Hair Loss Treatment
Are you gradually losing more hair coupled with hair thinning?
Early intervention will lead to hair regrowth and maintenance of healthy hair.
HOW DR.NG TREATS HAIR LOSS
Early hair loss treatment is essential to prevent worsening of your condition. Male and female pattern hair loss is one of the most common hair loss problems in clinical practice. It is characterised by distinct patterns of hair loss in men and women. Hair loss that is progressive can affect your confidence. With over a decade of experience treating both male and female hair loss, Dr Ng. will help you diagnose and customise a treatment plan to help you restore and maintain your hair.
Why hair loss treatment matters
Hair loss more than normal can be frustrating and perplexing. We normally lose an average of 100 scalp hairs per day. Each hair follicle undergoes a cycle of growth, rest and shedding. The human hair cycle duration differs with location on the human body. For example, the growth phase on human scalp hair may take 1-5 years.
While having hair is important in mammals to keep warm, to humans, it carries a deeper meaning. Hair loss is not something most of us take lightly, as we use hair to express ourselves, and communicate our unique personalities to our friends and the opposite sex. Alopecia is a medical term used to describe hair loss, and in some of the cases, it may reflect an underlying medical condition or recent stress to the body.
Does hair loss affect social impression?
It has been well documented and studied across many populations that hair loss leads to increased stress levels, anxiety and depression. It can affect one’s self image, self esteem and relationships. The ability to style your hair in the morning, or even throughout the day is something most of us would take for granted. Having a healthy head of hair gives one the perception of attractiveness, drive, confidence and vitality.
When you lose hair, it is not only how you view yourself that is important, it can also influence people’s impression of you. In studies comparing initial images of balding men to non-balding men, balding men were rated as less attractive, older, less likeable and less sexually attractive.
Different Types of Hair loss (Alopecia)
What is Male or Female Pattern Hair Loss?
Androgenetic alopecia is the most common cause of alopecia in both men and women. It is a non-scarring form of hair loss characterised by progressive miniaturisation of your hair follicles with a pattern distribution. The gradual loss and thinning of hair over the years is due to the effects of androgen (a hormone) and genetic influence. Often, there may be someone in the family that shares the same problem.
In males, it often starts after puberty, and the pattern of hair loss on the scalp involves the front, temples and vertex. For females, the condition starts later, and loss of hair in the frontal and mid regions of the scalp is the most common pattern seen. Testosterone levels in females should be checked if there are accompanying acne, facial hair and irregular menses, as it may indicate an underlying medical condition such as polycystic ovarian syndrome.
Hair Loss Myths Debunked
- Poor Diet contributes to hair loss – False. There is no current evidence to support this. Male and female pattern hair loss is a polygenetic condition.
- Low Testosterone levels in Men– False. Testosterone levels in men with hair loss is mostly normal. Male pattern hair loss is due to higher levels of Dihydrotestosterone (DHT), which is a breakdown product of testosterone.
- Balding means Cancer – False. There is no current evidence linking pattern hair loss to cancer in both men and women.
- Hair dryers damage hair follicles – False. Although too much heat can damage the hair shaft, the hair follicles remain intact.
- Hair sprays, wax and gels causes balding – False. The hair follicles are not affected when using these hair products.
- Balding starts only in mid age – False. The progression of hair loss is a slow process. In males, it often starts after puberty, and becomes more obvious with age. A lot of patients that we see are in their late teens to early twenties.
