replaced by thicker hair in a new anagen phase. You can check out a detailed animated explanation on hair growth cycle to understand the how hair grows from HERE.


For what Type and Stage of Baldness is minoxidil effective?

Minoxidil is more effective in younger people who have experienced hair loss for less than 5 years. Minoxidil is less effective when the area of hair loss is large.

Minoxidil use is more effective for central or vertex hair loss and may not be effective to treat receding hairline.

You can start minoxidil from early stages of baldness like Stage 1 and 2 to prevent progression of baldness. You can watch a detailed video on the stage-wise treatment of male and female pattern baldness from links at the end screen of this video.

It is proven that about 40% of men experience hair regrowth after 3–6 months of minoxidil treatment. Minoxidil must be used indefinitely for continued support of existing hair follicles and the maintenance of any experienced hair regrowth.

Before we move on to the Different formulations and combinations of Minoxidil, we will quickly list out some rare side effects of minoxidil.

Burning sensation or redness at the application site may occur. If these persist or worsen, contact your doctor or try a different formulation like minoxidil foam.

Rarely, this medication can be absorbed through the skin and cause systemic side effects including: unwanted facial/body hair, dizziness, fast/irregular heartbeat, fainting, chest pain, swelling of hands/feet, unusual weight gain, tiredness, difficulty breathing especially when lying down.

A very serious allergic reaction to this drug is very rare.

And lastly, Alcohol and propylene glycol present in some topical preparations may dry the scalp, resulting in dandruff and contact dermatitis.

Now let’s discuss on the different Formulations and Combinations of Minoxidil for Hair loss Treatment:

  1. Minoxidil 2%, 5% and 10% solution or foam. 2% is recommended twice daily for stage 1 and 2, 5% for stage 2 onwards twice daily and 10% stage 3 onwards once daily. Minoxidil foam is recommended for those who have scalp irritation on using regular minoxidil solution.
  2. Minoxidil 5 and 10% + Finasteride 0.1% – This is really effective hair loss treatment for stage 3, 4 and 5 and can revert your stage to previous level within 6 months to 1 year. 5% solution should be used twice daily and 10% once daily one or two hours before bed and hair can be washed with a mild shampoo the next day morning. This is also recommended for those who cannot tolerate oral finasteride of 1 mg daily and report adverse effects like erectile dysfunction and loss of libido.
  3. Minoxidil + Diaminopyridine – This is another effective combination. Here Diaminopyridine prolongs life cycle of a follicle by stimulating the anagen phase.
  4. Minoxidil + Aminexil – Here aminexil increases the circulation of blood to hair follicles which triggers an increase in hair growth and also prevents the hardening of hair shaft and the build-up of collagen around it. It can be used by both men and women dealing with hereditary hair loss or androgenic alopecia. Aminexil has no reported side effects.
  5. 5% minoxidil and 0.01% tretinoin is another proven topical combination where tretinoin increases the percutaneous absorption of minoxidil and hence the efficacy and safety of combined 5% minoxidil and 0.01% tretinoin once-daily therapy appear to be equivalent to those of conventional 5% minoxidil twice-daily therapy for the treatment of Andro-genetic Alopecia.

References:

Minoxidil + Tretonoin: https://www.ncbi.nlm.nih.gov/pubmed/17902730

Minoxidil + Finasteride: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4314881/

 

 

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10 GENUINE HOME REMEDIES FOR HAIR LOSS – THAT WORK AND THAT DO NOT

In Today’s article we will discuss on the 10 Genuine Home remedies for hair loss and hair thinning for both men and women. Some of these are proven to work and have a scientific basis while other natural remedies have no scientific background and either do not work, or act through a placebo effect.

There are many Hair loss solutions and treatments like hair fall shampoos, lotions and pills! There are 100s of products that claim to cure hair loss. Which one can you trust?
Now, Lets list out the 10 natural remedies for hair loss treatment based on research studies conducted in various years. Some of these might be very helpful, whether you’re trying to regrow hair that you’ve lost or simply like to improve your existing hair or to treat hair thinning.  And all Links & references to these research studies on hair loss remedies are provided in description below this video.

