An Introduction to Male or Men’s Hair Loss (Androgenic Alopecia or Male Pattern Balding)
Male androgenic alopecia (male pattern balding) is the most common form of hair loss seen in post-pubertal males, and readily identified by its familiar pattern of progression.
Until recently it was believed male balding was not a sex-linked characteristic (i.e. not transmitted on the X or Y chromosomes) and we could inherit the problem from either parent. However a 2005 German study found the X-linked androgen receptor (AR) genes – which we inherit from our mothers – to be the major determinant in early male patterned balding.
The management of male genetic hair loss is generally straightforward and uncomplicated. Young males seeking advice should always be encouraged to consult a trained professional for genuine, non-biased options to their particular problem.
Commercial hair loss ‘studios, clinics or clubs’ staffed by salesmen on commission, & selling dubious, overpriced treatment programs should be avoided.
Other general causes of hair loss in males are alopecia areata, poor dietary habits, illness/accidents, surgical procedures (especially where significant blood loss has occurred), certain prescription or illicit drugs (including anabolic steroids), or severe stress.
The Non-Surgical Management of Men’s Androgenic Hair Thinning
Male androgenic alopecia (male pattern balding) is the most common form of hair loss seen in post-pubertal males – and readily identified by its familiar pattern of progression.
Until recently it was believed male balding was not a sex-linked characteristic (not transmitted on the X or Y chromosomes) and we could inherit the problem from either parent. However a 2005 German study found the X-linked androgen receptor (AR) genes – which we inherit from our mothers – to be the major determinant in early-onset male pattern hair loss.
The percentages for male balding are around 20% of men in their 20’s; 30% in their 30’s and so on. There is no cure for this condition – because its predisposition is genetically-inherited – but may be stabilised using the appropriate interventions. This fact is especially important to younger males who can become quite distressed when faced with ‘balding’ at an early age.
When young males have the genetic inheritance to exhibit androgenic alopecia, it’s an inherited element of their secondary sex characteristics; those same hormonal surges to produce facial & body hair, muscle bulk, & deepening voice. Statistics suggest it’s more common for adult males to exhibit some degree of androgenic alopecia than not.
Dawber & Van Neste (2004) suggests 100% of young males will show some changes in the shape of their hairline (termed recession) following puberty – this does not always indicate the onset of androgenic alopecia. Recession is determined by one’s genetic ‘loading’ and androgen levels – and is part of the ‘maturing’ process.
How Male Hormones Affect the Hair
In susceptible men a percentage of the main male hormone Testosterone (TT) is converted to a more potent androgen (male hormones are known as androgens) – Dihydrotestosterone (DHT). DHT progressively exerts a ‘miniaturising’ effect on the hair follicles across the top of the scalp. Within a reduced growing phase affected follicles then produce fine-textured, unpigmented hair (termed vellus) that rarely grow beyond a couple of centimetres in length – thus thinning of the hair density is seen in this androgen-sensitive area.
Male androgenic alopecia usually begins with a receding of the hairline at the temples, and a concomitant thinning of the hair density on the crown. Over time all the hair follicles across the top and sides of the scalp may be affected; leading to – but NOT always – resulting in total baldness.
In should also be noted that DHT influence is one factor in scalp follicle hair loss; numerous internal and lifestyle factors – such as certain nutrient deficiency or the use of anabolic steroids – contribute to its onset and progression. Once activated, male balding is most vigorous from the late teens through to mid-30. The simple reason is that male hormone levels are at their peak during these years.
Assessing & Treating Male Thinning
With the approved treatments available today, successfully treating younger adult males is generally straightforward and uncomplicated. Diet, lifestyle & medical historyshould always be reviewed as well as a preliminary blood test for nutritional/metabolic baseline levels.
Any underlying disturbances in these levels have the potential to adversely affect treatment outcomes – and should be corrected before commencing any treatment regimen.
I stress the point here – despite their advertising claims, Commercial hair loss centres/studios DO NOT possess some ‘secret’ treatment formulae that can “double your hair density” or regain a full head of hair with a random course of laser therapy. Any of these treatment products they provide are readily available from Pharmacies or through your Doctor. Why give $$$$thousands to these multinational companies when the actual cost is often a fraction of what they charge..??
Minoxidil topical solution incombination withthe oral prescription medication Finesteride or Dutesteride is the approved pharmaceutical/medical treatment regime for male androgenic thinning.
Minoxidil remains the only topical medication approved to stimulate follicle hair growth. Under various brand names, Minoxidil is available ‘over the counter’ in 2% and 5% strengths. However these commercial preparations are known to be poorly absorbed and the 30% basic propylene glycol additive is the predominant cause of scalp irritation.
