Early male pattern alopecia can be a major psychological
problem to a young male. This 18 year old has early significant retraction of
his anterior hair line and also had some occipital thinning. There was a family
history of baldness but only in the grandparents. For this reason hormone
studies were done including testosterone and dehydroepiandrosterone (DHEAS) in
case of adrenal problems but these were all normal. He did not have hirsuitism
elsewhere or bad acne and was not taking any gym steroid supplements. Minoxidil topically or Finasteride orally
will slow down the rate of hair loss in virtually all treated patients. However
actual hair regrowth occurs in only 10% of topical minoxidil and 20% of oral finasteride
treated patients. The treatments are often combined. If hair regrowth occurs
the treatments must be continued indefinitely or the regrown hair will fall
out. Significant side effects are rare. Dutasteride is a new drug acting like
finasteride but more effective and well tolerated.
