by Giulia Basevi & Dr Kiran Sodha - All posts, Hair Loss Journal - 19/10/201814/11/2018 Male Pattern Balding Did you know up to 98% of men and 86% of women will experience some sort of abnormal hair loss within their life time? Hair loss is therefore likely to affect you too. This article focuses on Male Pattern Balding… What does hair loss actually mean? The term hair loss includes the thinning of hair all the way through to total loss. Hair loss can happen for a variety of reasons, including hormones, genetics, vitamin levels and chemotherapy. Male Pattern Balding (Androgenic Alopecia) Male Pattern Balding (MPB) is very common. 30% of men by 30 years are affected. The process of hair loss can start at any age after puberty, and the rate of progression will change significantly between men. It occurs naturally in men, and is more likely to happen if other members of your family are affected, as it is hereditary. MPB is diagnosed by its typical pattern of hair loss. Hair loss usually starts at the temples, where the hair line recedes, followed by progressive hair loss at the crown. Why does Male Pattern Balding Occur? Hair loss occurs due to the sensitivity of hair follicles to the male hormone Dihydrotestosterone (DHT) which is formed from testosterone. Exposure to DHT causes hair follicle growth on the head to slow down, shrink and eventually growth stops over time. There is a strong genetic component, so if there a history in a family of male pattern balding, then this is more likely to occur. What treatments are available for Male Pattern Balding? Male Pattern Baldness is a natural process and not a medical disease. The NHS in the UK does not provide treatment for MPB. However, there are effective treatments and the hair loss process can potentially be stopped or reversed. Hair that has been lost can also be regained to varying degrees. There are two main treatments, Finasteride and Minoxidil which are both available from The Doctor Service. Finasteride Finasteride (also known as propecia) is the most effective tablet treatment for MPB. This tablet is taken just once a day and blocks Testosterone being converted to the hormone DHT. How it works Studies have show up to 88% of men responsd to Finasteride. Blocking the production of DHT helps to allow follicles to grow back to their normal size, giving the appearance of more and thicker hair. Finasteride can improve the thickness and size of hair, and increase the number of hairs people have. Men will usually start to see significant improvement from 3-6 months, but the best results are usually seen after 12 months of treatment, and while up to 88% may receive results, there are men in which the treatment is not effective. Some men have a very good response to the medication, whereas others may only have a small improvement. It’s not possible to say which men will get the best response, but if you have lost most of your hair, or have lost hair some time ago then the treatment is likely to be less effective. Is it safe? Finasteride is a generally a safe medication to take, but it can have side effects in some people. Rarely some men have reported symptoms of low mood or self harm. If you experience this then you should stop taking the medication immediately and speak to a health professional. Are there any other side effects? Occasionally some men experience sexual dysfunction such as reduced libido and sexual dysfunction. It’s important to use contraception when taking finasteride such as condoms, as it is excreted in semen, and could theoretically increase the risk of congenital defects of a baby conceived during use of Finasteride. It is important that women do not handle the tablets too. If the treatment is stopped then men will usually start to notice hair loss again within 6-12 months, sometimes earlier. It is not available on the NHS, but it is available with The Doctor Service. Minoxidil (Regaine) Minoxidil is available as a lotion or foam that is rubbed on your scalp daily. It works by improving blood flow to the scalp and promoting hair growth. Although not as effective as Finasteride, it has been shown to work in up to 60% if cases. Regaine contains either 5% or 2% Minoxidil. 5% Minoxidil has been shown to be a more effective hair loss treatment and is a well tolerated medication. Safety and Side effects of Minoxidil There is a potential of skin irritation or headaches, but these do not happen often. Like Finasteride (Propecia), Minoxidil usually needs to be used for at least 3-4 months before significant effects are seen. The balding process will resume once Regaine is stopped. Any new hair that re-grows will usually fall out about 2 months after the treatment is stopped. For Best Results Minoxidil and Finasteride can be used together. The most effective hair growth with both treatments is expected at 12 months. You can order Finasteride from TheDoctorService.co.uk and Minoxidil is available directly from Chemist.net.