It has been estimated that up to 50% of men may be affected by baldness by age 50 and a large percentage of women also suffer thinning and loss of hair. It is therefore a significant problem and its cause is widely accepted as dihydrotestosterone or DHT in the most common male pattern baldness. DHT is one of the male hormones, produced largely in the prostate and responsible for certain male specific characteristics.
It seems that enzyme conversion of testosterone produces DHT in the body and the accumulating DHT can be detrimental to the growing (anagenic) phase of the hair. The build up of DHT near the hair follicles tends to shrink the follicles and shorten their growth phase, the hairs produced becoming thinner and weaker. The net result is that hairs are lost quicker than they can be replaced and thinning and baldness ensue.
One main type of treatment for baldness therefore centres around blocking the effects of DHT, either by reducing its production or by interfering with its action on the hair follicles. A commonly used drug for this purpose is finasteride (Propecia). Originally approved for the treatment of benign prostatic enlargement, finasteride works by binding to 5-alpha reductase and hence blocking its action in converting free testosterone to DHT. Finasteride is usually only prescribed for men and should not be used by pregnant or potentially pregnant women as it may cause birth defects in male foetuses. Another such anti-androgen drug is Dutasteride, but this does not appear to have a significant advantage over Propecia.
Natural DHT blockers include Saw Palmetto which acts in a similar way to finasteride, blocking 5-alpha reductase and blocking sites on cell membranes required for cells to absorb DHT, and Pygeum which reduces levels of DHT in the blood and also the number of sites where DHT can attach. This includes reducing the number of hair follicles where DHT would bind. Pygeum is often combined with Saw Palmetto to give a synergistic effect.
Other natural substances that can inhibit DHT production or action are nettle root, pumpkin seed oi, green tea, emu oil, and soy isoflavines. L-Lysine is a substance sometimes added in with a DHT-blocker and seems to make them work better.
Ketoconazole is a synthetic antifungal drug for skin infections and is also a 5-alpha reductase inhibitor and a hair growth stimulant so is ano0ther medicament that can be administered.
Copper peptides can be applied topically to the scalp and can shorten the resting phase of hairs. This results in more hairs being in the growing phase at any one time.
A second form of treatment for baldness focuses on increasing blood flow to the scalp. This can be achieved by daily massaging with essential oils, or with the more recent techniques involving low-level lasers.
Another new idea is called hair multiplication and attempts to clone hair follicles but this is far from being main-stream at present. The alternative of hair transplanting is though, and the techniques involved have improved steadily over recent years. It is now possible to take small grafts from donor areas on the back and sides of the head and transplant them to bald areas. Clumps of hair follicles involving only 1-4 follicles can be transplanted in this way and can achieve a very natural appearance. The procedure is rather painstaking and precise, and inevitably expensive.
For those suffering severe loss then, there is a wide choice of treatments available, from the fairly simple and straightforward to the more complex and time-consuming. Which is right for you will probably be determined by seeking qualified advice and the costs involved.
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