10. Head Massage: Gently massaging your scalp in circular motion and pressures, can improve the blood flow to the scalp hair follicles and stimulate hair growth. Doing this at least twice daily is found to be helpful. This can not only strengthen your existing hair, but it also proven to treat hair thinning,  specially if its due to nutritional deficiencies.  Supplements like biotin, collagen, vitamin C, zinc and others, along with scalp massage will revert your hair back to normal within 3 to 6 months if the cause is due to nutritional factors.  In addition, head massage also relieves stress and anxiety!

Before I list out the other remedies for hair loss, you should know that hair growth is primarily determined by genetics and on an individual’s overall health. But the good news is! These are natural remedies and have no side effects! So, why not try these! Whether singly or in combination, these can have an impact on your hair!  And also remember ! any treatment must be followed for atleast 6 months to see any kind of result.

9. Aloe Vera: Fresh aloe vera gel extract from a leaf has great anti-inflammatory properties. It reduces scalp inflammation specially in seborrheic dermatitis and dandruff  and reduces itchiness and scaling to a considerable extent. Studies also say, it stimulates blood circulation and improve delivery of oxygen and nutrition to hair follicles.
So, Now! How to use Aloe vera gel?
– Cut a healthy leaf from aloe vera plant.
– Peel one side of this and Scrape out the gel using a spoon.
– Apply this gel directly to your scalp and massage in circular motions.
– Leave it on for an hour or two and then wash off with a mild shampoo.
– Use this two or three times in a week for atleast 6 months consistently to see any results.

8. Ginseng: Taking ginseng supplements can promote hair growth by stimulating hair follicles and blocking the hormone DHT – DiHydroxyTestosterone.  The active ingredients in ginseng are called Ginsenosides. Ginseng is a special short plant with fleshy roots and the Asian variety is considered the best because it contains these active ingredients for hair stimulation. There are many supplements with ginseng available to purchase online. The link to this research study is provided in description below. And one more point to note: Ginger and Ginseng are not the same!

7. Coconut Oil: Though Coconut oil contains seven different types of fatty acids like the caproic, caprylic, capric, lauric acid, etc, there is no study to prove that coconut oil promotes hair growth. It is only a good conditioner and improves the luster of your hair, especially if you have dry hair. It also protects your hair by coating it and prevents damage to your hair shaft. Some recommend mixing lemon into coconut oil and apply on hair. This is not proven to promote hair regrowth.

6. Onion Juice: Onion juice has been shown to successfully treat patchy hair loss also known as alopecia areata by promoting hair growth in bald areas or patches. But only one such study is conducted in the year 2002 and with a small number of only about 38 patients. Also, it is not proven to grow hair in male pattern baldness or androgenetic alopecia.  I have discussed about onion juice and hair growth in a detailed episode. You can find that link in the video description below.

5. Garlic: Similar to onion juice, a 2007 research study found that applying garlic paste along with betamethasone valerate cream on bald areas produced more hair regrowth than using a placebo treatment with the steroid cream betamethasone. Again, this study was conducted only in 40 patients with alopecia areata and not androgenetic alopecia.  Much like onion, garlic is also full of minerals and vitamins that might help, but no proper scientific evidence found.  Applying a paste of blended garlic cloves can be tried as a home remedy for hair loss without any adverse effects. Do let me know the results if you have tried by commenting below!

4. Viviscal: Viviscal is an oral hair growth supplement containing a wealth of vitamins, minerals, and amino acids said to combat hair thinning. The key ingredient in Viviscal is the AminoMar Marine Complex, which contains shark cartilage and oyster extract powder. Studies have been conducted on this many times and all studies have shown its efficacy in hair thinning patients in both male pattern baldness and female alopecia. I recommend using this for stage 2 and 3 and to treat hair thinning in combination with minoxidil.

You can read stage wise treatment of male pattern baldness here.

