Q.: What causes Male Pattern Baldness?

In order to successfully treat hair loss, it is essential to understand it. Male pattern baldness occurs when hair follicles in the front of the scalp, crown or both areas are genetically programmed to stop producing hair in response to dihydrotestosterone (a by product of testosterone), a male hormone. The gene that makes this happen can come from either parent, and frequently the hair loss pattern is similar among extended family members. Only the follicle is affected; the scalp itself is generally completely healthy.

Here, the Norwood-Hamilton Scale shows common patterns of male pattern baldness.

Male Pattern Baldness

*Note the sides and back of the scalp are typically unaffected by male pattern baldness.

Q.: What are the medication treatment options?

Will Propecia or Rogaine produce the same results?

In late 1997 the FDA approved the drug finasteride to fight androgenetic alopecia (male pattern baldness) in men. Finasteride is the generic name of the drug (developed by Merck) which is marketed in a 1mg dose as Propecia, and a 5mg dose as Proscar. A single milligram is all that is necessary to achieve and maintain the hair stabilization or regrowth benefits of this medication. The 5mg dose of Finasteride (Proscar) is effective in treating some cases of enlargement of the prostate gland. Although the dose is different, these medications are the same.

The medication works by blocking the enzyme that converts the male hormone Testosterone into its metabolic byproduct, Dihydrotesterone (DHT). In the case of male pattern baldness, DHT is apparently the messenger hormone that directs the hair follicle to stop making hair. Therefore, blocking the formation of DHT has been found to help stabilize hair loss and to regrow some hair in affected men. Although DHT is felt to be important in a developing male fetus, researchers do not feel it maintains any important beneficial functions in adult males.

The results of two year medical trials studying the effects of Propecia in male pattern baldness revealed a greater than 83% response rate in study participants who either maintained their hair pattern and stopped losing hair, or 66% regrew an average of 10% more hair in an area of thinning hair. The medication was not felt to be effective for certain patterns such as temporal recession (hairline). It would not be expected to regrow hair in an area where an absolute loss of follicles had previously occurred.

In addition to Propecia, the only other FDA approved medication treatment for treating hair loss is Rogaine (or any generic of Minoxidil). For more information regarding Minoxidil and recent studies, click here Minoxidil Studies.

Other over the counter remedies exist, but have not gone through the rigorous testing required to receive FDA approval. Often, they are not placebo tested, and the studies that are done may not have statistical significance. Dr. Keene prescribes and recommends only the FDA approved medical treatments.

Q.: What are the Pre and Post Hair Transplant Surgery Instructions?

Pre-Op Transplant Surgery Instructions

Since we use only local anesthesia, our patients are encouraged to eat a normal breakfast.

The scalp has an excellent blood supply, so efforts to minimize bleeding help shorten the hair transplant procedure time and decrease the risk of bruising or swelling after the hair transplant surgery. Avoid medications or vitamins which can prolong bleeding.

Some of the medications that can prolong bleeding include: Aspirin and Aspirin containing cold and flu medications, NSAIDS such as Ibuprofen, Ketoprofen, Advil and Aleve. If you require NSAIDS for arthritis, new medications are available which do not cause bleeding. Please feel free to call for more information.

Post-Op Transplant Surgery Instructions

The first three days after surgery require the greatest care and caution while the grafts are healing in place. Activity should be limited to walking and sedentary activities. Strenuous and all normal activities can be resumed 1 week after surgery. For some patients it is possible to return to work in only 3-4 days. Others prefer to wait an entire week when most incisions are totally healed and sutures from the donor area can be removed.

Postoperative graft care involves gentle misting of the area with saline. Other than the elimination of certain activities, there is very little extraordinary care required. Most of the healing is automatic and depends on your unique rate of healing.

Medication: Three medications have been prescribed for you. It is advisable to take medications with food to prevent nausea. Take the medications spaced a minimum of 30 minutes apart. These medications are helpful, but not mandatory. If they make you feel sick or upset your stomach, you may stop them at any time.

  • PREDNISONE: This medication will help prevent swelling.
  • ANTIBIOTIC: An antibiotic such as cefzil will be prescribed as a precaution against a very low risk of infection. One single dose taken in the morning of the day of surgery together with your breakfast is sufficient.
  • PAIN RELIEVER: A mild narcotic-analgesic such as Hydrocodone (Vicodin) will be prescribed to help alleviate any pain that you might experience. This medication is optional after the first 24 hours. Generally, you will experience little or no pain at the graft sites. Some minor discomfort is common the first day or two after surgery, but is usually well controlled by a mild narcotic-analgesic. This medication can cause drowsiness. Do not consume alcohol while you are taking this medication.

Exceptions will apply–allergies to the above medications or other contra indications will result in a change in medications.

Do NOT use Rogaine (minoxidil) for 7 days following surgery or until the scabs are gone and the incisions are completely healed! This will prevent over-absorption of medication. However, once the incisions are healed, topical Minoxidil can help speed graft growth if used for at least 3 months after surgery. At that time you should wean yourself gradually off the medication.


It is recommended that you limit your normal activity during the hair transplant healing phase, but most normal activity can be resumed one week after surgery. It is recommended that you avoid activities that will exert excessive pulling on the back of the scalp for a few months as the donor incision can stretch if excessive tension is applied. Examples would be weight lifting exercise for your neck, deliberatiely working on stretching the area by bending your head forward, and massaging the area.

Q.: What is the cost?


Prices range from $5 to $3 per graft for FUT on an incremental basis, depending on graft numbers and from $7 to $3.50 per graft on an incremental basis for FUE. We include a $500 travel discount for out of state patients.

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Male Pattern Baldness | Hair Loss Clinic Tucson | FAQ