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Is Propecia (aka Finasteride) the Right Medication for You?

After months of stressing out about how much hair you’ve lost, you finally pay a visit to your dermatologist. You talk to your doctor, have an examination, and finally get the news you’ve been dreading. You have androgenetic alopecia, another name for male or female pattern baldness. You were trying to process the diagnosis and heard the dermatologist mention the medication Propecia, but couldn’t fully concentrate on what he or she was saying. You were too focused on the fact that you are losing your hair. Now that you’ve calmed down, you have decisions to make. Should you try taking Propecia or not? Will it work? Is there a less expensive generic version? Does it have any side effects? If these or other questions are swirling around in your head, you’re in the right place. We’re here to give you all of the information you need to help you decide whether Propecia is right for you.

Why is Propecia Prescribed?

Propecia, the brand name for the generic medication Finasteride, is FDA-approved to treat male pattern baldness. Although the medication is not FDA-approved to treat women, it is often prescribed off-label for female pattern baldness. Both Propecia and Finasteride work the same. The difference between the two medications is the price. Since Propecia is a brand name, it is more expensive due to associated marketing costs.

Is Propecia a New Hair Loss Medication?

Propecia has been available to treat hair loss for over 25 years. The medication was first used in 5-milligram doses in 1992 by urologists to treat enlarged prostates among men aged 50 and older. During trials, it was discovered that a side effect was hair growth. In 1997, one milligram of Propecia was formally approved for hair loss in men who are 18 and up.

How Does Propecia Treat Androgenetic Alopecia?

Propecia inhibits type II and type III 5-alpha-reductase isoenzymes. In simple terms, that means it prevents testosterone from converting into an androgen called dihydrotestosterone (DHT). Blocking DHT is important because excess DHT shrinks your hair follicles and interrupts your hair’s growth cycle. When your hair follicles shrink, hair becomes thinner and weaker. Hair falls out easily and doesn’t grow back.

How is Propecia Dosed to Treat Male or Female Pattern Hair Loss?

As mentioned previously, Propecia was originally marketed to treat benign prostatic hyperplasia at 5 milligrams. The dosage typically prescribed to treat male pattern hair loss is significantly less. Your doctor will determine the right dose for you; however, one milligram is the most common prescription for men. Women usually need a higher dosage than men. Doses prescribed for women can range anywhere from 1.25 to five milligrams.

Does Propecia Effectively Treat Hair Loss?

If you’re wondering whether or not you should give Propecia a try, the data is favorable. Propecia is effective in preventing further hair loss and growing new hair. Research has demonstrated that Propecia reduces serum DHT by 70 percent. (01) With the medication, testosterone cannot convert to DHT, which can damage the hair follicles. Furthermore, one study indicates that 48 percent of users achieved growth after one year. After two years, that number increased to 66 percent. The study also shows that Propecia halts hair loss. After two years, 83 percent of users in the study had no further hair loss. (02) It’s important to know that results are only seen while using Propecia. If you stop using the medication, new growth will likely fall out and your hair will look like it did before taking it. Further hair loss can also occur.

Can You Combine Propecia With Other Hair Loss Medications?

Dermatologists often find that combining Propecia with Minoxidil gives better results than using Propecia alone. The two medications serve different purposes. Propecia blocks the DHT from converting, while Minoxidil sends oxygen to the hair follicles, helping them open so healthy new hair can break through. You may also hear about retinol. When using topical Propecia, retinol has been proven to improve absorption of the medication, giving better results.

How Long Does it Take Propecia to Work?

It’s normal to be anxious to see results after starting a hair loss medication. When you take Propecia, you may see hints of new growth around the three or four-month mark. However, it typically takes six months to notice significant improvement. It generally takes a year to see full results.

Does Propecia Have Any Side Effects?

Many men are apprehensive about taking Propecia because they have heard it can cause undesirable sexual side effects. Some report erectile dysfunction, decreased libido, and ejaculation disorders. The side effects are rare, only affecting approximately one percent of men who take oral Propecia. If side effects are a concern, topical Propecia is an alternative that has been proven equally as effective without the same risk of side effects. Topical solutions work specifically at the site of the hair follicles without risking systemic exposure. (03)

Can Women Take Propecia?

Although Propecia is not FDA approved for women, many dermatologists prescribe the medication off-label for their patients with female pattern baldness. Both oral and topical Propecia has been proven effective for treating women. (04) Topical Propecia is absorbed into the skin of the scalp without systemic effects. Oral Propecia can be prescribed for women who are post menapausal, but isn’t recommended for women of childbearing age unless oral contraceptives are also being taken.

Are There Alternatives to Propecia to Treat Androgenetic Alopecia?

Other hair loss treatments exist, but keep in mind that prescription medications are most effective. Minoxidil is often used in conjunction with Propecia for both men and women. Propecia is effective for most, but in cases where stronger medications are needed, Dutasteride can be prescribed to men or women. Dutasteride works similarly to Propecia; however, it blocks an additional enzyme. Spironolactone can be prescribed to women but isn’t recommended for men because it can cause breast enlargement. Combination topical treatments are often a good choice because they conveniently combine multiple medications into one formula.

Propecia is a well-tested medication proven to help people with androgenetic alopecia. The medicine helps stop further hair loss and stimulates new growth in many patients with male and female pattern baldness. If you have additional questions about Propecia, let us know. Our board-certified dermatologists are available to review your case and recommend dosages, formulas, and other medications that work well with Propecia.

Resources:

(01) https://www.ncbi.nlm.nih.gov/books/NBK513329/#:~:text=2%5D%5B3%5D-,Finasteride%20is%20an%20FDA%2Dapproved%20pharmacologic%20agent%20for%20treating%20benign,a%20dose%20of%205%20mg.

(02) https://pubmed.ncbi.nlm.nih.gov/9951956/

(03) https://onlinelibrary.wiley.com/doi/full/10.1111/jdv.17738

(04) https://pubmed.ncbi.nlm.nih.gov/29464847/

Is Your Hair Healthy?

Has your hair been a little drier and frizzier than usual? Is it less manageable than it used to be? Figuring out whether or not your hair is healthy can be challenging. It can be difficult to distinguish between when it’s time for a deep conditioning treatment and a haircut or if something else is affecting your hair. If you know what to look for, though, assessing your hair’s health is easy. Here’s a simple guide designed to help.

How Do You Know When Your Hair is Healthy?

Is your hair smooth and shiny or dull and coarse? Hair that’s shiny and smooth is deemed more healthy, even when hair is wavy or curly. (01) As we age, natural graying can make hair seem dull or frizzy, but that doesn’t have to be the case. Daily conditioners, moisturizing treatments, and shine-boosting sprays can help.

Androgenetic alopecia, a fancy name for male and female pattern baldness, can also change your hair’s texture and appearance. Sometimes hair becomes finer due to miniaturization of the hair follicles. Because the hair becomes thinner, it could become curlier. In other cases, previously curly or wavy hair can flatten and be less able to hold its curls or waves.

Healthy Hair From the Inside Out

Healthy hair isn’t just what you see on the outside. What’s on the inside also counts. Hair is primarily made of keratin, which is a protein. Keratin is made out of amino acids and other molecules that come from foods we eat. That’s why eating a balanced diet and ensuring that you have all the right vitamins are so essential.

Your hair grows from a follicle beneath your scalp’s skin. A hair shaft extends from the follicle. The shape and angle of your hair shaft are what determines what type of hair you have. It’s made out of three layers:

Medullar- Inside layer
Cortex – Middle layer that determines your hair color and elasticity
Cuticle – Outside layer that makes your hair look shiny

When the cuticle is damaged by the sun, chemicals, blow drying, or other elements, the cells in the cortex can break or unravel, making your hair look dull or brittle.

What Damages Healthy Hair?

Typically, the hair’s cortex is filled with keratin, and the cuticle is smooth, allowing light to reflect. When the cuticle is damaged, your hair may seem dry and frizzy. The ends may be thinner than they used to be, but there is still an opportunity for repair. A haircut, deep conditioning, and time to regrow usually solve the problem. When the cortex is damaged, salvaging the hair is more complicated. At that point, hair is coarse and dull with split ends and some breakage.