Male Pattern Hair Loss
Male Pattern Hair Loss Treatment
- Topical Minoxidil 5%
- Oral finasteride 1mg
Potential Off-label treatments:
- Oral Dutasteride
- Topical finasteride
- Latanoprost solution
- Ketoconazole shampoo
Female Pattern Hair Loss
Female Pattern Hair Loss Treatment
- Topical Minoxidil 2-5%
Potential Off-label treatments:
- Oral Spironolactone
- Cyproterone acetate
- Latanoprost solution
- Ketoconazole shampoo
Oral finasteride 1mg is a 5 alpha reductase inhibitor and works by reducing the amount of active androgen, dihydrotestesterone (DHT) in men. More than 90% of men on this oral medication will experience a slowing of hair loss, and up to 60% may experience hair regrowth. These results are sustained over 5 years in one study, and is generally well tolerated. Hair regrowth with treatment is more prominent over the midscalp and vertex areas
Oral finasteride is contraindicated in women of childbearing age, pregnant women and children. Studies have shown that it causes male foetal genital abnormalities during pregnancy.
- About 2-4% of patients may experience a loss of libido, erectile dysfunction and reduced ejaculatory volume. However, there are studies to suggest that the rates of sexual dysfunction reduces over time whilst on treatment.
- Gynaecomastia (breast enlargement in men)
- Orthostatic hypotension. The sensation of feeling giddy when you stand up due to low blood pressure. The risk is increased when you are on blood pressure medicines such as alpha-blockers.
- Possibly slight increased risk of anxiety, depression and suicide ideation.
- Uncommonly, some patients may experience dizziness, weakness, shortness of breath and a skin rash.
- Post-finasteride syndrome is a constellation of side effects that persists after discontinuation of therapy. This is controversial and is currently being studied.
Generally, there is very little data to support that low dose oral finasteride causes infertility. Studies have shown that even in cases of infertility, it is reversible upon stopping treatment.
No, blood donation is no allowed and is contraindicated for those while on treatment and 6 months after your last dose of oral finasteride treatment.
A 4-week course of treatment is $64.9 before GST.
Topical Minoxidil has an interesting story. It was discovered by accident, as doctors were using the oral form to treat high blood pressure and noticed the incidental side effect of increased hair growth. While it is unknown how minoxidil actually works, it should be used for at least 6 months for maximum efficiency. It is common for hair to shed for the first 2-6 weeks when starting treatment, but treatment should be continued as it will slow progression of the hair loss and partially restore hair in some cases over time. Minoxidil treatment can be used for male and female pattern hair loss.
HAIR LOSS TREATMENT
schedule a consultation for hair loss treatment in singapore
To receive the best male or female hair loss treatment results, Dr.Ng offers a personalised treatment plan that is unique to your condition. Contact us to schedule an appointment with Dr.Ng today.
- Cash, TF. Losing hair, losing points? The effects of male pattern baldness on social impression formation. J Appl Soc Psychol. 1990; 20: 154–167
- Stough D, Stenn K, Haber R, et al. Psychological effect, pathophysiology, and management of androgenetic alopecia in men. Mayo Clin Proc. 2005 Oct. 80(10):1316-22.
- Olsen EA, Dunlap FE, Funicella T, et al. A randomized clinical trial of 5% topical minoxidil versus 2% topical minoxidil and placebo in the treatment of androgenetic alopecia in men. J Am Acad Dermatol. 2002 Sep. 47(3):377-85.
- Rossi A, Cantisani C, Scarnò M, Trucchia A, Fortuna MC, Calvieri S. Finasteride, 1 mg daily administration on male androgenetic alopecia in different age groups: 10-year follow-up. Dermatol Ther. 2011 Jul. 24(4):455-61.
- Varothai, S., Bergfeld, W.F. Androgenetic Alopecia: An Evidence-Based Treatment Update. Am J Clin Dermatol 15, 217–230 (2014). https://doi.org/10.1007/s40257-014-0077-5
- Traish AM. Post-finasteride syndrome: a surmountable challenge for clinicians. Fertil Steril. 2020 Jan;113(1):21-50.
- Glina S, Neves PA, Saade R, Netto NR, Soares JB, Galuppo AG. Finasteride-associated male infertility. Rev Hosp Clin Fac Med Sao Paulo. 2004 Aug;59(4):203-5.
- Oyama N, Kaneko F. Solitary fixed drug eruption caused by finasteride. J Am Acad Dermatol. 2009 Jan;60(1):168-9.