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Propecia
Long Term Test
Propecia Information (in the news)
The following
represent a comprehensive list of articles that address the use of
Propecia for hair loss treatment:
New Five-Year Study with Propecia Showed That the
`Hair Count' Gap Grew Over Time Between Men Who Treated Hair Loss with
Propecia, Compared to Men Who Didn't
PR Newswire
March, 2001
Finasteride Cuts Risk of Further Visible Hair Loss in Men
Doctors Guide News
July, 2002
Finasteride - A Review of Its Use in Male Pattern Hair Loss
Impotence & Male Health Weekly Plus
February, 1999
As
Young as You Feel: Weapons to Combat the Effects of Aging
Men's Fitness
Feb, 1999
Information from Your Family Doctor
American Family Physician
April, 1999
Drug Update: Hair Loss in Men
Family Practice news
April , 2001
Alopecia Areata
American Family Physician
April, 1990
The
Sex Appeal of Bald Men. (famous African American bald men)
Ebony
March, 1994
New Five-Year Study
with Propecia Showed That the `Hair Count' Gap Grew Over Time Between
Men Who Treated Hair Loss with Propecia, Compared to Men Who Didn't
PR Newswire
March 15, 2001
The longest
controlled clinical trial of a hair loss treatment ever reported showed
that men who took Propecia(R) (finasteride 1 mg) compared to men who
took a placebo had a considerable difference in their hair counts after
five years, according to data presented at the 59th Annual Meeting of
the American Academy of Dermatology.
The new study
showed a difference of 277 hairs in a one-inch diameter circle of scalp
in favor of men treated with Propecia for five years (n=219) vs. those
who received a placebo (n=15). Baseline hair counts of all men at the
start of the study averaged 876 hairs in the one-inch diameter circle.
"This study
provides new, long-term scientific data that Propecia helped the
majority of men with predominantly vertex male pattern hair loss keep
the amount of hair they have," said Keith Kaufman, M.D., senior
director, Clinical Research, Merck Research Laboratories. "The study
also was the first controlled clinical trial to evaluate the course of
untreated hair loss over a five-year period and to show the progressive
nature of male pattern hair loss."
Made by Merck &
Co., Inc., Propecia is indicated for the treatment of certain types of
hair loss in men only, based upon two-year studies. Propecia is a
once-a-day treatment and is the only pill for male pattern hair loss
approved by the Food and Drug Administration. Hair loss affects
approximately 30 million men in the United States. Propecia is not
indicated for use in women or children.
The five-year data
are from investigational extension studies of double- blind
placebo-controlled clinical trials that first demonstrated the safety
and efficacy of Propecia in 1,553 men age 18 to 41 with mild-to-moderate
male pattern hair loss (androgenetic alopecia) in the vertex region (top
of the head). Efficacy in bi-temporal recession (hair loss at the
temples) has not been established.
Men who entered
the initial 12-month studies of Propecia were randomized to receive
either Propecia (n=779) or placebo (n=774). The initial 12-month studies
were extended on an annual basis, with only a small number of men
remaining on placebo in subsequent years, as specified in the study
design. Men who completed each one-year extension were given the
opportunity to enroll in the next one-year extension, for up to five
years. The five-year data presented focused on the results of men who
continued on the same therapy -- either Propecia or placebo -- for the
entire five years.
Five-year
efficacy results
The studies
assessed the efficacy of Propecia by four separate endpoints: hair
counts in a one-inch diameter circle of the scalp; assessments of
"before" and "after" photographs by a panel of dermatologists; patient
questionnaires and investigator assessments of changes in scalp hair
growth. The effectiveness of Propecia vs. placebo was demonstrated as
follows:
-- Hair count: At
the start of the studies, baseline hair counts averaged 876 hairs in a
one-inch diameter area of scalp. By the end of the first year, men
taking Propecia had an average of 126 more hairs than men taking
placebo. This difference continued to grow, and, by the end of the fifth
year, the net difference between the groups increased to 277 hairs in
favor of the men taking Propecia. At the end of the fifth year, 65
percent of men taking Propecia (n=219) maintained or improved their hair
count compared to their hair count at the start of the studies, while
all of the men on placebo (n=15) lost hair count.
