What Is The Best Treatment For Male Patterned Baldness?
The number of hair follicles on the scalp varies between men and women. While men tend to have more follicles on the posterior area of the head, women show a pattern with dominant brown hair. Similarly, the pattern of hair loss varies between men and women. Male Pattern Baldness1 (also called Androgenic Alopecia) appears as a loss of hair from the forehead initially beginning as a receding hairline eventually accelerating to involve the entire crown leaving behind hair occupying only the sides and back of the scalp. The receding hairline in this condition follows a classic ‘M’ shaped pattern.
Although women tend to experience hair loss in a pattern of more generalized thinning of hair from the entire scalp, they are not exempted from developing male patterned baldness.
Major Causes Of Male Pattern Baldness
The most common cause of androgenic alopecia is genetic, inherited from either or both parents. Men can show the onset of symptoms any time after puberty while females show an average age of onset around 40 to 50 years of age. Earlier onset can be an indicator of severity2.
In recent times, extreme levels of stress are a factor which races to reach the top cause of early onset male pattern baldness. Nutritional deficiency, especially micronutrients like minerals and vitamins, is an often ignored cause of Androgenic alopecia.
Several hormonal factors play an important role in the onset and progression of male pattern baldness. A classic example is increased levels of dihydrotestosterone causing hair loss. It is also quite common for male patterned baldness to occur secondary to other diseases or treatments like chemotherapy.
Best Treatment For Male Patterned Baldness
The treatment for male patterned baldness is best tailored to the cause. While genetic factors are majorly non-modifiable, there are specific drugs that can help slow down or temporarily pause the process of hair fall.
A 2 to 5% Minoxidil topical application is considered as one of the best treatment for male patterned baldness. Few setbacks of the conventional drug therapy are slow onset of action coupled with cessation of therapeutic effects on discontinuing the drug3.
Finastride is another drug similar in treatment of male patterned baldness in terms of onset and duration of action and potential adverse effects. It is also used on the scalp surface and especially effective if the androgenic alopecia is caused due to hormonal disorientation. It is known to act by inhibiting dihydrotestosterone3.
There has been oral intake of drugs such as spironolactone, which seem to work for as long as the drug is taken.
Easily achievable and beneficial but extremely underrated lifestyle modifications like regular exercise, proper balanced diet and sufficient sleep may be considered as the treatment of male patterned baldness in persons where there are poor lifestyle practices that lead to accumulated stress.
Bringhraj (Eclipta alba) is well documented in many ayurvedic texts acts as an effective remedy that produces sustainable regrowth of hair from follicles with a tendency to become dormant if left without intervention4.
Most often, the nutrient supplementation, independently or as a combination, is effective as an auxiliary treatment. Sometimes, supplementation of the missing element alone can turn out to be the best treatment for male patterned baldness in specific cases like iron deficiency anaemia.
Without documentation of actual cure, the demand of extreme patient compliance with drug regimens and potential side effects of conventional drug therapy, people are increasingly choosing hair transplantation as the best treatment for male patterned baldness although it may be an expensive choice. The possible adverse effects of the hair transplantation surgeries are overcome with strict aseptic surgical practices, meticulous pre-operative, and postoperative care.
In individuals with non-invasive treatment preferences or least intervention tendencies, even the usage of wigs, cosmetic camouflage in the form of spray paints is seen to be helpful. These options provide more of a temporary solution to a permanent problem.
There are individuals who consider psychological support as the effect of hair loss on thinking patterns, behaviors and mental health is often underrated. It remains a cause of self-esteem issues, which can set off a vicious cycle of stress and hair loss. Good psychological support helps break this cycle.5
Hair loss symptoms and patterns are highly variable even among individuals of the same population for a given gender and age. The several options enumerated above are also highly variable in terms of effectiveness over time and adverse effects in different individuals. Hence, the best treatment for male patterned baldness would be to strike a balance between the causative factor and what best works for a particular individual under the guidance of a dermatologist in the vicinity.
The role of prevention in any medical condition cannot be ignored. Regular hair and scalp care in terms of hygiene, moisturizing, and protection from the sun, decreased usage of chemical and physical styling products go a long way in a head full of hair.
1) Textbook of Dermatology, Venereology, and Leprology. 4th Edition, Chapter 21, Devinder Mohan Thappa, Elsevier.
2) British Association of Dermatologists, Patient Information Leaflets, Androgenetic Alopecia.
3) Harrison’s Principles of internal Medicine, 18th edition, Table 53-5, Volume 1, McGraw Hill, 2012.
4) Dutta K.Anand .C.Burman Eclipta alba extract with potential for hairgrowth promoting activity. Journal of Ethnopharmacology Volume 124, Issue 3, July 2009 Pages 450-456.
5) Kaliyadan F, Nambiar A, Vijayaraghavan S. Androgenetic Alopecia: An update. Indian J Dermatol Venereol Leprol 2013 Volume 79 Issue 5;79:613-25.