Tag Archive for: Androgenetic Alopecia

Minoxidil vs Finasteride: Which Hair Loss Treatment is Best?

Happy Head customer using their topical treatment, made custom by a board-certified dermatologist. Which is better for you? Finasteride or Minoxodil?

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:

  1. Widens the blood vessels so more oxygen-rich blood can reach the hair follicles.
  2. Enlarges your hair follicles so thicker, stronger hair can grow.  
  3. Reduces the telogen (resting) phase of the hair growth cycle, so less hair is lost
  4. 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

 

5 Facts All Men Should Know About Hair Loss

Man looking at his hairline in the mirror, wondering what to do. Happy Head can help you stop hair thinning and loss in its tracks with custom topical solutions made with fda approved ingredients that are just for you.

A few weeks ago, my husband pointed out a Facebook meme that made us laugh. It showed two photos of hair and body care products. One photo included products that women use in the shower, and another photo showed the products that men use.  The women’s photo was loaded with products, including body wash, face wash, two different types of shampoos, and a couple of different types of conditioner. The men’s photo only had one product, a lone all-in-one bottle of body wash, shampoo, conditioner, shaving cream, and toothpaste. Not only was it funny, but it also depicted the scene in our shower pretty accurately. The truth is, though, although some men don’t give their hair a lot of thought, I don’t know of any who are thrilled about the idea of going bald. It’s a super sensitive topic. As nonchalant as my husband is about his hair, even a hint that his hairline is receding results in a very alarmed “What?” and a close scalp examination in the mirror that night.  Hair loss in men is common, but that doesn’t mean you’re okay with it. Nor does that mean that you have to accept your fate. So, if you’re a guy with some recession, thinning, or balding, this one’s for you. We’re here to fill you in on what you need to know about male pattern hair loss and what you can do about it.  

1. Hair Loss in Men is More Common Than You Realize

According to the American Hair Loss Association, by age 50, 85 percent of all men will have significantly thinning hair. (01)  Yes, you read that correctly. The majority of men will deal with some type of hair loss in their lifetime.  Men lose their hair for a lot of different reasons.  Balding or thinning hair can be due to autoimmune conditions, Covid, or even stress. The most common reason, though, is genetics. The vast majority of men with thinning or balding hair have androgenetic alopecia, male pattern baldness. Yup, that’s right. Your parents or grandparents may have passed along a baldness gene.  

Male pattern baldness, also known as androgenetic alopecia, occurs when your testosterone is converted to an androgen (a sex hormone) known as Dihydrotestoterone (DHT). The DHT attacks your hair follicles and causes a reaction called miniaturization which shrinks the follicles. When that happens, the hair that is already there falls out. New hair has trouble emerging through the shrunken follicles, and eventually, the hair stops growing.  

Although Male pattern baldness is the leading cause of hair loss among men; it’s not the only reason men lose their hair. Other forms of alopecia can cause hair loss among men as well. For example, Covid or other illnesses can cause a temporary hair loss called telogen effluvium. In this case, your hair will grow back within six to twelve months. Alopecia areata is an autoimmune condition that causes sporadic bald patches. Some men’s hair spontaneously regrows, but flares can occur at any time without notice.  Lichen planopilaris is another type of alopecia that causes inflammation, leading to scars over the hair follicles that prevent new hair growth.         

2. Timing is Everything When It Comes to Hair Loss Treatments

Many men avoid doctors like the plague. (02)  However taking a “let’s wait and see what happens” attitude isn’t recommended when it comes to hair loss. If you don’t get treatment when you first notice that your hair is thinning, then your hair loss will most likely progress, leaving you with a higher number on the Hamilton-Norwood Scale. In case you don’t know what that is, the Hamilton-Norwood Scale is a classification system developed to measure the extent of baldness. You don’t want to get high scores on that test.  