Does Healthy Hair Fall Out?

According to the American Academy of Dermatologists, losing about 50 to 100 hairs per day is normal as part of the hair’s growth cycle. (02) So, even if your hair is healthy, you might still see a few strands in the sink. When you lose more than that, there’s a problem. Hair loss due to physical defects is unusual compared to other types of alopecia. Here are four of the most common ones:

Loose anagen syndrome – When hair is loose and easily pulls out of the follicle because the root sheaths are not fully formed. More common in children than adults.
Traction alopecia – When hair is pulled out of the follicle by tight hair bands, braids, or any other styling habits.
Trichotillomania – A type of obsessive-compulsive behavior when people pull out their own hair.
Overprocessing – Straighteners, perms, bleach, and dyes use harsh chemicals that can break down your hair’s fiber. Using these harsh chemicals too often or incorrectly can irreversibly damage the hair’s fiber.

Other Reasons for Hair Loss

If you are losing your hair, and it’s not due to a physical defect, it may be due to alopecia. Here are some examples:

Telogen effluvium is a temporary form of hair loss that can happen after sudden illness such as Covid, surgery, or a stressful occasion. Hair spontaneously regrows after a few months.
Androgenetic alopecia (male or female pattern baldness) is the most common form of alopecia. Although it commonly occurs during middle age, people in their 20s may have this type of hair loss due to an overproduction of Dihydrotestosterone (DHT). Minoxidil, Finasteride, Dutasteride, and Spironolactone are prescription DHT blockers often prescribed to reverse hair loss caused by male and female pattern baldness.
Alopecia Areata is an autoimmune condition that causes circular bald patches about the size of a quarter. In addition to Minoxidil and Finasteride, immunosuppressants have recently been found effective in helping people with alopecia areata regrow their hair.

How to Keep Your Hair Healthy

Want your hair to look shiny and healthy? Here are some tips to help you keep your hair in top condition:

Diet – Eat a well-balanced diet with plenty of vegetables, fruit, and plenty of protein
Vitamins – Check your vitamin levels, especially biotin, iron, vitamin C, niacin, and zinc. Work with your dermatologist to supplement if any levels are low
Exercise – Regular exercise not only helps manage your weight and keep your heart healthy, but it also reduces stress which has been proven to affect your hair
Habits – Quit smoking and only drink in moderation
Sun protection – Wear a hat when you’re in the sun to prevent damage from ultraviolet rays
Chlorine – Wear a swim cap when swimming, or rinse your hair before or after swimming to get all of the harsh chlorine out
Wet Hair – Use a wide-tooth comb and treat wet hair gently
Condition – Use a quality conditioner each time you wash your hair
Styling – Watch heat styling, eliminate or minimize chemical treatment, and avoid tight hairstyles (ponytails, braids, buns, etc.)

No matter your age or gender, having healthy hair is a confidence booster. If you have questions about your hair’s health or are concerned about hair loss, let us know. One of our board-certified dermatologists will review the information you provide and let you know if you would benefit by using one of our customized prescription medications.

Resources:

(01) https://pubmed.ncbi.nlm.nih.gov/18004288/

(02) https://www.aad.org/public/diseases/hair-loss/insider/shedding#:~:text=It%27s%20normal%20to%20shed%20between,this%20condition%20is%20telogen%20effluvium.

Does Stress Cause Hair Loss?

People often joke around about how stress causes hair loss.

“I was so stressed I was losing my hair.”

“All these bills have me pulling out my hair.”

“This new job is making my hair fall out.”

But for many, stress causing hair loss is no laughing matter. So does stress really cause hair loss? Yes, stress can cause you to lose your hair. And when you’re trying to keep as much hair on your head as possible, managing stress becomes a top priority.

Stress: The Good and the Bad

When you feel your heart rate rise because you’re running late or you start to sweat during a work presentation, what you’re feeling is stress. This emotional and physical tension is part of the body’s natural response to potentially dangerous or new situations.

Known as the body’s stress response or the “fight-or-flight” response, stress can be positive. This emotion keeps you alert and driven, pushing the body to work harder and think faster. Stress works well for short periods, giving you enough energy to power through a challenging event. Long-term (chronic) stress, however, compromises your well-being – and may cause you to lose your hair. (01)

The Physiological and Psychological Effects of Chronic Stress

The stress response comes from your body’s autonomic nervous system, the same system responsible for your heart rate, vision changes, blood pressure, and breathing.

During a stressful situation, you may experience the following:

Increased heart rate
High blood pressure
Faster breathing
Sweating
Tremors

With chronic stress, you can see these additional symptoms:

Headache
Muscle tension or pain
Chest pain
Restlessness
Insomnia
Fatigue
Stomach upset

Chronic stress can lead to health problems like high blood pressure, skin conditions, obesity, and heart disease. (01)

Why Stress Causes Hair Loss

To understand why stress causes hair loss, you first need to know the basics of hair growth. Hair grows in a cyclical pattern, with new hair growth to replace older hair once it falls out. Every healthy strand of hair typically grows in three primary stages:

Anagen Phase
Catagen Phase
Telogen Phase

Anagen Phase

The anagen phase is also known as the “Growth Phase.” During this phase, a strand of hair grows from the hair follicle. As it grows, sebaceous glands condition and lubricates the hair. Hair grows at an average rate of six inches a year for most people. At any given time, about 80% of hair is in the anagen phase. This phase of rapid growth usually lasts about 2 to 8 years.

Catagen Phase

Unlike the anagen phase, the catagen phase lasts only briefly. The catagen phase lasts about ten days, though some people may have hair that remains in the catagen phase for up to 4 weeks. This phase accounts for about 1 to 2 percent of a person’s hair. It is at this point that growth stops, and the hair follicle shuts down to rest. (02)

Telogen Phase

Hair falls out of the follicle during the telogen phase. The telogen phase is aptly named the “resting phase” because the hair follicle shuts down for a short rest. During this phase, the follicles no longer supply nutrients, which causes the air to fall out.

The hair that’s lost is usually hairs that are at the very tail end of the telogen phase, called the exogen phase. Approximately 15% of hair is in the telogen phase at any given time. The scalp sheds an average of 100 hairs a day. With about 100,000 hair follicles on the scalp, the daily loss of 100 hairs is negligible. (03)

Hair Loss and Stress

Hair growth is determined by the stem cells within the follicles. Chronic stress affects the adrenal glands. A recent study published in the journal Nature–with support from the NIH’s National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), showed how the hormone corticosterone is impacted by the adrenal glands, which respond to stress. (04)

Stress increases corticosterone levels. Corticosterone prevents the stem cells within hair follicles from activating hair growth. Instead, hair follicles remain in an extended resting phase – in the telogen phase.

Telogen Effluvium

Telogen effluvium is the primary condition responsible for hair loss during stress. Stress can cause a greater than usual amount of hair to suddenly shift to the telogen phase all at once. During telogen effluvium, many strands stop growing, and hair follicles become dormant. Fortunately, hair typically regrows within 6 to 9 months. (05)

Signs of Telogen Effluvium

With telogen effluvium, hair loss is often abrupt. However, hair loss may begin only a few months after experiencing significant stress. Hair follicles prematurely enter the telogen phase, and the follicles may take up to 3 months to start regrowing hair.

Unlike other hair conditions, like alopecia areata, the hair loss pattern typically experienced by individuals with telogen effluvium is diffuse hair loss. In other diagnoses like female pattern hair loss or alopecia areata, hair falls off in a patchy pattern, or they may experience a widening of the hair part. In telogen effluvium, hair loss occurs throughout the head resulting in an overall thinning rather than bald spots. (05)

Other Hair Loss Conditions Caused by Stress

Telogen effluvium is the second most common type of hair loss for men and women, but it’s not the only hair loss condition due to stress. Chronic stress may also indirectly cause the following conditions:

Alopecia Areata

Although alopecia areata (AA) is an autoimmune disease, It results in hair loss. In alopecia areata, the immune system mistakenly targets hair follicles, causing patchy hair loss throughout the scalp. Stress may be a trigger for the immune sustain, resulting in further hair loss. There’s no cure for AA, but some prescription hair medications can help manage hair loss. (06)

Trichotillomania

During a bout of trichotillomania, known as “hair pulling disorder,” an individual may feel compelled to pull or tug at their hair. People with trichotillomania have episodes of the disorder during times of significant stress. Trichotillomania causes patches of bald areas where the hair pulling occurred. (07)

Does stress cause male pattern baldness?

