Dr.Venkataram Mysore MBBS.DVD.DNB. MD.DipRCPath (Lond) FRCP (Glasgow)
It is very important to understand male pattern hairless is a progressive
condition and hence patients need a combination of drugs in addition to HT.
Otherwise, fresh areas will become bald in future. Presently, there are
a) Minoxidil lotions 2%, 3, 5, 7, 10, 12.5%-it has to be applied daily twice
b) Finasteride 1mg tablets (propecia) - one tablet daily for 3-4 years and is
c) Combination of minoxidil with other drugs such as retinoic acid, azelaic
Other nondrug options include Platelet rich plasma micro needling. and low
level laser. These are second line options and are used when drugs don’t
THE DRUGS ARE OF GREAT VALUE IN PREVENTING FUTURE
BALDNESS AND THEREFORE IN ALL YOUNG PEOPLE WITH EARLY
HAIRLOSS, THEY ARE NEEDED TO BE TAKEN. Most young patients
with early and moderate baldness need drugs, even after they do
transplantation. Otherwise, they will lose their existing hairs and
need further sessions of transplantations.
There is no fixed period and course, as there is no curative effect of these
drugs. The drugs need to be taken as long as one wants to maintain hairs.
Usually for most people this means till they marry, establish their careers
and settle down. This means several years for any young man.
This is the most frequently asked question; there is a lot of misinformation
and exaggeration about the side effects. The patients need to understand
a) Any drug that has an effect will always have a side effect; there is no
b) So the real question should be: are these side effects serious, are they
Minoxidil cause minor itching; other wise it is safe. Finasteride is currently
the best drug for treating baldness. There is much exaggerated fear about its
side effects of impotence and infertility. This has been researched in detail in
several studies- and has been found that at the dosage at which it is given
for baldness, which is 1 mg daily or 5 mg weekly, it has been found to be
relatively safe. The side effects which have happened in 2% of patients
include sexual side effects such as sexual dysfunction, impotence. Even these
have been found to be temporary and reversible in most patients. So the
patient can stop them any time he wants to, around marriage time or
pregnancy time. FDA (federal drug administration USA) has recommended
that there is no causal relationship between the drugs and the side effect.
In our experience, we have found the drug to be safe. As a matter of caution,
we use the drug at half the recommended dose.i.e. 1 tab alternate days and
have found it to be effective and safe. We recommend that the drug be taken
without any hesitation, At the same time, we recognize the right of a patient
.In case the patient is not willing to take the drug, we emphasise that the
a) There are only two proven drugs for treating pattern hair loss.
b) The intake of drugs is not compulsory, but entirely voluntary.
These are not life saving drugs; therefore, a doctor does not force any
c) If out of any fear improper evidence, patient decides not to take
them, it is entirely his decision-however, there are no other proven
drug alternatives and therefore he should accept future hair loss and
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