If you visit a board-certified dermatologist as soon as you see signs of thinning or balding, your doctor will identify the cause of your hair loss. Once you are diagnosed, your dermatologist can recommend treatments to stop your male pattern hair loss and to promote new growth.  

3. Hair Loss Consultations Are Not a Big Deal (Really!)

If the idea of any medical procedure secretly has you a bit nervous, don’t let that prevent you from seeing a dermatologist.  The exam is much easier than you would expect, and trust me, your dermatologist will not think you are vain for seeking treatment.  Dermatologists evaluate men for hair loss conditions all the time.  So, while you may be out of your comfort zone, your dermatologist certainly isn’t.   

Your dermatologist will ask questions about your health, medications, family history, and lifestyle during your exam. The more detailed information you provide, the better. Your dermatologist will examine your scalp to evaluate your hair loss pattern and possibly do a pull test. A pull test measures the severity of your hair loss. During the test, your dermatologist will gently tug on small sections of your hair to see if any strands fall out.  If six or more do, you have active hair loss. Dermatologists usually diagnose androgenetic alopecia based on visual exam. A blood test or a small biopsy may be ordered if he or she suspects another type of alopecia. Don’t stress if you need a biopsy. You’ll be numb, the biopsy area is small, and it heals within a week.

4. Today’s Hair Loss Treatments are Effective and Natural Looking 

After you get a diagnosis, you’ll have many treatment options. The good news is more data than ever is available on hair loss treatments. Research indicates that many are not only safe, they’re highly effective. Here are some examples of the most popular prescription hair loss treatments used:

Minoxidil 

  • FDA approved to treat hair loss
  • Available in oral or topical formulas
  • Brings oxygen to the hair follicles, enlarging them so existing hair does not fall out and new hair can emerge

Finasteride

  • FDA approved to treat hair loss
  • Available in oral and topical formulas
  • Prevents testosterone from converting to DHT and attacking your hair follicles
  • First-line treatment for androgenetic alopecia

Dutasteride

  • Used off label to treat hair loss
  • Only available as a pill like our SuperCapsule
  • Prevents testosterone from converting to DHT and attacking your hair follicles
  • Prescribed if patient does not respond to Finasteride
  • Lower dosage prescribed for Dutasteride than Finasteride

Cortisone

  • Available in pill and topical formulas
  • Reduces irritation and inflammation

Retinoic Acid

  • Available in topical formula
  • Proven to improve absorption of topical Minoxidil and Finasteride

Compounded Topical Formulas

Research has shown that combinations of topical formulas are more effective than monotherapy.  For example, topical Finasteride combined with topical Minoxidil works better than one of the medications alone. (03)  Finasteride and Minodixil combined with Retinoic Acid is more effective because the retinol helps the scalp better absorb the other two medications. (04)

Alternative Hair Loss Treatments for Men

You may also be a candidate for treatments such as Protein Rich Plasma (PRP), laser light treatments, and hair transplant surgery. Let’s talk about what these are and how they work.

Protein Rich Plasma

PRP acts similarly to Minoxidil by bringing oxygen to the hair follicles to enlarge them. During a PRP procedure, your dermatologist draws your blood. The blood is then separated. The plasma is then injected into sites where your hair is thinning or balding. 

Laser Light Treatment

You may have seen ads for laser light caps. Do they work? Well, the jury is out. The philosophy behind them is that the light increases blood flow to the areas on your scalp that are thinning. More oxygen and nutrients are able to reach the hair follicles, allowing the hair to grow thicker and longer. Although research indicates that laser lights show promise for treating hair loss, the most effective intensity and frequency is still to be determined. (05, 06)  

Hair Transplant Surgery

In the 70s and 80s, you could always tell when a man had hair restoration surgery. You could actually see little circular holes where the plugs were implanted. It looked like a doll’s head. Over time, dermatologists have been perfecting the surgery and today’s techniques give a natural appearance. Dermatologists now move individual hairs from a place where the hair is dense to an area where the hair is thinning. (07) You can’t even tell that the hair has been transplanted.  