-- Before and
after photos: The panel of dermatologists who reviewed standardized
clinical photographs of men treated with Propecia (n=279) and men on
placebo (n=16) at the end of the five-year study rated 90 percent of men
treated with Propecia as having had no further visible hair loss
compared to baseline vs. 25 percent of men on placebo.
-- Patient
questionnaires: Questionnaires completed at five years by men on
Propecia (n=284) and by men on placebo (n=15) showed that men treated
with Propecia indicated a higher level of satisfaction with the
appearance of: their hair overall (63 percent vs. 20 percent), the hair
on top of their heads (59 percent vs. 13 percent) and their frontal
hairline (48 percent vs. 7 percent). Men treated with Propecia were more
likely to say that: their bald spot was getting smaller (61 percent vs.
20 percent); the appearance of their hair had improved (77 percent vs.
40 percent); they had experienced increased hair growth (75 percent vs.
40 percent) and their hair loss had slowed (90 percent vs. 67 percent).
-- Investigator
assessments: Physician investigators who evaluated the men treated with
Propecia (n=279) and men on placebo (n=13) at the end of five years
determined that 77 percent of the men treated with Propecia had
increases in scalp hair, compared with 15 percent of men on placebo.
Five-year
safety profile
The five-year
study confirmed the excellent safety profile of Propecia. In the initial
12-month clinical studies, the following side effects were the most
common and reported by a very small number of men: less desire for sex
(1.8 percent vs. 1.3 percent on placebo), difficulty in achieving an
erection (1.3 percent vs. 0.7 percent on placebo) and a decrease in the
amount of semen (0.8 percent vs. 0.4 percent on placebo). These sexual
side effects went away in all men who discontinued therapy because of
them and also disappeared in most (56 percent men who chose to continue
taking Propecia through the fifth year of the study. By the end of the
fifth year, the incidence of those side effects was less than or equal
to 0.3 percent in men who continued treatment with Propecia vs. men on
placebo.
Important
information about Propecia
Propecia is not
for use in women or children. Further, women must not use Propecia when
they are or may potentially be pregnant because it may cause
abnormalities of the male baby's sex organs. In addition, women should
not handle crushed or broken tablets when they are pregnant or may
potentially be pregnant.
Propecia tablets
are coated, which will prevent contact with the active ingredient during
normal handling provided that the tablets have not been broken or
crushed.
If the treatment
does not show results within 12 months, further treatment is unlikely to
be of benefit. If treatment is stopped, the hair that is gained will
gradually be lost.
Propecia was
approved by the FDA in December 1997 and is currently available in 53
countries worldwide.
Additional
resources
Men seeking
additional information about hair loss and Propecia can visit
http://www.propecia.com/
The website also includes a morphing device to allow men to view how
they might look if their hair loss progresses. Only a doctor can
determine if Propecia is right for an individual.
Merck & Co., Inc.
(NYSE: MRK) is a leading research-driven pharmaceutical products and
services company. Merck discovers, develops, manufactures and markets a
broad range of innovative products to improve human and animal health,
directly and through its joint ventures. Merck-Medco Managed Care
manages pharmacy benefits for employers, insurers and other plan
sponsors, encouraging the appropriate use of medicines and providing
disease management programs. Through these complementary capabilities,
Merck works to improve the quality of life and contain overall
health-care costs.
Propecia(R) is the
Merck registered trademark for finasteride 1 mg.
PROPECIA
(Finasteride)
Tablets
Patient
Information about
PROPECIA(R)
(Pro-pee-sha)
Generic name:
finasteride (fin-AS-tur-eyed)
PROPECIA is for
use by MEN ONLY.
Please read this
leaflet before you start taking PROPECIA. Also, read the information
included with PROPECIA each time you renew your prescription, just in
case anything has changed. Remember, this leaflet does not take the
place of careful discussions with your doctor. You and your doctor
should discuss PROPECIA when you start taking your medication and at
regular checkups.
What is
PROPECIA used for?
PROPECIA is used
for the treatment of male pattern hair loss on the vertex and the
anterior mid-scalp area.
