Tag Archive for: Avodart

Dutasteride or Finasteride for Hair Loss: Which Should You Use?

You’ve decided to be proactive and treat your hair loss.  After all, you’ve been staring at the mirror day after day, trying to convince yourself that you aren’t really losing your hair.  But, you are.  Now that you’ve decided to do something about it, which medication should you use?  Everywhere you look, there seems to be another hair loss solution that promises to give you a full head of shiny hair in no time. 

Here’s what any qualified dermatologist will tell you. In addition to Minoxidil, you’ll need a prescription DHT (an acronym for dihydrotestosterone) blocker to effectively treat male pattern baldness.  Two are on the market:  Finasteride and Dutasteride.  Both have been tested and are prescribed often.  Which one is better?  We’ll run down the list of pros and cons and give you the information you need to have an educated discussion with your dermatologist.

Why Do People Use Finasteride or Dutasteride?

Before we get into what Finasteride and Dutasteride are and how they work, let’s talk about why you need one of these medications.  There are many types of alopecia that cause balding and thinning, but the most common type is male and female pattern baldness.  Male and female pattern baldness is a genetic condition that occurs when your body converts testosterone into an androgen called dihydrotestosterone (DHT).  If you are genetically predisposed to male or female pattern baldness, DHT can attack your hair follicles and cause something called miniaturization.  Miniaturization occurs when the hair follicles shrink. Healthy new hair can’t emerge and existing hair falls out.  

How Finasteride and Dutasteride Work 

Finasteride and Dutasteride are in a class of medications called 5-alpha reductase inhibitors, also known as 5-ARIs.  The medicines were initially designed and marketed to treat Benign Prostatic Hyperplasia (BPH), also known as an enlarged prostate.   When testing effectiveness in treating BPH, researchers discovered that balding patients taking Finasteride experienced hair growth.   The reason why is that the medications are anti-androgens, which means they prevent the conversion of testosterone to DHT.  DHT causes both enlarged prostates and hair loss.  If the testosterone doesn’t convert, your hair follicles will remain healthy.  

What is the Difference Between Finasteride and Dutasteride?

Finasteride is sold under the brand names Proscar and Propecia.  The medication was FDA-approved to treat male pattern baldness in 1997.  Dutasteride is sold under the brand name Avodart and is used off-label to treat male pattern baldness.  Dutasteride is a newer medication.  

Finasteride inhibits Type 2 isoenzyme of 5a-reductase.  Dutasteride inhibits Type 1 and Type 2. You could say that Dutasteride is stronger because it inhibits an extra enzyme.  Does that mean that Dutasteride is a better choice?  Although one study found Dutasteride to be more effective, that isn’t always the case. (01)

You Need to Give DHA Blockers a Test Run

According to Dr. Ben Behnam, Board Certified Dermatologist and founder of Happy Head, you won’t know which medication will work better for you until you try one.  Logically, Dutasteride should work better for everyone because it has broader coverage, but that isn’t always the case.  He has seen situations where patients respond better to Finasteride.  That’s one of the reasons why dermatologists typically recommend Finasteride first.  Finasteride can often get the job done at a lower dosage than Dutasteride.  Finasteride is also often combined with Minoxidil to get desired results.  The two medications work synergistically to halt hair loss and generate growth.  Minoxidil brings oxygen to the hair follicle, enlarging the follicle, while Finasteride blocks the DHT from attacking the follicle.  

You Need to Consider How Risk Adverse You are to Potential Side Effects

Side effects are always a possibility with any medication.  However, DHT blockers are of particular concern to many men because of potential sexual side effects.  Both Finasteride and Dutasteride have similar risks and safety profiles. (02) The truth is that side effects are rare with both medications.   If you’re still concerned, though, Finasteride comes in a topical formula.  The topical has been proven to penetrate the scalp’s surface and work as effectively as the oral pill.  Men can get the same benefit without systemic effects. 

Can Women Use Finasteride and Dutasteride?

Just as men get male pattern baldness, women experience female pattern baldness.  Female pattern baldness is also caused by DHT.  Although Finasteride is not FDA approved for women, many dermatologists prescribe the medication to their female patients.  The only caveat is that Finasteride is not recommended for women who are or are thinking about getting pregnant.  Dutasteride isn’t prescribed to women as often as Finasteride, however, women can take the medication if they are not of childbearing age.  Spironolactone, another DHT blocker, is usually prescribed rather than Dutasteride.  

 

Need help selecting the right medication to treat your male or female pattern baldness?  Want more information about whether Finasteride or Dutasteride are right for you?  We’re here to help.  Our board-certified dermatologists are on call to answer your questions and make personalized recommendations.  

 

Resources:

(01) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6388756/#:~:text=One%20study%20discovered%20that%20dutasteride,in%20inhibiting%20type%201%205AR.&text=After%20studying%20the%20mechanism%20of,than%20finasteride%20in%20treating%20AGA.

