Dear Dr. G,

Greetings on the first weekend of November, as we venture into the month-long men’s health awareness of Movember.

Although I love to participate in the facial hair growing activities promoting dialogue on issues related to male cancers and mental health. Sadly, as a Chinese man, I am not just facial hair depleted; now I am also follicular challenged in the crown. And this is also the beginning of my challenges in the bedroom.

I am a 35-year-old man who is happily married. In recent months, I begin to notice that I was shedding hair in the shower. And the bald patch in the crown began to appear like the expanding water of the Mediterranean Sea.

Feeling rather depressed and deflated, I started using a medication to bulk up the scarcity in the head.

To my horror, three months after starting the medication, I did not notice significant crowning glory and now I even lost my morning glory. In addition, I began to notice weakening erectile rigidity, even when I was fully aroused.

I read the medical instructions stating there is a small side effect of lessening libido and erectile dysfunction. I understand the risk is small and usually transient.

I would like to be the first person to put Dr. G on the spot this November asking about hair loss. Why is it happening to certain man and not the others?

What treatment is available to help men who are follicle challenged?

Is there any treatment that can revive the follicles without challenging the manhood?

For men started with medication facing challenges in the crown and waist down, what can we do now?


Follicular challenged

Hair loss or male pattern baldness; is also medically known as alopecia. The extent of the hair loss can be confined to a small patch, or extends to the whole body. The common etiology of male pattern baldness is related to the hormonal imbalance and genetic causes, however medical reasons for hair loss such as side effects of the medicine or autoimmune conditions are also noted.

Individuals should have between 100,000 to 150,000 follicular hairs in the head. The number of daily loss is quite variable, however the average of 100 strands loss per day is considered healthy. The first sign of excessive hair loss is excessive loss noted in the bathroom and wide-parting thinning crown.

Alopecia is well recognized to be the source of psychological distress, as hair is often considered essential part of the individual identity. Men typically associate a full head of hair with youth and vigor, and therefore the thinning crown is often a sensitive issue of discussion.

The treatment for various forms of hair loss has emerged over the last few decades. The medications that are used in the treatment of alopecia include minoxidil and finasteride. Minoxidil is applied by rubbing into the scalp twice a day to stimulate hair regrowth. This can take between one to six months to be evident. On the other hand, finasteride is responsible to deplete the conversion of testosterone to its active form. This has the effect of increasing hair retention and regrowth. The drug is reported to have a two percent risk of decreasing sex drive and inducing erectile dysfunction. In reality, this figure is believed to be higher.

Hair transplantation is the ultimate restoration of the lost crown. A surgeon will move the healthy hair from the back and side of the head to the thinning area. Surgical techniques such as follicle transplant, scalp flaps and scalp reduction are also adopted for men to regain the crowning glory.

Martin Luther King once said: “The ultimate measure of a man is not where he stands in moment of comfort and convenience, but where he stands at the time of challenge and controversy.” Instead of the complications of medications, cumbersome of transplant and the hideousness of comb-over, most men would concede to the receding hairline and embrace the baldness by shaving their full crown. The spirit of Movember is annual event involving the growing of moustaches to raise awareness of medical challenges faced by men globally.

When Dr. G is put on the spot by the follicular challenged men troubled by challenges of in the crown and below the waistline, his response is “The ultimate measure of a man is not where the follicles stands in the comfort and convenience, but where the manhood rise to the occasions despite all challenges in life.”

On that note, happy Movember, with or without facial hair!

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