PROPECIA is for
use by MEN ONLY and should NOT be used by women or children.
What is
male pattern hair loss?
Male pattern hair
loss is a common condition in which men experience thinning of the hair
on the scalp. Often, this results in a receding hairline and/or balding
on the top of the head. These changes typically begin gradually in men
in their 20s.
Doctors believe
male pattern hair loss is due to heredity and is dependent on hormonal
effects. Doctors refer to this type of hair loss as androgenetic
alopecia.
Results of clinical studies:
For 12 months,
doctors studied over 1800 men aged 18 to 41 with mild to moderate
amounts of ongoing hair loss. All men, whether receiving PROPECIA or
placebo (a pill containing no medication) were given a medicated shampoo
(Neutrogena T/Gel(R) Shampoo). Of these men, approximately 1200 with
hair loss at the top of the head were studied for an additional 12
months. In general, men who took PROPECIA maintained or increased the
number of visible scalp hairs and noticed improvement in their hair in
the first year, with the effect maintained in the second year. Hair
counts in men who did not take PROPECIA continued to decrease.
In one study,
patients were questioned on the growth of body hair. PROPECIA did not
appear to affect hair in places other than the scalp.
Will
PROPECIA work for me?
For most men,
PROPECIA increases the number of scalp hairs, helping to fill in thin or
balding areas of the scalp. Men taking PROPECIA noted a slowing of hair
loss during two years of use. Although results will vary, generally you
will not be able to grow back all of the hair you have lost. There is
not sufficient evidence that PROPECIA works in the treatment of receding
hairline in the temporal area on both sides of the head.
Male pattern hair
loss occurs gradually over time. On average, healthy hair grows only
about half an inch each month. Therefore, it will take time to see any
effect.
You may need to
take PROPECIA daily for three months or more before you see a benefit
from taking PROPECIA. PROPECIA can only work over the long term if you
continue taking it. If the drug has not worked for you in twelve months,
further treatment is unlikely to be of benefit. If you stop taking
PROPECIA, you will likely lose the hair you have gained within 12 months
of stopping treatment. You should discuss this with your doctor.
How should
I take PROPECIA?
Follow your
doctor's instructions.
-- Take one tablet
by mouth each day.
-- You may take
PROPECIA with or without food.
-- If you forget
to take PROPECIA, do not take an extra tablet. Just take the next tablet
as usual.
PROPECIA will not
work faster or better if you take it more than once a day.
Who should
NOT take PROPECIA?
-- PROPECIA is for
the treatment of male pattern hair loss in MEN ONLY and should not be
taken by women or children.
-- Anyone allergic
to any of the ingredients.
A warning about
PROPECIA and pregnancy.
-- Women who are
or may potentially be pregnant:
-- must not use
PROPECIA
-- should not
handle crushed or broken tablets of PROPECIA.
If a woman who is
pregnant with a male baby absorbs the active ingredient in PROPECIA,
either by swallowing or through the skin, it may cause abnormalities of
a male baby's sex organs. If a woman who is pregnant comes into contact
with the active ingredient in PROPECIA, a doctor should be consulted.
PROPECIA tablets are coated and will prevent contact with the active
ingredient during normal handling, provided that the tablets are not
broken or crushed.
What are
the possible side effects of PROPECIA?
Like all
prescription products, PROPECIA may cause side effects. In clinical
studies, side effects from PROPECIA were uncommon and did not affect
most men. A small number of men experienced certain sexual side effects.
These men reported one or more of the following: less desire for sex;
difficulty in achieving an erection; and, a decrease in the amount of
semen. Each of these side effects occurred in less than 2% of men. These
side effects went away in men who stopped taking PROPECIA. They also
disappeared in most men who continued taking PROPECIA.
In general use,
the following have been reported infrequently: allergic reactions
including rash, itching, hives and swelling of the lips and face;
problems with ejaculation; breast tenderness and enlargement; and
testicular pain.
Tell your doctor
promptly about these or any other unusual side effects.
-- PROPECIA can
affect a blood test called PSA (Prostate-Specific
Antigen) for the screening of prostate cancer. If you have a PSA test
done, you should tell your doctor that you are taking PROPECIA.
