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Causes
Doctors do not know why certain hair follicles are programmed to have a shorter growth period than others. Although a person's level of androgens -- male hormones normally produced by both men and women -- is believed to be a factor, hair loss has nothing to do with virility. For that matter, the presence or absence of dandruff has no effect on balding either. An individual's genes, however -- from both male and female parents -- unquestionably influence that person's predisposition to male or female pattern baldness.

Temporary hair loss can occur in conjunction with a high fever, a severe illness, thyroid disorders (see Thyroid Problems), iron deficiency, general anesthesia, drug treatments, hormonal imbalance or extreme stress, and in women following childbirth. In these conditions, collectively known as telogen effluvium, a large number of hair follicles suddenly go into a resting phase, causing hair to thin noticeably. Drugs that can cause temporary hair loss include chemotherapeutic agents used in cancer treatment, anticoagulants, retinoids used to treat acne and skin problems, beta-adrenergic blockers used to control blood pressure, and oral contraceptives.

Hair loss can also be caused by burns, X-rays, scalp injuries and exposure to certain chemicals -- including those used to purify swimming pools, and to bleach, dye and perm hair. In such cases, normal hair growth usually returns once the cause is eliminated. Ringworm can also cause hair loss.

The causes of alopecia areata, a disorder that often strikes children or teen-agers, remain unexplained. In most cases the hair grows back, although it may be very fine and possibly white before normal coloration and thickness return.

Although too-frequent washing, permanent waves, bleaching, and dyeing hair do not cause baldness, they can contribute to overall thinning by making hair weak and brittle. Tight braiding and using rollers or hot curlers can damage and break hair, and running hair picks through tight curls can scar hair follicles. In most instances hair grows back normally if the source of stress is removed, but severe damage to the hair or scalp sometimes causes permanent bald patches.

Treatment
Hormone therapy may be prescribed for certain types of hair loss, but not without some risk. Although most cases of alopecia areata are resolved naturally, some doctors try to speed recovery with corticosteroids applied topically or injected in the scalp. The treatment may be painful and may cause permanent scarring in the scalp brought on by skin atrophy. Cortisone taken orally may stimulate new hair growth, but the effect is likely to be temporary. Prednisone, another orally administered steroid, has proved effective for alopecia areata patients, but its potential side effects include weight gain, metabolic abnormalities, acne and menstrual problems. Hormone therapy in the form of birth-control pills may reverse baldness due to hormonal imbalances in young women.

Hair transplantation involves the relocation of plugs of skin from parts of the scalp containing active hair follicles to bald areas. A patient may need several hundred plugs -- implanted 10 to 60 at a session. The transplanted hair may drop out, but new hair usually begins to grow from the transplanted follicles within several months.

A form of cosmetic surgery called scalp reduction involves tightening the scalp so that hair-bearing skin from the back and sides of the head is pulled toward the crown. Hair may then be transplanted to the remaining bald area at the top of the head. Like hair transplants, the process is painful and expensive, and it does nothing to retard genetic or age-related hair loss.

On average 20 percent of the world's male population report hair loss during their lifetime. Hair loss can begin as early as the teenage years; by age 35 almost 40 percent of men demonstrate some degree of hair loss.

Propecia (finasteride) is the first prescription oral medication for the effective treatment of male pattern hair loss. In clinical trials Propecia was shown to:

Maintain or increase the amount of hair in 83 percent of men.
Promote visible hair regrowth in 66 percent of men.
Reduce the level of dihydrotestosterone (DHT), an apparent cause of hair loss.
Demonstrate an excellent safety profile.

Propecia Testimonials

"I started taking Propecia and I noticed a black spot (of hair) on my head that I never had before. I though I would let you know that you have a winner with Propecia. Good luck!"

"I have been using Propecia for just over a month, and its doing wonders for me."

"I am thrilled with Propecia. I have been counting my hairs and I was losing about 160 hairs every two days. After 2 months on Propecia, I am losing only 32 to 36 hairs a day."

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"I have been taking Propecia for 4 months. I love it. You wouldn't believe my head. My hair doesn't seem to be falling out anymore, or at least I'm losing a lot less than I used to. I'm so happy!"

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