3. Biotin: Biotin, zinc, copper and collagen supplements  or from foods rich in these sources are also very useful for hair regrowth if used in conjunction with other treatments like minoxidil.

2. Jojoba Oil and Rosemary Oil or any other Oil: These have no effect on hair growth and hair regrowth and these work similar to coconut oil as already discussed!

1. Licorice roots:  Licorice is thought to opens skin pores and strengthens weakened hair follicles by its antiandrogenic, anti-inflammatory, antioxidative, angiogenic, and hair-stimulating features.  It is also found to be helpful in hair loss due to telogen effluvium.

One last and very important natural DHT blocker to mention is Saw Palmetto. This is a proven remedy for androgenetic alopecia. This is also used for the treatment of prostate enlargement. There are many supplements available which contain this substance.

Links to all these research studies are provided in description below,  for your reference.

Garlic: https://www.ncbi.nlm.nih.gov/pubmed/17314444

Oils and hair: https://www.ncbi.nlm.nih.gov/pubmed/12715094

Viviscal: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3509882/ and

https://www.ncbi.nlm.nih.gov/pubmed/27506633

Licorice root – https://www.ncbi.nlm.nih.gov/pubmed/29945259

 

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PROPECIA – FINASTERIDE SIDE EFFECTS | Hair loss Treatment in Men

Hello Friends and Patients!

In one of our most important article on the stage-wise treatment of hair loss in men, we discussed about the two FDA approved medications: The tablet Finasteride commonly known as Propecia and minoxidil topical application on the scalp.

We also discussed almost everything on hair loss in our previous episodes, starting from what causes hair loss both in men and women, the stages of hair loss in men and women, the medical treatments of hair loss, important facts and misconceptions on hair loss, some bad habits that can cause hair loss, foods that can reverse hair loss and many more. You can checkout that article category from HERE.

Now, Lets first quickly recap some important points on Finasteride and then we will discuss the side effects and real facts on the long term use of finasteride – like, does it really have those side effects?

Finasteride is a 5-Alpha-Reductase inhibitor which blocks the formation or conversion of testosterone to Di-Hydroxy-Testosterone (in short DHT). DHT is the hormone responsible for male pattern baldness or androgenetic alopecia. It acts on the hair follicles and gradually miniaturises the follicles and completely kills them as discussed in our previous articles.

Please checkout my detailed articles and videos on these topics like DHT and hair loss and stage-wise treatment of male pattern baldness.

Now lets jump to our topic and start listing out some important myths, facts and figures on the medication Finasteride for hair loss.

# 1. Finasteride  is used to treat male pattern baldness. And, its action is only at the crown and in the middle of the scalp. It is not helpful in treating receding hair line, except when started very early when the hair follicles are still in the miniaturized state.

#2. Finasteride must be used by adult men only over the age of 18. I suggest over the age of 20 years. Because this is the hormone responsible for the development of secondary male characters like beard growth, chest hair and so on.  But once these male characteristics are developed, blocking DHT does not alter beard growth or body hair.

#3. Women and children must never use this drug. It is not FDA approved for women because it can cause some serious birth defects if taken by pregnant women.

#4. How to use Finasteride?
1 milligram tablet has to be taken by mouth, And, with or without food does not matter! Preferably early morning is the best time, when testosterone levels are higher and avoid at night to reduce most of its side effects like loss of libido and other similar effects which we will discuss shortly.  You ingest 1 mg daily or 1mg on alternate days depending on your hair loss intensity and balancing the benefits versus the side effects.

#5. How Long to use Finasteride to see the results?  Use this medication regularly in order to get the most benefit from it. Remember to use it at the same time each day like early morning as already discussed.  It may take from 3 to 6 months to notice some beneficial effect.

#6. Can I discontinue the medication once I achieve the desired results?

No, Never! You must continue to take this medication to maintain your hair growth. When you stop taking finasteride, any benefit you achieved in hair growth is generally lost within 12 months.