Male pattern baldness, also known as androgenic alopecia, is not caused by stress. The condition is caused by genetics. Unlike telogen effluvium, androgenic alopecia is not temporary. With early treatment, however, individuals with androgenic alopecia can slow hair loss or regrow hair.

In general, hair loss can be caused by a variety of factors. Finding the reason for your hair loss is important in addressing the issue. Our Happy Head licensed, board-certified dermatologists can help you determine the best approach to your hair loss including a custom topical hair regrowth treatment that’s made for you. Our hair regrowth products are made for both men and women, so there’s a solution for everyone. Contact us to learn what Happy Head can do for you.

Resources:

(01) https://medlineplus.gov

(02) https://www.ncbi.nlm.nih.gov

(03) https://www.nejm.org

(04) https://www.nih.gov

(05) https://www.ncbi.nlm.nih.gov

(06) https://www.niams.nih.gov

(07) https://www.sciencedirect.com

Can Female Pattern Hair Loss be Reversed?

Women have a reputation for being fixers. When something goes wrong, the first thing we want to do is fix it. So it’s not surprising that when we lose our hair, we want to take action and figure out if there’s anything we can do to make it grow back. Fortunately, female pattern hair loss can be reversed with treatment. It doesn’t happen overnight, but women start to see improvement within six months to a year. If you have questions about what products are most effective and if there are any side effects, you’ve come to the right place. Here’s everything you need to know.

Female Pattern Hair Loss Is Common

Female pattern hair loss, also called androgenetic alopecia, is the most common type of alopecia among women. Over 21 million women in the United States experience hair loss due to the condition. Besides normal recession that happens to most people as they age, the front of the hairline isn’t usually affected. There is a very distinct, recognizable pattern, though. The process usually starts with a widening of the center hair part and thins on the top and crown of the scalp, making a Christmas tree pattern. Women usually don’t become near or totally bald the way men do.

Too Much DHT Causes Hair Loss

The exact cause of female pattern hair loss isn’t completely understood. Experts believe that there are genetic and hormonal connections. If one of your parents or grandparents lost their hair due to androgenetic alopecia, there’s a chance that you may too.

What we do know is that an androgen called Dihydrotestosterone (DHT) is to blame. Just as men have small amounts of estrogen, women have small amounts of Testosterone. Hair loss begins when some or a lot of that Testosterone is converted to DHT. DHT interrupts your hair’s growth cycle. The androgen miniaturizes the hair follicles, which means that the hair follicles shrink. Existing hair in miniaturized follicles thins or falls out. New hair can’t break through. Fortunately, Happy Head’s board-certified dermatologists have a topical treatment specifically made for women that helps curb hair loss and boost regrowth with our custom Topical Spironolactone.

Myths About Female Pattern Hair Loss

Many myths about what causes female pattern hair loss exist. Let’s discuss three common topics that women often blame for their hair loss:

Vitamin Deficiencies

Vitamin deficiencies, especially iron and Vitamin D, are linked to hair loss. However, they don’t cause androgenetic alopecia. Vitamin deficiencies cause a temporary condition called telogen effluvium. Once the deficiency is identified and treated, hair loss typically stops and new hair grows.

Birth Control Pills

Research indicates that during initial use of oral contraceptives, women may experience more shedding than usual. However, after a few months, the hair grows back on its own. (01) The same is true when women who are stable when taking oral contraceptives go off of the medication.

Antidepressants

There is a lot of talk in various Facebook and support groups about whether antidepressants are the root of women’s hair loss. If you think that your antidepressants are causing an issue, it’s important not to change your dosage or stop taking your medication without first consulting with your doctor. Yes, it’s true that some antidepressants can cause medicine-induced alopecia, although it’s rare. The type of alopecia induced is typically a temporary form of telogen effluvium. However, if hair loss due to antidepressants concern, be sure to consult with your dermatologist. Effective hair loss medications can often be used in conjunction with antidepressants.

There’s No Age Limit

Women of all ages can experience female pattern hair loss. Although most women start to notice their hair thinning in midlife, meaning ages 40 through 60, hair loss due to androgenetic alopecia can start any time after puberty.

Patterns of Hair Loss Are the Key to Diagnosis

There isn’t one specific test that dermatologists use to determine whether or not you have female pattern hair loss. Dermatologists can typically make a diagnosis based on a visual evaluation since androgenetic alopecia has such specific patterns in women. Other information that he or she will use includes:

Medical history
Blood tests to check vitamin levels
Pull test to see if strands fall out easily
Visual inspection of hair follicles to check for miniaturization

Your dermatologist may also do a biopsy to rule out other forms of alopecia.

Treatments for Female Pattern Hair Loss

If you are diagnosed with female pattern hair loss, medications are available and have been proven to be effective. One is over-the-counter, and the others are only available by prescription.

Minoxidil (Rogaine)– Available over-the-counter in two and five-percent foams. Although the five percent is designated for men, women often use the five percent formula. Stronger liquid formulas are available by prescription. Oral pills are also available, but carry a very small risk of hirsutism.
Finasteride (Proscar, Propecia)– A DHT blocker FDA approved for men, prescribed off-label for women. An effective topical formula is also available.
Dutasteride (Avodart) – Another DHT blocker that is prescribed as a second-line of treatment after Finasteride. Dutasteride blocks two enzymes, while Finasteride blocks one. Finasteride is effective for most women, so Dutasteride isn’t prescribed as often.
Spironolactone (Aldactone) – A DHT blocker that is prescribed when women’s treatment has plateaued using other treatments.

Potential Side Effects from Hair Loss Medications

Potential side effects of taking oral hair loss medications are different for women than for men. Minoxidil can cause a temporary, initial shedding among some women because it speeds up the resting phase of your hair. This makes your hair fall out faster than normal when you first start using the medication. Minoxidil also makes the growth phase last longer. If you use Minoxidil and experience irritation, you may want to test a formula without propylene glycol. Research indicates that the culprit is often the propylene glycol, not the Minoxidil. (02)

Finasteride, Dutasteride, and Spironolactone are not typically prescribed for women of child-bearing ages. Aside from that, side effects are usually rare and mild, if present at all. If you are concerned about side effects, or interactions with other medications you are taking, topical hair loss treatments may be a better option for you. Topicals are proven to work as effectively as oral medications without the same risk of side effects since topicals are not systemic. (03) You can also combine topical treatments with oral treatments.

Treatment for Female Pattern Hair Loss Isn’t One-size-fits-all

Treating female pattern hair loss may take some experimenting. Different treatments are effective for different women. Whereas five percent topical Minoxidil may work for some, others may need ten percent. The same is true for Finasteride and the other DHT blockers. Also, remember that combinations of medications with different objectives are often used. For example, Minoxidil and Finasteride are often used at the same time. Retinoids are also often used to enhance the absorption of other medications.

If you have female pattern hair loss and would like more information on treatment options, we’re here to help. Our board-certified dermatologists are happy to review your case and recommend the hair loss medication that would be best for you. Best of all, our prescription medications can be customized and will be delivered directly to your front door.

Resources:

(01) https://pubmed.ncbi.nlm.nih.gov/4736624/

(02) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2684510/

(03) https://onlinelibrary.wiley.com/doi/10.1111/jocd.14895?af=R

Do You Need a Hair Loss Doctor? – How to Know When It’s Time for a Professional Opinion.

Did you know that many types of hair loss can be reversed? If you didn’t, you’re not alone. According to a 2018 study that evaluated why people don’t seek treatment for their hair loss, a significant number of people with androgenetic alopecia aren’t aware that treatments are available to help them regrow their hair. (01) This is one reason why people don’t seek medical attention when their hair is thinning or balding. However, if you are experiencing male or female pattern baldness, not only can treatment help you regrow your hair, but the earlier you begin treatment, the better your results.

