Men Baldness

Even men who never “go bald” thin out over the years. Unlike those with reversible telogen shedding, those with common male-pattern hair loss don’t notice much hair coming out; they just see that it’s not there anymore. Adolescent boys notice some receding near the temples as their hairlines change from the straight-across boys’ pattern to the more “M-shaped” pattern of adult men. This normal development does not mean they are losing hair.

Some “myths” about male-pattern baldness

* You inherit baldness through your mother’s male relatives. Actually, baldness can come from either side of the family, or both. Looking at your family can give you at best an educated guess about how you’ll turn out.

* Longer hair puts a strain on roots. They don’t. And hats don’t choke off the circulation to the scalp to cause hair loss either.

* Shampooing does not accelerate balding.

* “Poor circulation” does not cause hair loss, and massaging doesn’t stop it.

Many conditioners, shampoos, vitamins, and other products claim to help hair grow in some unspecified way. These are harmless but useless. To slow down hair loss, there are two basic options:

* Minoxidil (brand name: Rogaine): This topical application is over-the-counter, no prescription is required. It works best on the crown, less on the frontal region. Available as a 2% solution, Rogaine may grow a little hair, but is better at holding onto what’s still there. There are few side effects with Rogaine. The main problem with this treatment is the need to keep applying it twice a day, and most men get tired of it after a while. In addition, Minoxidil works less well on the front of the head, which is where baldness bothers most men. This drug also comes in a higher strength, 5%, which may be a bit more effective.

* Finasteride (brand name: Propecia): This is a lower-dose version of a drug that shrinks prostates in middle-aged men. Propecia is by prescription and is taken once a day. Propecia does grow and thicken hair to some extent, but its main use is to keep hair that’s still there. It’s therefore best for men who still have enough hair to retain. One side effect is impotence, but this is no more common than it is in the general population, and is reversible when the drug is stopped. Taking Propecia once a day is easier that applying minoxidil, but the prospect of taking a pill daily for years doesn’t sit well with some men