Tag Archive for: Dutasteride

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

 

Is There a Genetic Test that Can Predict Hair Loss?

Nowadays, there’s a genetic test for just about everything.  Even to determine our dog’s lineage.   Just one quick saliva sample or blood test and, within days, you can find out if you’re destined for cancer, diabetes, or heart disease.  There’s even a DNA test to determine whether you’re likely to experience anxiety.  

Suppose a genetic test can give you accurate information to guide your health care plan and prevent future disease.  Can it also accurately predict whether you’re predisposed to losing your hair?  If a genetic test shows that you are likely to inherit your Great Uncle Bernie or Aunt Bonnie’s hairline, is there a way to ensure that you don’t follow in their footsteps?  Are genetic hair tests reliable?  Do dermatologists use DNA tests to help make diagnoses? Before you click “Buy Now” to order a genetic test kit, keep reading.  We’re here to answer your questions about genetic testing for male and female pattern baldness.

Can Alopecia Really be Inherited?

When people hear the word “alopecia,” they often think of hair loss caused by a medical condition.  Types of alopecia such as alopecia areata and lichen planopilaris are caused by autoimmune conditions.  Androgenetic alopecia, however, is a type of alopecia that is inherited.  It’s the most common type of alopecia.  As many as 80 percent of all men will experience male pattern baldness in their lifetime. (01)  In addition, many women experience female pattern baldness, usually around menopause.  

What’s the Link Between Genetics and Pattern Baldness?

A study conducted on twins confirms what we’ve long suspected.  Male and female pattern baldness have a genetic component. (02)  About 79 percent of men who were balding in the study could attribute their hair loss to their genes.  But, there’s a catch.  Researchers are still working to fully understand which genes are affected.  We’re still learning.  Here’s what we do know.  There are 63 genes that could potentially cause baldness.  Six of those are associated with the X chromosome, where the Androgen Receptors (AR) are found.  It’s also possible that not one isolated gene is the culprit.  Several genes working together may be to blame.

Can You Take a DNA Test to Determine Whether You Will Go Bald?

Ads make genetic testing very tempting, especially if your Mom or Dad starts losing their hair in their 20s.  It would be nice to know whether you will lose your hair too.  But, unfortunately, we’re not quite there yet.  As mentioned previously, there are still too many unanswered questions about which genes are involved and how the genetic process affects your locks. Also, false positives are not unusual with genetic testing.  You don’t want a test to tell you that you’ll experience androgenetic alopecia if that isn’t really the case. (03)

How do you Know if the Type of Alopecia You Have is Genetic?

When men and women experience androgenetic alopecia, they see specific hair loss patterns.  The first sign for men is usually a receding hairline.  The hair loss then progresses to the top, creating a horseshoe pattern above your ears that circles around to the back of your head.  Female pattern hair loss typically presents differently.  Women usually notice thinning on the top and crown.  Often, women will notice a widening of the center part.  Many other conditions cause hair loss besides androgenetic alopecia.  If you think your hair loss is genetic, be sure to have your dermatologist confirm your findings.  Early diagnosis is key to preventing further hair loss and to stimulating new growth.  You also want to make sure you’re addressing the right condition with the right treatment.  

Do Dermatologists Use Genetic Testing to Diagnose Male and Female Pattern Baldness?

The truth is that dermatologists don’t need high-tech tests to determine whether or not patients have androgenetic alopecia.  Most of the time, they can tell from your hair’s appearance and your hair loss pattern.  If there is any doubt, he or she may use a densitometer to magnify your hair follicles to see if miniaturization is occurring.  Miniaturization is when the hair follicles shrink, causing existing hair to fall out and preventing new growth.  Your dermatologist may order a biopsy and blood test to rule out other causes. Patients often ask about the benefits of running a hair analysis based on what they hear about on social media.   Hair analysis is not used to diagnose male or female pattern baldness.  Instead, it’s used to determine whether there’s lead, arsenic, or another substance causing your hair loss.  

What Can You Do to Treat Hair Loss Caused by Genetics?

