Hair Loss/Hair loss
QUESTION: I am suffering from male pattern baldness (my front hairline has receded quite a bit) and now hair on the crown is thinning.I used to loss hair with bulbs when I started losing hair 5/6 years ago, but now apparently I am not losing hair.Still, it is thinning.I am using Minioxidil 5% but I can't see any development apparently. Besides, sometimes I see some small broken hairs during bath. Is the solution good for male pattern baldness?My skin and scalp is not oily. Does washing scalp with hot water help? If yes, what is the right procedure?I maintain a good diet and I do exercise. However, both my parents and few of my kinsmen have hair loss problems.Oil massage with coconut oil or herbal oil is a traditional practice here. Is it harmful? Is any kind of medication or diagnosis necessary? Please communicate any kind of medication or diagnosis necessary? Please communicate if there is any way for regrowth. Regards.
ANSWER: Thank you for including a photo. It is pretty certain from distribution of hair loss seen in the photo plus the family history of others with hair loss that you have inherited male pattern baldness. Shampooing with hot water is not going to help. The use of a 1% zinc pyrithione shampoo will gradually release zinc ions into the skin which will inhibit the enzyme which make DiHydroTestosterone -DHT- the hormone which tells the hairs to grow old. 2%Ketoconizole shampoo is also beneficial in lowering the DHT in the hair follicle. You should be able to buy both from the Chemist where you live and alternate their use, shampooing daily. Stay away from hot oil massages of the scalp as the oil can kill the follicles if too hot. The best medication you can get is 1mg Finasteride taken daily and in India it is available as Finpecia. That will lower your DHT by 66% which is enough so that you will have a very good chance of stopping the baldness and even getting some back.
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QUESTION: Thank you sir for your valuable time and prescription. I have few more questions and would be beneficiary through the answers--
(1) How long should I continue medication? (Finasteride and minioxidil)
(2) Some people say finasteride impacts sexual capacity? Do you have any comment on that?
(3) Is washing head with hot water harmful for scalp?
(4) In Bangladesh, only Ketoconizole shampoo is available. Is it enough or do we need both the shampoos?
(5)Will Zinc Sulphate USP 61.8mg capsule will work as an alternative of 1% zinc pyrithione shampoo?
1. You should use finasteride daily until we come up with a topical lotion which works better or until you do not care if you go bald.
2. The actual controlled studies done scientifically with many thousands of men studied showed only one man in 400 wanted to stop the medication due to sexual capacity. I think the medication is very safe and have taken it myself for the past 21 years and prescribed it seven years ago for my son when he was 20 years old. The misinformation on the internet comes from blogs and not medical journals.
3. Washing with warm water is not harmful.........very hot water could cause problems.
4. Daily Ketoconizole shampoo should be adequate to suppress DHT better than most other shampoos.