(02) https://pubmed.ncbi.nlm.nih.gov/24411083/

 

 

Can Female Pattern Hair Loss be Reversed?

Woman looking at her hair closely trying to figure out how much hair she's lost. She's wondering if her female pattern hair loss can be reversed. Happy Head's board-certified dermatologists can help with custom topical hair growth treatments, oral medications, and more.

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.  

Happy Head's women's formula using a combination of compounded ingredients including Spironolactone and Minoxidil. This treatment is made to order and customized to you.

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

 

 

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.

Oral Minoxidil by Happy Head, formulated by board certified dermatologists. What's the secret behind its success?

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.

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/

 

When Women Get Male Pattern Hair Loss

Women can also suffer from hair loss, but there's help online to get a dermatologist diagnosis and formulation that works for you. Happy Head's dermatologists understand how female pattern hair loss works and how to help you regrow your hair.
Female pattern hair loss can progress from a widening part to overall thinning. But what happens when women get male pattern hair loss?

I met my friend Barbara (01) twelve years ago when our boys were toddlers. Barbara is a tiny woman with lots of spunk. I always thought of her as strong, smart, and confident. She called one day and confided in me that it bothered her that her hair was thinning. She had been losing hair on the crown of her head since she was in her late 20s, and she never did anything about it. She knew that I had lichen planopilaris and wanted to get the name of the dermatologist I used to treat my hair loss.  

Anyone knew just from looking at Barbara that her hair was sparse, and it took me by surprise that she hadn’t already had it checked out by a dermatologist or a hair specialist. But then again, Barbara isn’t exactly a fashionista.  She’s an elder care nurse who spends most of her weekdays in scrubs and her weekends in sweats. But still, I was surprised. Barbara visited my dermatologist, and it turns out that she has androgenic alopecia, also known as male pattern baldness. Who knew that women can get male pattern baldness? And who knew that it could start so young?

How Do Women Get Male Pattern Baldness?

Women get male pattern baldness for the same reasons men do. Also known as androgenic alopecia, female pattern hair loss is usually inherited. The condition occurs when a woman has a shorter than normal period of hair growth and a longer than normal period between when her hair sheds and grows. In some cases, women have the misfortune of inheriting smaller hair follicles and thinner strands of hair.  

Almost every woman experiences female pattern hair loss at some point in her life. Most first notice androgenic alopecia around menopause, but it can start any time after puberty begins. If anyone on either side of your family has lost his or her hair, it’s more likely that you will too. 

What Does Female Pattern Baldness Look Like?

There’s some good news if you have female pattern baldness. Women’s hairlines usually don’t recede and you won’t end up with a donut. The other good news is that women typically don’t go completely bald. Usually women with androgenic alopecia have one of three different patterns of hair loss. A bald spot can form at the crown of your head, you could lose hair along your center part, or your hair could thin all over. In some cases, hair gets so thin that the scalp can be seen.

How to Identify Male Pattern Baldness in Women

Although it’s tempting, don’t try to self-diagnose or treat yourself if you think you have androgenic alopecia. Get an appointment with a board-certified dermatologist and hair specialist. Your dermatologist may do one or several of the following:

  • Evaluate your hair loss pattern
  • Review your medical history
  • Rule out other possible causes for your hair loss, such as iron or vitamin D deficiency, thyroid disease, or another type of scarring alopecia
  • Determine whether you are producing too much androgen (male hormone)
  • Use a dermoscope or a microscope to look at the structure of your hair shaft
  • Take a small biopsy of your scalp and send it to a pathologist

Androgenic Alopecia Often Goes Undiagnosed in African American Women

Women of every race are affected by androgenic alopecia and other types of hair loss. African American women are no exception. In a 2016 survey conducted at Boston University’s Sloane Epidemiology Center, 47.6 percent of African-American women surveyed reported hair loss. (02)   

However, like my friend Barbara who noticed that her hair was thinning and didn’t do anything about it, many African-American women are not seeking treatment for androgenic alopecia. Out of the group surveyed, 81.4 percent reported that they had never consulted with a physician about their thinning hair or bald spots.

The moral of this story? If you think that your hair is thinning and have a history of hair loss on either your Mother’s or Father’s side of the family, don’t ignore it. Make an appointment with your dermatologist to get evaluated and treated. 

Do Asian Women get Alopecia?

Asian women do get alopecia, but traditionally rates have been lower than those of Caucasian or African-American women. (03) That number seems to be on the rise, though. Diet is believed to be a contributing factor.   

Early research indicates that diets rich in vegetables, herbs, and soy may contribute to hair growth and health thanks to their anti-inflammatory nutrients. (04) The traditional Asian diet, loaded with fish and vegetables, meets that criteria.  

Today’s modern Asian diet looks more like a typical American diet though, filled with processed foods. The fat, salt, and empty calories lead to higher BMI and blood sugar levels that have been linked to female pattern hair loss. (05)

 

Topical treatment by Happy Head, being piped out of the glass pipette. Each topical treatment is customized to your patient profile.

