Men's health: hair and skin problems
There are a number of common skin and hair problems for which men seek advice from pharmacists. These include hair loss, shaving problems, acne and fungal infections.
Male pattern baldness
Male pattern baldness (alopecia androgenetica) is the most common form of hair loss in men. It usually develops gradually and typically involves the appearance of a bald spot on the crown of the scalp, accompanied by hair thinning at the temples. Male pattern baldness can start at any time, but most men first become aware of it as they approach their thirties. It is estimated that two-thirds of all men will be affected by male pattern baldness. This occurs most commonly in Caucasians, followed by Afro-Caribbeans. Male pattern baldness is hereditary but, curiously, maternal genes appear to have the stronger influence.
Male pattern baldness is androgen-dependent and may be associated with oversensitivity of hair follicles to dihydrotestosterone (DHT). Men with a genetic deficiency of type-II 5a-reductase (the enzyme that converts testosterone to DHT) do not develop male pattern baldness. One study has shown a link between smoking and hair loss.
Other types of hair loss can be caused by serious systemic illness, chemotherapy, scalp infections (eg, ringworm), stress and thyroid disease. It is important to establish the correct diagnosis because some types of hair loss can be reversed.
It is now recognised that male pattern baldness can cause considerable psychological distress and have a significant impact on quality of life. Consequently, some men with male pattern baldness are easy targets for charlatans and miracle-cure merchants. Referral to a qualified trichologist (see Institute of Trichologists website: www.trichologists.org. uk) can be helpful but this service is not available on the NHS. Nothing can prevent male pattern baldness and only general measures such as good hair care, avoidance of unnecessary trauma to the hair or scalp and a balanced diet can be recommended. Advice from a hair stylist can also help (eg, a short haircut draws less attention to thinning or receding hair than hair combed over a bald spot).
Effective treatments for baldness are drug treatment (using the antihypertensive minoxidil or the anti-androgen finasteride) or hair transplants.
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Citation: The Pharmaceutical Journal URI: 10997048
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