Treatment for male or female pattern baldness is designed to meet two goals.  The first is to stop the progression of your hair loss.  The second is to promote new hair growth.   The best way to accomplish those two goals is by using a combination of medications simultaneously.  Here are medications often included in treatment plans for androgenetic alopecia:

  • Minoxidil topical foam – A vasodilator that enlarges the hair follicles
  • Finasteride, Dutasteride, or Spironolactone  – Prevents testosterone from converting to DHT that attacks the hair follicles and causes hair loss
  • Topical or oral cortisone – Treats any redness or irritation (not needed for evey patient)

Some men are concerned about experiencing sexual side effects with oral Finasteride.  If this is the case, topcial Finasteride has been proven to be just as effective without the side effects. (04)  Even better, topical solutions which mix Finasteride with Minoxidil, Cortisone and Retinol offer an even more effective all-in-one solution.  The retinol improves absorption of the other three medications.  

Are There Other Causes of Hair Loss Besides Genetics?

Male and female pattern hair loss are the only types of genetically induced alopecia.  However, other types of alopecia exist and treatment plans are designed to treat the type of alopecia you are experiencing.  Examples of other types of alopecia include:

  • Temporary Alopecia (Telogen Effluvium) – Occurs due to sudden illness, stress, or shock and usually reverses itself without treatment
  • Autoimmune Alopecia (Alopecia Areata and Lichen Planopilaris) – People experience flares and periods of remission
  • Trauma-induced Alopecia (Traction Alopecia and Trichotillomania) – Alopecia results from hairstyles that pull on the hair follicles or when people pull out their hair as a stress response)

Can You Prevent Hereditary Hair Loss?

Let’s play pretend for a minute.  Let’s say that a genetic test does exist that will determine whether or not you will lose your hair.  The tests come back showing that you are genetically predisposed to androgenetic alopecia.   Is there a way to prevent hair loss before it begins?  Sure, eating right, exercising, and managing stress never hurt.  But, even with that, you can’t necessarily fight Mother Nature.  That would be nice, though.  If male or female pattern baldness does rear its head, then it’s time to take action.  

Can You Reverse Hereditary Hair Loss

If you’re experiencing male or female pattern baldness and want to learn more about products available, contact us.  Although there isn’t a way to prevent androgenetic alopecia from occuring in the first place, there are things you can do to reverse the condition.   Minoxidil, Finasteride and other medications have been found to be safe and effective. Our board-certified dermatologists and hair specialists are available to answer your questions and help you develop the ideal treatment plan for your needs and lifestyle. 

 

Resources:

(01) https://www.ncbi.nlm.nih.gov/books/NBK538178/

(02) https://academic.oup.com/biomedgerontology/article/60/8/1077/545174

(03) https://www.nature.com/articles/gim201838

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

 

Everything You Need To Know About Finasteride Interactions

If you have aging parents or grandparents and have seen their overflowing pill boxes, you know that it’s important to track their medications. One prescription can easily interact with another, and boom, you’re at the doctor’s office figuring out which drug is the culprit.  

Dermatologists and hair specialists often recommend prescription hair loss medications because they are safe and effective.  However, if you are taking other drugs or supplements at the same time, you should be aware of potential unintended interactions.  Since Finasteride, also sold under the brand names Propecia and Proscar, is FDA-approved to treat hair loss, it’s the one most often prescribed.  So, for that reason, we’ll tell you everything you need to know about what mixes well with Finasteride and what might not be the best combination.

Finasteride is a Leading Treatment for Male and Female Pattern Baldness

Research continually demonstrates that Finasteride, a medication originally developed to treat Benign Prostatic Hyperplasia (BPH), is one of the most effective ways to treat androgenetic alopecia.  The statistics tell the story.  After two years on Finasteride, 83 percent of men included in Merck’s research study did not experience further hair loss.  More than 70 percent showed increased hair growth. (01)  Finasteride works just as effectively for women. (02)  That’s why Finasteride is often dermatologists’ drug of choice when it comes to stopping further hair loss and stimulating new growth.  

Finasteride Increases the Testosterone Levels in Your Body

So, how does Finasteride help stop your hair from shedding?  It blocks an enzyme called 5-alpha-reductase (5-AR).  When 5-AR isn’t produced, testosterone can no longer be converted to an androgen called Dihydrotestosterone (DHT), which is what causes your hair follicles to miniaturize.  Finasteride also increases testosterone levels in your body.  More testosterone shrinks prostate size and helps your hair grow.  The only catch is that when you stop taking Finasteride, any new growth will be lost.   

