Every guy is at risk of losing his hair, some more quickly than others. It sucks. The follicle itself shrivels up and is rendered incapable of regrowing anything. This type of hair loss is called androgenetic alopecia, often referred to as male pattern baldness. (That's the permanent kind, not the temporary thing that happens sometimes due to stress.) This plays out in two ways: the thinning of each hair and the overall loss of density. But, in certain cases of alopecia, these losses are not truly “permanent.” At least, not right away. Sometimes, it can be slowed down or delayed.
So there's hope! If you’ve been losing hair or if you think you’re at risk of hair loss of thinning, then read on for some possible fixes. The insight and advice comes from Dr. Francesco Fusco, MD of Wexler Dermatology in NYC. His main point? You've got to be proactive.
First of all, why is my hair falling out?
Fusco says that there’s something called miniaturization happening at the follicular level when a hair falls out. “Miniaturization refers to the slow shrinking of the hair follicle and the diminution of the hair within, until eventually the follicle no longer exists,” she says. “The remaining tiny hair falls out and nothing grows back.” She says that this is often genetic and caused by a hormone called dihydrotestosterone (DHT), which is a byproduct of testosterone. DHT clings to the follicle and then slowly shrinks it. This most commonly happens at the temples, the crown, and the front of the head. (This is also why you don’t see guys losing their hair around the sides and back.)
But it is possible to regrow that hair, right??
It depends. “If a follicle has closed, disappeared, scarred, or not generated a new hair in years, then a new hair wouldn’t be able to grow,” Fusco says. But if the follicle is still intact, yes, it is possible to regrow the hair—or to improve the health of the existing thinner hairs.
What can I do?
There are some common solutions and some uncommon ones:
Oral Medication: “In cases of androgenetic alopecia, finasteride is still the gold standard,” says Fusco. (Finasteride is the generic version of Propecia, which can be prescribed by your dermatologist and is also available via mail subscriptions.) Fusco says that even younger men can slow or delay hair loss by starting a daily finasteride prescription. “This medication works by inhibiting an enzyme that leads to hair loss,” she notes. “In clinical trials, 90 percent of the patients either gained hair or maintained their hair over a five-year period.”
Topical Medication: There are a few alternatives to finasteride, should it prove to be ineffective or if it starts causing side effects (some patients report losing their sex drive on the drug). One of these options is minoxidil (aka Rogaine). It’s a topical product, available over the counter, that stimulates hair growth “by activating potassium channels in the follicle—this results in growth factors and prostaglandins that promote hair growth,” Fusco says. “This keeps the hairs in the growth cycle for a longer period of time.” Your dermatologist may be able to prescribe minoxidil formulations of higher percentages, she adds. So, see your doctor to decide which route is best.
Herbal Supplements: “Saw palmetto is available over-the-counter and is an herb that has traditionally been used to treat men with prostate problems,” Fusco says. “It is popular among men who do not want to take finasteride because it has been suggested that saw palmetto may block some of the receptor activity on the hair follicles which are stimulated in androgenetic alopecia.”
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