#7. What are the Side effects of Finasteride?
Well! this topic is controversial. Many studies have been conducted on this.
The incidence of side effects like erectile dysfunction, ejaculation impairment, and decreased libido has been confirmed. But the incidence is very low, like 1 in 1000 patients and even less in most studies. Some studies reveal that most of these side effects men experience are psychological. While some other studies indicate long term use of this drug can cause irreversible side effects like erectile dysfunction, ejaculation impairment, and decreased libido. But this is true for 5 milligram daily dose!, which is used for the treatment of prostate enlargement.
However if you experience these effects, try your best to avoid it psychologically, diverting your mind into daily exercise for atleast 30 minutes in evenings and taking finasteride 1 mg in early mornings. If you still experience these side effects, discuss with your doctor and stop this medication.  You can make a decision whether the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

#8. Other side effects: Other rare side effects like allergic reaction to the drug is extremely unlikely.  You might experience allergic rash or something like that but extremely rare.
Another rare side effect is occurrence of man boobs, medically called gynaecomastia. But its very rare. You might even feel tenderness in the part and sometimes even some pain or tenderness in your testicles.

#9. Risk of Prostate Cancer: Finasteride is not approved for prevention of prostate cancer. There is a lot of controversy on this topic. Some research studies show it prevents the occurence of prostate cancer, while some other studies say it may slightly increase the risk of developing a very serious form of prostate cancer. Talk to your doctor about the benefits and risks.

#10 Do I need to use finasteride tablet  in combination with topical Minoxidil ? Yes! this combination if one of the most effective treatments for hair loss and hair thinning since many many years. Minoxidil acts by increasing the local scalp vascularity and finasteride acts by blocking DHT in male pattern baldness. This deadly combination can even reverse hair loss by bringing miniaturised or thinned out hair follicles back to life!

So, there you have it folks! If you found the video helpful, please hit the like button and share this with your friends. Also comment below with your feedback and queries.
Stay Healthy!!

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HAIR TRANSPLANT TECHNIQUES EXPLAINED | FUE or FUT?

In Todays article, we will learn in brief about the techniques of hair transplant surgery to treat hair loss and male pattern baldness. The advantages and disadvantages of each hair restoration technique and which one you should opt for when you decide to undergo hair transplant, specially important is to achieve natural appearance by mimicking original hair orientation.

Hair Transplantation: is a minimally invasive surgical procedure where hair follicles are removed from one part of body (called the donor site) and  transplanted to a bald or balding part of the body usually scalp. Hair transplant can also be used to restore hair anywhere in the body like eyebrows, beard hair, chest hair and so on. And remember it’s a simple one day procedure done on OPD basis.

Now, Lets Quickly know how this is done.  There are two main methods for harvesting hair from Donor Site:

  1. Strip Harvesting and FUT – Follicular unit transplant (FUT). This is the traditional hair transplant method which involves extracting a linear strip of hair bearing skin from the back or the side of the scalp. The strip is then dissected to separate individual grafts. These hair follicles at the back of your scalp are usually resistant to the action of DHT – dihydroxytestosterone which is responsible for male pattern baldness. This strip of hair taken from back of the scalp is generally about 1–1.5 x 15–30 cm in size. Then this incision is closed by suturing.

 

  1. Follicular Unit Extraction (FUE): In this method, individual follicular units containing 1 to 4 hairs are removed under local anesthesia; this micro removal typically uses tiny punches of between 0.6mm and 1.0mm in diameter. The surgeon then uses very small micro blades or fine needles to puncture the sites for receiving the grafts, placing them in a predetermined density and pattern, and angling the wounds in a consistent fashion to promote a realistic hair pattern.
    FUE takes place in a single long session or multiple small sessions. The FUE procedure is more time consuming than strip surgery.

 

These two methods have their own Pros and Cons like:

Strip FUT is more invasive and involves incision and suturing and can sometimes leave a bad scar on the back which may sometimes be difficult to conceal by long hair styles.
Whereas the FUE is cosmetically better but more time consuming and expensive to the patient.

