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Neil Sadick, MD
Weill Cornell Medical College, New York Presbyterian Hospital
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DAVID R. MARKS, MD: Hi, and welcome to our webcast. I'm Dr. David Marks. Hair loss: For some people it's a fact of life. For others it's cosmetic death. Whatever your opinion, the fact remains that 40% of all women and half of all men will lose hair at some time in their life. Why does it happen, and what are the treatment options?
My guests today are two experts. First is Dr. Neil Sadick and on his left is Dr. Michael Reed.
DAVID R. MARKS, MD: What's the most common cause of hair loss in men and women?
NEIL SADICK, MD: The most common cause, numbers 1, 2 and 3, are genetic, so your parents really predispose as to whether you're going to lose your hair during your lifetime.
DAVID R. MARKS, MD: In both men and women?
NEIL SADICK, MD: In both men and women.
DAVID R. MARKS, MD: Are the patterns of hair loss different in men and women?
MICHAEL REED, MD: Yes. Men lose their hair in the front of the scalp, and then in the back of the scalp, and it meets in the middle and they cue-ball out. Some time in their life, they lose it all. Women get see-through hair as time goes by, although sometimes right behind the frontal hair zone they'll have an almost bald spot that occurs.
DAVID R. MARKS, MD: What does see-through hair mean?
MICHAEL REED, MD: It means when you look at the person in a normal viewing circumstance you can see more scalp than hair.
DAVID R. MARKS, MD: What are the treatment options for men and women? Are they the same?
NEIL SADICK, MD: There are some drugs that are the same and some are different. In men the major treatment options are minoxidil in a 2 or 5% concentration, marketed as Rogaine. That is a topical application that's applied. Propecia is the new drug on the block, and that probably is more effective. It's a pill that you take once a day, and that has been shown to slow down hair loss and grow hair in a significant number of individuals.
In women, topical minoxidil remains, at 2%, the major FDA-approved topical therapy for hair loss, and we're now utilizing drugs that block androgen and androgen receptors, such as spironolactone, in treating women with diffuse hair loss that do not respond to topical minoxidil.
DAVID R. MARKS, MD: And androgens are male hormones, so you're blocking male hormones in the women?
NEIL SADICK, MD: Yes. We're blocking male hormones and male hormone receptors, and that is the major internal medicine that's being utilized for women with diffuse genetic hair loss.
DAVID R. MARKS, MD: What about hair transplantation for men and women?
MICHAEL REED, MD: Hair transplantation is at an all-time peak in terms of looking natural, being reasonably dense and having satisfied patients. Men and women both benefit. The number of women that we're doing is rapidly increasing, and probably in the next five years it'll be 50/50 men and women, but both can benefit and both should investigate it, especially if they've lost a lot of hair in the frontal portion of their scalp, because the frontal part of the scalp is transplant country. The middle scalp and the back scalp is medical treatment country. They work together.
DAVID R. MARKS, MD: Where should a person who's losing their hair go to get information about treatment options?
NEIL SADICK, MD: The best place to find out about treatment of hair loss is to consult your dermatologist. If you don't have a dermatologist, I would speak to your internist or all the American Academy of Dermatologists for a referral of a dermatologist that has interest and expertise in treating hair disorders.
DAVID R. MARKS, MD: Thank you both for a quick overview of hair loss. And thank you for joining our webcast. I'm Dr. David Marks. Goodbye.
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