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 Dr. Alan J. Bauman is the Founder, Medical Director and Chief Surgeon of the Bauman Medical Group, P.A. located in Wharfside at Boca Pointe in Boca Raton, Florida. His practice is dedicated exclusively to treating male and female pattern hair loss. Dr. Bauman uses state-of-the-art medical and surgical techniques to help his patients maintain and/or restore their scalp hair.
Oliver
2004-03-22
Rogaine for receding hair line
How does Rogaine and/or other DHT products work on receding hair lines - specifically the area around the temples taht receds back to form the "M"? My research to date suggest they dont work very well.Thank You
Oliver,
Thank you for your question regarding non-invasive medical treatments (Rogaine/Minoxidil and Propecia). We know with great confidence today that male pattern hair loss is caused by the production of DHT in the body. DHT is a by-product of testosterone which is the trigger that causes susceptible hair follicles to miniaturize, then eventually die. You inherit the 'susceptibility' to male pattern hair loss genetically from your family (mother's or father's side), and it can skip generations.
When it comes to medical therapy, Propecia (finasteride 1mg/day) is the preferred 'first-line' treatment. Propecia is a safe, effective prescription treatment that is a simple, easy pill to take. From the thousands of participants in the long-term studies we know that men on Propecia will have a 90% chance (after 5 years) of looking the same or better. Compare this to those men who were not on the medication (taking a sugar pill or placebo)---they had a 75% chance of looking MUCH worse after 5 years! Propecia works to decrease DHT levels in the body which will protect susceptible hair follicles from miniaturization and it will reverse the miniaturization of the miniaturized hair follicles. Typically, it takes about 6 to 12 months to appreciate the 'results' of Propecia. Keep in mind that the 'results' could be that you look THE SAME. Remember, when it comes to a progressive condition like hair loss, looking THE SAME is a good thing. Most patients, however, do see some kind of regrowth and visual improvement. Side-effects are extremely rare with Propecia and only occur in one-half percent of patients more than a placebo.
You should realize that there is no such thing as a 'herbal' DHT blocker and no shampoo or other topical treatment has been proven to block DHT. DHT travels in the bloodstream, so you need systemic therapy (a pill) to affect DHT levels. No shampoo or topical treatment can do this. Also, Propecia tends to work better where you have more hair (i.e.: the crown/vertex), however I have seen patients who had regrowth of the frontal hairline (but this is pretty rare). For the most part, you can expect Propecia to stop the progression of the frontal hairline recession.
The other medical treatment we use to treat hair loss is Minoxidil (the active ingredient in Rogaine). Minoxidil is a topical solution that you need to apply to the scalp twice daily in order to see results. While the mechanism is not completely understood, we know that minoxidil DOES NOT affect DHT. Minoxidil probably works as a "hair follicle stimulator" encouraging them to grow longer and thicker hairs. The FDA-approved labeling says that it is only for the crown, but as physicians, we know that where ever you put the minoxidil it will work. That means that if you are receding in the frontal hairline, you should put the medication there as well. Remember that all medical treatments (minoxidil and Propecia) tend to work better where you have more hair (usually the crown/vertex).
Another treatment that is becoming more popular for frontal hairline recession is the use of low-level laser therapy. This can be done in the form of a 'hood' (usually in-office) or a handheld laser device (LaserComb). Early scientific research is promising--showing increases in hair counts, hair caliber and tensile strength. Like any treatments, it typically takes 6-12 months to see results. I consider laser treatments to be at least as good as minoxidil. Patients usually notice a decrease in shedding within the first 90 days and increases in hair growth a few months later.
At my clinic I offer a microscopic analysis of the scalp to record hair density and hair caliber measurements. These measurements can be used to track the progress of any treatment program. If non-invasive treatments with Propecia and Minoxidil doesn't get you to your goal, then you will need to consider follicular-unit hair transplantation to restore hair to the thinning area.
Let me know if you have more specific questions. You can email me at doctorb@baumanmedical.com or participate in a free 'virtual' consultation through my website www.baumanmedical.com. If you send photos of the hair loss you are having, I can give you a better idea of what to expect from the various treatments.
Keep me posted on your success.
Sincerely, Alan J. Bauman, MD
Medical Director
Bauman Medical Group, Boca Raton--FL
877-BAUMAN-9
doctorb@baumanmedical.com
www.baumanmedical.com
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