1. What are the hair loss causes in men?

Almost all hair loss in men (98%) is from a single cause - a hormone called Dihydrotestosterone (DHT). This little hormone is actually made in the body from the big hormone everyone knows - Testosterone. So DHT causes male pattern hair loss once a man hits puberty and his testosterone levels rise BECAUSE then more of the little hormone starts to get made! That little hormone slowly but surely starts to make the hair on the top of a man s scalp grow thinner and less dense. For some men, their genetics protects them from significant hair loss because not all hair has a receptor for this hormone (DHT). However, most men have the genetic predisposition to lose at least some of their hair in the typical "male pattern," and unfortunately this loss is relentlessly progressive.


2. Options for combating Hair loss in men

Despite what you read on the internet, there are only three proven treatments for male pattern hair loss. The first has been around a while - Rogaine, also known as minoxidil. It is available over the counter in several forms (2% solution, 5% solution, liquid, and foam) and many other purported "hair loss remedies" include it in their formulations. Many of my patients find good results with it provided that they use it, which involves putting it on your scalp and letting it dry once or twice daily. Since hair takes at least a year to demonstrate change due to its long growth cycles, patients have to be committed to daily use. Also, when you start to use it, the thinner hair might shed to make way for a thicker hair to grow. This shedding causes some patients to discontinue use if they are uninformed, even though it means the product is actually working! The other product which is proven to combat hair loss is Propecia, also known as finasteride. It is FDA approved only for male hair loss at this time although some early research showed promise in certain cases for women. Propecia is a once a day pill and it can have a dramatic effect on decreasing hair loss. Once again, despite what is published on the internet, very few patients experience side effects with this drug and it also is beneficial for the prostate. Around my office we refer to Propecia as "Vitamin P" because it is such an important part of keeping a man s hair. Incidentally, Propecia is highly counterfeited these days, so although generic finasteride is available, this is one case where I recommend sticking with the brand name version of the drug.The last remedy which works is to have your hair replaced with hair restoration surgery. Unlike the older methods of hair transplantation, today s techniques give results that are completely natural and often undetectable, so a lot more people than you realize have had at least some replacement done. Obviously, this is the best option for someone who has already lost some hair. If you still have hair that is simply thinning, most hair doctors recommend a combination of any or all of the above depending on the degree of loss. That being said, I have seen some dramatic results with this combination of treatments even though the results from a single treatment can be both visible and significant.


3. Does hair transplantation work for men?

Hair transplantation works for almost everyone! It is the rare case where transplanting hair is not an option. When starting to consider a hair restoration procedure, remember that;

1) results take a full year (so if you are getting married next month and want hair from hair transplant this is not a viable plan!),

2) that the rate of current hair loss should be stopped or slowed to the extent possible, and

3) that doctors and surgeons who specialize in hair restoration exclusively are probably your best option for getting great results.


4. Are there any differences in the hair transplant treatment done to men?

There are slight differences in the hair restoration techniques used for men than there are for women. In the first place, men lose hair in a different pattern than women do. Women will often keep a hairline whereas men s hairlines will recede. Another important difference is that men can go "squeaky bald" whereas women tend to keep at least some growth even into old age. Because of this, planning for where to put the hair is an important consideration in men. You must not only replace the lost hair, but also hedge against possible future loss in other areas. It is also normal for an adult male to have some slight recession at his hairline. While it is possible to transplant these areas, it is often less desirable since a "mature" hairline carries several positive social connotations including success, wealth, and experience, etc. The hairline of a seventeen year old just does not look "right" on a sixty year old man! Women may be able to carry the same hairline their whole lives. Lastly, men have more options when it comes to medical therapies for preserving native hair. Therefore it is more common for a physician to recommend both hair surgery AND medical treatments for hair loss. Simultaneous treatments often show better results overall and who doesn t want the best results?


5. What are the new hair restoration treatments available for men?

Right now the newest hair treatments are hair lasers (the hoods that would be located in a doctor s office are what have the best scientific evidence at this point) and a different technique for surgery called Follicular Unit Extraction or FUE. The laser treatments last about a year and are similar to Rogaine in that they help the hair to grow as thick as possible but may not regrow hair on a completely bald scalp. The Follicular Unit Extraction technique results nearly invisible scarring and is a better choice for those men who like to wear their hair short. It also heals extremely quickly but very few practitioners can do large cases so it is still a rare (albeit in demand!) procedure.