Gone today, hair tomorrow

I'm thinning on top, even though I'm pretty hairy all over. What gives, and what should I do?

--M.A., San Diego, CA

Alex Khadavi, M.D., board-certified dermatologist, supports a proactive approach--short of growing a mullet and turning it into a gravity-defying comb-over.

"The description you give indicates that you have male-pattern hair loss," he says. "This condition is caused by a hormone by-product of testosterone called dihydrotestosterone, or DHT. When DHT is produced locally within the hair follicle, it causes regular hairs to turn into miniature hairs, eventually killing the hair follicle. This process doesn't happen overnight--in fact, it usually takes three to 10 years to notice." It's a common condition, suffered by millions of American men.

At the point when you begin to notice hair loss, Khadavi says that you may have already lost half of the 110,000 or so hairs on your head. "Even at this stage, you can dramatically improve the quality of hair on your head, but once you have a shiny, bald head, that means your hair follicles are gone, and there's no product that will reverse that. In that case, your best option is transplantation."

Before you get to that stage, Khadavi recommends that you seek out professional help from a board-certified dermatologist. Keep in mind that not all hair loss is caused by an excess of DHT. Hair loss can also be caused by conditions such as the autoimmune disorder alopecia, and is associated with crash diets, severe protein deficiencies, anemia, or medical treatments such as chemotherapy.

For male-pattern hair loss, your options include topical and internal applications. Khadavi says you don't necessarily have to settle on just one hair-loss treatment. "Often, my patients use both a pill form and topical treatment at the same time." Ask your doctor for information on what's best for you. (In the interest of full disclosure, Khadavi is the developer of Revivogen, a hair-loss product that occasionally advertises in MEN'S FITNESS.)

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