From the Guidelines
Male pattern baldness can be effectively treated with topical minoxidil and oral finasteride, which are the most proven options for preventing further hair loss and promoting hair regrowth. These treatments have been shown to be effective in numerous studies, including a recent review of 30 articles by a task force assigned by the Indian Association of Dermatologists 1. Minoxidil works by prolonging the growth phase of hair follicles and increasing blood flow to the scalp, while finasteride blocks the conversion of testosterone to dihydrotestosterone (DHT), the hormone primarily responsible for male pattern hair loss.
Some key points to consider when treating male pattern baldness include:
- Starting treatment early, as it is more effective at preventing further hair loss than regrowing already lost hair
- Continuing treatment long-term, as stopping will result in resumed hair loss
- Potential side effects of finasteride, including reduced libido or erectile dysfunction in a small percentage of users
- Additional options, such as low-level laser therapy devices and hair transplantation surgery, which can be effective for appropriate candidates
It's also worth noting that platelet-rich fibrin (PRF) has shown promise as a safe and effective treatment for androgenetic alopecia, particularly in mild cases 1. However, more research is needed to fully understand its efficacy and optimal treatment protocols. In contrast, the evidence for platelet-rich plasma (PRP) is more controversial, and further studies are needed to standardize its preparation and treatment protocols 1.
Key treatment recommendations for PRP include:
- Using a manual double-spin method for preparation
- Performing a minimum of 3-5 sessions with a 1-month interval between sessions
- Using a recommended dose of 5-7 mL PRP with a concentration of 1-1.5 million platelets per uL
- Not requiring activation of PRP when used for androgenetic alopecia 1.
From the FDA Drug Label
Minoxidil topical solution 5% is for men with hair loss or thinning hair that begins on the vertex of the scalp. Minoxidil topical solution 5% is more likely to regrow hair in men with hair loss in the range shown. If men have more hair loss than shown, minoxidil topical solution 5% may not work.
Minoxidil topical solution 5% is indicated for the treatment of male pattern baldness, specifically for men with hair loss or thinning hair on the vertex of the scalp. The medication is more likely to be effective in men with a limited amount of hair loss. If the hair loss is more extensive, the medication may not work 2.
From the Research
Definition and Prevalence of Male Pattern Baldness
- Male pattern baldness, also known as androgenetic alopecia (AGA), is a common hair loss disorder affecting up to 80% of males by the age of 80 3.
- It is characterized by androgen-related progressive thinning of hair in a defined pattern, resulting in diminished self-esteem, reduced confidence, and distress in affected men 3.
Treatment Options for Male Pattern Baldness
- Finasteride 1 mg daily and topical 5% minoxidil twice daily are recommended as first-line treatments for male-pattern hair loss (MPHL) 4.
- Other treatment options include self-hair transplantation, irradiation by light-emitting diodes and low-level lasers, and topical application of adenosine for MPHL 4.
- Minoxidil, finasteride, and low-level laser light therapy are effective for promoting hair growth in men with androgenetic alopecia 5.
Effectiveness of Treatments
- A systematic review and meta-analysis found that minoxidil, finasteride, and low-level laser light therapy are superior to placebo in promoting hair growth in men with androgenetic alopecia 5.
- Topical minoxidil 2%-5% 1 mL twice daily or finasteride 1 mg daily are recommended as first-line treatments, followed by the use of Food and Drug Administration-cleared HairMax LaserComb® in patients who do not respond to first-line modalities 6.