Storage
and handling.
Keep PROPECIA in
the original container and keep the container closed. Store it in a dry
place at room temperature. PROPECIA tablets are coated and will prevent
contact with the active ingredient during normal handling, provided that
the tablets are not broken or crushed.
Do not give your
PROPECIA tablets to anyone else. It has been prescribed only for you.
Keep PROPECIA and all medications out of the reach of children.
THIS LEAFLET
PROVIDES A SUMMARY OF INFORMATION ABOUT PROPECIA. IF AFTER READING THIS
LEAFLET YOU HAVE ANY QUESTIONS OR ARE NOT SURE ABOUT ANYTHING, ASK YOUR
DOCTOR.
1-888-637-2522,
Monday through Friday, 8:30 A.M. TO 7:00 P.M. (ET).
Issued May 2000 MERCK & CO., INC.
Whitehouse Station, NJ 08889, USA
* Registered trademark of MERCK & CO., Inc.
** Registered trademark of MERCK & CO., Inc.
*** Registered trademark of Johnson & Johnson
Finasteride Cuts
Risk of Further Visible Hair Loss in Men
Doctors Guide News
July, 2002
In men with
androgenetic alopecia, treatment with finasteride 1 mg/d for five years
leads to a marked and sustained reduction in the risk of developing
further visible hair loss.
The findings were
reported here at the 20 th World Congress of Dermatology (WCD).
In two replicate,
double-blind studies, men aged 18 to 41 years with androgenetic alopecia
(AGA) received finasteride 1 mg or placebo for up to five years. Global
photographic assessment of scalp hair growth by an expert panel showed
the superiority of finasteride over placebo.
In a post-hoc
analysis, Dr. Keith Kaufman, of Merck Research Laboratories in Rahway,
New Jersey, United States, and colleagues examined the effect of
finasteride on the five-year risk of developing further hair loss based
on these GPA data.
The analysis
included 713 patients who received finasteride 1 mg/day (645 patients)
or placebo (68 patients) continuously from randomisation to study
completion or discontinuation. All patients underwent global
photographic assessments during the five-year study period.
Finasteride
treatment led to a 93 percent reduction in the risk of developing
further visible hair loss from baseline to end point, relative to
placebo. Development of further visible hair loss was observed in the
majority of placebo-treated patients by year 3.
The highest rates
of further visible hair loss for placebo patients occurred in men of
younger age, earlier onset of hair loss, longer duration of hair loss,
more severe hair loss pattern, and/or parental history of hair loss.
"These findings
suggest that there are differences among men with [androgenetic
alopecia] with respect to susceptibility of scalp hair follicles to
continued follicular miniaturization," Dr. Kaufman said.
Regardless of the subgroup examined, treatment with finasteride reduced
the risk of further visible hair loss relative to placebo, confirming
the key role of dihydrotestosterone produced by type II 5 alpha-reductase
in mediating hair loss in men with androgenetic alopecia, he added.
The study was
supported by Merck Research Laboratories.
Finasteride - A
Review of Its Use in Male Pattern Hair Loss
Impotence & Male Health Weekly Plus
February 1999
According to the
authors' abstract of an article published in Drugs, "The 5 alpha-reductase
inhibitor finasteride blocks the conversion of testosterone to
dihydrotestosterone (DHT), the androgen responsible for male pattern
hair loss (androgenetic alopecia) in genetically predisposed men.
Results of Phase III clinical studies in 1,879 men have shown that oral
finasteride 1 mg/day promotes hair growth and prevents further hair loss
in a significant proportion of men with male pattern hair loss.
Evidence suggests
that the improvement in hair count reported after one year is maintained
during two years' treatment. In men with vertex hair loss, global
photographs showed improvement in air growth in 48% of finasteride
recipients at one year and in 66% at two years compared with 7% of
placebo recipients at each time point. Furthermore, hair counts in
these men showed that 83% of finasteride versus 28% of placebo
recipients had no further hair loss compared with baseline after two
years.
