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Of course, a man's midlife crisis is indispensable to baldness - more rigorously, it is male androgenetic alopecia, also known as male pattern alopecia, which can also be abbreviated as male alopecia or MAA.
Some scholars estimate that by the age of 50, up to half of all men will experience some form of male pattern of male baldness; As you get older, the proportion of baldness increases. A survey report in the United States also showed that the risk of moderate or severe MAA in men aged 40~49 is 53%.
Arash Mostaghimi, a dermatologist at Brigham and Women's Hospital in Boston, pointed out that gene and hormone levels are key to hair loss, but the exact mechanism has not yet been fully revealed, which is why therapies aimed at delaying or even reversing hair loss are still incomplete.
Of course, male friends should definitely do something to avoid hair loss as much as possible.
Causes of male baldness
The average human head has about 100,000 hairs. Each hair has a hair follicle attached to it, and a hair follicle can hold one to five hairs. In Mustajimi's words, the scalp hair follicle is "basically a separate organ" because "it has its own stem cells that can be regenerated".
Typically, male pattern baldness is caused by an increase in the 5-alpha-reductase enzyme in the scalp, which converts testosterone to dihydrotestosterone (DHT). It's not clear why some people have higher levels of DHT than others, but genetics definitely play a role.
When there is too much DHT in a man's scalp, this hormone initiates a complex process that causes hair follicles to shrink and hair to become thinner and less frequent. (Hair in bald areas of men usually goes through a process of thinning, even as thin as peach fluff.) ）
This hair loss occurs in a predictable sequence: first around the temples and then to the top of the head – 5α-reductase and the resulting increase in the level and activity of dihydrotestosterone, which leads to tragic male baldness.
How to treat and prevent hair loss
If you're starting to worry about hair loss, the first step is to make an appointment with a dermatologist. Dermatology is a large department with specialists who specialize in hair loss.
Dermatologists will tell you that if you're concerned about hair loss, it's best to start early, as medications are often better suited to prevent hair loss than to reverse it.
In the words of Mustajimi: "The sooner you start, the more likely you are to keep your existing hair." ”
First-line drugs
Dermatologists typically recommend two FDA-approved medications: minoxidil and finasteride.
Danilo Del Campo, a doctor at the Chicago Skin Clinic, said: Minoxidil is best known for helping hair growth. Patients should use it daily, preferably twice a day. It is available in foam or drops for topical use, and a propylene glycol-free formula is recommended, as propylene glycol can irritate the scalp. It can take several months from the start of the medication to the regrowth of mature hair.
Of course, topical minoxidil is not suitable for everyone, and many patients do not like to use it frequently. In addition, as with any hair loss treatment, when the patient stops taking the drug, he will lose the effect he has previously obtained and the hairline will continue to recede.
Another option is to take minoxidil pills internally, which is the off-label therapy that some dermatologists have been using for years. Del Campo cautions that taking minoxidil internally can cause hair to grow in different areas, including the beard and armpits, depending on the individual.
Finasteride in the form of oral pills is approved (with prescription) for the treatment of hair loss in men. Studies have shown that most men who take finasteride maintain or improve hair coverage within five years.
Delcampo said there is a risk of mild erectile dysfunction with oral finasteride, which generally disappears when patients stop taking the drug. However, "this is something that I take very seriously when I discuss it with my patients." (Topical finasteride in spray or drop form is not approved by the FDA, but Americans can buy it online through a simple online survey.) ）
Finasteride is better at preserving hair, while minoxidil is better at regrowing hair. For patients, combination therapy is more effective than medication alone.
Dr. Delcampo says topical minoxidil typically costs $10 to $30 per month, and finasteride pills cost about $15 per month.
Other therapies
There are other options for people with male pattern baldness. One of these is the injection of platelet-rich plasma (P.R.P. for short). During this treatment, the doctor takes the patient's blood, separates the plasma and injects it back into the skin.
This is a costly treatment that can range from $500 to $1,500 per treatment, and patients typically receive three or four major treatments, followed by monthly maintenance treatments.
A recent meta-analysis concluded that platelet-rich plasma therapy appears to be beneficial in some patients, but its utility is difficult to confirm because all relevant studies have been conducted in different ways. Neither experts such as Del Campo recommend P.R.P. as a stand-alone treatment.
Another option is low-intensity laser therapy (LLLT for short). Patients can wear a helmet-like "laser cap" or use a comb-like "hair growth comb" to stimulate hair follicles with a specific wavelength of low-intensity laser light from the device.
Mustajimi notes that while there is evidence that using these devices to stimulate the scalp may help with hair growth, they are expensive. Allegedly, the price of domestic LLLT equipment in the United States is between $200 and $3,000; The cost of one treatment in the clinic is 200~500 USD, and the doctor recommends doing LLLT at least several times a week, and it usually takes several months to see results. In Mustajimi's view, LLLT should only be seen as an adjunct to other therapies.
Hair transplantation
Some dermatologists consider a hair transplant to be the best way to grow hair. This technology has come a long way over the past two decades. During a hair transplant, hair follicles are removed from one place and relocated to the area of hair loss. Doctors typically take healthy hair follicles from the patient's posterior occipital area and transplant them to the hairline, crown of the head, and other places where they are needed.
It is important to point out that hair transplants usually do not produce immediate results, and the original hairline is still constantly receding, so the surgeon's technique is important. Dr. Carolyn Goh, associate clinical professor of dermatology at UCLA Health, says a hair transplant combined with ongoing medication provides the best results. Of course, the cost of a hair transplant is quite high, with a minimum of $7,000 and a maximum of tens of thousands of dollars.
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There are many rumors about baldness. Some people say that wearing hats too often can lead to hair loss, others attribute not wearing hats in cold weather, and some people feel that not washing their hair quickly or too often is the problem. Del Campo said these claims are false.
Also, it's to say that exposing your scalp to the sun or rubbing it with onions/garlic stimulates hair growth. How decisive is heredity in hair loss? Can a man foresee the future above his head from his father or grandfather? At present, the scientific community has no deep insight into this, and my grandfather's hairline is only a very imperfect prediction reference.
Dr. Ge pointed out that if a man's grandfather has experienced middle-aged baldness and the man has experienced the same, the grandchild will generally become bald earlier than the grandparent and may be bald at a very young age...... Sad!
Sources:
What Actually Helps With Hair Loss
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