Q. What is DHT?
Ans. Dihydrotestosterone (DHT) is produced from the male hormone testosterone by the enzyme 5-alpha reductase. DHT is the androgen thought to be most responsible for the type of hair loss also known as male pattern baldness. DHT has a very high affinity for the androgen receptor and is estimated to be five to ten times more potent than testosterone. Other androgens that may be significant in pattern loss include androstenedione, androstanedione and DHEA (especially in women). All of these fall into hormonal pathways that can potentially result in elevation of DHT downstream via various enzymes. It is possible that certain DHT metabolites may play a role in male pattern hair loss as well.
Q. What's the best hair loss treatment?
Ans. There is no simple answer to this. No one treatment offers spectacular hair growth for all people who use it. However, there are a few treatments that yield decent results for a majority of people. (Decent is defined here as cessation of further hair thinning and perhaps some regrowth, ranging from a little to moderate.) Some people do respond unusually well--but then some don't respond at all. Most fall somewhere in between. Since there are multiple factors in male pattern hair loss, it is wisest to approach the problem from several angles to maximize results, as some treatments are complementary and address different underlying causes. A common fundamental approach is to use an "antiandrogen" of some kind, whether systemic (such as finasteride) or topical (such as spironolactone or azelaic acid), and a growth stimulant such as minoxidil (Rogaine). To this basic program many add a topical SOD. Other options include therapeutic shampoos, such as the antimicrobial and growth stimulant shampoos. Still other approaches that may help include dietary and nutritional considerations and even lifestyle modifications. There are many adherents to such a "kitchen sink" approach. You can also start with a single hair loss treatment, though due to the long lag time before you can actually verify efficacy, this can be very hit and miss and may bring less than optimal results by only addressing one aspect of a larger problem.
Q. Is stress a factor in hair loss?
Ans. Sometimes stress can play a role in diffuse loss. Stress-induced loss ordinarily regrows within a year of eliminating the cause.
Q. How long does it take to see results from any hair loss treatment program?
Ans. At least 2-3 months, though usually significantly longer. Many do not notice any apparent improvements until well after a year. Best results are often seen after the two-year mark. This is because hair follicles undergo a relatively long dormancy period in between hair growth cycles (usually about 3 months). In addition, hair only grows about 1/2 inch per month in non-thinning areas and usually considerably slower in thinning areas. Since it generally takes several cycles of growth/fallout/regrowth, with the hair getting thicker and longer each time, it can take a great deal of time to see noticeable improvement. Note that best regrowth results are seen with hair that was lost within the last five years and in areas of the scalp in which there is still some fine hair.