What Treatments are Available to Women with Female Pattern Baldness?

Treatments for androgenic alopecia are designed with two goals in mind:

  1. Prevent further hair loss
  2. Stimulate hair growth

Sounds logical, right? Well, it is. Here are medications that dermatologists typically prescribe:

Retinol (Tretinoin)

Retinol is derived from Vitamin A and has been found to be effective for treating female pattern hair loss when used either alone or in combination with Minoxidil. (06) Retinol has been proven to stimulate growth and improve the absorption of other ingredients that promote hair growth.

Minoxidil (Rogaine)

Minoxidil, sold over-the-counter under the name Rogaine, is a hair regrowth treatment. It works by enlarging the hair follicles and elongating your hair’s growth phase. Minoxidil is available in both a topical foam and a pill. Although the foam is available in a two percent formula for women and a five percent formula for men, dermatologists often recommend the five percent for women to use for androgenic alopecia. Any hair growth realized while using Minoxidil can be lost if you stop using the product, so it is highly recommended to use it under the care of a licensed dermatologist.

Finasteride (Propecia)

Finasteride is a prescription medication that was initially designed to treat enlarged prostates. Because it prevents testosterone from converting into dihydrotestosterone (DHT), the medicine is helpful for women with female pattern hair loss. (07)  Finasteride is available as an oral medication and as a topical solution. Many women prefer topical to avoid potential side effects.

Dutasteride (Avodart)

Dutasteride is similar to Finasteride. Both medications prevent your body from converting testosterone into DHT, which causes female pattern baldness. Dutasteride is newer to the market and is used off-label for androgenic alopecia in women. Finasteride is highly effective for most women, but when stronger medications are required, Dutasteride is a good option. (08) Like Finasteride, Dutasteride is best for women who are not pregnant or thinking about becoming pregnant.   

Spironolactone (Aldactone)

Spironolactone is an effective treatment for hormone-induced hair loss that is only prescribed to women. The medication blocks DHT production by simultaneously decreasing testosterone and increasing estrogen.

Data indicates that Spironolactone is highly effective for treating female pattern baldness. In a research study conducted, 74.3 percent of patients who were treated with Spironolactone reported stabilization or improvement in their hair loss. (09)  

Oral Spironolactone can cause low blood pressure, drowsiness, and other side effects. Topical Spironolactone, which does not go through the digestive system and is less likely to induce side effects, is often prescribed and preferred. Topical Spironolactone is often compounded with Minoxidil to help your hair grow even faster and thicker.   

Compounded Topical Treatments

If you’re not thrilled about using multiple products, all-in-one topical treatments that combine multiple medications into one are now available and can be more effective than using just one medication alone. (10)  Popular combinations are:

  • Finasteride, Minoxidil, and Retinol
  • Minoxidil and Spironolactone

Many women appreciate the convenience and ease of applying just one formula twice a day.  

With So Many Medications Available to Women With Androgenic Alopecia, How Do You Choose?

Are you confused about all of the different options? If so, that’s understandable since some of the DHT blocking medications work similarly. Thankfully, dermatologists have experience selecting the right medications for patients with female pattern hair loss. Your dermatologist will help you choose the right medication, dosage, and combination of medication based on the severity of your hair loss and your medical history.  

Remember that treatment for female pattern hair loss isn’t one-size-fits-all. Different medications work for different women. It’s common to go through a trial process to see what works best for you.  

Also, keep in mind that patience is key when treating androgenic alopecia. Medications work over time, so it may be a few months before you see a noticeable improvement, no matter which treatment you and your dermatologist choose.

Women With Androgenic Alopecia Often Need a Support System

Every woman deals with androgenic alopecia differently. My friend Barbara took her diagnosis in stride, but many women are devastated. Hair is a huge part of a woman’s identity, and losing it can take a toll on a woman’s confidence.  

If you’re having trouble coping with your hair loss, resources are available to you. Best of all, some of the resources are free. Facebook has a closed group dedicated to females with androgenic alopecia. Members share information about their diagnosis and treatment plans. Sometimes, they’re just there to tell each other that it’s okay to be sad about their hair loss. Whether it’s on Facebook, another social media outlet, or in person, support groups are a good way to connect with others who are feeling the same way as you about your hair loss situation.  

If you’re not in a good place mentally, make sure you contact a qualified psychologist or a psychiatrist. Depression and anxiety are common among women with female pattern hair loss. It’s important to seek help so you can regain your sense of self.


Resources:

(01) Name has been changed to protect confidentiality

(02) https://www.sciencedaily.com/releases/2016/03/160304093239.htm

(03) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4560543/

(04) https://www.karger.com/Article/Fulltext/504786

(05) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4560543/

(06) https://pubmed.ncbi.nlm.nih.gov/3771854/

(07) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7060023/

(08) https://pubmed.ncbi.nlm.nih.gov/25382509/

(09) https://www.jaad.org/article/S0190-9622(15)01878-2/fulltext

(10) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4314881/