Patient: Dear Doctor I am a 25 year old, male who has been suffering from continous hair loss for the last 4 years. My hair has gone extremely thin and bald patches are appearing. I do not have a family history of hair loss. I have been using minoxidil and finasteride over the last 4 years and no change has occurred. My hair continously falls. Please could you indicate why this is the matter and what I can do to resolve this issue, I do not wish to have a hair transplant but I would like to try out any other medications or lotions to resolve the issue. Thanks
Doctor: Androgenic alopecia (male pattern baldness) is caused by high testosterone levels. It is a distressing condition special ly in younger individuals. Minoxidil and Finasteride are approved drugs for treatment of baldness in men. Nizoral shampoo, commonly used as an anti-dandruff, is also observed to improve baldness however, it is not approved as a recommended treatment for baldness. Laser treatment for baldness is a new option but can be pricey and still needs further studies to assess the risks vs benefits. Hair transplant is a more promising option. I will take the liberty of imposing lifestyle modifications as these may also help improve baldness. Aerobic exercise has the effect of decreasing testosterone levels hence can improve baldness. Metabolic syndrome, aka as insulin resistance syndrome, may also cause baldness. To diagnose this, the weight, height, waist circumference, blood pressure, blood cholesterol and blood sugar levels should be known. If your weight is more on the heavy side, try consulting your doctor and ask if you have metabolic syndrome. Correcting this paired w/ lifestyle modification may help improve baldness. You may want to consult a dermatologist to know more of your options. I do hope I have enlightened you in some way. I wish you well always.