My hair is thinning where I part it. Am I on my way to balding?

Hello,

Welcome to icliniq.com.

I saw your clinical picture (attachment removed to protect patient identity). It is grade 1 progressing to grade 2 androgenetic alopecia (AGA)/male pattern hair loss. Androgenetic alopecia is a progressive condition with hormonal and genetic influence. I would like to know if any of your family members are diagnosed with androgenetic alopecia.

Yes, Accutane (Isotretinoin) is known to cause alopecia but not AGA. Accutane causes diffuse hair loss. You will get back that hair after you stop Accutane. Treatment options include:

1. Minoxidil solution/ spray. Available in 2, 5 and 10 percent (concentration depends on grading). This is a long-term treatment. You need to use it for years.
2. Multivitamin hair nutrients containing biotin, calcium, and zinc.

I would like to mention few hair care tips here:

1. Always use lukewarm water to wash your hair, never hot water.
2. Do not comb your hair when it is wet.
3. Use a wide-toothed comb and the tip of the tooth should be blunt so that it does not irritate the scalp.
4. Avoid using hair dryers, straighteners.
5. Eat protein-rich food, egg, chicken, fish, milk, curd, lentils. Hair is made up of a protein called keratin. You need to have more protein in your diet.
6. Exercise daily for 40 minutes at least, six days a week. This is to keep hormones under normal balance. Androgenetic alopecia has hormonal influence as well.

Hope this little piece of information is helpful for you. Take care.

Hello,

Welcome back to icliniq.com.

Good to hear that you are working out every day and you are on a protein-rich diet. Minoxidil is Rogaine. It is available in 2, 5, and 10 % concentrations. It is an over-the-counter medication. You have grade 1 progressing toward grade 2. Yes, it definitely works.

The mechanism of action of Minoxidil is by increasing the blood supply to the hair roots so that it tries to halt the progression of hair loss. Also, it helps to grow new hair during the initial stages of AGA. You are a perfect candidate for Minoxidil. Accutane-induced hair loss is reversible. You will have to take hair nutrients as well, which have biotin (should be at least 10 mg), zinc, calcium, and pantothenate in it. Take one pill in the morning after breakfast. Use Anaphase shampoo, it is a good adjuvant shampoo while on Rogain.

There is another oral medication, it is called Finasteride. It is an antiandrogen medicine, it prevents the conversion of testosterone into dihydrotestosterone (DHT), DHT is the one responsible for hair loss in men. It is a prescription medication, you will have to do a blood test before taking it. I cannot prescribe it. I do not feel you need Finasteride at this stage. You can start with Rogaine 5 % topical spray/solution, apply six sprays in the morning after washing the scalp, and 6 sprays at night 30 minutes before going to bed. In the solution, use 1 ml in the morning and 1 ml at night. Apply to areas where it is less dense. The only thing is this therapy is a little expensive and to be used constantly for many years. If you stop it abruptly you will go back to the same density of hair prior to Minoxidil therapy.

Let me also tell you other options: Platelet-rich plasma (PRP) therapy - here we extract the growth factors from your 10 ml of blood and inject it into the scalp. These growth factors boost the growth of new hairs. This therapy is for faster results.