5. Perceptions of Bald or Balding Men Have Changed for the Better

Men with thin or thinning hair tend to have lower self-esteem and lack confidence, which could explain negative perceptions of their appearance. (08)  The key is to work with what you do have so you feel as confident as possible.  

Yes, there was a time when bald or balding men were deemed less attractive. That’s no longer the case, though. Today, men who embrace their look are seen as intelligent, successful, and confident. (09) Jeff Bezos, Samuel L. Jackson, Ed Harris, and The Rock are prime examples. So if your hair is thinning or balding, work with your barber or hair stylist to find and own a fresh new look. That look can evolve as you undergo hair loss treatment.  

If you notice some recession, thinning, or balding, and are concerned, contact us for a discrete consultation from the comfort of your home, on your schedule. Our board-certified dermatologists and hair specialists are available to evaluate how much hair you’ve lost and your scalp’s condition. Most importantly, they can offer a customized prescription solution to give you the desired results.  

 

Resources:

(01) https://www.americanhairloss.org/men_hair_loss/introduction.html

(02) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6560804/#:~:text=At%20the%20societal%20level%20masculine,not%20go%20see%20the%20doctor.

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

(04) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2693596/

(05) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8906269/

(06) https://www.karger.com/article/fulltext/509001

(07) https://www.aad.org/public/diseases/hair-loss/treatment/transplant

(08) https://pubmed.ncbi.nlm.nih.gov/16307704/

(09) https://journals.sagepub.com/doi/abs/10.1177/1948550612449490

 

How to Avoid Side Effects from Finasteride

If you’ve seen television ads for any medication, you know that almost all of them have potential side effects.  By the time the announcer gets to the end of the (sometimes very long) list, you’re probably wondering why doctors even prescribe the medication in the first place.  But, of course, some medications have more side effects than others.  And, some medications get a bad rap just because one or two out of thousands had unusual reactions.  

Fast forward to Finasteride.  Finasteride, also known as Propecia or Proscar, is often prescribed to treat hair loss due to various conditions.  Finasteride was originally marketed to treat men with enlarged prostates.  During drug trials, doctors noticed that men who took Finasteride as a prostate treatment experienced hair growth.  Finasteride was then FDA-approved to treat hair loss too.  In this case, the side effect was a good one.  However, some male Finasteride users have reported some undesirable sexual side effects.  Should you be concerned?  Not really.  The side effects aren’t typical.  Plus, there are ways to avoid the side effects if that’s a concern.  We’re here to share why you shouldn’t worry if your doctor has prescribed Finasteride to treat your hair loss.         

 

Why is Finasteride Prescribed for Hair Loss?

Finasteride is what’s called a DHT blocker.  DHT is an acronym for dihydrotestosterone, which is an androgen, a male sex hormone. When men and women experience androgenetic alopecia, an enzyme called 5-alpha-reductase converts testosterone to DHT.  When this happens, DHT can bind to the receptors on your hair follicles, shrinking the follicles during a process called miniaturization.  Over time,  the anagen phase of the hair growth cycle is reduced.  The result is hair that is shorter and thinner.  Eventually, new hairs become so small that they can’t penetrate the hair follicle.  As a DHT blocker, Finasteride prevents this process from happening, so you maintain your existing hair and continue to grow healthy new hair.    

What Hair Loss Conditions Does Finasteride Treat?

Oral Finasteride is FDA approved to treat androgenetic alopecia, male and female pattern hair loss.  Male and female pattern hair loss is the most prevalent type of alopecia worldwide.  There isn’t a way to predict who will experience pattern hair loss.  The condition is genetic and can be inherited from either the maternal or paternal sides of the family.  There isn’t a specific test to diagnose androgenetic alopecia.  Dermatologists and hair specialists can make the diagnosis by evaluating a patient’s hair loss pattern. 

