MEN'S HEALTH MATTERS:It may be an inherited condition, but can a receding hairline be stopped?
Q I’m 25 years of age. Over the past 12 months I have started to lose my hair and feel that I will be bald like my father. I was wondering if I can do anything about hair restoration. What would you advise?
AMale pattern hair loss (balding), also called androgenic alopecia, appears as a receding hairline with or without hair loss on the top of the head. It is an inherited condition. Men who develop balding are genetically more sensitive to the effects of the hormone dihydrotestorone (DHT). It is thought that DHT shortens the amount of time the hair spends in the growth phase. It also causes the hairs to become smaller and finer (miniaturisation).
It was said that baldness was inherited from the mother’s side of the family, but it is now believed that it can come from either side of the family. About 50 per cent of men by the age of 50 will have some degree of male pattern hair loss.
There are a number of treatments available for male pattern hair loss with varying success rates. Probably the most common is Minoxidil. Minoxidil is a Rogaine TM. This was originally a treatment for high blood pressure but it was noted that unwanted hair growth was one of the side effects. It’s since been made into a topical solution for treatment of hair loss. The way it works is that it dilates small blood vessels, though the exact way it restores hair growth is uncertain. It is unfortunately something that needs to be done on an ongoing basis because if you stop the treatment you usually return to your pre-treatment hair thickness within about four months.
It has a varying success rate, and generally the hair growth is finer and thinner than that of your normal hair.
There is a tablet called Finasteride (PropeciaTM), which blocks the enzyme, which converts testosterone to DHT. As a result, it decreases DHT’s effects on the hair. It is taken once a day. It is difficult to predict who will respond well and how much hair regrowth there will be.
There have been some large clinical trials; these were limited to mild to moderate hair loss. It is not known exactly how long you have to be on the treatment, but it is probably indefinitely. It does, however, have side effects, like all medications, and a more in-depth discussion with your doctor or dermatologist would be advisable if you are considering Finasteride.
Hair replacement surgery has also improved greatly over the past number of years, with the techniques becoming much more complex and, as a result, the cosmetic appearance has become much more subtle. Hair transplantation relies on the fact that there are areas of the scalp where the hair doesn’t tend to be lost, commonly on the sides and back of the head. Small pieces of hair and the hair roots from these areas are transplanted to the bald or thinning areas. This is usually a time consuming and laborious process and the number of hairs or transplantations can vary to involve thousands of grafts. It is not without its risks and is an expensive procedure. I would advise you to get as much advice from your own doctor, dermatologist, etc, about who to attend, what type of treatment to have before embarking on any programme.
Q I am 22 years of age and recently had a painful episode from an erupting wisdom tooth. Is it usual practice to remove wisdom teeth? If I do nothing about it, will it cause problems and could it cause my other teeth to go crooked?
AWisdom teeth can erupt at any time from 18 to 80. The trouble they cause can vary from none at all to a slight discomfort as they come through the gum (rather like a baby teething) to a full blown infection of the gum around the tooth, resulting in swelling in the area and an inability to open the mouth and also a raised temperature.
The lesser symptoms can be treated with warm salty mouth rinses (a level teaspoon of salt in a cup of warm water) and Ibuprofen (400mg three times daily for the duration of the discomfort). The more serious symptoms may require antibiotics in addition to the non-steroidal anti-inflammatory drugs mentioned above.
One painful episode does not mean that the tooth should be extracted. If it is coming up in good alignment and with room, it may be a one-off event.
If there is a repeat episode within a few months then it tends to be a recurrent problem and extraction will have to be considered. If the tooth is not coming through in a good alignment and is likely to cause damage to the adjacent tooth and tissues then extraction may also be the best option. Your dentist will be able to give you advice about this.
It used to be thought that erupting wisdom teeth could make your lower teeth crooked, particularly as the pain can often radiate them. This is not the case. Lower front teeth can begin to crowd as a natural phenomenon, which often occurs in the mid to late 20s. This can happen whether your wisdom teeth are extracted or not. You should consult your dentist who will give you more advice relating specifically to your problem.
- This weekly column is edited by Thomas Lynch, consultant urological surgeon, St James's Hospital, Dublin with a contribution from Dr Patrick Ormond, consultant dermatologist and dermatological surgeon, St James's Hospital, Dublin and from John Adye-Curran, dental surgeon, Rathfarnham, Dublin
