It lacks the pain of a heart attack, the threat of prostate cancer, and the complications of high blood pressure. Still, despite the best efforts of Michael Jordan and all of the trendy guys who've followed his shiny-scalp example, millions of men are distressed by hair loss.

What's normal?
A man's scalp is covered by about 100,000 hair follicles. During the normal hair-growth cycle, each follicle passes through a two- to three-year period of growth, followed by a period of involution and rest that lasts from three to four months. During the involution phase, some of the follicles die, which is why a healthy scalp loses about 100 hairs a day. But most of the follicles get back to growing new hairs, so a man's hair stays full—unless something goes wrong.

It lacks the pain of a heart attack, the threat of prostate cancer, and the complications of high blood pressure. Still, despite the best efforts of Michael Jordan and all of the trendy guys who've followed his shiny-scalp example, millions of men are distressed by hair loss.

Treatments for baldness

Doctors don't think of male pattern baldness as an illness—but 33 million American men are troubled enough to spend about $1.5 billion a year on treatments.

Some men turn to scalp surgery and hair transplants, others to wigs and toupees. But the Holy Grail is a pill or potion that can cover a shiny pate with a man's own hair.

In 1989, the U.S. Food and Drug Administration cleared the shelves of many worthless products marketed to gullible and vulnerable men for generations. But two medications remain standing; both can help, but neither is a miracle cure for baldness: 

      Minoxidil tablets are a prescription drug for hypertension. But for more than 10 years it has also been available as Rogaine, a nonprescription lotion for hair loss. It works by prolonging the growth phase of hair follicles that are still active but its benefits last only while you use it regularly. Rogaine is more effective for bald spots than receding hairlines, but it's only partially effective at that. In one study, 36 percent of men who had used the product for several years felt it was worth the time and money. According to the manufacturer, Rogaine should be applied twice daily. Scalp irritation can occur; dizziness and low blood pressure are less common side effects.

Finasteride is an oral prescription medication that blocks the conversion of testosterone to DHT. It is marketed as Propecia, which is a 1-milligram tablet. (The 5-milligram tablet is known as Proscar, and is prescribed for benign prostatic hyperplasia, or BPH.) Propecia was approved largely on the basis of four studies. Although the drug had positive results, they were hardly dramatic. For example, after a year of treatment, men taking Propecia had an average of 876 hairs in a one-inch circle on the scalp, while those taking a placebo pill had 769 hairs. In another trial, 50 percent of men taking Propecia and 30 percent of men taking a placebo pill thought their appearance had improved. Because Propecia cannot revive hair follicles that are inactive, it won't help men who are already bald.

Men who find the drug helpful will have to continue taking it indefinitely to maintain even modest improvements. Propecia is generally safe, but 1 to 2 percent of men experience diminished sexual drive (libido) and potency, which rebound when they stop taking the drug.

To treat or not to treat?From a medical point of view, there is no need to treat male pattern baldness. At best, the treatments are expensive and only partially effective. Although treatment is generally safe, some men may experience side effects. Take a look in the mirror and think it over. And before you decide, try to imagine Michael Jordan, Bruce Willis or Chris Daughtry.