Finasteride is also used to treat other types of alopecia, including alopecia areata and lichen planopilaris, which are caused by autoimmune conditions.  However, the prescription is considered off label when prescribed to treat hair loss other than androgenetic alopecia.   

Is Finasteride Effective in Preventing Hair Loss and Stimulating Growth

If you’re wondering whether Finasteride is worth the risk of whatever side effects could occur, that’s a valid question.  Although deciding whether to use Finasteride is highly personal, research indicates that Finasteride is highly effective in promoting growth and preventing further hair loss.  Over 80 percent of men who use Finasteride see improvement, and over 65 percent see new hair growth.  Not only that, the results are long-term.  A study of 1879 men indicates that hair count present after one year was maintained during the second year of treatment.

What are Finasteride’s Side Effects?

Side effects caused by oral Finasteride are usually mild and disappear after you stop taking the medicine.  Here are a few signs to watch:

  • Anxiety 
  • Depression
  • Dizziness
  • Weakness
  • Headache
  • Inability to urinate
  • Testicular pain
  • Runny nose
  • Rash, itching, swelling of the face, lips, or tongue, or other signs of an allergic reaction
  • Swelling of your hands or feet

Although these side effects aren’t exactly desirable, they aren’t most mens’ biggest fear.  Most are more concerned about potential sexual side effects such as:

  • Decreased libido
  • Erectile dysfunction
  • Decreased semen volume
  • Breast enlargement & tenderness
  • Premature ejaculation

The good news is that these side effects aren’t common.  Some men who do experience the sexual side effects find that their symptoms disappear over time as their bodies acclimate to the medication.  If not, discontinuing the use of Finasteride usually resolves the issue.

How Common are Side Effects from Finasteride?

As mentioned previously, side effects from Finasteride aren’t common.  The main reason is that the dosage typically prescribed to treat alopecia is usually very low, much lower than the dosage prescribed for prostate treatment.  As a matter of fact, only 3.8 percent of men who took Finasteride experienced side effects during the drug’s clinical trials.  That’s compared to 2.1 percent of men who took a placebo.  

Want to Avoid Finasteride Side Effects?  Use Topical Finasteride Instead

If you’re still a little worried about using Finasteride, even though the risk of side effects is low, there’s a simple solution. Use topical Finasteride instead of oral Finasteride.  The topical solution has been proven to be just as effective in treating male and female pattern baldness without the same risk of side effects.  Whereas oral Finasteride is metabolized in your stomach, topical Finasteride is not systemic.  Even better, topical Finasteride has less impact on serum DHT concentrations.  Think of it as a highly effective spot treatment for your hair.     

Research also indicates that combining Minoxidil with Finasteride yields even better results than using either medication alone.  Adverse reactions among patients were rare, indicating that the combined medication is not only a good choice, but a preferable one.  

Are You a Good Candidate for Finasteride?

Finasteride is often prescribed to both men and women to treat androgenetic alopecia.  The medication is generally safe for most people.  There are some exceptions though.  Finasteride is not recommended if you have kidney problems, prostate cancer, liver disease, or any other liver-related issues.  The medication is also not recommended to women who are pregnant, trying to get pregnant, or are breastfeeding.

What Should You Do if you Experience sexual or Other Side Effects from Finasteride?

If you think Finasteride is causing side effects, stop taking the medication and contact your dermatologist.  The side effects usually go away after the medication is out of your system.  However, you’ll want to work with your dermatologist to identify a substitute.  

When considering a new medication, it’s important to do your research and feel confident about your choice.  Finasteride is no exception.  If you have questions and are looking for answers, we’re here to help.  Our board-certified dermatologists and hair specialists look forward to giving you the information you need, when you need it, to get the healthiest, most effective hair loss treatment.  

 

Resources:

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

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

(03) https://pubmed.ncbi.nlm.nih.gov/34634163/#:~:text=Conclusion%3A%20Topical%20finasteride%20significantly%20improves,impact%20on%20serum%20DHT%20concentrations.