The clinical
efficacy of oral finasteride has not yet been compared with that of
topical minoxidil, the only other drug used clinically in patients with
male pattern hair loss. Therapeutic dosages of finasteride are
generally well tolerated. In Phase III studies, 7.7% of patients
receiving finasteride 1 mg/day compared with 7.0% of those receiving
placebo reported treatment-related adverse events. The overall
incidence of sexual function disorders, comprising decreased libido,
ejaculation disorder, and erectile dysfunction, was significantly
greater in finasteride than placebo recipients (3.23 vs. 2.1%). All
sexual adverse events were reversed on discontinuation of therapy and
many resolved in patients who continued therapy. No other drug-related
events were reported with an incidence > =1% in patients receiving
finasteride. Most events were of mild moderate severity. Oral
finasteride is contraindicated in pregnant women because of the risk of
hypospadias in male fetuses.
CONCLUSIONS: Oral
finasteride promotes scalp hair growth and prevents further hair loss in
a significant proportion of men with male pattern hair loss. With its
generally good tolerability profile, finasteride is a new approach to
the management of this condition, for which treatment options are few.
Its role relative to topical minoxidil has yet to be determined." The
corresponding author for this study is: KJ Mcclellan, Adis Int Ltd, 41
Centorian Dr, Private Bag 65901, Auckland 10, New Zealand. For
subscription information for this journal, contact the publisher: Adis
International Ltd, 41 Centorian Dr, Private Bag 65901, Mairangi Bay,
Auckland 10, New Zealand.
As Young as You
Feel: Weapons to Combat the Effects of Aging
Men's Fitness
February, 1999
You go to the gym
and pump iron until your arms are so sore that you can't even scratch
your back. You do cardio work until your heart feels like it's going to
thump out of your chest. You're careful to eat the right foods and get
enough rest. And yet, you're still at risk for looking old before your
time.
See, at the same
time you're working so hard to take care of your body's insides, the sun
and other factors are conspiring to damage its outside - your skin and
hair. Even if you haven't noticed any wrinkles, your skin may already be
damaged, especially if you had serious sunburns or spent a lot of time
outdoors in your youth.
Being concerned
about the condition of your skin and hair isn't mere vanity. Like it or
not, staying young and vibrant in attitude as well as appearance can
help your career. And in a competitive workforce, any edge can make a
difference. So, to provide you with some guidance, we've consulted
dermatologists on the Men's Fitness Advisory Board to bring you the
anti-aging products that can help slow the effects of Father Time.
Wrinkles
away
"Sun is the major
culprit, the chief bad actor in aging the skin," says dermatologist
Joseph Bark, MD, a fellow of the American Academy of Dermatology and
author of Your Skin ... an Owner's Guide (Prentice Hall, $11). "So
investing in a bottle of sunscreen is a long-term investment in the
health of your skin. The higher the SPF [sun protection factor], the
better. We're talking 30- to 50-rated sunscreen."
Coppertone Sport
Ultra Sweatproof suntan lotion SPF 30 or 45 ($8 for four ounces) fits
the bill and gives long-lasting protection. It's waterproof but not
greasy, and it dries quickly.
What's the next
best thing to a good sunscreen? Alpha hydroxy acids, according to Bark.
"[Alpha-hydroxy-containing products] are extremely efficient at
resurfacing the dead layer of the skin and smoothing the skin out," he
says. "They also give the skin a certain translucency that's attractive,
and they smooth fine lines."
When choosing an
alpha hydroxy, look for concentrations of 5 to 8 percent, says Arnold W.
Klein, MD, full clinical professor of medicine/dermatology at UCLA
Medical Center with a private dermatology practice in Beverly Hills. You
can increase the concentration when your skin gets used to the
treatment.
Aramis makes an
alpha hydroxy called Lift Off!. with SPF 7 protection (two ounces for
$28 or 3.4 ounces for $38), and Clinique's alpha hydroxy is called
Turnaround Lotion ($25 for 1.7 ounces). If budget is an issue, Klein
says you can do just as well with more affordable alpha-hydroxy acids
available in your local pharmacy; he recommends products from Alpha
Hydrox, NeoStrata and Aqua Glycolic.
