Androgenetic alopecia or common male pattern baldness (MPB) accounts for more than 95% of hair loss in men. By the age of twenty, 20% of men and by thirty, 30% of men will experience some degree of appreciable hair loss.
Contrary to common belief, most men who suffer from male pattern baldness are extremely unhappy with their situation and would do anything to change it. Hair loss affects every aspect of the hair loss sufferer’s life. It affects interpersonal relationships as well as the professional lives of those suffering. It is not uncommon for men to change their career paths because of their hair loss.
Hair loss tends to progress over the years, although the rate can vary dramatically from person to person and the rate of loss can vary significantly over time
Recognise how devastating male pattern baldness can be for men of all ages.
Read here a true story of a young man who suffered from this disease
“When I first realized I was losing my hair, more than 10 years ago, I was absolutely mortified. First, I went through a phase of denial. I tried to convince myself that This can’t really be happening to me. I mean, I was only 19! The simple act of having a shower was a torture for me. To see my .. hair in my hands and going down the drain with each passing day felt like a slow death.
I was having trouble concentrating at work. I couldn’t enjoy going out with my friends because I was becoming increasing self-conscious about my appearance, and I hated to look at myself in the mirror or in store-front reflections. I became obsessed with my hair , and as the weeks passed, my self-esteem was diminishing. I had excelled at every sport I played, got academic awards, and felt as though I could conquer the world. Since then, I have suffered from major depression, severe OCD, and anxiety.
Society tells us that men shouldn’t care about losing their hair. Buck up! Get it together! It’s only hair. Deal with it. It’s part of life.Well, that’s easy to say if it’s not happening to you. But the truth is, while society doesn’t like to admit it, we are all judged by our appearance, especially when we’re young.
Only those who have been affected by hairloss will understand me. When my mother was dying from cancer when I was 17, I never saw her cry until she began losing her hair. If that doesn’t make people understand the gravity of hairloss, I don’t know what will.
I’m not as OK as I may pretend to be… on the inside, I’m sick of trying, tired of still fighting a daily battle with my reflection and my self-esteem”.
Cause of Androgenic Hair Loss
(Male Pattern Baldness)
Male pattern baldness is a genetic disorder. Hair follicles that are sensitive to dihydrotestosterone (DHT) begin to miniaturise, shortening the lifespan of each hair follicle. Eventually, these affected follicles stop producing cosmetically acceptable hair.
Male pattern baldness is generally characterized with the onset of a receeding hairline and thinning crown. Hair in these areas including the temples and mid-anterior scalp appear to be the most sensitive to DHT. This pattern eventually progresses into more apparent baldness throughout the entire top of the scalp, leaving only a rim or “horseshoe” pattern of hair remaining in the more advanced stages of MPB.
Dihydrotestosterone (DHT) is a derivative or by-product of testosterone. Testosterone converts to DHT with the aid of the enzyme Type II 5-alpha-reductase which is present in hair follicles.
The first step in making a rational assessment of the extent of your hair loss, is to compare your present hairline with the hairline on a photograph taken a few years ago. This will give you an approximate idea of how much hair loss has occurred and the rapidity of the process. Looking in a mirror is one way to appraise the loss at the back of your head. The best way to accurately assess the hair loss in this area is to have a friend take a Polaroid photo of the back of your head. Another way is to ask your barber or hairdresser.
A visit to a physician who specialises in hair restoration is a worthwhile step. A thorough history and examination of the scalp can reveal the extent and trend of the hair loss process. With the use of trichoscope, (a special magnifying apparatus )the physician can measure the actual degree of hair loss in various areas of the scalp. This has the advantage of establishing number of thin hair and quality of hair present at the time of examinations which is used to judge the response to hair loss therapy. Careful assessment of the hair loss process is critical to accurate prediction of the rate and extent of hair loss.
The scientific way to assess your degree of baldness is to compare your pattern with the standard patterns described by Hamilton & Norwood (below). They depict the most common configurations of male pattern baldness. Comparing your own front and back with these diagrams can tell you where you stand now. Discussion with a knowledgeable physician can give you some idea of what is likely to be in your future based upon an examination of you in his office.