Nobody wants to leave work early or spend money on doctor’s appointments that aren’t necessary. Life is way too busy for that. So, how do you know whether your hair loss warrants a visit? Here’s a guide to help you with everything you need to know, from when it’s time to get a professional opinion to what type of doctor you’ll need.

How Much Hair Loss is Too Much?

Everyone sees a few strands of hair in the sink or on the shower floor from time to time. That’s a normal part of the hair growth cycle and is expected. Losing 50 to 100 hairs during the shedding phase is normal. How do you know if you’re losing more than that, though? Here are a few signs:

Gradual Hair Loss

Thinning on top of your head
Growing bald spot
Receding hairline
Widening center or side part
Thinning ponytail

Sudden Hair Loss

Seeing a bald spot or area appear within 1 or 2 days
Losing clumps of hair
Watching all or most of your hair fall out all at once

Both Gradual and Sudden Hair Loss Requires Medical Attention

Whether you notice gradual or sudden hair loss, we recommend you seek medical attention. In addition to losing hair on their heads, some people lose hair on their face and their bodies. If you notice bald spots or missing hair in areas such as your eyebrows, eyelashes, beard, mustache, or other areas, that also warrants a doctor’s visit.

Male and female pattern baldness is the most common type of hair loss, and usually does not have any accompanying symptoms besides hair loss. However, people with other types of alopecia such as alopecia areata and lichen planopilaris may experience burning, stinging, itching, or tenderness resulting from inflammation. If this is the case for you, treatment is needed as quickly as possible to limit the amount of hair lost and have the best possible chance of regrowth.

What Type of Doctor Treats Hair Loss?

Finding the right person to help diagnose and treat your hair loss can be tricky. There are a lot of different types of practitioners who claim to help people with their thinning hair and bald spots. Here’s a rundown of who’s who:

Trichologist

A trichologist is a specialist who focuses on treating hair and scalp diseases. Although trichologists have specialized training, they are not medical doctors. They can’t write prescriptions or perform medical or surgical procedures.

Holistic Medicine Doctors (Naturopaths)

A holistic medicine doctor focuses on a whole-body approach to improving health and wellness. Rather than just looking at symptoms, naturopaths evaluate a patient’s mind, body, and spirit. Prevention comes first, and treatment comes second. Although holistic medicine doctors can order lab tests and use botanical therapies, they cannot write prescriptions unless they also hold medical degrees.

Dermatologist

A dermatologist is a medical doctor trained to treat skin, hair, and nails. Dermatologists have the training and expertise necessary to conduct a full evaluation, run any necessary tests, and prescribe medications if needed. Some dermatologists have more specialized training and experience working with hair loss than others. When selecting a dermatologist, ask questions such as what hair loss conditions he or she typically treats and what treatments are most often used.

Why Self Diagnosis is a Bad Idea

There are many good reasons why you should get a professional diagnosis. Access to the wealth of online information may make you feel like an expert, but you’re not. You may come to the wrong conclusion about why you’re losing your hair. Another reason why is that using ineffective medication is expensive. There is an abundance of nonmedical treatments on the market, such as vitamins, supplements, shampoos, and topical solutions, but research indicates that they have temporary or little effect on hair growth. The cost of over-the-counter treatments is actually higher than the cost would be for proven, supervised medical treatments. (02)

How a Hair Loss Doctor Makes a Diagnosis

Dermatologists use a staged approach to evaluating hair loss conditions. Typically, he or she will review your medical history to determine if there’s a pre-existing or new condition that is causing your hair loss. Whether your hair loss is gradual or sudden, your hair loss pattern will point your doctor in the right direction during your evaluation. For example, androgenetic alopecia usually presents with thinning on top, a receding hairline in men, and a widening part in women. Bald spots about the size of a quarter are often seen in patients with alopecia areata. A microscope can see if there is any redness caused by inflammation from scarring alopecia or a possible fungal infection.

Other tests sometimes used include a pull test to see how much and easily hair falls out. Usually, just a visual exam is all that is needed to diagnose androgenetic alopecia. However, if your doctor needs more information, biopsies are the gold standard for a diagnosis.

Treatment Options Available Through Hair Loss Doctors

Hair loss treatment depends upon the condition that is diagnosed. The most proven, commonly prescribed medications include:

Minoxidil

Topical Minoxidil, a vasodilator that increases the amount of oxygen to the scalp, is often prescribed to treat male and female pattern baldness and various other types of alopecia. Minoxidil is available over-the-counter in two and five-percent liquid and foam topical formulas. Higher topical doses and oral pills are only available by prescription. It’s best to use Minoxidil under a doctor’s supervision. Once you start using the medication, any hair that has grown can be lost if you stop taking it.

Finasteride

Finasteride is a topical and oral medication only available by prescription. The medication is typically prescribed to treat androgenetic alopecia; however, it has been proven effective for generating hair growth among patients with lichen planopilaris and other types of alopecia. (03) Finasteride works by blocking the production of DHT, which causes hair loss. Finasteride has a reputation for causing sexual side effects among men. If this concerns you, talk to your doctor about using topical formulas instead. Topicals work equally as effectively without side effects. (04)

Dutasteride

Finasteride is effective for most patients and is usually used as a first-line medication to treat hair loss. If you do not respond to Finasteride, your doctor may recommend trying Dutasteride, which works similarly to Finasteride. The difference between the two medications is that Finasteride inhibits one type of isoenzyme, while dutasteride inhibits two types.

Spironolactone

If you are a woman, your doctor may recommend Spironolactone, which blocks aldotestosterone, a hormone produced in the adrenal glands. Spironolactone is not usually prescribed to men since it can cause feminizing side effects.

Combination Treatments

Some types of alopecia require a combination of medications. For example, doctors often prescribe Minoxidil and Finasteride simultaneously. Minoxidil enlarges the hair follicles, while Finasteride prevents testosterone from converting to DHT. Retinol helps the absorption of other topical hair treatments, and cortisone can be added to prevent irritation.

Protein Rich Plasma (PRP)

Protein Rich Plasma treatments are a three-step process that involves drawing and separating your blood and injecting the separated platelets. Protein derived from the PRP process is believed to help your hair grow by encouraging cell growth. Only licensed practitioners can perform this medical procedure.

Hair Transplant Surgery

Hair transplants are becoming more common thanks to improved techniques that have been developed throughout the years. Because hair transplants are a type of surgery, doctors performing hair transplants must be licensed.

Why Prescription Hair Loss Medications are Superior to Over-the-Counter Treatments

As you’re probably already aware, the number of products on the market to treat hair loss is pretty overwhelming. Trying out a new shampoo that you find on Amazon may be harmless but could cost a lot of money without much hair gain. The window to regrow your hair could also close while you’re experimenting. The difference between the OTC products and what your dermatologist prescribes is research. It may not sound like much, but it’s a big deal. Clinical studies provide dermatologists with a scientific basis for providing advice and treatment. Clinical studies are also FDA-regulated, ensuring safety and properly reported results.

Need a Hair Loss Doctor? We Can Help.

Finding a dermatologist who is also a hair specialist can be difficult. If you have questions or are interested in treatment for your alopecia, contact us. Our licensed dermatologists will consult with you to determine whether you would benefit from using Happy Head or any other type of medication that treats hair loss.

Resources:

(01) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6029958/

(02) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6029958/

(03) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4809380/

(04) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4314881/#:~:text=Studies%20show%20that%20topical%20finasteride,post%2D%20treatment%20with%20oral%20finasteride.

September is Alopecia Awareness Month – 5 Facts You Need to Know

In 1986, the National Alopecia Areata Foundation (NAAF) declared September Alopecia Awareness Month. Throughout the month, public service and fundraising campaigns will generate awareness about alopecia areata and support people who live with the condition. If you see someone sporting a blue ribbon this month, odds are they are promoting alopecia awareness.

As a telemedicine company dedicated to helping people regrow their hair, Happy Head is proud to support the movement. Being diagnosed with alopecia can make people feel powerless. However, recent advances give patients more options and hope than ever before. Here are some facts about the condition and what you can do if you or someone you know is diagnosed.