Take your
vitamins
Another product
that can attack wrinkles is Renova ($60 for 40 grams), a topical
treatment available by prescription. Renova has the same active
ingredient as Retin A, an acidic form of vitamin A used to treat acne,
but it's in a base more suitable for sun-damaged skin. Bark says that
Renova can help smooth out fine lines. "It can erase small color changes
in the skin due to aging and sunlight exposure," he adds. "It resurfaces
the skin with a younger population of cells so that it looks smoother,
more translucent and much more attractive."
Renova can cause
some redness and irritation if you use too much too soon. To give your
skin achance to grow accustomed to the treatment, Bark advises patients
to use it once every two or three days at first, then increase the
frequency over the next couple of months.
Available
over-the-counter are retinols, which are the alcoholic derivatives of
Retin A, such as Estee Lauder's Diminish ($48 for one ounce) and
Prescriptive's LSW ($50 for one ounce). But Klein is skeptical of the
effectiveness of retinols. "There is really a paucity of evidence to
suggest they are beneficial in causing anti-aging effects topically on
the skin," he says.
Other products
containing a topical form of vitamin C offer a limited antiaging effect,
Klein says. "There are not really any conclusive studies about their
efficacy at this point," he says. "I just know that patients who use
them really like their ability to make them look better." Vitamin C
products from Cellex-C (http://www.cellex-c.com/)
and SkinCeuticals (www.skinceuticals.com) are popular with Klein's
patients.
Hairs
looking at you
For combating hair
loss, the prescription medication Propecia ($50 for a one-month supply)
claims to possibly even grow hair. "It tends to have men keep their hair
in about 80 to 85 percent of the cases," Bark says, "as long as they
stay on it. And in about 60 to 63 percent, the guys grow hair back."
Side effects include wilted woodies in a small percentage of users.
Klein adds that
the topical solution Rogaine ($30 for a one-month supply), has proved a
great success, especially now that it's available in a higher
concentration of 5 percent. But he cautions against other topical
hair-growth promises. "All of these hair products that you hear grow
hair are rubbish for the most part," he says. "For something to claim
hair growth, it has to have good double-blind studies that show
efficacy, and Rogaine has shown that."
For a mild
shampoo, Bark recommends Neutrogena ($6 for 6 ounces). What about those
shampoos that claim to thicken hair? "They coat the hair with protein,
and it feels a little thicker," Bark says. "But you have to watch those
a little bit, because you can get build-up."
While most of
these products are not cheap, they do hold promise to keep you looking
young. And if that's important to you, they just may be worth a closer
look.
Information from
Your Family Doctor
American Family Physician
April 15, 1999
Treating Baldness
in Men
What is
male pattern baldness?
Male pattern
baldness is hair loss that happens because the male hormone testosterone
(say: tess-toss-ter-own) changes the hair roots.
Can male
pattern baldness be treated?
Male pattern
baldness doesn't have to be treated, but many men feel better about the
way they look if their "bald spot" is covered. Some treatments are
minoxidil (brand name: Rogaine), finasteride (brand name: Propecia),
hair transplants and toupees (hairpieces).
Which
treatment is right for me?
This is a personal
decision to make after looking at all of your options. Ask to see
"before" and "after" pictures of men who have used the methods you're
thinking about trying. Think about these factors: how far along your
baldness is; how you feel about having surgery; the cost (both now and
in the long term); and how easy it is to use.
Do these
medicines cure baldness?
No. Nothing cures
baldness. Two medicines can help regrow some lost hair, but not all of
it. Finasteride and minoxidil usually regrow only enough hair to cover
part of the bald areas. Both of these medicines work better on the crown
of the head than on the front hairline.
Will
minoxidil or finasteride work for me?
There is no way to
predict who will respond to these medicines. It may take up to six
months before you can tell if the medicine is working. Men who are
younger, who have a smaller bald area and who start using the medicine
early may have better results. These medicines may be most helpful for
men who have just started balding.
Do these
medicines have side effects?
Like all
medicines, these medicines cause some side effects. A few men have had
sexual side effects (a decrease in sexual urges) from finasteride that
went away after they stopped taking the medicine. Minoxidil causes an
itchy scalp in a few men. This also goes away when the medicine is
stopped.
