The Balding Truth in Men

Here’s what you can do when your crowning glory begins to disappear.

You’re a middle aged male and balding, don’t worry you’re not alone. By the age of 50, about 50 per cent of men will suffer from male pattern baldness. Dr. Robert P. Feinstein of Columbia University quoted the same figure and says that the highest incidence is among white men. Asian are next then African Americans. Surprisingly the lowest incidence is among Eskimos people known to cover their heads most of the time. Hair Growth and Balding The problem starts at the temples, proceeds to the sides to form an “M” shapes, then spreads to the top of the head. We lose about 100 strands of hair daily, but this is part of the three phrase cycle of hair growth. Anagen phase – lasted two to six years for each strand, the hair follicle grows deep into the scalp and sprouts a shaft on the other side. Catagen phase – during the two weeks period, the follicle stops growing and shrinks. Telogen phase – the final stage. Old hair falls out while new strands in their anagen phase push through. At any given time, 85 to 90 per cent of our hair is in the anagen phase, while 10 to 15 per cent is in the telogen phase. Male pattern baldness or androgenic alopecia (AGA) occurs because the anagen phase shortens. So you continue to lose your hair but didn’t grow enough new ones anymore. The reason is a higher level of 5-alpha-reductase that converts testosterone into dihydrotestosterone (DHT), which retards the anagen phase. However, while testosterone changes into DHT on the scalp, its overall level continues to rise till men reach 70 years of age. The male hormone testosterone stimulates hair growth. Balding men will often losing hair on their scalp while at the same time gaining hair in areas that had little or no hair before – like the nose, ears and eyebrows. The Causes Heredity is the primary cause of male pattern baldness.

In heredity syndrome, some men may asked, why their brothers isn’t balding like them. This is because their brothers have “lower penetrance or susceptibility to inheritance. We have been blaming women for our balding because the gene defect in the x-chromosome is always inherited from the mother. But in 2008, German scientist Markus Nothen and Roland Kruse discovered a new gene that can be inherited from both parents, which is why we see a similarity between father and son. Another direct cause of balding is oral ingestion of cholesterol reducing drugs, anti coagulants, anabolic steroids and medicine to treat Parkinson’s disease, gout, ulcers, convulsions, depression and hypertension. Treatment Doctors, commonly prescribe two treatments; Minoxidil – a tropical treatment that causes blood vessels in the scalp to dilate. Finasteride or Propecia reduces the conversion of testosterone to DHT. Minoxidil is effective in 70 to 80 per cent while Propecia works in 80 to 90 per cent of cases. Some would not like to massage minoxidil on to their scalp, they expect spraying on to their scalp to work. Or, they can simply swallow Propecia. Another consideration is that minoxidil works effectively on the back of the head and propecia on the crown. These drugs are not harmful, but some precautionary measure needs to be taken. Minoxidil opens up blood vessels, people with angina pectoris (inadequate blood to the heart muscle) should avoid taking it because blood may rush to the scalp instead of the heart.

A heart attack might occur. And for men already taking Proscar (the 5 miligram version of finasteride) for urinary problems should avoid Propecia. Propecia is only for men as it increases testosterone. Pregnant women should avoid even touching it. It can adsorb through the skin and harm the foetus. Naturally, you should consult your doctor before taking either drug. Another treatment is hair Transplantation, a surgical technique that simply relocates existing hair follicles from a healthy part of the scalp (donor site) to the balding area (recipient site) In follicular unit transplantation (FUT), some scalp are strip off from the back of the head and stitch the gap. Trained “cutters” dissect the strip and remove hair follicles carefully. The doctor “planter” will then pierce the scalp with a needle, remove it and quickly insert the follicle. Cutting and planting take place at the same time. Some men don’t like the scar left behind by the stitching, though hair will eventually grow and cover it. Doctors will employ follicular unit extraction (FUE), where they pluck follicles out of the donor site and plant them the same way. Transplantation is very effective. Most men retain almost 100 per cent of their transplanted hair. 3 to 6 months are needed to see the impact, 6 to 12 months for visible growth, 3 to 5 years for full effect. Hair transplantation is permanent. The International Society of Hair Restoration Surgery (ISHRS) estimates that US$1.8 billion is spent annually on hair transplants globally. What can we do? The only problem caused by baldness is psychological. Many balding men feel highly stressed due to a reduced level of self –esteem and a perceived diminished attractiveness. But others feel no such misgivings about themselves and are happy to accept their baldness. Mahatma Gandhi, Eisenhower, Andre Agassi, Yul Brynner and Michael Jordon all of them are world renowned and all of them are bald.