This baldness may be the case: your head is slowly but steadily losing its hair, and your hair is becoming increasingly scarce… For those who are too inconvenienced, there are many solutions.
There is nothing abnormal about this phenomenon, it is usually an “androgenetic baldness”, very common in men after 50 years. In some people, hair loss even begins much earlier, sometimes before the age of 20. “Androgenetic alopecia is an enhancement of a natural physiological process, which simply manifests earlier than normal.”
However, if it becomes complex, baldness can be treated. From natural treatments to transplants to drugs, the solutions are numerous.
The market for “natural remedies”
Whether it is through a “grandmother’s recipe” passed down from generation to generation, a home made hair lotion or a course of food supplements, certain nutrients are recognized for their beneficial action on the hair. Wheat germ, millet, green tea, brewer’s yeast, castor oil, cedarwood essential oil, but also proteins, vitamins and minerals, are thus reputed to boost blood flow, accelerate the hair cycle, or even strengthen the hair, giving it a more dense appearance. A very profitable market has therefore been organized around the fight against baldness: the offer is promising, access is easy and does not require a medical prescription, and the risks are almost non-existent. But while these products are finding many followers, Professor Boehncke nevertheless warns against their ineffectiveness on androgenetic alopecia: “By definition, it is not linked to any deficit but to a natural phenomenon. You can find anything and everything on the Internet, but these supplements are not standardized and no controlled study has shown their effectiveness on this type of baldness “.
Medicines, in which cases?
Since the 1990s, several drug solutions for baldness have been developed. Among them, Finasteride, which certainly remains one of the most prescribed drugs. Originally used to treat benign prostatic hyperplasia, it was later formulated to fight baldness. By inhibiting the action of the enzyme responsible for converting testosterone into DHT, the hormone responsible for hair loss, it effectively slows down the process, not without the risk of side effects (see box). Put simply, it changes the hormonal signal to instruct the follicle to continue producing hair. On paper, Finasteride could therefore restart the production of inactive hair follicles and regrow hair even after their disappearance. But Professor Boehncke tempers: “We cannot do miracles. I always warn my patients that the treatment generally does not allow the hair to grow back where it has gone, but simply slows down the inevitable physiological process of hair loss, allowing the situation to stabilize for a few years. ”
The beneficial action is therefore not final: if the drug is stopped, hair loss resumes immediately.
The specialist therefore prefers to direct towards other solutions: “Certainly, Finasteride is the most effective medicinal solution, but when a patient wants to treat androgenetic baldness, I rather offer him a local solution, causing fewer side effects, like Minoxidil ”.
Unlike Finasteride, Minoxidil comes in the form of a lotion that is applied directly to the scalp, daily. Originally developed to treat high blood pressure, it causes vasodilation of blood vessels, which promotes activity of the hair follicle. Its few side effects (local irritation, eczema, drop in blood pressure, etc.) remain fairly mild and stop when treatment is stopped.
And the transplant?
Another solution for those who cannot cope with their baldness: a transplant. We now even speak of “micro-graft” because the patient’s hair is no longer reimplanted in groups but individually, on the bald areas. To do this, follicular grafts are removed from the occipital area – at the back of the head – by excision. “This is an area that is not affected by baldness in most men,” explains Dr Michael Mühlstädt, head of the Dermato-Surgery Unit at HUG. “The procedure is done under local anesthesia. There remains a small scar, but it will be hidden by the hair. ”
In the short term, the result of a micrograft is astounding. But the dermatologist warns: “It is imperative that the one who performs the transplant has a good technical expertise and that he is also able to predict the evolution of baldness and to position the grafts so that the appearance remains natural, otherwise, the risk is to end up with a grafted area isolated from the other hairs which will eventually disappear. ”
In addition to micrografting, some specialized clinics praise the PRP (platelet rich plasma) technique, which involves injecting blood plasma into the scalp with the promise of slowing hair loss and stimulating regrowth. A rather expensive technique, which, like the transplant, can require several sessions and a few hundred francs depending on the severity of the baldness.
Note also that no drug or surgical treatment is reimbursed in the case of “natural” androgenetic alopecia, the problem being considered purely cosmetic.
There remains then an alternative inexpensive and without side effects: accept the inexorable aging of the body (and hair), ignoring social pressure and idealized male stereotypes. Bruce Willis, Seal or Zinédine Zidane have succeeded… why not you?
Finasteride: watch out for side effects of the baldness medication
Finasteride (also known by its trade name PROPECIA®), widely prescribed for its notable effectiveness on hair loss, has recently been the subject of legal battles, particularly in Canada where victims’ associations are calling for its withdrawal from the market. They call into question the seriousness of the adverse effects on sexual and psychological health. Like the young Théo (contacted through the French association AVFIN), who detailed the effects of which he is a victim: “All of a sudden, it was as if my body had died out. On the one hand, my sexuality, with loss of desire, total helplessness, affected genitals. From a mental point of view too, with a loss of motivation and personality, an inability to concentrate, excruciating mental fog, suicidal desires…
”Contacted about the side effects of PROPECIA®, the Merck Sharp & Dohme laboratory, manufacturer of the drug and owner of the patent, told us that it “proactively communicates with health authorities and service providers to quickly make full information available on all (its) drugs.” The leaflet for PROPECIA® 1 mg, which is regularly updated, warns against the possibility of undesirable effects: erectile dysfunction, a decrease in libido, an ejaculation abnormality, or even breast swelling.
