A healthy head of hair is often associated with youth and vitality. But as men age, many begin to notice thinning—or even significant hair loss.
“Most hair loss in men is due to male pattern hair loss,” says board-certified medical, surgical, and cosmetic dermatologist Dr. Leslie Carter, owner of Deschutes Dermatology in Bend. “It’s estimated that 80% of men will experience some degree of it, and it’s hereditary.” While other causes of hair loss do exist, she notes, they’re far less common.
This type of hair loss is progressive and driven by DHT, a potent form of testosterone that gradually shrinks hair follicles over time. “Eventually, the follicles stop producing hair altogether,” she explains.
These days, more men are seeking treatment earlier—sometimes in their teens or early 20s—not just to regrow hair, but to preserve what they already have.
“I always prefer to treat early,” notes Dr. Carter. “It’s much easier to maintain hair than to regrow it once it’s gone, especially in more advanced stages.”
That early approach allows for simpler, more effective treatment plans. And while every patient is different, Dr. Carter emphasizes a comprehensive, personalized strategy.
“I look at what’s happening physiologically and ask, ‘Why is this occurring?’ Then I build a program that addresses those factors,” she states. “We take a multi-modal approach, meaning we often combine therapies that work in different ways. In most cases, that combination approach is more effective than relying on just one treatment alone.”
Treatment typically begins with oral and/or topical medications designed to block or manage DHT. Dr. Carter carefully reviews potential side effects and works closely with patients to find an approach they’re comfortable with.
“I listen to their concerns and help put things into perspective,” she explains. “And if something doesn’t feel right, we adjust. It’s a process of fine-tuning to get the best results with the fewest side effects.”
Another commonly used option is minoxidil (Rogaine®), available in both topical and oral forms, which helps stimulate blood flow to the scalp. “We often combine it with a DHT blocker, or sometimes use just one or the other,” she notes.
Red light therapy is another important tool that benefits most patients. It works by increasing blood flow to the scalp and reducing inflammation, helping to support healthier hair growth. While some at-home devices are available, medical-grade laser treatments offered in-office are significantly more powerful and are typically done one to three times per week before tapering.
Because hair growth takes time—often three to six months to see visible improvement—Dr. Carter also uses genetic testing to make the process more efficient and targeted from the start.
“We use a simple cheek swab to understand how your body is likely to respond to different treatments,” she says. “That allows me to fine-tune your plan instead of relying on trial and error.”
This insight helps guide the selection and dosing of oral medications and also supports the creation of customized topical formulations, which are prepared by a compounding pharmacy for each patient.
For patients who are good candidates, growth factor therapies may also be incorporated as part of a comprehensive treatment plan. At Deschutes Dermatology, these are delivered using a needle-free device that helps infuse the solution into the scalp while also increasing blood flow.
To stay at the forefront of hair restoration, Deschutes Dermatology partners with GetHairMD™, an organization that develops and continually updates advanced treatment protocols.
“They have a medical board that evaluates new technologies as they emerge,” states Dr. Carter. “Over time, those innovations may become part of standard treatment options.”
Because hair loss can be complex, Dr. Carter emphasizes the importance of specialized care.
“Most dermatologists have training in hair loss, but more advanced cases often require additional time and attention,” she emphasizes. Appointments at her practice are typically longer than standard visits, allowing for a more in-depth and personalized approach.
“Hair plays a big role in how we see ourselves,” she adds. “When it starts to change, it can really impact confidence. The good news is that it’s becoming more accepted to talk about it—and there are more effective treatment options than ever before.”
DeschutesDermatology.com
"Hair plays a big role in how we see ourselves. When it starts to change, it can really impact confidence. The good news is that there are more effective treatment options than ever before.”
—Dr. Leslie Carter, owner of Deschutes Dermatology in Bend