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

 

The Real Story Behind Vitamins that Prevent Hair Loss

I hate to start with a spoiler, but I’m going to start with a spoiler.  Neither vitamins nor supplements are FDA-approved or regulated for any type of hair loss.  Or, for any other health condition for that matter.  This means that information required to establish safety and effectiveness has not been submitted to or approved by the FDA.  Yet, do an Amazon search using the terms “vitamins for hair loss,” and pages and pages of products appear with assurances that the vitamins will help you regrow your hair.  Biotin, keratin, saw palmetto, and proprietary collagen blends are just a few that pop up on the first page, with prices varying from $11 to over $176.  Trying to figure out which ones are effective and worth the investment can make your head spin.   

If your hair is thinning or balding, it’s smart to question whether vitamins will help or if manufacturer promises are too good to be true.  So which ones do dermatologists and hair specialists recommend?  We’re here to answer your questions and set the story straight.  

Get Diagnosed Before You Buy Vitamins to Treat Your Hair Loss

Before you even think about trying any vitamins, you need to start with a diagnosis.  After all, you need to know what condition you’re treating.  Here are the three most common types of alopecia that cause either temporary or permanent hair loss:

  • Telogen Effluvium

Telogen effluvium is a type of temporary hair loss that can occur up to several months after a traumatic or stressful incident.  The condition can be triggered by various events, including high fevers, surgery, certain medications, nutritional deficiencies, and autoimmune diseases.  When physiologic stress occurs, hairs that would normally be in a growing phase are abruptly pushed into a resting phase, resulting in shedding.  The shedding can occur in either small or large amounts.  While hair loss from telogen effluvium can be upsetting in the short term, the long-term prognosis for regrowth is good.  No medication is typically needed.  Hair usually grows back within six months to a year.  

  • Androgenetic Alopecia

Androgenetic alopecia is also known as male or female pattern baldness.  The hair loss condition occurs when too much testosterone converts to an androgen called dihydrotestosterone (DHT).  The condition is genetic and can come from either the maternal or paternal sides of your family.  The hair loss pattern among men with androgenetic alopecia differs from that of women.  Men tend to lose their hair on the front and top of their heads.  Women usually notice their hair loss first along their widening center parts.  Oral and topical medications have been proven to help prevent further hair loss and facilitate growth.  

  • Alopecia Areata

Alopecia areata is an autoimmune hair loss condition that can affect women, men, and children.  Hair loss is usually noticed first in small round or oval patches.  In some cases, hair spontaneously regrows, and in others, the hair loss becomes permanent.  Treatment usually focuses on treating any underlying conditions and using topical and oral medications.

Determining whether you have one of these forms of alopecia is a multi-step process.  Your dermatologist will likely order blood work as part of the diagnostic process.  The lab results will indicate whether vitamin deficiencies could be contributing to your alopecia.  If so, you may benefit from supplementation.  

Vitamins are Helpful When People with Alopecia Have Deficiencies

Much conflicting information exists about the role that vitamins and supplements play when it comes to hair loss.  More research is clearly needed.  The general rule of thumb when it comes to vitamins is to supplement if there’s a deficiency.  Particular deficiencies can be associated with the three types of alopecia we discussed.  Here are the three most common:

Vitamin D

Research has demonstrated that people with telogen effluvium, androgenetic alopecia, and alopecia areata are likely to have vitamin D deficiencies. (01)  The greater the deficiency, the greater the hair loss.  Vitamin D is absorbed into the skin by keratinocyte cells.  The cells process keratin which is found in your hair, nails, and skin.  When your body has a vitamin D deficiency, the keratinocytes in your hair follicles have difficulty regulating the growth and resting phases of the hair cycle.  

Iron

In addition to checking for Vitamin D3 deficiencies, dermatologoists typically check their patients’ iron levels. Iron deficiency inhibits hemoglobin production which produces the oxygen responsible for hair cell growth and repair.  Low iron is a common cause of alopecia and can easily be remedied with a supplement.  

