Today I am going to tell you about popular (and approved) types of treatment for androgenetic alopecia, including hormone action modifiers, non-hormonal therapy, and surgery. As we do not fully understand the mechanisms of male pattern baldness, the available remedies have limited success.
Magazine and TV ads usually promote miracle treatments for hair loss; however, the vast majority of advertised products are completely ineffective. If you do not want to waste your time and money on worthless treatment, use only FDA-approved drugs – finasteride and minoxidil.
Finasteride is a 5α-reductase type 2 inhibitor (blocks the conversion of testosterone to 5α-dihydrotestosterone), being the most successful hormonal treatment in men for now. Nevertheless, there is a risk of developing gynecomastia and erectile dysfunction while taking finasteride. It takes three to six months of continuously using finasteride before any effect is seen, and the balding process usually resumes within six to twelve months, if treatment is stopped. A similar drug, dutasteride (a dual inhibitor of 5α-reductase types 1 and 2), is not FDA-approved as a hair loss treatment, and may have serious long-term side effects.
Minoxidil is a widely used topical non-hormonal medication for hair loss in both men and women. It was initially designed as an antihypertensive vasodilator medication, but stimulated excessive hair growth as a side effect. Minoxidil stimulates hair follicles and growth, but does not affect 5α-dihydrotestosterone, so as soon as the treatment is stopped, the genetically predisposed hair follicles will still be destroyed. Apart from itching and hypertrichosis, there is another important risk during the use of minoxidil ― you can accidentally kill your cat. You should never: a) allow cats to lick treated areas; b) apply minoxidil products to your cat. The feline species is deficient in hepatic glucuronidation enzymes required to metabolize the parent drug to inactive metabolites, which may result in increased conversion to the active minoxidil sulfate metabolite. Poor minoxidil exposed cats die from pulmonary edema, pleural effusion, and compromised cardiac function.
Finally, after all efforts to slow down the progression of your hair loss have been made, you can undergo hair restoration surgery. It is known that the follicle’s response to androgens can vary from stimulation (e.g. beard) to inhibition on scalp areas (androgenetic alopecia), or can show no effect (e.g. eyelashes). This difference provides an opportunity to transplant the follicles from non-balding regions into the balding areas. The surgery is an expensive and painful procedure, because it involves the transplantation of micro-grafts with several follicles. Moreover, in case of continual progression of balding, further transplants are required to avoid isolation of the transplanted region.
I should note that current methods of hair loss treatment do not give you hope for significant hair regrowth, and the success greatly depends on early intervention. The importance of developing new hair loss treatments is not limited to cosmetic purposes. The human hair follicle is a rich scientific model for studying cell biology, immunology, developmental biology, the process of controlled cell regeneration and differentiation, and human genetics.