How do I
use these medicines?
Minoxidil is
sprayed on and rubbed into the scalp twice a day. Finasteride is a pill
you take once a day. Both medicines must be used every day. When you
stop taking either medicine, you start to lose hair again.
For more
information about balding and treatments, you can visit the Web site of
the National Alopecia Areata Foundation at:
http://www.alopeciaareata.com/ or phone 415-456-4644.
Drug Update: Hair
Loss in Men
Family Practice news
April, 2001
The treatment of
hair loss in men has improved vastly in recent years, thanks mostly to
two drugs that promote hair growth and improve the appearance of
existing hair: finasteride and minoxidil.
One of two disorders, androgenetic alopecia or alopecia areata, is
generally responsible for hair loss in young and middle-aged men.
Androgenetic
alopecia, also known as male pattern baldness, causes a characteristic
pattern of hair loss, including temporal recession of the hair, thinning
of the hair at the frontal and vertex regions of the scalp, and complete
loss of hair with the exception of some fringing. It usually begins
before the age of 40--sometimes as early as age 12--and it affects about
half of the male population before they reach the age of 50.
Finasteride and
minoxidil are the only drugs that are approved to treat this type of
hair loss, although estradiol has also been used with some success. Both
finasteride and minoxidil promote hair growth, slow hair loss, and
increase the length and diameter of existing hair.
Alopecia areata, unlike androgenetic alopecia, is assumed to have an
autoimmune cause. Patients with this condition may have small patches of
hair loss that regrow spontaneously, or they may have extensive patches
of hair loss that do not resolve.
Treatment with
minoxidil is generally beneficial for stimulating hair growth in men
with mild or moderate alopecia areata; a 40% response rate is typical.
How ever, minoxidil will not help men with one of the most severe forms
of alopecia areata, in which all the scalp hair is lost: alopecia
totalis. Anthralin is another main stay of therapy for alopecia areata,
as are glucocorticoids, which can be used topically, intralesionally, or
orally. The preferred glucocorticoid treatment is intralesional
injections of triamcinolone.
Psoralen with
ultraviolet A therapy is a more controversial treatment for alopecia
areata. Although it works well, long-term therapy is necessary to
maintain the effects, and this long-term use may lead to several health
problems. Topical immunotherapy is also showing promise for treating
alopecia areata and is currently under study. Patients with alopecia
areata should be referred to a specialist for treatment.
Alopecia Areata
American Family Physician
April, 1990
Abstract: Alopecia
areata is a condition involving hair loss in one or many areas of the
scalp for no identifiable reason. It can affect men or women, and is
most common in people between the ages of 20 and 50. Sufferers from
alopecia totalis lose all their scalp hair, and victims of alopecia
universalis lose their body hair. Alopecia areata usually begins with
hair loss in one patch on the scalp, then involves other patches. Some
areas of baldness may regrow hair. The hairs at the periphery of the
widening bald patch are tapered and lighter toward the base and called
'exclamation point' hairs. Signs of inflammation can be seen in
microscopic sections of skin from the affected region. Alopecia areata
may be familial and is associated with certain diseases, such as Down
syndrome and certain thyroid diseases. Nail changes may also occur.
Since the
condition has a high relapse rate, the success rates of different
treatments are hard to evaluate. Triamcinolone acetonide, injected into
the affected area, corticosteroids, and minoxidil (Rogaine) are often
used. These agents do not produce continued regrowth after the patient
stops using them, and side effects may occur. An allergic contact
dermatitis (local allergic reaction) may also induce hair growth as may
the application of ultraviolet irradiation. Drugs that stimulate the
immune system have also been found effective.
Since alopecia
areata leads to physical changes that many people find distressing,
physicians should offer support and make patients aware of the support
groups that exist. (Consumer Summary produced by Reliance Medical
Information, Inc.) Abstract: Alopecia areata is an asymptomatic,
nonscarring hair loss with spontaneous remissions and exacerbations.
