It may seem a peculiar American vanity that men have in-boxes full of hair
loss treatment offers and spend billions of dollars on hair loss treatments
each year. Not so. As Gersh Kuntzman illustrates in his book Hair! Mankind's
Historic Quest to End Baldness, chrome-dome anxiety has tormented us for
ages. Caesar's laurel wreaths? Classic red herring, Kuntzman says.
Baldness is biblical, too -- from the Maccabees to Samson and Delilah (a
story Kuntzman calls "practically a commercial for Propecia") -- the
Old Testament is littered with hair loss. If there'd been email back then, it's
a good bet Elijah would be agonizing over whether or not to Buy Rogaine
"Help me ... help you. Help me, help you."
That famous line from the film Jerry Maguire may be the best advice a
doctor could give his or her patient.
"Some patients have the attitude, 'I'm putting myself in the hands of a
professional,'" says Stephen Permut, MD, chairman of family and community
medicine at Temple University School of Medicine in Philadelphia. "They want
you to make all their decisions for them."
Permut prefers to have patients get involved in their own care and engage
For as long as men have been fretting over their expanding foreheads,
they've been scrounging for hair loss treatments. From hippo fat pomades to the
urine of young foals, history is full of just-so-crazy-they-might-work
concoctions. They didn’t work. And a quick Googling reveals that most of the
products and services marketed today are only slightly less absurd.
In reality, there’s a very limited number of effective treatments for male
pattern baldness. Given that two-thirds of American men will experience a
significant level of thinning by the age of 35, it's worth running through the
The pill to prevent hair loss
Looking for a pill to keep from going bald? Finasteride, known more commonly
as Propecia, is taken daily in 1 mg doses. Because it works by lowering
dihydrotestosterone (DHT) levels, it’s assumed it can reduce hair loss for a
majority of men. It also often achieves a measure of regrowth.
"I recommend that everyone [with any hair loss] take finasteride,"
says Robert M. Bernstein, MD. Bernstein is associate clinical professor of
dermatology at Columbia University and founder of the Bernstein Medical Center
for Hair Restoration. "To patients who are younger,” he says, “I also
recommend minoxidil. But the mainstay is finasteride. The data show that, over
five years, it significantly retards hair loss in 85% of users."
Both finasteride and minoxidil, the only other FDA-approved hair loss
product (most commonly marketed as Rogaine), require a commitment. Stop either
of these hair loss treatments and your progress vanishes. Within months, you'll
lose whatever hair you managed to retain or grow back.
Finasteride does have potential sexual side effects. A very small percentage
of men experience decreases in libido and other problems, but this is rare and