What is male hair loss (male pattern baldness/androgenic alopecia)?

Male hair loss is the most common type of hair loss. It is caused by increased sensitivity to male sex hormones (androgens) in certain parts of the scalp, and is passed on from generation to generation.

In the past, baldness was often seen as something unfortunate or undesirable. However, this attitude has changed over the years and nowadays a clean-shaven head is usually considered both fashionable and attractive.

What causes male hair loss?

Some men have areas on the scalp that are very sensitive to the male sex hormones that circulate in men's blood. The hormones make the hair follicles - from which hair grows - shrink. Eventually, they become so small that they cannot replace lost hairs. The follicles are still alive, but are no longer able to perform their task.

The condition usually starts in men aged 20 to 30 and follows a typical pattern. First, a receding hairline develops, and gradually the hair on top of the head also begins to thin. Eventually, the two balding areas meet to form a typical U-shape around the back and sides of the head. The hair that remains is often finer, and does not grow as quickly as it used to.

Can male hair loss be prevented?

Male hair loss is genetically determined (passed on from parents). Although a doctor can offer medical treatment to improve the condition, this may have side effects.

What can be done at home?

You need to decide how you feel about hair loss. Male hair loss affects a large part of the male population and people react very differently to it.

It is important to try to accept hair loss for what it is - something natural. Rather than trying to camouflage bald spots with remaining hair or a wig, it is probably a better idea to leave your hair as it is, or shave it off completely. If, however, you decide to try to regain your hair, possible medical treatments are discussed below.

How is male hair loss treated?

Baldness is generally regarded as natural, and not a disease. So if a person decides they wish to try to get their hair back, they will probably have to pay for the lengthy, expensive procedure themselves.

Treatment with medication

· Minoxidil lotion (Regaine regular strength or Regaine extra strength) is applied twice daily to the scalp. Minoxidil was originally invented as a treatment for high blood pressure; the hair growth is a side effect that, in this case, has proved useful. It is not available on NHS prescription, but can be purchased over-the-counter. About 60 per cent of patients benefit from it to varying degrees and its effects start to wear off as soon as it is stopped.

· Finasteride (Propecia) is a medicine taken in tablet form that partially blocks the effects of the male hormones (an 'anti-androgen'). It is used in a higher dose to reduce the size of the prostate gland in men with benign prostatic hypertrophy. Propecia has been shown to halt further hair loss and promote re-growth of scalp hair in approximately 80 per cent of patients after three to six months. Treatment must be continued to sustain the improvement in hair growth. It is only available on private prescription and a months supply costs around £30.

Plastic surgery

Plastic surgery may be the only reliable way to replace lost hair, and techniques for restoring hair growth are constantly improving. These include:

· a transplant, where the surgeon moves non-sensitive hairs from the back of the head to the top. This is best for men whose hair loss is limited to the front of the scalp. Factors that determine whether a person is a suitable candidate include age, hair colour, the nature of hair loss, and whether the hair type is straight or curly.

· scalp reduction, a technique that is most suitable for men with a small, well-defined bald spot on the top of the head.

· flap-surgery, which involves making the part of the scalp that still contains hair larger. This is a possibility in cases of hair loss over a small area.

Hair loss in women

Women can also suffer hair loss, especially those with many relatives who are also prone to losing their hair.

The female pattern sets in at a later age than in men and is usually limited to the top of the head. Total baldness is rarely seen in women.

The only treatment licensed for hair loss in women is Regaine for women.

How does it work?

Regaine for women solution contains the active ingredient minoxidil, which is a medicine used for the treatment of hereditary hair loss. It is not fully understood how minoxidil stimulates hair growth.

Minoxidil was first used in tablet form as a medicine to treat high blood pressure (an antihypertensive). It was noticed that patients being treated with minoxidil experienced excessive hair growth (hypertrichosis) as a side effect. Further research showed that hair growth could also be stimulated by applying a solution of minoxidil directly to the scalp. The amount of minoxidil absorbed through the skin into the bloodstream is usually too small to cause internal side effects.

