Dr Sunaina Hameed's
Family Dermatalogy, Asthetic Lasers, Anti-Ageing Medicine & Plastic Surgery.

BALDING IN MEN AND WOMEN

The medical term for balding or hair thinning is called 'Androgenetic Alopecia' (AGA) in men and 'Female Pattern Hair Loss' (FPHL) in women. It is referred to as "patterned" hair loss because it mostly affects the 'crown' of the head and the temples, while the patient continues to have good density of hair over the back of the scalp.

AGA and FPHL are characterized by progressive thinning of the hair over the typical areas, rather than actual hair fall/shedding. Men notice a broadening of the forehead with obvious balding. Women complain about a widening of the hair partition, shortening of hair near the forehead hairline, thinning of hair at the sides of the scalp, inability to grow their hair very long or thinning of their ponytail.

This condition is caused by a complex interplay between genetics and hormones. Familial balding, especially from the maternal side of the family plays an important role. Balding is relatively uncommon among Asians, when compared with Caucasians or Negroes. However, beyond the age of 60, balding is so common that it can be considered a normal part of ageing.

Although it is referred to as 'Androgenetic', most patients are NOT hormonal misfits. Your genetic composition might simply make your scalp more 'sensitive' to the normal levels of hormones in your blood. Since women have lower levels of testosterone in their blood, hair thinning in women is more limited. This gets progressively worse after menopause, when the ovaries no longer produce estrogen; the hormone which makes scalp hair thick and lustrous, while making facial and body hair fine and scanty.

Certain hormonal disorders like Polycystic Ovarian Disease (PCOD) or ovarian tumors may lead to altered hormonal levels and more severe balding in women.

Hamilton has defined 8 stages of balding in men, with stage 1 being the mildest form of balding and stage 8 being the most severe. Your dermatologist will be able to help you through non-surgical means if you start your therapy before stage 5, which is visible balding over the top of your scalp.

Treatment can prevent further thinning of hair and can give a 40-50% improvement in hair density, when used regularly over a period of 8-10 months. Never use any prescription medications without consulting a qualified dermatologist. Hair fall therapy may be supplemented with supportive measures such as iron, vitamins and certain shampoos which can temporarily create an illusion of increased hair volume. Ketaconazole shampoos used to treat dandruff, is scientifically proven to be effective in the treatment of patterned hair loss as well. Minoxidil still remains the gold standard in the treatment of androgenetic alopecia. Amnexidil can help those who are allergic or intolerant to Minoxidil. Newer formulations like biotin, saw palmetto or caffeine-based hair serums have also shown promising results.

Some of these formulations are pushed deeper down the scalp using needles, and this is known as Mesotherapy. However this treatment is still controversial and unapproved. A newer treatment option which has generated great excitement amongst patients and dermatologists alike is the PRP (vampire) treatment. A small vial of your own blood is centrifuged and platelet-rich plasma is then drawn from it and injected into your own scalp. PRP is full of growth factors which work better than any medication is stimulating hair regrowth. Dermarollers are sometimes used to push down the plasma even deeper into your scalp. These treatments require 3-5 sessions at 6-8 weekly intervals. It is a cost-effective and semi-invasive treatment for patients who are poor candidates for surgery. And for those who do not wish to explore surgical options.

Last but not the least, PATIENCE is a virtue with any hair loss therapy. There are plenty of options available today and your dermatologist can help you decide the most favorable course of action, based on your needs and means. For more serious balding, surgical hair transplantation is the treatment of choice. However, you will still have to continue the use of topical medications, and the transplantation may need to be repeated every few years, in order to maintain hair density.

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