The current generation Minoxidil formulations boast advanced penetration agents, DHT hormone blockers, Minoxidil activators, ‘vellus-reversal’ properties, and anti-inflammatory agents. They can also be ‘tailored ‘to the client’s hair loss problem, their skin sensitivity; their skin tone – or even the way it feels on the individual’s scalp.
EXCLUSIVE TO ANTHONY PEARCE TRICHOLOGY
is the Practitioner Strength form of Activance Rhodanide, and a ‘hair loss specific’ Saw Palmetto/Siberian Ginseng Complex. Both products have been developed by Australia leading Research Pharmacist for hair + scalp treatments.
Activance is a natural nutrient (Vitaminoid) therapy that has ALL the advantages of Minoxidil but none of its side-effect or precaution issues. Activance will also promote follicle, scalp + hair shaft health. It can be used on the skin to clear ‘blotchy’, blemishes + acne. Practitioner Strength Activance Rhodanide is 50% stronger + many times more anti-inflammatory + effective than the commercial form found in salons + pharmacies.
Saw Palmetto Complex was formulated to explicitly lower Testosterone-DHT ratios AND as a tonic for male reproductive/urological health. This is NOT just another Saw Palmetto product..!!
Saw Palmetto Complex can also be safely taken by women to lower Testosterone (TT) levels + alter TT pathways (by converting TT back to Oestrogen)
The oral medication Finesteride (Propecia/Proscar, Finasta) and its newer competitor (to the Australian market) Dutesteride (Avodart) are both inhibitors of the enzyme 5-alpha reductase (5-AR). 5-AR converts testosterone to DHT. Both medications stabilise androgenic alopecia in about 80% of men.
For those wanting to accelerate their hair regrowth, an addition to the above combined therapy approach would be the short-term use of the blood pressure drug Loniten – from which topical Minoxidil was originally derived. Under medical supervision, one half of a 10mg tablet is taken at bedtime (to minimise any blood pressure lowering effects) for two months only. Increased facial/body hair is the commonest visual side effect of Loniten therapy (>80%), so its use in women to accelerate scalp hair regrowth is not advisable.
At 50mg per day the mineral zinc is an inhibitor of 5-alpha reductase, but as it antagonises the absorption of copper & iron it should only be taken at full dosage for 3-4 months – and not in conjunction with copper or iron supplementation.
Laser Light Therapy
Photo-biotherapy such as ‘soft/cold’ low level laser light (LLLT) is a strong vasodilator & moderates the skin’s immune response. To be therapeutically effective these laser appliances should be classified ‘3A’; be in the red light spectrum + wavelength vicinity of 660-780nm. Bio-available power output should be 60-100mW. Note: some commercially-sold hand held lasers have a power output of 1.5-5mW! I believe they offer little more than placebo effect.
LLLT as a SINGLE therapy will not regrow hair to any aesthetically-satisfying degree in my opinion. This was confirmed by the unpublished research study of eminent Dermatologist Dr. Anthony White (Low energy laser treatment for androgenetic alopecia: 1994). So beware the claims of laser hair loss treatment salesmen!!
As a combination therapy however, LLLT can enhance the scalp environment due to its anti-inflammatory & blood perfusion properties – so hair growth potential is maximised. LLLT is consistently effective (in a combined therapy approach) for inflammatory scalp problems, and for settling telogen effluvium hair shed. LLLT is a non-UV light source and considered an adjunct (2nd line additional) treatment.
The current surgical option for advanced androgenic balding is Follicular Unit Extraction hair transplantation (FUE). FUE is a non-scarring/non-‘strip excision’ procedure that’s totally undetectable when performed by a transplant specialist. Dr. Johnathan Chan of AHTI (www.hairtransplantinstitute.com.au) is arguably the most talented exponent of this procedure in Australia at this time.
There is strong evidence to support the use of sodium lauryl sulphate + Paraben-free shampoos for healthy follicle function and optimal hair growth. Anti-inflammatory hair loss treatment shampoos such as the new Activance range are the next generation hair + skin cleaners for maximum results.
As a continuously growing & metabolically-active tissue, hair requires high levels of available nutrients for hair cell DNA synthesis & development. In terms of nutrient supply however, hair is a ‘non-essential’ tissue – receiving its full nutrient supply only after vital tissues have been accommodated. For this reason the taking of a quality multi vitamin/mineral & amino acid supplement is often advised.
Other general causes of hair loss in males is alopecia areata or the ‘scarring’ alopecias; poor dietary habits, illness/accidents, surgical procedures (especially where significant blood loss has occurred), certain prescription or illicit drugs (including anabolic steroids), or severe stress* from whatever cause.
*Stress may be emotional, physiological or psychological