How to keep your hair on

Q: I AM a male in my late 30s. For the past few years my hairline has been receding slowly but surely. I feel that I look much older than my age would indicate. I'm really worried about the possibility of ending up bald. Also, the idea of eventually having to wear a toupee is not very appealing. There are lots of advertisements for hair transplants but I'm worried that they don't really work. Before investing my time and money could you let me know your opinion? Dr Rose writes: The most common form of baldness, or alopecia, is inherited male pattern baldness. Hair loss begins in the temple and crown, with the bald area gradually widening. Occasionally, young women and menopausal women are affected. In rare cases, hair loss is caused by the absence of hair roots or abnormalities of the hair shaft.

A hair transplant can help to replace lost hair. The most modern technique involves several visits to the doctor's office. After anaesthetising the patient's scalp the doctor takes about 40 minigrafts of hair from the back of the head. These are preservedin a saline solution for later use. Prior to transplantation, the grafts are divided into a few hundred smaller grafts. The success of hair transplantation varies with the transplanted areas sometimes becoming bald and patchy over time.

An alternative to hair transplantation is to coat the scalp daily with a drug called minoxidil. Using this drug, hair growth may occur in four or more months. The drug, originally used in the treatment of high blood pressure, seems to show positive results in about one-third of all men. However, this is an expensive treatment and as soon as they stop using the drug, hair growth stops and can relapse to pre-treatment stage.

If you are considering any of these treatments make sure that you consult a physician who is experienced in this area. Do not play around with over-the-counter remedies that claim to eradicate baldness.

Q: My husband and I have been married for six years and have been enjoying oral sex for most of our married life. He says that oral sex is very common. I disagree. Can you help us settle this dispute? Dr Rose writes: Studies indicate that in the United States, about 50 to 80 per cent of women have performed oral sex (fellatio) on their male partners. About 50 per cent of couples have engaged in cunnilingus, the stimulation of the female genitals by a partner's mouth or tongue. It appears that the younger the couple is the more acceptable they find the practice. As many as 90 per cent of married couples under the age of 25 have engaged in oral sex. The number of Asian men and women who engage in oral sex has not been studied but it is probably quite a bit lower.

Not everyone feels comfortable about performing oral sex. Of the women surveyed, a significant percentage do not enjoy it. For some cultures the subject is actually taboo. However, if you and your husband find oral sex to be satisfying and pleasurable, you should continue to enjoy it.

Q: My daughter is 23 years old and for the past 10 years, she has had sweaty palms, even in the winter. As a result, everything she holds gets sweaty. She is too embarrassed to shake hands with anyone. Can you tell me what is the cause and what she can do about the sweat? Dr Rose writes: Your daughter may be suffering from a condition known as hyperhidrosis. Individuals with this disorder are plagued with excessive sweating in the palms, armpits, soles or all three even when the weather is cool. This constant sweatiness canbe very embarrassing. Fortunately, the condition improves in most sufferers by the time they reach their late 20s or early 30s.

Treatment is with anticholinergic drugs (drugs that interfere with the secretion of sweat), by applying aluminium chloride to the affected areas to block the sweat glands and by wearing clothing made from natural fabrics such as cotton and wool.

It is also possible that the excessive sweating is a response to psychological stress and is caused by anxiety and fear. Your daughter may benefit from seeing a psychologist.

Dr Rose Ong is a certified family physician licensed in the United States. She welcomes enquiries but cannot answer them individually. Specific questions should be addressed to your own physician. Additional enquiries: Peak Corporate Health Management, 525-6600, fax 525-8100.