Male baldness

Key points:

1. 5AR converts testosteron to dihydrotestosterone, inhibition of 5AR improves hair growth and slows hair loss.

2. Finasteride (a type 2 5AR inhibitor) and dutasteride (type 1 and 2 isoenymes) are used to treat Androgenic alopecia

3. Main side effects of 5AIRs are effects on sexual function, breast enlargement and a possible increase in the risk of prostate cancer

4. Early onset of AGA is a strong predictor of early onset of severer coronary heart disease and metabolic syndrome

5. Hair thinning usually on ly becomes noticeable after losing 50 % or more of scalp hair

6. The typical history for a man with AGA is gradual onset of thinning after puberty. There is a gradual thinking of hair on the crown and vertex of the scalp, and frontal recession

7. When discussing treatment, emphasis

• no treatment will completely reverse the process
• the response to treatment is quite variable 
• some people will not respond to particular treatments

8. Treatment options 

• no treatment 
• hair piece
• medical treatment 
• topical minoxidil 2-5%
• oral finasterid 1 mg daily 
• oral dutasteride 0.5 mg daily (not approved for hair loss use yet in Australia)
• surgery 

Reference

http://gplearning.racgp.org.au/content/AFP/16Apr/Clarke.pdf