Alopecia in men; Baldness - male; Hair loss in men

Treatment is not necessary if you are comfortable with your appearance. Hair weaving, hairpieces, or change of hairstyle may disguise the hair loss. This is usually the least expensive and safest approach for male baldness.

There are two main drugs used to treat male pattern baldness:

• Minoxidil (Rogaine) -- a solution that you apply directly to the scalp to stimulate the hair follicles. It slows hair loss for many men, and some men grow new hair. The previous degree of hair loss returns when you stop applying the solution.
• Finasteride (Propecia, Proscar) -- a prescription pill that inhibits the production of the male hormone dihydrotestosterone. Like minoxidil, you are more likely to have slower hair loss than actual new hair growth. In general, it is somewhat more effective than minoxidil. The previous degree of hair loss returns when you stop taking the drug.

Hair transplants consist of removing tiny plugs of hair from areas where the hair is continuing to grow and placing them in areas that are balding. This can cause minor scarring in the donor areas and carries a modest risk for skin infection. The procedure usually requires multiple transplantation sessions and may be expensive. Results, however, are often excellent and permanent.

Suturing hair pieces to the scalp is not recommended. It can result in scars, infections, and abscess of the scalp. The use of hair implants made of artificial fibers was banned by the FDA because of the high rate of infection.

Male pattern baldness does not indicate a medical disorder, but it may affect self-esteem or cause anxiety. The hair loss is usually permanent.

• Psychological stress
• Loss of self-esteem due to change in appearance

Call your doctor if:

• Your hair loss occurs in an atypical pattern -- rapid hair loss, diffuse shedding, hair loss in patches, or breaking of hair shafts.
• Your hair loss is accompanied by itching, skin irritation, redness, scaling, pain, or other symptoms.
• Your hair loss begins after starting a medication.
• You want to attempt to treat your hair loss.

Sinclair RD. Male androgenetic alopecia (Part II). J Men’s Health Gend. 2005; 2(1): 38-44. 

Sinclair RD. Male androgenetic alopecia. J Men’s Health Gend. 2004; 1(4): 319-327.     

Habif TP. Clinical Dermatology. 4^th ed. St. Louis, Mo: Mosby, Inc. 2004.