1) 6.8 Million People in the United States Are Affected by Alopecia Areata (01)

If you have alopecia, there’s a whole community out there who can relate. Alopecia areata is an autoimmune disease affecting about 2.1% of the American population. (02) The percentage may seem small, but it isn’t.

Three types of alopecia areata exist:

Patchy Alopecia Areata is the most common type. It leaves small, round spots on your scalp
Alopecia Totalis is when people lose all of the hair on their scalps
Alopecia Universalis occurs when people lose all of the hair on their entire bodies

Alopecia areata can occur with little to no warning in otherwise healthy people. The condition occurs when a person’s immune system attacks the hair follicles, causing inflammation and hair loss. Usually, the head and face are affected, but people can lose hair from any part of their bodies in small or large patches. Neither doctors nor researchers fully understand the cause, but they believe that genetic and environmental factors are involved.

Alopecia areata is unpredictable, which makes it especially frustrating. Some people are only affected once, while others have recurrences. Hair regrowth is unpredictable as well. Some people can fully regrow their hair, while others cannot. Treatments to help people regrow their hair are available, but unfortunately, there isn’t a cure.

2) Alopecia Areata Has Some Common Symptoms

If you think you may be experiencing alopecia areata, you may see:

Round patches about the size of a quarter on your scalp or other areas. Keep in mind that everyone is different. The patches may be smaller or larger.
Hair growing and falling out at the same time in different parts of your body
Substantial hair loss, quickly
Asymmetrical hair loss on one side of the scalp rather than on both sides
Hair that is narrow at the base and next to the scalp that looks like exclamation marks
Rows of tiny dents in your fingernails

Keep in mind that alopecia areata presents differently in every person. If you lose your hair, it’s difficult to determine how much you will lose or how long the episode will last. Trying to self-diagnose alopecia areata is not recommended if your hair is thinning or balding. Make an appointment with a board-certified dermatologist and hair specialist to get a professional evaluation and diagnosis.

3) Other Types of Alopecia Can Cause Hair Loss Too

Many conditions can cause hair loss besides alopecia areata. Examples of common types include:

Telogen Effluvium causes temporary hair loss due to illness or stress.
Androgenetic Alopecia results when too much testosterone converts to an anagen called Dihydrotestosterone (DHT) and is the most common cause of baldness and thinning among men and women.
Traction Alopecia occurs when hair is pulled back too tightly into buns, braids, or ponytails.
Cicatricial Alopecia (scarring alopecia) occurs when scars form over the hair follicles causing existing hair to fall out and blocking the growth of new hair.

The best thing to do if you notice that your hair is thinning or balding is to consult with a medical professional. He or she can evaluate your case and run any tests necessary to make a diagnosis. In many cases, treatments such as Minoxidil and Finasteride are available to help regrow hair that has been lost.

4) New Medications Are Showing Promise in Treating Alopecia Areata

Some people with alopecia areata experience spontaneous hair regrowth. Others do not. When hair does not regrow on its own, treatment is available.

Exciting progress has been made recently in helping people with alopecia areata regrow their hair. It has recently been discovered that a category of medications called Janus Kinase (JAK) inhibitors can effectively block the inflammatory response thought to be the cause of alopecia areata, allowing for hair growth. Although JAK inhibitors are often prescribed off-label, one JAK inhibitor was FDA approved in June. Olumiant (Baricitinib), a medication used to treat rheumatoid arthritis, was approved for adult patients with severe alopecia areata. In clinical trials, the medication helped a significant number of people regrow their scalp hair to 80 percent compared to a placebo. (03)

Other treatments often used to treat alopecia areata include:

Corticosteroids help calm inflammation and suppress the immune system to prevent further hair loss and allow new growth
Minoxidil stops hair from thinning and induces hair growth by enlarging the hair follicles
Topical Immunotherapy can be used to suppress the immune response
Phototherapy is ultraviolet light therapy sometimes used in conjunction with other treatments

Not every treatment works for every patient. Often, patients need to try different medications to determine which works best for them. Using multiple medications that achieve different objectives is also common. For example, a patient may use Minodixidl with steroid injections and an oral immunosuppresant. It’s also important to know that some patients will need to continue medications, even if their hair has regrown. Discontinuing medication may cause a relapse.

5) You Don’t Have to Leave Your House to Find a Support Group

Coping with alopecia areata is difficult for many people. Stress, anxiety, and depression can easily accompany hair loss. For many people, losing their hair is like losing part of their identity. The grief process takes time. In the meanwhile, a support group may help. Thanks to social media, phones, and Zoom, you don’t even need to leave your sofa to access some services.

The National Alopecia Areata Foundation (NAAF) offers support networks, a youth mentor program, and access to a free online community. There are also Facebook groups, including one called Alopecia Areata, one called Alopecia Areata, Find a Cure, and another one for Parents of Children with Alopecia Areata. The networks are a fast, easy way to connect with others who may have had similar experiences.

Although the cause of alopecia areata is still unknown, thanks to alopecia awareness activities, determined patients, and dedicated doctors, great progress is being made in the development of treatment options. If you have any questions about alopecia areata or any other type of hair loss condition, contact us. Our board-certified dermatologists are happy to help point you in the right direction.

Resources:

(01) https://www.naaf.org/alopecia-areata

(02) https://www.naaf.org/alopecia-areata

(03) https://www.fda.gov/news-events/press-announcements/fda-approves-first-systemic-treatment-alopecia-areata

Oral Minoxidil: Truth Behind Its Hair Growth Success

There has been some press and a lot of talk about the benefits of low-dose oral Minoxidil recently. Our phone lines have been flooded with questions in response. Is oral Minoxidil the cure for balding and thinning hair? Will it work for me? What’s the truth behind its growth success? That’s what everyone wants to know.

In response, we thought it would be helpful to share answers to some of the frequently asked questions we’ve been getting. If you’re thinking about asking for a prescription, make sure you read this first. We’ll explain what oral Minoxidil is, how it works, and some things you should consider if you decide to give it a try.

What’s the Big Deal About Oral Minoxidil?

In previous blog posts, we talked a little bit about the abundance of over-the-counter (OTC) products on the market that promise to help people who are experiencing hair loss regrow their hair. Shampoos, conditioners, vitamins, and supplements are easy to buy and tempting to try. If you’ve already tried one (or five), you know what we mean. We’ve also discussed how with the exception of two and five percent Minoxidil liquid and foam, which are marketed under the brand name Rogaine, the products that are truly effective in treating hair loss are only available by prescription.

Recent press has reiterated this point and has touted the benefits of low-dose oral Minoxidil. Minoxidil is an inexpensive medication and has been proven to be effective in treating male and female pattern hair loss (androgenetic alopecia) and other types of alopecia.

What is Minoxidil?

Minoxidil was originally developed and marketed to treat high blood pressure. The medication is a vasodilator. It relaxes the blood vessels, allowing blood to pass through more easily. When Minoxidil was initially tested for high blood pressure, doctors and researchers noticed that one of the side effects was hair growth. Minoxidil brings more oxygen to the scalp’s surface, enlarging the hair follicles and offsetting the effects of miniaturization that results in hair thinning and balding. Through the enlarged follicles, new hair can grow, and existing hair remains strong and healthy.

Why is Oral Minoxidil Prescribed Off Label?

Liquid and foam Minoxidil are FDA approved for treating hair loss. Oral Minoxidil is prescribed off-label for hair loss because it has been approved to treat high blood pressure but not for hair loss. Prescribing medications off-label is common practice in dermatology. Many dermatological conditions ranging from skin pigment disorders to inflammatory conditions, do not have standard FDA-approved treatments, so dermatologists use research findings to prescribe off-label to treat their patients’ conditions.

How is Oral Minoxidil Usually Prescribed to Treat Hair Loss?