Biotin

People don’t typically have Biotin, Vitamin B7, deficiencies in industrialized countries.  A regular diet typically provides enough nutrients to ensure adequate levels.  However, some research studies have demonstrated that biotin deficiencies often exist in people with hair loss. (02)(03)  Experts have conflicting views on whether biotin supplements are necessary, even when there’s a deficiency.  It’s best to consult with your dermatologist on this one.  

Should You Take Vitamins if You Don’t Have a Deficiency?

Even if you don’t have a deficiency, it’s tempting to take vitamins to see if they will help regrow or thicken your hair.  More isn’t always better though, especially in this case.  Taking too many supplements or the wrong type of supplements can create issues.  For example, extra vitamin A or vitamin E can cause hair loss, which is what you are trying to prevent in the first place.  

Prescription Medications Are Often Used With Vitamins to Get Better Results

If your dermatologist doesn’t think that you are a good candidate for vitamin supplementation, prescription medications may be a good alternative.  This is especially true if you have been diagnosed with male or female pattern baldness.  Medications commonly prescribed include:

Minoxidil (FDA Approved)

A vasodilator designed to enlarge the hair follicles so you can start to regrow your hair.  

Finasteride, Proscar, Propecia (FDA Approved)

A medication that blocks the conversion of testosterone into DHT that attacks your hair follicles.

Dutasteride, Avodart (Not FDA Approved)

A DHT blocker prescribed as a second-line medication if Finasteride does not give the desired results.

Spironolactone (Not FDA Approved)

A DHT blocker prescribed only to women as a second-line medication if Finasteride does not give the desired results.

Minoxidil and Finasteride are both available in oral and topical formulas.  Topicals are often preferred, especially among men, because they do not cause sexual side effects such as lower libido.  Topical medications have been proven to be just as effective as oral medications.

The most effective hair loss plans often combine vitamins and other over-the-counter treatments with prescription medications. Vitamin D, Minoxidil, and Finasteride would be a logical combination if a person with androgenetic alopecia has a vitamin D deficiency.  Prescriptions that effectively combine multiple topical medications into one are available and are convenient and easy to use.  

Some Supplements Have Shown Moderate Improvement in Hair Loss

Although they are supplements rather than vitamins, there has been a lot in the news lately about pumpkin seed oil, saw palmetto, and rosemary oil.  While not quite as effective as Finasteride, these supplements have demonstrated a significant increase in hair growth. (04)  These supplements may be a good adjunct therapy when combined with prescription hair loss medication.

Curcumin, the active ingredient derived from turmeric, is known as a natural anti-inflammatory.  Interestingly, curcumin did not improve hair growth on its own, but it did give positive results when combined with Minoxidil.  The hypothesis is that the curcumin helped the Minoxidil better penetrate the scalp.  However, more research still needs to be conducted.  

Garlic gel, derived from onions, scallions, shallots, leeks, and chives, doesn’t live up to the hype.  Users did not see a significant difference in hair growth.  

As with any product you try as a hair loss solution, make sure to consult with your dermatologist first.  Even products that seem innocuous can have side effects or contradict other medications.  Your dermatologist is the best person to evaluate your treatment plan and determine the best mix of prescription and over-the-counter options.  

What To Do If Vitamins Aren’t the Answer to Your Hair Loss

Vitamins can be helpful if your bloodwork indicates that you have certain deficiencies.  If not, proceed with caution.  Even the most effective supplements aren’t typically as strong as prescription medications to slow hair loss and stimulate growth.  If you need an alternative solution for your thinning or balding hair, Finasteride, Minoxidil, and other medications are effective and are available by prescription.  For more information about your options, contact us.  Our board-certified dermatologists and hair specialists are available to answer your questions and make recommendations based on the type of alopecia you have.  We can even customize a formula to meet your specific needs.

