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Pindara Private Hospital Magazine - Issue Six

Goodbye for Good MALE PATTERN BALDNESS AD MEN’S HEALTH While there are a number of treatments available for male pattern baldness, there is no cure. The cause of male pattern baldness is well established, with up to five genes that are involved. Identical twins go bald at the same age, rate and pattern irrespective of diet, lifestyle or stress levels. Hippocrates noted that castration saved the eunuchs in the Persian army from baldness. Effective treatments include Minoxidil lotion and tablets, Finasteride and Duasteride tablets. Unproven treatments include lasers, LED light sources and plasma-rich proteins. Cosmetic options include camouflage sprays, wigs and hair transplant surgery. Investigation of the genetics of baldness may lead to new treatments, but there are none available yet. Hair transplantation still offers the best hope for men with hair loss restricted to a small region of the scalp. If the ultimate size of the baldness is too great, then the available hair density for transplantation is not enough, leading to a very thin cover of the recipient region. Treatment Options 5-alpha reductase inhibiters The benefits are clear: men who start taking one milligram of Finasteride daily at the first signs of hair loss will not go bald. If erectile dysfunction, ejaculatory problems and reduced libido develop then cessation of the drug is recommended. There is only a reduction in risk for low-risk prostate cancer and a suggestion of a slight increase risk in the high-risk cancers, although this might be explained by the increased recognition of prostatic cancer due to the smaller prostate size. The addition of Duasteride 500 micrograms once a week gives further benefits. Minoxidil The effect on hair growth of Minoxidil having a viagra-like effect was discovered by accident. Hair removal laser has led to a renaissance in the use of Minoxidil tablets, as now effective management of the unwanted hair elsewhere is possible. Low doses of Minoxidil, (as low as one milligram a day) can still grow hair with minimal effect on blood pressure. About 75% of topical 5% Minoxidil users get some benefit and 1% get fantastic results. The combination of Minoxidil and Finasteride maximises hair regrowth. Alternative therapies Vitamins and dietary supplements do little in this kind of baldness. We at The Skin Centre (www.skincentre.com.au) are currently trialling platelet rich plasma injected into the scalp. Multiple treatments are required. There is no data to suggest a lasting response yet. So, while there is no cure, it's important to remember the earlier the balding scalp is treated the more effective the treatment will be. Dr Michael Freeman, Dermatologist 32 Pindara Magazine 2015\2016


Pindara Private Hospital Magazine - Issue Six
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