Am I right in my understanding that baldness is hereditary, and the genes responsible for the condition are inherited from male relatives on the mother's side on the family? And if this is so and we all contain a predisposition for whether or not we become bald, does this mean that it is a condition that cannot be prevented or cured but simply delayed? Name and address withheld

Your knowledge of baldness cannot be faulted. There is probably more than one gene responsible for early baldness but you are quite right in thinking that the genetic pattern of baldness in a family tends to be more akin to that exhibited by the male relatives on the mother’s side than on the father’s side.

Baldness cannot be cured, any more than lines on the face; the redistribution of fat, muscle weakness and all the other signs of ageing cannot be eradicated. Baldness is part of the ageing process just as is greying of the hair. The average European starts to go grey at 34, whereas in the African races it is 10 years later, at 44. The consolation is that there is evidence, despite the periodic denials, that men who go bald early tend to have a higher level of testosterone.

There are means of delaying the process, which we will discuss in answers to the other questions.

In the USA, a product which claims to help re-grow hair, named Avacor, has been heavily promoted in radio and TV advertising for about the last year. Has anyone done controlled tests to determine if it works? Is it just another fake cure? Name and address withheld

There are only two products which are licensed to treat baldness, and only two products which occasionally, but not always, work. One is Minoxidil, which is a drug used to treat high blood pressure. It was discovered by chance that if it was applied to the scalp the hair regrew in about a third of cases. Minoxidil is also known as Regaine (or Rogaine in US), and is now available in a stronger, 5 per cent, solution which has to be obtained on prescription from a GP or dermatologist. This acts rather more quickly than the normal dose of 2 per cent, so that improvement is usually noticed within eight weeks, rather than 16 weeks. As a result of applying Minoxidil, there will be a cosmetically acceptable regrowth of hair in about 10 per cent of patients. Rather more people than this will be pleased with the result, but patients have to realise that it doesn’t cause as strong a regrowth of hair as the fine locks they had at 22.

Unfortunately, once the Minoxidil is no longer applied, the hair is lost again and, even if it is applied continuously, sooner or later nature catches up with the patient. Minoxidil is much more effective if it is used early. Patients who are going to be concerned about losing hair earlier than their contemporaries should start applying it as soon as any baldness is noticed. It is easier to prevent baldness than to cure it. It must always be applied for three or four months before hope is abandoned.

The other drug which works is finasteride, which is marketed in Britain as Propecia. Propecia is better known in Britain as Proscar, which was used in the treatment of benign enlargement of the prostrate. Propecia is, therefore, a powerful drug but fortunately it is now produced as a very low dose tablet (one milligram), which can be taken daily.

Most people will not have untoward side effects from taking finasteride Propecia in small quantities. However, there are some patients who notice side effects - in particular a decrease in libido, and even some degree of impotence. Theoretically, there might also be a reduction in the ejacular response, but it is very hard to say whether this is so.

I have not heard of Avacor. Drugs are known by different names throughout the world, but the present teaching is that the only ones which are agreed to be effective in a proportion of cases are finasteride Propecia and Minoxidil. A word of warning to British readers - there is an English product called Avaca, which is used in dermatology for the removal of warts – I would hate to think what it would do to a sensitive scalp.

I am excessively hairy in most areas. I have done my own research into the possible reasons for hirsutism, and polycystic ovarian syndrome (PCOS) seems to be the main culprit. However, I am not over-weight, I do not have acne and have regular periods. Is it still possible that I am suffering from PCOS, or are there other possible causes? I have never been to my GP about the problem, because of severe embarrassment. I should just like to know what it could be, and what action my GP would take? Name and address withheld

Hirsutism, unwanted hair or excessive hair, is the characteristic of certain races and certain families. In particular, women are, not unreasonably, disturbed if they have a male pattern of distribution of body hair, ie, a line of pubic hair stretches up to the umbilicus (the belly button), they have hair around their nipples or on their chests. This male pattern may be found in women who are otherwise average. There are now all sorts of ways in which excessive and/or unwanted hair can be removed.

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