Hamilton Classification for Male Baldness
- No recession
- “Adolescent” or “Juvenile” hairline
- Temporal Recession < 1
- Mild recession along frontal hairline
- “Mature” hairline
- Further Frontal Recession
- Deeper recession at corners
- Earliest stage of balding
- Hair loss Predominantly in Vertex (crown)
- Frontal Hairline Recession may be Present
- Further frontal hair loss and temporal recession
- More thinning of vertex (crown)
- Solid band of hair across top separating front from vertex
- Frontal and temporal areas enlarge further
- Band separating the two areas becomes narrower and sparser
- Frontal and vertex balding areas merge into one and increase in size
- Narrow horseshoe band of hair
- Low hairline in the back
- Hair in permanent zone may be sparse
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In the past few years, medicine has made tremendous strides in the treatment of men’s & women’s hair loss. With the advent of 5-alpha-reductase inhibitors, other newer treatment modalities and the evolution of surgical hair restoration, for many, living with noticeable hair loss is no longer inevitable.
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.
Microneedling in androgenetic alopecia- Wonder therapy
Dr. Rachita has published a study on the effect of microneedling in androgenetic alopecia, first in humans. This study has got many accolades across the globe and now many follow this therapy. She is a pioneer in micro needling therapy. This therapy boost the response of hair loss medications and also helpful in those who do not show response to hair loss medications.
Mechanisms of Dermaroller
As one rolls the derma roller over the skin, it creates micro-channels on the skin of the scalp. Each tiny wound created by the dermaroller goes through the three classic phases of wound healing:
- Follicle differentiation
- Hair shaft & cycle regulation
- Stem cells activation
- Hair follicle neogenesis
Platelet-rich plasma (Abbreviation: PRP) – is the autologous Platelet-Rich Plasma (PRP) is a blood derivative containing the patient’s own platelets concentrated up to tenfold the original blood concentration. Several different growth factors and other cytokines present in platelets stimulate hair follicle. PRP serves as a safe and effective treatment option both in mens & women hair loss.
Dr Rachita Dhurat has developed a double centrifugation technique for preparation of PRP. Due to her expertise in the field of PRP preparation method, she has been invited to train dermatologists.
To develop a PRP preparation, blood must first be drawn from a patient. The platelets are separated from other blood cells and their concentration is increased during a process called centrifugation. In an average 3-4 sessions of PRP are required.
On December 22, 1997 the FDA approved a 1mg dose of finasteride for the treatment of androgenic alopecia in men (male pattern baldness).
Finasteride inhibits Type II 5-alpha-reductace, the enzyme that converts testosterone into a more potent androgen dihydrotestosterone (DHT). Finasteride is not a steroid at all. Finasteride 1 mg dose can effectively lower DHT levels by as much as 60% when taken daily. This 60% reduction in DHT has proven to stop the progression of hair loss in 86% of men taking the drug during clinical trials.
Dutasteride is more potent in inhibiting production of DHT and has shown superior efficacy than finasteride in various clinical trials. Dutasteride has been approved by Korean FDA .
Sexual adverse events of the both drugs were negligible and reversible, however sexual side effects are overrated.
Minoxidil was the first drug approved by the FDA for the treatment of male pattern baldness.
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.
Low light therapy (LLLT)
Low level laser light, when applied to the scalp, is one of the newest therapies to treat hair loss. It totally offers a natural method for hair treatment.
How LLLT Works?
LLLT photo-biomodulation may stimulate new hair growth. LLLT mediates new hair growth through either a direct or an indirect increase in proliferative activity within the hair follicle epithelial matrix. Evidence also points out that laser energy reverses follicular apoptosis (programmed cell death)
Physicians who use LLLT in treating androgenetic alopecia have usually found that LLLT is most effective in persons with minimal to moderate hair loss but is less effective with major hair loss. Keep in mind, responses to LLLT is somewhat unpredictable and results vary from person to person.
LLLT can be effective in treating male and female pattern hair loss when either used alone or in conjunction with other medical therapies. Physicians have observed that the overall condition and health of existing hair may be improved in a LLLT treated area, even if no new hair growth is stimulated.
LLLT has been observed to improve outcomes of hair transplantation by improving patency of grafts and speeding healing time.
LLLT Today: How Long Does Treatment Take to Be Effective?
Hand-held devices come with recommended protocols for home use. LLLT in a medical setting may require regular therapy sessions over a period of months. As with the medical treatment of androgenetic alopecia, hair restoration using LLLT is not a one-time “fix” for hair loss. It must be repeated at intervals to maintain results; medical treatment also must be maintained to retain results.
Benefits of LLLT
- Reverses & stop hair loss
- Energizes weakened hair follicles
- Increases blood flow & circulation around the hair follicles (takes away harmful waste products such as DHRT & ATP)
- Stimulates re-growth of hair
- Transform thin hair into thick hair