 

So the question is, which technique you should opt for to get the best results with proper hair orientation. Well, though expensive, you should opt for:

Robotic Hair Restoration method of Hair transplant:  This method uses cameras and robotic arms to assist the surgeon with the FUE procedure. In 2009, NeoGraft became the first robotic surgical device FDA approved for hair restoration. The ARTAS System was FDA approved in 2011.  This ARTAS system is a proven and permanent solution that provides natural results without any stitches or scars and without any damage to existing hair.

 

The High Definition Stereoscopic Vision System Utilizes Artificial Intelligence Algorithms to Identify and Select the Best Hair Follicles for Harvesting.

 

Please locate your stage of baldness to decide your treatment option FROM HERE.

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Stage wise Hair loss Treatment in Women – Female Pattern Baldness

In Today’s article, we will look into the stages of female pattern baldness and the best treatment options for hair loss in women. In my previous article, we discussed on the causes and mechanism of female hair loss and hair thinning and the telogen effluvium.

The pattern of hair loss in women is different from that in men. We have discussed male pattern baldness and its stage wise treatment in earlier episodes. Now we will discuss stages wise treatment of female pattern baldness – that’s again androgenetic alopecia.

The male pattern hair loss is typically seen at the front of the hairline and at the crown of the head, whereas women with androgenetic hairloss more often have diffuse thinning on all areas of the scalp but thinning starts typically at the front portion of the scalp.  Remember the reduction in hair thickness and density leads to a reduction in the overall hair volume.  But complete baldness in women is very rare.

The stages of hair loss in women is measured by different scales. One simple and the conventional scale used is the Ludwig’s scale. This scale has three stages. In all three stages, the hair line is preserved unlike the male pattern baldness, where hair line recedes and then completely lost.

Stage – 1: There is minimal thinning of hair at the front portion of the scalp as you can see in the illustration. This type of hair loss can be easily covered or hidden by hair styling techniques. But this does not mean that you should not start treatment at this stage.  We will discuss treatment options later.

Stage – 2: There is moderate thinning and noticeable widening of the mid-line part.

Stage – 3: There is much more diffuse thinning, with a see-through appearance on the top of the scalp or the thinning is seen over the entire scalp.

Now lets discuss on the treatment options for hair loss in women.

Firstly you need to confirm this is androgenetic alopecia and rule out other causes of hair loss like PCOS, thyroid disease and other causes as discussed in my previous article.

The first line of treatment for female pattern baldness is:

  1. MINOXIDIL solution: This is the first and foremost medication used for the treatment of hair loss in females as well as males and easily available over the counter medication without any prescription. This is an FDA approved medication for hairloss. In women generally 2 % or 5 % minoxidil applied on the affected area of scalp once or twice daily is used. 2 % is used for the treatment of Stage 1 and 5% solution is used for stage 2 and 3 . This is important to prevent you from going into stage 2. The higher the stage, the more difficult the treatment is. And remember minoxidil is not a miracle drug. You need to consistently apply it for alteast 3 to 6 months to see some obvious improvement. If minoxidil works for you, then you need to keep using it daily to maintain those good results. If you stop abruptly, you’ll start to lose hair again. Also You must know how to properly use minoxidil solution. Use the dropper or the spray pump and apply on a dry scalp on the affected area and gently massage with your fingers in a circular movement. Do not over do it and also prevent it from going into your eyes. Then wash your hands thoroughly after use. Do not shampoo you hair for at least four to six hours after application. If this is causing irritation on you scalp, then its more likely a contact dermatitis. You might need to consult your doctor. It actually not caused by minoxidil, but the alcohol content in minoxidil solution causes this irritation.
  1. Anti Androgens: This type of treatment has to be taken by consulting your doctor. Some women who don’t respond to minoxidil are prescribed with the anti-androgen drug spironolactone for treatment of androgenic alopecia. This is usually prescribed to women with polycystic ovary syndrome (PCOS) because they tend to make excessive androgens that cause hairloss as discussed in my previous episode.

 

  1. Hair transplantation: This is the final option, if no treatment works.

 

 

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10 Causes of Hair loss and Hair Thinning is Women | Telogen Effluvium

We will list out the 10 common causes of hair loss in women in this video. Whether its hair thinning or baldness in women, the common reason is female pattern baldness or androgenetic alopecia.