Minoxidil dilates the tiny blood vessels in the scalp, which increases the blood circulation to the hair follicles. This may be how minoxidil stimulates hair growth.

The solution should be applied to the affected areas of the scalp twice a day. The scalp and hair should be dry before applying the solution. It may take twice daily applications for at least four months for any hair regrowth to become noticable.

Regaine will not work for everyone and it is not possible to predict individual responses. If there is no improvement after a year you should stop using the treatment.

If your hair growth is stimulated, you will need to keep using Regaine twice a day for the growth to continue. Regrown hair may disappear three to four months after you stop using Regaine and the balding process will then continue.

What is it used for?

· Hereditary hair loss (alopecia androgenetica) in women aged 18 to 65 years.
Warning!

· This preparation is for external use only.

· Do not apply to areas other than the scalp.

· Wash your hands after applying this medicine to avoid inadvertently transfering it to other areas.

· Avoid use on broken or inflamed skin.

· Avoid contact of this medicine with the eyes and the moist membranes lining the inside of certain parts of the body, eg mouth, nasal passages (mucous membranes). Rinse with cold water if accidental contact occurs.

· Avoid inhaling the spray mist when using the pump spray applicator.

· Stop using this medicine and consult your doctor if you experience chest pain, increased heart rate, faintness, dizziness, sudden unexplained weight gain, swollen hands or feet, or persistant redness or irritation of the scalp.

· Your hair may shed when you first start using this medicine. This is due to old hairs falling out as new hairs grow in their place. If shedding persists for longer than two weeks, discontinue treatment and consult your doctor.

Use with caution in

· Heart disease or an irregular heart beat. If you have a heart condition you should consult your doctor before using this medicine.

Not to be used in

· Allergy to minoxidil, ethanol or propylene glycol

· Treated or untreated high blood pressure (hypertension)

· Any scalp abnormality, eg psoriasis, eczema, sunburn or broken skin

· Women with a shaved scalp

· Women who are using other medicines or occlusive dressings applied to the scalp

· Pregnancy

· Breastfeeding.

· This medicine is not recommended for women under 18 or over 65 years of age, as there is no information available regarding its safety in these age groups.

This medicine should not be used if you are allergic to one or any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy.

If you feel you have experienced an allergic reaction, stop using this medicine and inform your doctor or pharmacist immediately.

Pregnancy and Breastfeeding

Certain medicines should not be used during pregnancy or breastfeeding. However, other medicines may be safely used in pregnancy or breastfeeding providing the benefits to the mother outweigh the risks to the unborn baby. Always inform your doctor if you are pregnant or planning a pregnancy, before using any medicine.

· The safety of this medicine during pregnancy has not been established. It should not be used by pregnant women. Seek medical advice from your doctor.

· There is no information available about the safety of this medicine during breastfeeding. For this reason, the manufacturer states that it should not be used by women who are breastfeeding. Seek medical advice from your doctor.

Side effects

Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with this medicine. Because a side effect is stated here, it does not mean that all people using this medicine will experience that or any side effect.

· Itching

· Skin irritation

· Dry skin

· Flushing of the scalp skin due to widening of the small blood vessels (erythema)

· Flaking scalp

· Unwanted growth of hair on other parts of the body, including the face

· Worsening of hair loss

The side effects listed above may not include all of the side effects reported by the drug's manufacturer.

For more information about any other possible risks associated with this medicine, please read the information provided with the medicine or consult your doctor or pharmacist.

How can this medicine affect other medicines?

Certain medicines that are applied to the skin can increase the permeability of the skin. These include corticosteroids such as hydrocortisone, retinoids such as isotretinoin or tretinoin, dithranol, urea and vaseline. You should not use Regaine if you are using any other medicines on your scalp, because they might cause more minoxidil to be absorbed through the skin into the bloodstream. This could increase the risk of any side effects.

You should not use Regaine if you are taking any medicines for high blood pressure. This because there is a theoretical risk that the Regaine could enhance the effect of the blood pressure medication and make you feel dizzy.