If you’re a man and you notice more and more hair sticking to your hairbrush or coming loose in the shower, take comfort in knowing that you’re not alone.
Research shows that approximately 90% of men will experience some form of hair loss in their lifetime.
Yes, male pattern baldness – the thinning or complete loss of hair at the temples and top of the scalp is so common.
What – if anything – you choose to do about it is up to you.
But for men who are considering or currently taking pharmaceutical remedies, a recent study might interest you.
Earlier this month, the medical journal JAMA Dermatology published a “meta-analysis” of 23 studies done on various drugs for male pattern baldness.
The analysis interpreted research on the relative effectiveness of three widely used male pattern baldness drugs – dutasteride, finasteride and minoxidil – when used at different doses over periods ranging from two to four months.
As New York dermatologist Dr. Anthony Rossi told CNN, “This meta-analysis is important. [because] we do not have randomized clinical trials that compare these drugs for male pattern baldness to each other.
In the studies, the drugs were used for periods of 24 weeks or 48 weeks. Here’s how they stacked up against each other:
The analysis found that the drug most likely to reduce male pattern baldness was a 0.5 milligram oral dose of dutasteride.
Dutasteride is approved by the FDA to treat men with benign prostatic hyperplasia (BPH). When prescribed by a physician to treat male pattern hair loss, it is considered “off label” use, meaning there is no clinically tested evidence that a drug will effective for a given condition.
That said, physicians still have discretion to prescribe off-label drugs because, as Rossi noted, “many drugs are used off-label, but there is usually enough evidence to explain why we think these drugs will work. “.
However, some of the troubling potential side effects of dutasteride include decreased sex drive, decreased ability to maintain an erection, and difficulty ejaculating.
The second most effective drug in the analysis was a 5 milligram oral dose of finasteride.
Like dutasteride, finasteride is also a prostate medication; unlike dutasteride, it has been approved by the FDA to treat hair loss in men as well.
The potential side effects of finasteride are similar to those associated with dutasteride.
The third most effective dose was a 5 milligram oral dose of minoxidil.
After that, the fourth most effective treatment was an oral dose of 1 milligram of finasteride, followed by topical application of a 5% solution of minoxidil.
The topical version of minoxidil (foam, liquid or shampoo) is sold without a prescription and therefore does not require a doctor’s prescription.
Minoxidil, both in its oral and over-the-counter form, requires the user to stay on it in perpetuity. Once use is discontinued, any hair growth gains will soon be lost. The trade-off for this, however, is that there are none of the sexual side effects with minoxidil that are associated with dutasteride and finasteride. The most common side effects of minoxidil are dermatological, ie dryness, itching or redness of the scalp.
The study also noted that the different drugs listed above had different potential benefits at different stages of the 24 and 48 week periods. For example, finasteride produced the highest total hair count while minoxidil produced the greatest production of “mature” hair (as opposed to wispy “baby hair”).
It should also be noted that the study was performed only for hair loss in men.
What all the experts agree on is that the most important aspects of treating hair loss is to first determine the cause of hair loss (stress, medical conditions, illness, etc. are all potential causes of hair loss) and to remedy them at the first signs. .
This is also the time when non-pharmaceutical options tend to be most viable.
Dr. Alan Bauman of Bauman Medical in Boca Raton is one of the nation’s leading hair restoration doctors, and like many specialists in the field, he offers a range of safe, non-pharmaceutical, and side-effect-free options.
For example, he thinks medical-grade low-level laser light therapy caps should be part of any hair treatment protocol.
“Proper and consistent use of medical grade low intensity laser therapy treats hair loss, thinning hair and has been scientifically proven to improve the appearance of hair quality, strength and hair thickness, as well as promotes hair regrowth,” he says. . However, he warns that “even with constant use [of a laser cap]it can take six to 12 months to see changes visible to the naked eye.
Medical grade low level laser light therapy caps are FDA cleared to treat male and female pattern hair loss.
Nutraceuticals are another option for those who suffer from hair loss. These include products such as supplements such as Viviscal Professional hair growth vitamins, anti-DHT transdermal patches for androgen-related hair loss, anti-DHT shampoo and supplements for cellular rejuvenation via activation of telomerase.
Minimally invasive treatment with PRP
In recent years, a minimally invasive treatment in which a patient’s platelet-rich plasma (PRP) is injected into the scalp has become increasingly popular.
Dr. Daniela Dadurian of MD Beauty Labs in West Palm Beach says she has had success doing this treatment on her patients.
As she explains, “The procedure consists of a combination of PRP, derived from the patient’s own blood, and polydioxanone (PDO) threads. A vial of the patient’s blood is drawn, centrifuged, and the patient’s own platelets, blood growth and repair factors are immediately injected back into the scalp. The treatment is done in a series of three treatments at four week intervals. The growth factors contained in PRP stimulate the growth of hair follicles, thereby increasing hair density and thickness.
A second component of this treatment are PDO sutures, which she explains, “are absorbable sutures that were originally developed for cardiac surgery and are now FDA cleared for cosmetic procedures. For hair restoration purposes, small PDO threads are placed in the scalp prior to PRP injection Once placed in the scalp, the threads dissolve over a period of four to six months They are not visible to the naked eye and cannot be felt by the patient, but they stimulate the production of collagen and elastin, the main factors necessary for hair growth.
Finally, Dadurian adds Thymosin Beta 4 Injectable Peptides “twice daily for 10 days after the combination PRP and threading treatment, as it has also been shown to help stimulate hair growth.”