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Expert Q&A

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How can I keep from going bald?

Asked by Anthony, Tennessee

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I'm 28 and noticed my hair has started thinning out. My father is completely bald, and nobody on my mother's side is. For the first time this week, I can see my scalp through my hair. If I could simply keep the hair I have, I would be happy. What alternatives to drugs can you give me? I've done enough research to know that baldness is caused by DHT and have seen a lot of "DHT Blockers" on the Internet. Are there any vitamins I can take, shampoos I can use or foods to cut out of my diet that will help? I would prefer to use something that I didn't have to use every day simply from a cost standpoint. Thanks!

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Living Well Expert Dr. Jennifer Shu Pediatrician,
Children's Medical Group

Expert answer

Thanks for your question. Male pattern baldness (also called androgenetic alopecia) is the most common cause of hair loss. It tends to run in families and can start as early as the teen years. This type of hair loss affects about one-third of men and women, but while men may lose most or all of their hair, women typically just have thinning. Males are more prone to the condition if other males in the family have had hair loss, and women tend to take after other women in the family who have had thinning hair. This type of hair loss is thought to be caused by an imbalance of hormones causing an increased amount of DHT, or dihydrotestosterone, and may have a genetic link to a part of the X chromosome.

I consulted with a dermatologist, Dr. Jeffrey Benabio of The Derm Blog, who shared the following information:

Progression of hair loss can be stopped or slowed by using minoxidil 5 percent topical solution (Rogaine) twice daily. For men, an oral medication called finasteride (Propecia) also helps stop hair loss by blocking the production of DHT. It takes several months for these treatments to start working, and hair loss will begin again if the medications are stopped.

Unfortunately, there is little evidence to show that dietary supplements, vitamins or shampoos can help. If a person has low iron levels (which is rare in men), then taking an iron supplement may help. Nutritional deficiencies are uncommon, but they can cause hair loss. In malnourished people, multivitamins can have some benefit. Prenatal vitamins do not help hair loss in otherwise healthy people.

Topical DHT-blocking treatments are widely advertised on the Internet. In theory, they could be helpful; however, there are no good studies that show they work. Minoxidil has been shown in studies to regrow hair in people with male pattern baldness and would be a better use of your money.

Finally, applying various herbs or oils to the scalp have been suggested as possible treatments; however, there are no scientific studies that these remedies help. Hair loss is common, and unfortunately, companies often exploit people's desperate desire to grow hair to sell their products.

Hair loss may also be caused by diseases: thyroid disorders, poor diet, stress, recent surgery or trauma, and medications can all cause hair loss. Addressing any of these problems may prevent further hair loss. I encourage you to talk with your doctor about the best treatment for your situation. Good luck!

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