Dosage may differ based on your body weight and other factors; however, the typical prescription of oral Minoxidil to treat alopecia is 2.5 milligrams. Dr. Ben Behnam, dermatologist, hair specialist, and founder of Happy Head hair loss solutions, recommends building up slowly over a month to avoid side effects. “Use a pill cutter,” says Dr. Behnam. “Take one-quarter of a tablet for the first two weeks, one half of a tablet during the second two weeks, and a full tablet after that.” As with any prescription medication, patients should only take oral Minoxidil under the supervision of a licensed physician.

What are the Side Effects of Oral Minoxidil?

According to Dr. Benham, oral Minoxidil is a relatively safe medication, and side effects are rare. Oral Minoxidil does not cause weight gain or sexual side effects. Although most people do not have any side effects, people who do may experience changes in blood pressure, heart palpitations, headaches, and ankle swelling. If you have concerns about fluctuating blood pressure, Dr. Benham suggests buying an inexpensive blood pressure cuff and checking your blood pressure weekly.

If you’re of middle-eastern descent and are using oral Minoxidil at higher doses, there’s a risk that you could grow hair on your face or other parts of your body. That usually doesn’t happen at the lower doses though. There’s also a higher chance of hirsutism in women than men.

Most side effects resolve on their own after a week of continuously taking the medication. However, if your symptoms don’t resolve, Dr. Ben recommends contacting your dermatologist and discontinuing the medication.

Can You Use Oral Minoxidil and Topical Hair Loss Treatments at the Same Time?

Using oral Minoxidil at the same time as topical hair loss treatments is often recommended for the best results. The reason is that oral Minoxidil may work as a stand-alone treatment for some, but many people will also require an anti-antigen such as Finasteride. Minoxidil will open the hair follicles, but it won’t block testosterone from converting to DHT. Therefore, most people need a DHT blocker to complement the Minoxidil.

What other Medications Exist to Treat Male or Female Pattern Baldness?

Both oral and topical medications are available to treat androgenetic alopecia. Oral medications include:

Finasteride (Propecia)

A DHT blocker that’s typically prescribed as a first-line medication due to its high efficacy. Although not common, some men taking oral Finasteride experience some sexual side effects. Topical Finasteride, has been proven to work equally as well as oral Finasteride without the same risk of side effects.

Dutasteride (Avodart)

Dutasteride is also a DHT blocker. The difference between Finasteride and Dutasteride is that Dutasteride inhibits two isoenzymes while Finasteride inhibits one. That said, FDA-approved Finasteride is effective for most people with male or female pattern baldness. When Finasteride isn’t quite strong enough, Dutasteride is prescribed off-label. Knowing whether Finasteride or Dutasteride will work best in each case is usually unknown until a patient tries one of the medications. Based on Dr. Behnam’s experience, Finasteride works better for some people than Dutasteride, even though Dutasteride is a stronger medication. That’s why Finasteride is used as the first-line treatment.

Spironolactone

Sprironolactone is a second-line DHT blocker prescribed to women when Finasteride isn’t effective. Men typically aren’t candidates for the medication because it can cause feminizing side effects.

Topical Medications

In addition to Minoxidil, topical Finasteride and combination medications are available. Formulas that combine prescription medications such as Minoxidil and Finasteride are beneficial because they contain both a vasodilator and a DHT blocker into one. Patients often prefer the convenience of using one medication rather than multiple medications. Topicals are also often preferred because they work as effectively as oral medications without the same risk of side effects.

Is it Okay to Take Oral Minoxidil if You’re Already on Other Blood Pressure Medications?

If you are currently on a blood pressure medication, check with your cardiologist before adding oral Minoxidil. Knowing whether you can take oral Minoxidil with other blood pressure medications depends on what you’re taking and your current blood pressure. Again, your cardiologist is the best one to advise you.

How Do I Get a Prescription for Oral Minoxidil?

The best way to get a prescription for oral Minoxidil is by scheduling a meeting with your dermatologist or hair specialist. If you aren’t currently under the care of a practitioner, Happy Head has licensed dermatologists who can review your case and determine whether you are a candidate for the medication. Contact us if you would like more information.

We covered a lot of ground, so let’s review. Dermatologists do often recommend oral Minoxidil to their patients. It’s a reliable medication with relatively low side effects. However, oral Minoxidil often needs to be combined with a DHT blocker to get the results that most people want. The right combination of medications varies and can take some trial and error. Hair loss treatment isn’t one-size-fits-all and can be affected by factors such as weight and genetic make-up. If you have further questions, Happy Head is here for you. Reach out and we’re happy to help.

What You Need to Know About How to Take Finasteride

If you want finasteride to work its magic and regrow your hair, you’ll need to know how and when to take the medication. Whether you’re taking oral finasteride or the topical version, understanding how to take finasteride will get you the best results.

What is finasteride?

Finasteride is one of only two FDA-approved prescription medications typically used for treating hair loss in males. Originally, finasteride was prescribed to treat benign prostate enlargement and other prostate issues. However, finasteride doctors may also prescribe finasteride to treat hair loss. (01)

How does Finasteride work?

Most cases of hair loss in men occur because of increased amounts of dihydrotestosterone (DHT) in the body. DHT is a hormone that plays a significant role in the development of male sex characteristics and is must more potent than testosterone. DHT is so powerful that it attaches to the same sites as testosterone, like the hair follicles.

An excess of DHT impacts hair follicles and causes them to shrink. In turn, these injured hair follicles become unable to grow hair. By the age of 50 years, over half of the men in the U.S. will probably experience hair loss mediated by DHT. Finasteride works by limiting the action of 5-alpha-reductase, the enzyme used to produce dihydrotestosterone (DHT). The resulting decrease in DHT slows hair loss and can encourage hair regrowth. With regular use, finasteride reduces DHT levels in the body by an average of almost 70 percent. (02, 03)

What types of hair loss can finasteride treat?

The FDA approves Finasteride to treat the most common type of hair loss for men: male-pattern hair loss, also known as androgenetic alopecia. Male-pattern hair loss affects about 50 million adult males in the U.S. With finasteride, men may see an 83% stabilization of hair loss, and 60% of cases may see their hair regrow. Because finasteride prevents DHT from forming, it works on most DHT-related types of hair loss. (01)

What should you tell your doctor before taking finasteride?

Like most medications, finasteride comes with some contraindications. Before taking finasteride, let your doctor know if you’ve ever experienced the following:

Liver disease
Abnormal liver tests
Prostate cancer
An allergy to finasteride

Give your doctor a list of medications, both prescription and nonprescription, that you’re currently taking. This list should include any vitamins, nutraceuticals, and herbal products. Inform your doctor if you smoke, consume alcohol, or use drugs. (01)

Although finasteride shows excellent results in men, children and women in their reproductive years are not typically prescribed finasteride. For both men and women, a doctor may perform laboratory tests and thoroughly assess before prescribing finasteride whether the medication is taken orally or topically. (01)

How should I take oral finasteride?

Oral finasteride is taken daily with a full glass of water, as prescribed. Taking finasteride at the same time each day helps to keep a stable level of finasteride in the body stable at all times. For best results, finasteride should be taken regularly without missing any doses. Because oral finasteride works internally, women are not usually prescribed oral finasteride.

How should I apply topical finasteride?

Topical finasteride is a liquid that is applied using a calibrated dropper. To use a dropper:

Line up the dropper to the scalp area.
Apply the solution by squeezing the dropper.

While finasteride does come in a spray or gel form, a calibrated dropper offers a mess-free application. A dropper, rather than a gel or spray, makes medication application more accurate and reduces medication waste. Rather than trapping medication onto existing hair – where it can’t do its job – a dropper spreads medication directly onto the scalp. Because topical finasteride is applied externally, the medication is safe to use for women over 50. (04)

What if a dose is missed?

When a finasteride dose is missed, avoid the temptation to double up on the next dose. Instead, skip the missed dose. Take the next dose at the regular time instead and resume treatment as prescribed.

People who forget to take their finasteride too often or who skip their treatments frequently may not see successful results. Too many missed doses lower finasteride levels and may produce lackluster results. To see the full advantages of finasteride treatments, it’s crucial to adhere to the prescribed regimen.

What should I do when too much finasteride is taken?