Resources:

(01) https://pubmed.ncbi.nlm.nih.gov/34553483/

(02) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4989391/#:~:text=Biotin%20deficiency%20was%20found%20in,risk%20factors%20for%20biotin%20deficiency.

(03) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6388561/

(04) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6388561/

(05) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6388561/

 

DHT Blockers: Fight Hair Loss with These Powerful Weapons

Men are willing to do just about anything besides see a doctor.   Given a choice, 72 percent of men would rather clean the bathroom, mow the lawn, or do any other household chores. A lot of men aren’t even getting their yearly check-ups. (01)   So when it comes to hair loss, not many guys are rush to the dermatologist for a diagnosis and medication.  But they should.  

The most powerful hair loss weapons against male pattern baldness are only available by prescription.  Sure, there’s an endless number of products sold over-the-counter claiming that they work, but the reality is that they aren’t powerful enough to get the job done.  This is true for women who have female pattern baldness too.   

If your hair is thinning or balding, a DHT blocker may be just what the doctor ordered.  Read on to learn more about what DHT is, why DHT is causing your hair loss, and why DHT blockers may be the solution to your hair loss issues.  

What is DHT?

Dihydrotestosterone (DHT) is a sex hormone, known as an androgen.   Androgens are typically produced in males’ testicles and women’s ovaries.  The adrenal glands also produce androgens.  DHT is a little different than other androgens, because it is converted from testosterone.  Men naturally have more testosterone in their bodies than women, however, an enzyme called 5-alpha reductase (5-AR) converts about ten percent of testosterone in all adults to DHT.  

How Does DHT Cause Hair Loss?

When too much testosterone converts into DHT, the excess amounts of DHT interfere with your hair’s growth cycle.  The hair follicles miniaturize, make existing hair fall out, and prevent new hair from breaking through.    

Will a Blood Test Tell Me If I’m Producing Too Much DHT?

It seems logical that DHT levels can be monitored since testosterone levels can be checked.  That’s not the case, though.  DHT levels may fall within the normal range on a blood test but still be elevated enough to cause male or female pattern baldness.  This is especially true if your body is sensitive to DHT.  When testosterone levels increase, DHT has the potential to be an even bigger problem.  

Can I Prevent Androgenetic Alopecia?

Unfortunately, there isn’t a way to predict whether or not you’re going to lose your hair.  Androgenetic alopecia, male and female pattern baldness, is genetic.  If a family member on either your maternal or paternal side has gone bald, there’s a chance that you could too. The only catch is that you don’t have a way of knowing whose or which genes you inherited.  

Men on testosterone replacement therapy or get testosterone injections often ask if the medication will contribute to their hair loss.  Depending on the patient’s sensitivity, the supplemental testosterone could cause an increase in DHT leading to increased hair loss.  

Is Overproduction of DHT Just a Guy Problem?

When people think of androgenetic alopecia, men typically come to mind.  Bruce Willis, The Rock, Matthew McConaughey, Jeff Bezos are all prime examples.  You don’t see too many bald or balding female celebrities.  The reality is that a significant number of women are affected although the number isn’t as high as it is for men.  One research study found that out of 954 patients diagnosed with pattern baldness, 23.9 percent were women. (02)  Women typically have a lower level of testosterone; however even when lower levels of testosterone convert to DHT, hair loss can occur.  

What Can You Do to Reduce the DHT Levels in your Body?

The most effective way to reduce your DHT level is to use a DHT blocker.  If you’ve been dealing with hair loss issues for a while, you’re probably well aware of the overwhelming number of over-the-counter (OTC) hair loss options.  It’s not unusual for patients to spend a lot of time and money with these products before giving up and turning to their dermatologists for prescription options. 

Prescription DHT blocking medications reduce the amount of 5a-reductase enzyme, which converts testosterone into DHT in your body.  Here are the DHT blockers most commonly prescribed by dermatologists and hair specialists:

Oral & Topical Finasteride 

Finasteride is one of the most well-known DHT blockers.  The medication was FDA approved in 1992 under the name Proscar to treat enlarged prostates and five years later under the name Propecia to treat androgenetic alopecia.  Although both men and women can use Finasteride, it is not recommended for use in women who are or could become pregnant.  

