Men cannot stop themselves going bald but it is now scientifically possible to delay the process for a decade or two and perhaps even more.
This can be achieved through the use of a new drug called Propecia. Propecia is the fust genuine oral medication designed to prevent hair loss, and in most men it goes beyond this and actually reverses balding by stimulating new growth.
While this sounds like the answer to many prayers, there is a price. The drug has to be taken every day to maintain the effect. If a man wants to delay balding for a decade, he has to take one little brown Propecia pill every day for 10 years. Once he stops, balding will resume.
Although some pharmacies discount the price, the drug is expensive and usually costs about $80 a month on private prescription. For those who do not have private health insurance and therefore cannot get a rebate, the cost of taking it over a decade runs well past $9000.
Experts say that while the drug is effective for 99 per cent of men, those who want to use it have to be well motivated because it is slow to work. After about 4 months, half the men taking the drug notice less hair in their combs and less on the pillow in the morning. The other half don’t notice because they never look.
Waiting for results can be frustrating, because for many months the change is not readily apparent. Then, at about 12 months, men can be heard saying, ‘Hey, I’ve got no worse.’
As long as men stay on the drug, their existing hair will be protected and no more will fall out. The situation with regrowth is more complex. While propecia facilitates substantial regrowth in the first year, there is less in the second year and then even less or none in the third and fourth years. This does not necessarily mean that no new hair will grow in future. In its growth cycle, human hair usually grows for 2 years and rests for 2. It is not known if propecia will facilitate a new growth cycle again in years 5 and 6.
Men can use a special global scalp camera to monitor their progress. Using the same positions, settings and lighting, over a year the camera takes a close-up series of colour photographs of the scalp showing hair changes.
Male-pattern balding can start anytime after puberty. Traditionally, it begins with a receding frontal hairline, which is followed by a bald patch over the crown. Eventually all hair is lost except for a rim around the head. Twenty per cent of men will start showing signs of such hair loss by the age of 20, 30 per cent by the age of 30. As each subsequent decade passes, the percentage will increase proportionately.
Once balding begins, it continues in fits and starts for the next 10 to 40 years. Men commonly go through phases of accelerated hair loss lasting 3 to 6 months followed by periods of stability lasting 6 to 18 months.
The pattern of balding is determined by two things: genetic inheritance and male hormones. Little can be done about the inheritance (the balding gene is still to be found) but something can be done about the hormones. By interrupting the hormones, Propecia is able to put the genetic process on hold. The hormone that is linked to balding is a derivative of testosterone called dihydrotestosterone. The drug works by stopping the conversion of testosterone into this derivative. The beauty of it is that it does not interfere with testosterone levels in the body and therefore does not have any marked effect on virility or masculinity.
During clinical trials it was found that about 0.5 per cent of men reported either loss of libido or slightly softer erections. At higher doses Propecia is capable of shrinking an enlarged prostate and research is under way to see if smaller doses have a similar effect. Researchers are also evaluating whether this drug has a role in the prevention of prostate cancer.
Although the clinical trials were conducted on men with mild to moderate balding, the drug may also work on men with advanced balding. Some men with extensive hair loss have experienced regrowlh on Propecia.
Generally, the drug is well tolerated, and with long-term use, no adverse effects are anticipated. It will not cause men to sprout new hair in unexpected places – its action is confined to the head.
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