If a finasteride overdose occurs and the person has trouble breathing, has a seizure, or is unconscious, seek medical attention as soon as possible. The Poison Help line (1-800-222-1222) can also offer assistance if an overdose is suspected.

What finasteride side effects may occur?

Like any other medication, side effects may occur with oral or topical finasteride. There is a higher risk for side effects when taking the oral form of finasteride. Studies on topical finasteride indicate a very low incidence of sexual side effects. Specifically, only one subject out of 268 participants (or 0.37%) showed any sexual side effects when taking finasteride topically. On the other hand, oral finasteride is linked to sexual side effects in 1.8% to 3.8% of users. (05)

Other rare side effects that may occur with finasteride are:

Depression
Changes in breast or nipple shape and size
Rash
Hives
Nipple discharge
Itching
Facial swelling
Difficulty breathing
Problems swallowing

In most cases, doctors prescribe the lowest dose and titrate the medication up to reduce side effects and ensure safety. Many people who do experience mild side effects find that the effects disappear after their bodies adjust to the medication.

What should I know about the storage and disposal of this medication?

Appropriate storage and disposal of finasteride keeps the medication safe and in good condition. Finasteride should be kept tightly closed when not in use and kept in the container it came in. Store the medication out of reach of children and away from moisture and extreme temperatures. Discarded medication and containers should be disposed of in such a way to ensure pets and children can not obtain them. We encourage our users to read our blog titled “Side Effects of Topical Finasteride: Review of Current Medical Literature.”

What other information should I know?

Your doctor will monitor your progress on finasteride to ensure efficacy and safety. Monitoring may include a short assessment or laboratory tests. Because finasteride isn’t for everyone and requires a prescription, don’t let anyone else use your finasteride.

How long does finasteride take to work?

Every person sees results from finasteride at a different pace. Some individuals may not see results until three months into regular medication use. However, finasteride starts working and lowers DHT from the very first dose.

Finasteride has a short half-life, which means it doesn’t last long in the body. Because of its short half-life, it’s essential to stick to your doctor’s prescribed schedule to keep enough medication in the body for peak effectiveness. Taking finasteride for hair loss takes patience. So, remember, a finasteride regimen is not a sprint – it is a marathon with a worthwhile prize in the end! (04)

Finasteride and Then Some!

Happy Head uses a proprietary formula of topical Finasteride and a 40% higher concentration of Minoxidil with Retinoic Acid. Each product is crafted individually for each client, offering the best results and the lowest risk for side effects. Every hair growth formula is customized, factoring every client’s age, sex, and medical history. At Happy Head, you’ll have the attention of board-certified dermatologists specializing in hair growth every step of the way. If you are interested in a science-based satisfaction-guaranteed hair growth formula, visit Happy Head today.

Resources:

(01) https://www.pdr.net/drug-summary/Propecia-finasteride-378.609

(02) https://www.webmd.com/skin-problems-and-treatments/hair-loss/hair-loss-treatments-men#1

(03) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3262531/

(04) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6609098/

(05) https://reference.medscape.com/drug/propecia-proscar-finasteride-342824#4

REJUVENAGING® with Dr. Ron Kaiser Podcast Featuring Dr. Ben Behnam

Dr. Ben Behnam was recently invited to participate in the inspirational podcast Rejuvenaging, hosted by Dr. Ron Kaiser. Dr. Kaiser is a psychologist, keynote and TEDx speaker, and author of the triple award-winning book Rejuvenating the Art and Science of Getting Older with Enthusiasm. He likes to think of his podcast as a mental gym, a place for information about wellness, positive psychology, and, what he likes to call, goal-achieving psychology. During the podcast, Dr. Ben and Dr. Kaiser discussed healthy ways to cope with hair loss, from both a physical and psychological perspective. If you didn’t get a chance to tune in, here are some highlights that you won’t want to miss.

The First Step in Coping with Hair Loss is Realizing that You’re Not Alone

Whether you’re male or female, if you’re in life’s second half-century, there’s a pretty good chance that you’re experiencing some type of hair loss. According to American Hair Loss Association, 85 percent of men and 50 percent of women lose a significant amount of hair by the age of 50. So when you look at the numbers, you’ll find that most people are experiencing some sort of hair loss by age 50.

Dr. Ben defines hair loss in two ways: thinning and balding. When someone’s hair is thinning, you can see their scalp through the remaining hair. When people are balding, hair is completely missing, and you can see their heads.

Female Hair Loss No Longer Carries a Stigma

A couple of years ago, no one talked much about female hair loss. It was taboo. But now, over 50 percent of Dr. Ben’s patients are women with hair loss issues. Hair loss is becoming much more accepted in society. When women talk about their hair loss, it’s good because putting the conversation out there benefits both men and women.

It’s Important to Identify the Underlying Reason for Your Hair Loss

There are different reasons why people lose their hair. Three common reasons include nutritional deficiencies, anxiety, and genetics. Treating hair loss means understanding the cause.

Common nutritional deficiencies Dr. Ben often finds in his patients are low Vitamin D, iron, and biotin. Those vitamins are necessary for hair growth. Vegetarians who don’t get enough protein in their diets also tend to experience issues with hair loss. When Dr. Ben finds that patients are lacking vitamins or protein, he supplements their diets with additional proteins and collagen. He also adds Vitamin D and iron.

Many times, Dr. Ben’s patients have already seen another doctor and are on medication for hair loss, but their hair still isn’t growing. By the time they go to him, he doesn’t need to add another medication. He’s just helping with lifestyle changes, so the medication works better. Without the proper foundation, hair loss medication can’t work. What you eat affects how you look.

Hair Loss and Mental Health are Closely Intertwined

Anxiety can lead to hair loss in a few different ways. One, when people are anxious, they are more likely to pull on their hair. Physical manipulation will lead to more hair loss. Unfortunately, patients can also experience a lot of different stressful situations that can lead to hair loss. One example is an 18-year-old patient with alopecia who did not go on birth control and could not use condoms for religious reasons. She got pregnant and had to make difficult choices. She hid her pregnancy from her parents and experienced great stress from the ordeal. In situations like this, where stress is a hair loss trigger, Dr. Ben offers support by giving referrals to a therapist.

Diagnosing Hair Loss Requires a Specialist

When someone experiences alopecia, Dr. Ben uses a holistic approach to treatment. He looks at mental status, home life, stress levels, metabolic, and other health issues. He believes that he should look at everything when he’s making a diagnosis and developing a treatment plan.

Seventy to 80 percent of men are relatively easy to diagnose. They don’t have nutritional deficiencies, mental issues, or any factors that would cause alopecia. They have clear-cut cases of male pattern hair loss. But then there’s that 20 percent that doesn’t fall into that category. Women are also a bit more challenging to diagnose. Every case is different, and he believes that you have to evaluate each case individually.

People with Androgenetic Alopecia Can Regrow Their Hair

Depending upon the cause of your hair loss, treatment is available to help regrow your hair. People who experience male and female pattern hair loss tend to get good results with available medications. Medications used include Finasteride, which is Propecia, a prostate medication that’s used to block testosterone. Dr. Ben has seen excellent results with patients who use Finasteride. Rogaine, which is a topical product sold over the counter, is also called Minoxidil. Minoxidil is an oral medication used to control high blood pressure. Since Minoxidil dilates the blood vessels, more oxygen reaches the scalp and causes hair growth.

Finasteride, Minoxidil, and other hair loss treatments take about 6 months to start seeing results.

You Don’t Have to Experience Side Effects Associated with Oral Hair Loss Medications

One of the side effects of Propecia is erectile dysfunction. So, a couple of years ago, Dr. Ben and Dr. Sean developed a Finasteride alternative. It’s a topical Finasteride, meaning that you’re not ingesting it. Clinical studies have proven that topical Finasteride has a lower risk of sexual side effects, yet it is still effective. The dermatologists were quite excited about the discovery, so they developed Happy Head, their own formula of topical Finasteride combined with prescription-grade Minoxidil. They tested Happy Head with patients and found that patients who experienced sexual side effects with oral Finasteride did not have the same side effects with the topical. The product was researched for two years before being launched nationwide.

