A Response to 'Male Balding Is a Major Risk Factor for Severe COVID-19'

Androgenic alopecia (AGA) might have evolved to reduce prostate cancer risk by increasing UV exposure to the scalp, but this theory is debated. Treatments like minoxidil and finasteride are used for AGA, though the exact causes and evolutionary reasons for hair loss are unclear.

Balding scalps have more androgen receptors, leading to increased TGF-beta, which causes blood vessel loss and hair follicle miniaturization. Blocking androgen signaling and TGF-beta may help prevent hair loss.

Male-pattern baldness might increase UVB exposure on the scalp, potentially affecting vitamin D and skeletal health. The hypothesis is debated, with some seeing it as a minor benefit in specific contexts.

A 25-year-old male experienced significant hair loss due to telogen effluvium and androgenetic alopecia. He began using finasteride, minoxidil, and vitamins, seeing some regrowth but remains worried about hair density.

A 22-year-old male experiencing hair thinning and loss, possibly due to seborrheic dermatitis or low vitamin D, is cautious about using minoxidil or finasteride due to heart palpitations and high blood pressure. Suggestions include using ketoconazole shampoo to control inflammation and focusing on treating the dermatitis first.

DHT may inhibit hair growth by affecting mitochondrial function, leading to hair follicle miniaturization. Treatments like minoxidil and PP405 may promote hair growth by altering metabolic pathways, potentially counteracting DHT's effects.