Oral Finasteride is highly effective as a hair loss treatment.  One research study found that 80 percent of participants who took Finasteride saw an increase in hair growth. (03)  However, some people who take oral Finasteride report undesirable sexual side effects, including decreased libido.  A good solution is using topical Finasteride rather than oral.  Topical Finasteride has been proven to be as effective as oral without the side effects in many studies. (04)  

Topical Finasteride Combined With Minoxidil

Minoxidil is not a DHT blocker, but it has an important role in hair growth for people with male and female pattern baldness.  Minoxidil is what’s called a vasodilator.  It enlarges the blood vessels so more oxygen reaches the scalp.  As a result, it makes the hair follicles bigger so new hair can emerge.  Minodixil and Finasteride are a dynamic duo when used together to fight hair loss.  The Finasteride prevents the testosterone from converting into DHT while the Minoxidil ensures that your scalp is conducive to new hair growth.  A research study conducted in 2020 found that the combination of Finasteride and Monoxidil was safe and more effective than monotherapy. (05)

Dutasteride

Dutasteride, also known as Avodart, is another DHT blocker originally developed to treat enlarged prostates.  It is also a 5-alpha reductase inhibitor.  Although Finasteride and Dutasteride work similarly, the medications have some differences.   Whereas Finasteride is FDA-approved to use for hair loss, Dutasteride can only be used off-label.  It has not yet been FDA-approved.  Finasteride is usually highly effective in treating androgenetic alopecia and is typically used as a first-line medication.  In cases where patients need an extra boost, Dutasteride can be helpful.  Research has shown that men who used Dutasteride for 24 weeks had thicker hair than men who used Finasteride. (06) 

Spironolactone

Spironolactone is FDA approved to treat high blood pressure, heart failure, and fluid retention due to kidney and liver diseases.  It is not FDA-approved to use for hair loss and is used off-label for women.  Spironolactone typically isn’t prescribed to men because it can cause feminizing side effects.  Like Finasteride and Dutasteride, Spironolactone slows down androgen production.  The medication has been found to be both safe and effective. (07)

How Do DHT Blockers Work?

Now that you have a better idea of what DHT blockers are available, the next question that needs to be answered is how do they work?  The mechanics behind the prescription medications approved or used as DHT blockers are similar.  First, preventing testosterone from converting to DHT inhibits the miniaturization of the hair follicles.  Secondly, when the levels of scalp DHT are lowered, the number of hairs in the anagen phase are maintained or increased.  Think of anagen as the active phase of the hair growth cycle.  This is when the cells in the roots of your hair divide rapidly and form new hair.  Elongating the anagen stage gives your hair more time to grow.  

Get More Information On Prescription DHT Blockers

If you’re experiencing androgenetic alopecia and want more information on DHT blockers, contact us.  If, like many, you haven’t yet been to a dermatologist, free phone consultations are available with board-certified dermatologists and hair specialists.  

Formulas are available for men and women and can even be customized based on your specific needs.  We are happy to remove or add ingredients as needed and appropriate.  You can also see before and after photos of our patients.  You can get an idea of what you can realistically expect to see after using Happy Head hair loss solutions that block the DHT causing your alopecia.

Resources:

(01) https://newsroom.clevelandclinic.org/2019/09/04/cleveland-clinic-survey-men-will-do-almost-anything-to-avoid-going-to-the-doctor/

(02) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5312176/

(03) https://pubmed.ncbi.nlm.nih.gov/15316165/#:~:text=In%20the%20clinical%20evaluation%20at,the%205%25%20topical%20minoxidil%20group.

(04) http://www.bioline.org.br/pdf?dv09011

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

(06) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6388756/

(07) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3769411/