For most women, hair is more important than anything else on their body. Its an expression of their style and personality. Women are more sensitive than men and hence Hair loss in women can be absolutely devastating for self-image and emotional well-being.
So, Hair loss is n’t just a male problem. Women also lose hair the same way men do, but the percentage of females affected by baldness or hair loss or hair thinning is lesser when compared to males.  Its only about 10 percent in the third decade of life. But still its significant because only 45% of women will maintain a full head of hair throughout their lifetime. The pattern of hair loss in females is little different than male pattern baldness.

Causes of Hair loss in Women:

Remember loosing some hair daily is absolutely normal. So do not panic if you loose 50 to 100 hair strands daily.  I have discussed in detail about all this stuff in my previous hair loss articles.

  1. Genetic / Androgenetic alopecia or the female pattern baldness. Yes this is the most common type of hair loss even in women like the male pattern baldness. So what is the mechanism of action. Its pretty much similar to male pattern alopecia – the culprit is again DHT – the di hydroxytestosterone which is produced from testosterone. Normally even females have small amount of testosterone in their blood. The problem starts when this is converted to DHT in your body and again in genetically predisposed females and depending on the sensitivity of hair follicles to DHT the damage begins – that is the miniaturization of hair follicles. This can be even more aggravating in disorders of hormonal imbalances like PCOD where there is even more testosterone available for conversion to DHT which speeds up hair loss.
  2. Thyroid Disorders: Both hyperthyroidism and hypothyroidism can cause hair loss or hair thinning. This is easy to diagnose. Watch out for the unique signs and symptoms of thyroid disease and get a simple blood test to check the levels of thyroid hormones.
  3. PCOS or PCOD: Polycystic Ovarian Syndrome or Poly cystic ovarian disease is another common cause of hair loss in women. This is very easy to diagnose with classical signs and symptoms like hirsutism – meaning abnormal facial hair growth in women. Also Acne or pimples and irregular or delayed periods. A simple pelvic ultrasound and hormone tests including serum FSH, LH, testosterone and oestrogen levels may help in diagnosing this condition and then start early treatment.
  4. Pregnancy and Child birth is another hormonal cause for hair loss or hair thinning. But most of these hormonal imbalances are generally reversible on treatment.
  5. Oral Contraceptive pills can also trigger hair loss due to hormonal imbalances.
  6. Other medications like blood thinners and medicines that treat high blood pressure, heart disease, arthritis, and depression can all lead to some amount of hair loss in women.
  7. Dieting or Crash diets: This is becoming another common reason for hair loss in women caused by nutritional deficiencies. The deficiencies can be from one or more element like Protein deficiency and also Vitamin A, D and b12 deficiency or even iron deficiency. But this type of hair loss can be easily reversed with nutritional foods that promote hair growth.
  8. Traction Alopecia: This is again very common due to traction or pulling of hair from bad hair styling like tight braiding or tight pony tails or even from bad hair styling options.
  9. Chemotherapy for Cancer treatments is another important cause, but do not worry, this is not permanent form of hair loss.
  10. Stress: This is actually an important factor often ignored. Not only emotional stress but also stress from trauma or illness or surgery and stuff like that can cause hair loss, but again its temporary and reversible. Last but not the least
  11. Alopecia areata or pathy hair loss is not uncommon in women. As discussed in my earlier artilces, its an auto immune condition where hair follicles are damaged by body’s own immune response.

What is Telogen effluvium?  Most of the causes I discussed except androgenetic alopecia and alopecia areata, the hair loss is temporary and reversible and all these factors may cause telogen effluvium. This is a form of temporary hair loss where the anagen phase of hair growth cycle slows down, meaning that fewer hairs enter the next two stages. But hair grow back within 3 to 6 months after the cause has been dealt with. You can check my animated video and article explaining the hair growth cycle here.  Also next article is on Female Pattern baldness Treatment with Stage wise treatment.

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