It’s Time to Get Rid of the One Size Fits All Mentality When it Comes to Hair Loss

Dr. Ben and Dr. Sean set out to change the hair loss field. After two years of launching Happy Head, it’s still the only company in the U.S. with a customizable prescription hair loss solution that’s available nationwide. Most products on the market are mass-produced. With Happy Head, however, patients can change the concentrations of ingredients, remove ingredients, and replace ingredients. For example, the change can easily be made if you need .25 percent Finasteride rather than one percent. A month later, if the .25 percent isn’t strong enough, the dose can be increased. Traditional corporate thinking is to produce in large volumes to reduce cost. With Happy Head, the needs of individuals are unique, so the product is customized to meet those individual needs.

Fast, Easy Access to Prescription Hair Loss Treatments is Available

Happy Head is a telemedicine website with licensed doctors and pharmacies in every state. It works by going on the Happy Head website to submit photos and complete a medical questionnaire. The process takes about five minutes. Within 24 hours, a doctor reviews the information you provided and writes a prescription. You receive a bottle in three days. There isn’t a charge for the consultation. If the doctor who reviews your case determines that you’re not a candidate, your money is refunded.

If you’re over 50 and experiencing hair loss, you’re not alone. Eating well, managing stress, and living as healthy of a lifestyle as possible all contribute to the quality of your hair. If you are experiencing male or female pattern hair loss (androgenetic alopecia), medications are available to help regrow your hair. Simply visit happyhead.com and complete a brief survey. A licensed dermatologist will review your case and determine whether you are a candidate for prescription hair loss medication.

Minoxidil vs Finasteride: Which Hair Loss Treatment is Best?

It’s not unusual for people to collect a graveyard of failed hair loss products before they throw in the towel and accept the fact that going it alone with over-the-counter (OTC) options isn’t working. We hear it all the time with our patients. After all, the OTC market for hair loss products is huge. There are vitamins, supplements, shampoos, oils, conditioners, diets, and more, all promising to help you regrow your hair. The ads are pretty convincing.

The reality is that the two products that are most effective in helping people with androgenetic alopecia (a fancy name for male and female pattern baldness) slow down the progression and regrow their hair are both FDA approved. They’re research tested and should be used under a dermatologist’s supervision. Those two products are Minoxidil (Rogaine) and Finasteride.

What exactly are Minoxidil and Finasteride? Which one should you use for your hair loss? Are there any side effects? If you’re looking for answers, you’re in the right place. We’ll give you the information you need to help you choose the most effective hair loss medication.

What is Minoxidil?

You may have heard of Minoxidil, which is sold OTC under the brand name Rogaine in two and five percent liquid and foam. Rogaine is available at retail stores such as Walgreen’s and CVS and online. Stronger Minoxidil formulas are available, but only with a doctor’s prescription. You can also get a Minoxidil custom topical treatment made by a board-certified Happy Head dermatologist.

Minoxidil was originally marketed as an oral medication to treat hypertension in the 1970s. During the product’s testing, researchers noticed that their balding patients who took Minoxidil began to regrow their hair. A topical formula was then developed and approved.

How Does Minoxidil Work?

Scientists are still learning about how and why Minoxidil works to support hair growth; however, this is what we do know. When people experience androgenetic alopecia, their hair follicles shrink, producing finer and thinner hairs over time. Minoxidil does four things to help counteract the miniaturization:

Widens the blood vessels so more oxygen-rich blood can reach the hair follicles.
Enlarges your hair follicles so thicker, stronger hair can grow.
Reduces the telogen (resting) phase of the hair growth cycle, so less hair is lost
Keeps your hair in the anagen (growth) phase longer so your hair can grow longer

Does Minoxidil Have Any Side Effects?

The most common side effect from using topical Minoxidil is mild redness or irritation. This usually goes away after using the medication for a while. If you are experiencing irritation, you can try using less of the medication or use it every other day until your skin adapts.

What is Finasteride?

Finasteride, also marketed under the brand names Propecia and Proscar, was first developed as a pill to treat Benign Prostatic Hyperplasia (BPH), also known as an enlarged prostate. Like Minoxidil, when Finasteride was being tested, researchers found that hair growth was a side effect in men experiencing hair loss. The oral medication was FDA approved to use for androgenetic alopecia in 1997 at a dose of 1 mg.

How Does Finasteride Work?

Finasteride inhibits types II and III of an enzyme called 5-alpha-reductase isoenzyme. In layman’s terms, that means it inhibits the conversion of testosterone to dihydrotestosterone (DHT). When testosterone converts to DHT, the hair’s growth cycle is interrupted. Hair follicles shrink and shorten the hair. As a result, the hair falls out easily and does not grow back. As a DHT blocker, Finasteride prevents this process from happening. Research indicates that Finasteride is highly effective. Finasteride reduces prostatic DHT levels by more than 90 percent and serum DHT levels by approximately 70 percent. Increasing the dosage does not correlate with higher serum reduction. (01)

Does Finasteride Have Any Side Effects?

It’s not uncommon for men to be concerned about taking oral Finasteride because of the medication’s reputation for sexual side effects. Finasteride can cause a decrease in sex drive or trouble getting or keeping an erection. That’s only the case for oral Finasteride, however. Topical Finasteride has been proven equally as effective without the risk of sexual side effects. (02)

What’s the Difference Between Minoxidil and Finasteride?

Minoxidil and Finasteride have two very different roles in treating androgenetic alopecia in men and women. Finasteride blocks the DHT to prevent hair loss from occurring in the first place. Because it also prevents miniaturization of the hair follicles, existing hair does not thin and new hair is able to grow. Minoxidil works at your scalp’s surface, enlarging the hair follicles.

Can You Use Minoxidil and Finasteride at the Same Time?

Because Minoxidil and Finasteride complement each other well as a treatment for androgenetic alopecia. Dermatologists often prescribe the two medications together. As a matter of fact, research has proven that not only can the medications be used together, but doing so has higher efficacy than using just one of the medications alone. (03)

Does it Matter Which Form of Medication You Use?

Both Minoxidil and Finasteride are available in oral pill and topical formulas. The medications are equally effective, regardless of whether you choose to take a pill each day or apply the topical. Many men prefer topical Finasteride over oral. As mentioned previously, the topical is equally effective for treating male pattern baldness without the same risk of side effects. Once you start using a hair loss medication, whether you use Minodixil, Finasteride, or a combination, it’s important to use the treatment daily. Once you stop, your hair loss will resume within a few weeks. Switching between oral and topical solutions should not stimulate hair loss.

How Do I Know What Dosages I Need?

Your dermatologist will prescribe the proper dosages based on your weight, recommendations from pharmaceutical companies, and experience. Even though five percent Minoxidil is marketed for men and two percent for women, many women use the five percent solution and foam. Research indicates that five percent is safe and it’s also more effective than the two percent. (04) Higher strengths of Minoxidil are available by prescription.

Which Treatment Option Should I Try First?

Since Minoxidil and Finasteride work differently, it’s a chicken and the egg kind of a question. Most dermatologists would likely recommend trying both, especially if you use topicals. All-in-one topical Minoxidil and Finasteride formulas are available if you prefer not to use multiple medications. Many people prefer the convenience of using one product.

How Do I Know if I’m a Good Candidate for Hair Loss Treatment?

The best way to get started is by scheduling an appointment with your dermatologist. However, if you don’t have one, or if you just have some questions that you would like answered, we’re here to help. Our board-certified dermatologists and hair specialists are available to review your history and recommend a personalized treatment plan. We can even customize a prescription formula to meet your specific needs.

Resources:

(01) https://www.ncbi.nlm.nih.gov/books/NBK513329/#:~:text=2%5D%5B3%5D-,Finasteride%20is%20an%20FDA%2Dapproved%20pharmacologic%20agent%20for%20treating%20benign,a%20dose%20of%205%20mg.

(02) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4314881/#:~:text=Studies%20show%20that%20topical%20finasteride,post%2D%20treatment%20with%20oral%20finasteride.

(03) https://pubmed.ncbi.nlm.nih.gov/32166351/

(04) https://jamanetwork.com/journals/jamadermatology/article-abstract/555638