You can not stop the process, but you can treat it early
Androgenetic alopecia, also known as male pattern baldness, is a major cause of loss of hair in men. The incidence of this disease is determined by genetic influences, with the highest prevalence is among those with European ancestry. Despite major psychological impact, as studied in various scientific publications, it is known that there are few men who seek treatment.
How baldness occurs
First, it is worth explaining a fundamental concept that is the mechanism through which the disease arises and manifests.
Most people believe that hair are thin because they fall more than normal. This is a very common mistake! In fact, what happens is that the male hormone (testosterone and its derivatives) bind to receptors which are in themselves for, leading to miniaturization of the wires in genetically susceptible patients. In this sense, it is interesting to know the age at which the individual's relatives began to notice a decrease in hair.
We should ideally intervene before that.
We know that the clinical manifestations of male pattern baldness are variable and the first signs are already emerging in adolescence, with some characteristic patterns of loss of hair. The "inputs", known as "androgenetic alopecia Bitemporal standard", are the initial manifestation. Following, there is a loss on the vertex (top of head) and in the middle region, preserving the hair of the occipital area (closest to the neck).
The hormone dihydrotestosterone or DHT can be produced from testosterone circulating in a possible chemical reaction due to an enzyme (a protein that accelerates chemical reactions) called 5-alpha-reductase. DHT is five times more potent than testosterone and is the key hormone in the onset of androgenetic alopecia. The fact that the receptors for this hormone they are not evenly distributed across the scalp hair loss explains patterns.
Miniaturization of the wires is what leads to the disappearance of the hair in a given region. However, the exact mechanism involved remains unknown, it is believed that the male hormones through their connection with those located in the receptors, lead to a change in growth.
The clinical diagnosis is essentially, that is done only by physical examination. It is important to pull the hair, to differentiate from other causes fall. Dermatoscopy (examination lens) displays miniature by and collaborates with this diagnosis also being useful in patient follow-up. Other diagnostic tools as biospia, trichogram and videodermatoscopia may be used, depending on each case.
How to treat?
Therefore, it is important to note that there is very little that can be done to prevent the disease, since it is genetically determined. However, treatment initiated early delays and even a slight improvement the clinical picture. Therefore, it is essential that the children of parents bald stay tuned and ideally seek the dermatologist to start monitoring about 10 years before the age at which his father began to notice hair loss and / or the smallest signal inputs.
At first, topical medications are indicated as minoxidil, specific shampoos and lotions. If necessary and the patient agrees, can make use of finasteride, oral medication. We note that both the drugs mentioned stimulate hair growth in some men, but are more useful as preventing clinical manifestations than as recovery of baldness. Because the disease is chronic and progressive, treatment should be initiated early and maintained for a long time.
Both drugs have a good safety profile. The minoxidil, used at 5%, is a drug used in place as hair lotion twice daily in dry scalp. At first, during the first two months can be increased hair loss, which should be interpreted as indicative of good response to treatment. The peak effect occurs at about 16 weeks of use. The most common side effects are local irritation, increased by in unwanted locations (face and hands) and tachycardia.
Finasteride inhibits one enzyme 5-alpha-reductase, which is responsible for converting testosterone to DHT. It is an oral medication originally used to treat a prostate disease, benign prostatic hyperplasia. However, to reduce circulating DHT, can produce significant and lasting increase in the growth of hair. It is more responsive to the loss of cases of the top of head hair and top front, with minimal response in temporal regions and the previous line.
However, treatment should be continued because the benefits are not maintained with medication withdrawal. Additionally, the disease is progressive, as already said. As side effects, finasteride can cause loss of libido, ejaculatory dysfunction, breast enlargement and depression in a small number of individuals. These general changes are transient, but there are some case reports in which these changes have become persistent.
In more advanced cases, it may be given the hair transplant. The donor area is the occipital region, place where the lack hormone receptors, and thus remain despite the circulating hormones, even when placed in other regions.
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