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Hair Today, Gone Tomorrow: The Causes of Male Pattern Baldness

Summary & Participants

For men experiencing noticeable hair loss, the number one priority is usually getting the problem solved. Many ignore the actual causes of their hair loss, even though understanding them can be an important first step in treatment. Our panel will take a close look at the different factors that can lead to hair loss.

Medically Reviewed On: July 02, 2008

Webcast Transcript

DAVID R. MARKS, MD: Men who are losing their hair usually have one priority: getting it back. But in the process, the causes of hair loss are often ignored. That's a mistake, since understanding why we lose hair is the first step in treating it.

With me today to talk about what causes hair loss are two experts. First is Dr. Neil Sadick. He's a cosmetic surgeon and a dermatologist at the Weill Cornell Medical College. Also here is Dr. Michael Reed, a dermatologist and a hair transplant surgeon at NYU.

What causes men to go bald?

MICHAEL REED, MD: Most men go bald because they picked the wrong family tree and it's just in their genes to go bald as they get older. That's probably the cause of baldness in 95 percentof patients that I see in my practice. It's just heredity male pattern baldness that happens after puberty.

DAVID R. MARKS, MD: There is, I think, an old wives' tale that baldness comes from your mother's father. Is that true?

MICHAEL REED, MD: It's an old wives' tale, and sometimes a new wives' tale, but it's a polygenic type of situation. I see people who have no family history of hair loss. I see people who no one in their neighborhood ever lost their hair, and still they're losing their hair. So it's not that simple. There seems, perhaps, to be a trend from the maternal side, but it's not that simple.

DAVID R. MARKS, MD: What about the other 5 percentof people? What's causing hair loss in them?

NEIL SADICK, MD: The major causes are related to things such as medications that people are taking, particularly antihypertensive drugs, drugs that are being prescribed for depression, and then there are a number of other disease states, such as alopecia areata, which is an immunologic type of hair loss, that really make up the majority of other causes of hair loss that we see.

DAVID R. MARKS, MD: Some of the treatments are directed toward some chemical, 5 alpha reductase. Tell us about that.

NEIL SADICK, MD: 5 alpha reductase is an enzyme that is felt to play a major role in genetic hair loss, particularly in men. It was actually identified in a group of pseudo-hermaphrodites in the Dominican Republic, and that enzyme, which was isolated, is felt to be the major enzyme that's responsible for genetic hair loss, and the newer drugs that are now being developed block that enzyme and have been able to slow down the progress of genetic hair loss.

DAVID R. MARKS, MD: Is there a way to test a man for this chemical to see and predict if they're going to lose hair?

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