What’s the story on the effectiveness of the various baldness treatments on the market today? The many products advertised on TV make some pretty amazing claims. Is there any independent research available to compare the different treatments? —T.H., via e-mail
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1. Castration. Don’t be a wuss. A real man does what it takes to get results. Male-pattern baldness is thought to arise from a particular version of an androgen receptor gene. If you’ve got the wrong one, a testosterone breakdown product, dihydrotestosterone (DHT), gradually reduces hair growth by shrinking the size of the hair follicle, meaning thinner and eventually no hair. No testosterone, no baldness. Whatever other beefs they may have, eunuchs have been famed since the days of Hippocrates for killer hair. Caution: Castration is best thought of as a preventive measure. If DHT has already wasted your follicles, shutting off the tap now won’t necessarily bring them back.
3. Finasteride. Like minoxidil, finasteride was first used to treat another medical condition—in this case, enlarged prostate. Unlike minoxidil, finasteride attacks the source of the problem by blocking an enzyme that converts testosterone into the troublesome DHT. The net result is about the same: the hair growth period is extended and the resting period reduced, resulting in more and denser hair growth; studies are mixed on whether it increases hair thickness. Although you can’t put much stock in anecdotal evidence, a friend who tried finasteride experienced total regrowth on the crown plus three-quarters of an inch in hairline resurgence. After a year on the stuff he started seeing other effects, including unusually thick hairs plus twinned and occasionally triplet hairs. Being an anal-retentive scientist type, my friend had collected loose hairs for nearly a year before starting on finasteride. Comparing before and after, he found an increase in hair thickness of roughly 30 percent.