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Effects – especially sexual disorders – which can persist for several years after stopping treatment. “This is the paradox of this drug: it must be used early enough for it to be effective, but its effects can have a lasting impact on the sex life and the morale of young men in particular,” explains Prof. Boehncke. It is our responsibility as a physician to offer the appropriate solution on a case-by-case basis, to inform about the risks and to advise that treatment be discontinued at the first side effects”.
Surgery and tattooing
Very expensive and time-consuming, surgery involves implanting stem cells from pieces of healthy hair into the scalp.
Another technique is to have your scalp tattooed to give the effect of a shaved head.
Can we fight against baldness?
For some men, hair loss really takes a toll on their morale. Apart from not being able to gel and comb their hair anymore, they have difficulty living their baldness and fear that their sex appeal will take a hit.
But is it possible to slow down hair loss and hair loss? Can we fight against baldness or is it inevitable?
The Hamilton Norwood classification
Androgenetic alopecia, commonly called baldness, affects both men and women. It is characterized by a gradual loss of hair, starting, generally, with the forehead, “the gulfs” or the top of the head. It is linked to an excess of male hormones, androgens, and evolves in stages. This is Hamilton’s classification:
- Stage 1: Hair grows normally.
- Stage 2: the onset of baldness appears on the frontal part of the scalp.
- Stage 3: the gulfs widen
- Stage 4: for some people, baldness goes up to the tip of the skull (vertex), for others the hair starts out en masse and reaches the forelock.
- Stage 5: baldness is clearly established and there is more area without hair than area with hair.
- Stage 6: The top of the skull is completely smooth, only the sides of the head still have hair. Baldness gives the appearance of tonsure;
- Stage 7: Baldness is permanently established and there is hardly any hair left except for the low crowns.
Take care of your scalp
If you are just at the start of alopecia, there are some precautions you can take to limit hair loss. The first is to use a mild shampoo that is gentle on the scalp.
It is also advisable to perform head massages to stimulate the scalp.
Note that hair loss shampoos are not helpful. At best, they can help treat seborrhea and psoriasis, but they won’t work against baldness.
Meeting mineral needs
Hair health is also important. Thus, it has been observed that a diet that is too fatty will promote baldness.
Conversely, a balanced diet will meet their needs for iron, copper, zinc, silicon and vitamins. In addition, a healthy lifestyle is obviously recommended.
To compensate for the lack of minerals, certain food supplements can strengthen the hair and slow down hair loss. They are over-the-counter, available in pharmacies.
Medication for baldness
Certain drugs may be recommended but for them to be effective it is necessary not to have passed stage 5.
Hair lotions based on minoxidil slow hair loss and stimulate hair growth. The results are not always there but can appear after 4 to 6 months.
Finasteride tablets work by inhibiting the enzyme that converts testosterone into dihydrotestosterone (DHT), the form of hormone that can cause hair follicle activity to stop by over-stimulation. Their main property is to slow down hair loss.
If it is possible to treat baldness, the question of the value of this fight against androgenetic alopecia must be asked. Is baldness synonymous with loss of virility or beauty? Can you live well in your own skin without having hair on your head? Depending on the answer, you can choose to fight… or take it on!
Photo credit: Wikimedia Commons
his picture shows two major patterns of the Dr. O’Tar Norwood’s complicated male pattern baldness classification system. This system is based on the Hamilton scale and is often called the Norwood-Hamilton scale.I: Small to no recession of the hairline.
II: Triangular, often symmetrical, areas of recession at the frontotemporal hairline.
III: Small hair loss enough to be considered as baldness according to Norwood. There are symmetrical deep recession at the temples that are sparsely covered by hair or bald.
III vertex: The hair loss is mostly from the top the head (vertex) with limited recession of the frontotemporal hairline that does not exceed the recession seen in III.
IV: More severe frontotemporal recession than in III and there is sparse hair or no hair on the vertex. The two areas of hair loss are separated by a band of moderately dense hair that extends across the top. This band connects with the fully haired fringe on the sides of the scalp.
V: The vertex hair loss area is separated from the frontotemporal area but it is less distinct. The sparse band of hair across the crown is narrower and the vertex and frontotemporal areas of hair loss are larger.
VI: The bridge of hair that crosses the crown is gone and only sparse hair remains. The frontotemporal and vertex areas are joined together and the extent of hair loss is greater.
VII: The most severe form of hair loss and only a narrow band of hair in a horseshoe shape remains on the sides and back of the scalp. Remaining hair is usually fine and not dense.
IIA: The hairline is anterior to the coronal plane 2 cm anterior to the external auditory meatus.
IIIA: The hairline has receded back to a point between the limit of IIA and the level of the external auditory meatus.
IVA: The hairline has receded beyond the external auditory meatus but has not reached the vertex.
VA: The area of hair loss includes the vertex. Hair loss more severe than VA cannot be distinguished from Types VI or VII.