In the past few years, medicine has made tremendous strides in the treatment of men's hair loss. With the advent of 5-alpha-reductase inhibitors such as Propecia and the evolution of surgical hair restoration, for many, living with noticeable hair loss is no longer inevitable. For the first time in the history of mankind, it is now possible to stop or slow the progression of hair loss and to replace lost hair through surgery with completely natural results. However, with that said, the vast majority of hair loss treatments being marketed today are still nothing but "snake oils."
You've all seen the ads in the back of men's magazines, you've heard the commercials on the radio and you've seen the infomercials promoting miracle treatments for hair loss. The bottom line is that the vast majority of advertised "treatments" do not work for the prevention and treatment of hair loss. If a hair loss treatment is not approved by the FDA or recommended by The American Hair Loss Association, chances are you are wasting your precious time and money. Remember, successful treatment of hair loss is greatly dependent on early intervention. It is critical to begin treatment with an effective product as soon as you notice the onset of hair loss.
The following two treatments have been clinically proven to successfully treat hair loss in men to varying degrees.
Finasteride is the generic name for the brand name drugs Proscar and Propecia. Finasteride was originally developed by Merck as a drug to treat enlarged prostate glands (Proscar). During the trials on men with prostate problems an intriguing side effect of hair growth was observed. Since finasteride had already been approved by the FDA to treat enlarged prostates in men, Merck and Company decided to pursue the possibility of developing finasteride as the first pill to treat male pattern baldness.
On December 22, 1997 the FDA approved a 1mg dose of finasteride for the treatment of androgenic alopecia in men (male pattern baldness). Propecia is the first drug in history to effectively treat male pattern baldness in the vast majority of men who use it.
How Propecia/Finasteride Works:
Finasteride's hair-raising success is due to its ability to specifically inhibit Type II 5-alpha-reductace, the enzyme that converts testosterone into a more potent androgen dihydrotestosterone (DHT). Propecia's 1 mg dose of finasteride can effectively lower DHT levels by as much as 60% when taken daily. It is DHT that shrinks or miniaturizes the hair follicle, which eventually leads to baldness. This 60% reduction in DHT has proven to stop the progression of hair loss in 86% of men taking the drug during clinical trials. 65% of trial participants experienced what was considered a substantial increase in hair growth.
At this point, the only truly effective medically proven way to arrest the hair loss process is to lower DHT levels. The American Hair Loss Association recommends finasteride as the first line of attack for all men interested in treating their male pattern baldness.
While Propecia is generally well tolerated, as with all drugs side effects can occur.
• loss of interest in sex,
• trouble having an orgasm,
• abnormal ejaculation,
• swelling in your hands or feet,
• swelling or tenderness in your breasts,
• feeling like you might pass out,
• runny nose, or
• skin rash.
The sexual side effects of Propecia may continue after you stop taking it. Talk to your doctor if you have concerns about these side effects. Propecia may also cause decrease in blood prostate specific antigen (PSA) levels, and can affect the PSA blood test.
Minoxidil (loniten) was the first drug approved by the FDA for the treatment of male pattern baldness. For many years, minoxidill, in pill form, was widely used to treat high blood pressure. Just like finasteride researchers discovered a very interesting side effect of the drug. People taking the medication were growing hair in unexpected places like on their cheeks and the back of their hands, some even grew hair on their foreheads.
Some enterprising researchers had the notion that applying minoxidil topically, directly on the head, might grow hair on balding areas. Well it did this to varying degrees depending on the extent of the hair loss. For it's time, this treatment was revolutionary.
While minoxidil has been clinically proven to slow the progression of hair loss and regrow some hair, most informed experts see it as a relatively marginally effective drug in the fight against hair loss. Since minoxidil has no effect on the hormonal process of hair loss its positive effects are at best temporary and usually yield somewhat disappointing long-term results.
With that said, The American Hair Loss Association still recommends the drug for those who have not responded favorably to finasteride treatment or for those who would like to add another product to their regimen. The AHLA does not recommend minoxidil as the first line of attack for men suffering with male pattern baldness, but does recognize it as an effective treatment for a small percentage of its users.
Reviewed by Paul J. McAndrews, MD