Although the etiology is unknown,the disorder is associated with
vitiligo, atopy, pernicious anemia, Downsyndrome and thyroiditis. The
area of hair loss may remain localized or mayinvolve the entire scalp or
all body hair. Treatment is difficult to assessbecause of individual
response and spontaneous remissions, as well as a highrate of relapse.
intralesional injection of corticosteroids is the most commonmode of
treatment, although systemic steroid therapy, contact
allergens,minoxidil, psoralens plus ultraviolet light, and other agents
have been tried.COPYRIGHT American Academy of Family Physicians 1990
The Sex Appeal of
Bald Men. (famous African American bald men)
Ebony
March 1994
In the ~40s and
~50s, it was pomade-brushed waves that sent women into a blushing
frenzy. later, in the 60s and ~70s, it was the Afro that caused female
hearts to flutter. More recently, men donning curls, dreadlocks or
geometric cuts have won the affection of many young women. But the
timeless "do" that has garnered the most faithful group of female fans
is the classic bald, clean-as-a-white look.
To many women,
nothing is more appealing than a Black man who is confident enough to
break with convention and bare a smoothly shaven head. In their book,
bald is beautiful, bold and, more importantly, bodaciously sexy.
The trend may have
gotten its start years ago when soulful balladeer Isaac Hayes was
popular on the music scene, Harlem Globetrotter Curly Neal wowed
audiences on the basketball court and Marvelous Marvin Hagler bullied
victims in the boxing ring. Today an increasing number of
African-American men are shaving their heads, making the bald look more
popular than ever. And now, a variety of Black men, from television
personalities and film execs to sports stars and recording artists, have
adopted the no-hair trend.
For some
entertainers, flaunting the "un-do" is a personal rebellion against
America's view that hair should be perfectly coiffed. For others, it's
a matter of fashion. But for many men, choosing the bald look is simply
their way of beating Mother Nature to the draw. By choice or chance,
baldness is, they say, the most convenient style around.
But what do so
many women find appealing about the hairless craze? Everything Jewelry
and fashion designer Kim Harris of Atlanta says, "Bald men are powerful
and sexy."
Harris and other
women say that baldness, by choice or chance, can be a very seductive
force that beckons immediate attention. "You know someone is nice
looking when they don't have hair and they still look nice,"adds
34-year-old Cheryl Chandler a Xerox account marketing executive in St.
Louis. "I've always been attracted to guys with receding hairlines. If
I walked into a room, I'd notice them first."
Chandler is not
alone. "I think of a bald man as someone who has class, someone who has
it all together," says Tina Wimbush, 31, who works for the U.S. Census
Bureau in Maryland.
Other women say
it's the positive energy that bald men exude that is most attractive.
"Bald men demonstrate confidence and self-assuredness. And that,
coupled with a nicely shaped head, is quite appealing," says Cassandra
Bronson, a 40-year-old teacher consultant in Flint, Mich., who is
happily married to a bald man.
Yet, other women
can't quite pinpoint their intrigue with shiny crowns. "It's something
about a bald man that just grabs my attention," says medical center
owner Kathy Williamson, 41, of Los Angeles. "I think you get to the
real essence of a man when he's bald. There's not a lot of room for
pretense."
This no-nonsense,
masculine perception of maneless men is pervasive, relationship experts
say. "For some women, bald men symbolize masculine virility," says Dr.
Patricia A. Outlaw, a clinical psychologist in Baltimore. "It's daring
and different to be bald."
Moreover, the
difference can be quite enticing for women who feel that men hide behind
a veneer of masculine pride. "Women like to kiss and to touch the bald
head. They see it as a vulnerability in a man," says psychiatrist Gail
E. Wyatt, a sex and relationship researcher at UCLA. "The head is a
vulnerable part of the body, so when you expose it, you say, ~I'm up for
this.' Baldness is truly an attention-grabber."
Bald men haven't
amassed a large female following because they lack hair. No, it goes
deeper than that. The clean-shaven men featured here, many women say,
are sexy and appealing because they are a perfectly polished package of
machismo and maturity, intrigue and integrity, and, most of all,
sophistication and sensuality.
Europe and
UK |
Worldwide
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Propecia
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