Brief Answer: Hair loss management Detailed Answer: Hello XXXXXXX Welcome to healthcare magic. From your history, I understand that you have a hereditary pattern of hair loss, medically termed as " Androgenetic alopecia " or "Male pattern hair loss". Due to factors like stress, pollution and lifestyle patterns, we are seeing cases of androgenetic alopecia even in the early 20's. However, with proper treatment and follow up, it is possible to arrest hair fall and prevent if from progressing rapidly. 5% Minoxidil and oral finasteride at the dose of 1 mg are US-FDA approved treatments for androgenetic alopecia. I suggest that you could start using 1 ml of 5% minoxidil solution( e.g.- Mintop) twice a day on the sides of the scalp as well as the top portion where the hairs are sparse. ( It comes with a dropper with a 1 ml indicator mark). Apply once in the morning after bath on dry scalp and once at bed time. Oral finasteride is a prescription drug which is usually given for advancing grades of baldness. This can be obtained only after consulting a dermatologist. You could also take tablets containing Biotin, cysteine, methionine and saw palmetto (e.g. Keraglo men) one tablet a day after lunch or dinner for 3 months. This could be obtained over the counter. Try to have a nutritious diet rich in protein and anti oxidants( bright coloured fruits and vegetables). Try to cut down stress by practicing yoga/ relaxation techniques. Hard water does not directly cause hair fall, but may contribute by making the hair brittle and thus more prone to breakage while combing. It will also help if you could reduce weight as obesity is linked to insulin resistance and this can accelerate hereditary hair fall. With all the above measures, I am sure that you can preserve the existing hair as well as see new hair formation. Remember that minoxidil takes at least 4- 6 weeks to start showing results. It could take anywhere from 3-4 months for you to appreciate change in hair density. Hence, patience and compliance are the keys to successful hair fall treatment. Also remember that since your hair loss is genetically programmed, hair fall can restart once you stop all the medications. Hence it is important that you continue the treatment as long as you want to retain good hair. Hope this helps you address your concerns. If you have any further queries, I will be glad to assist. Take care. Dr. Johny Chacko

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