Hair Loss Clinic in Kitchener Waterloo

There are various treatment options for male pattern baldness, otherwise known as androgenic alopecia, in our Kitchener-Waterloo based clinic.

 

What is androgenic alopecia?

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Androgenic alopecia, often called male pattern baldness, is a genetically determined form of hair loss driven by the hormone dihydrotestosterone (DHT) acting on susceptible scalp follicles. In predisposed men, DHT binds androgen receptors in the follicle’s dermal papilla and alters growth signals, progressively miniaturizing terminal hairs into thinner, shorter, lighter strands. Over successive cycles, the anagen (growth) phase shortens and the telogen (rest) phase lengthens, leading to visible thinning that typically starts at the temples and crown and may merge over time. Unlike shedding disorders such as telogen effluvium, androgenic alopecia is chronic and patterned; early recognition enables mechanism-targeted treatments (e.g., finasteride/dutasteride to reduce DHT; topical minoxidil to prolong anagen) that can slow loss and improve density.

 

What treatment options are available?
 

• Finasteride

• Dutasteride

• Topical minoxidil

• Oral minoxidil

• Compounded topical finasteride

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While each of these can post potential risks, we review the risks with you to determine the best option(s).

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Finasteride
Blocks type II 5-alpha-reductase, lowering scalp and serum DHT to slow follicle miniaturization in androgenetic alopecia. Main concerns are sexual or mood side effects (uncommon), gynecomastia risk, and teratogenicity to a male fetus via handling.

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Dutasteride
Inhibits both type I and II 5-alpha-reductase, reducing DHT more than finasteride and often yielding stronger hair retention. Similar side-effect profile to finasteride, with potentially higher rates due to deeper DHT suppression.

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Topical Minoxidil
Prolongs the anagen (growth) phase and enlarges miniaturized follicles, likely via potassium-channel opening and local vasodilation. Benefits build over 3–12 months; common issues are scalp irritation and initial shedding.

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Oral Minoxidil
Low-dose tablets can promote regrowth when topical therapy fails, using the same follicular mechanisms systemically. There are real risks associated with oral minoxidil that require an in-depth risk benefit discussion.

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Compounded Topical Finasteride
Pharmacy-made solutions/gels aim to lower scalp DHT with less systemic exposure than oral tablets. Efficacy can approximate oral in some users; quality and concentration vary by compounder, and systemic effects are still possible.

 

Compounded Topical Dutasteride
Custom formulations target potent local DHT reduction by blocking both 5-alpha-reductase isoenzymes at the scalp. Early clinical use suggests strong effects, but variability in compounding, absorption, and long-term safety data warrants cautious monitoring.

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Every patient is different and our first step is to confirm that your diagnosis is androgenic alopecia. Afterwards, we will work with you to pick a treatment plan that is in line with your goals.