Older men who have not lost hair from the front sides of their heads probably do not have much testosterone.
A derivative of the male hormone, testosterone, called dihydrotestosterone, causes male pattern baldness. With aging, hair on the front sides and top of the head become thinner, lighter and shorter so that you have difficulty seeing it. A 2% solution of monoxidil, called Rogaine, increases the blood supply to these hairs and helps to slow their loss, although it really does not effectively help to grow new hair. Another drug, called spironolactone, can block the male hormones that cause hair loss, but when taken by mouth, it can cause loss of sexual drive and impotence. However when it is applied to the scalp as a 2% solution in alcohol, it also can slow hair loss. When Rogaine solution is applied to the scalp at the same time as spironolactone, it emits a highly offensive odor, so they cannot be applies together. On the other hand, Rogaine can be applied in the morning and a 2% solution of spironolactone can be applied at night without causing the odor. The Food and drug Administration has not approved spironolactone solution for treatment for hair loss.
Many doctors have lost their initial enthusiasm for Proscar, the drug used to treat enlarged prostates. Men and women have two masculinizing hormones: testosterone and dihydrotestosterone. Testosterone is necessary for sexual desire and the ability to achieve an erection and it does not cause hair loss. However, in the cells, testosterone can be converted to dihydrotestosterone which does cause hair loss. Proscar blocks the formation of dihydrotestosterone, but it has not been shown to prevent male pattern baldness effectively in humans.
By Gabe Mirkin, M.D., for CBS Radio News
1) AL Dallob, NS Sadick, W Unger, S Lipert, LA Geissler, SL Gregoire, HH Nguyen, EC Moore, WK Tanaka. The effect of finasteride, a 5 alpha-reductase inhibitor, on scalp skin testosterone and dihydrotestosterone concentrations in patients with male pattern baldness. Journal of Clinical Endocrinology and Metabolism 1994(Sep);79(3):703-706.
2) F Fruzzetti, D Delorenzo, D Parrini, C Ricci. Effects of finasteride, a 5 alpha-reductase inhibitor, on circulating androgens and gonadotropin secretion in hirsute women. Journal of Clinical Endocrinology and Metabolism 1994(Sept);79(3):831-835.
3) E Stoner, GL Andriole, R Boake, BR Bracken, W Brannan,H Fuselier, W Bremner, RC Bruskewitz, CE Cox, AL Patterson, GR Cunningham, PC Devine, PF Schellhammer, M Elhilali, J Geller, JT Grayhack, LH Harrison, PB Hudson, J Imperato, ED Vaughan, MM Lieber, MC Lippert, GH Malek, JD Mcconnell, P Narayan, JP Perreault, MI Resnick, R Norman, R Rittmaster, NA Romas et al. 3-Year Safety and Efficacy Data on the Use of Finasteride in the Treatment of Benign Prostatic Hyperplasia. Urology 1994(March);43(3):284-294. To make spironolactone solution: 1210 mg spironolactone in 60 cc ethyl alcohol plus 10 cc propylene glycol.
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