Finasteride Interactions are Uncommon

Complications stemming from Finasteride use are rare.  That’s not to say that it doesn’t or can’t happen.  Certain medications can either increase or reduce the amount of Finasteride in your bloodstream.  Carbamezepine, Rifampin, and St. John’s Wart may reduce Finasteride’s efficacy by metabolizing the Finasteride faster in your liver.  Other medications such as Itraconazole and erythromycin may actually increase the levels of Finasteride in your blood.  Checking with your doctor is the best way to know if other medications you are already taking will contradict Finasteride.  

Avoid Interactions with Other Medications by Using Topical Finasteride Versus Oral 

If you have androgenetic alopecia and are worried about Finasteride interacting with the other medications you are taking, ask your doctor about using topical Finasteride.  Research indicates that topical Finasteride is equally as effective as oral. (03)   Think of topical Finasteride as a spot treatment.  It works directly on the areas where your hair is thinning to prevent further hair loss and stimulate growth.  Oral Finasteride, on the other hand, is systemic since it is metabolized in your stomach.  Topical Finasteride is the ideal solution for men and women who want the benefits of the medication without any potential drug interactions.  

Some Medications Make Finasteride Work More Effectively

Some medications have been found to increase the efficacy of Finasteride.  Because some medicines work synergistically, dermatologists and hair specialists often recommend that patients use multiple hair loss treatments simultaneously to maximize results.  

Minoxidil, also marketed under the brand Rogaine, is a topical hair loss solution that has proven to complement Finasteride. (04)  While Finasteride blocks the testosterone from converting to DHT, Minoxidil enlarges the hair follicles, preventing hair loss, and allowing new growth to break through.  Minoxidil is available in both oral and topical formulas.

Retinol is also a medication that is often prescribed with Finasteride.  Retinol, a derivative of Vitamin A, is often prescribed to reduce wrinkles and improve skin texture.  The medication increases collagen production and stimulates the production of new blood vessels bringing oxygen to the skin.  In addition, retinol has been proven to improve the absorption of topical Finasteride. (05)

When patients with hair loss experience inflammation, topical or injected cortisone is often prescribed in conjunction with Finasteride as well.

Taking Finasteride, Minoxidil, Retinol, and Cortisone all at the same time can seem like a lot of medications to remember.  Fortunately, topical formulas are now available that combine all into one convenient bottle.    

Alternatives to Finasteride

Other options exist if you are experiencing male or female pattern baldness and oral or topical Finasteride aren’t suitable for you.

Dutasteride

Finasteride is effective for most people.  However, an alternative medication is Dutasteride. Dutasteride works similarly to Finasteride by blocking the conversion of testosterone into DHT.  The difference between the two medications is that Finasteride inhibits the Type 2 5AR isoenzyme,while Dutasteride inhibits both Type 1 and Type 2.  In addition, Dutasteride’s prescribed dosages are typically lower than Finasteride’s because the medication is a bit stronger.  

Spironolactone

Spironolactone, also known as Aldactone, is used off-label to treat female pattern hair loss.  It was originally marketed to treat fluid retention caused by liver and kidney disease. The medication is only prescribed for women because it can cause feminizing features when used over time.  Research has not yet been conducted on a large sample size, but four women included in a study, saw reduced hair loss and experienced some growth. (06)

PRP

PRP, an abbreviation for Platelet Rich Plasma, is a three-step process designed to trigger hair growth by increasing the amount of oxygen available to the hair follicles.  First, blood is drawn. Then, blood is then separated into three groups using a centrifuge.  Lastly, the platelet rich plasma is injected into the scalp. PRP is often used in conjunction with other treatments to maximize results.  

Hair Transplant Surgery

If you are concerned about drug interactions, hair transplant surgery may be an option and a long-term hair loss solution.  During the past few years, many advances have been made in how the procedure is performed.  Rather than taking strips of hair to transplant, surgeons are now able to move individual hairs giving a more natural look.  

Low-light Laser Therapy (LLLT)

You may have seen ads recently for laser caps marketed for hair growth.  Most use light in the red or infrared range to penetrate the scalp and target the hair follicles.  Early studies show promise for the technology, but more research needs to be conducted on the efficacy.  One study found that LLT works better when used with Minoxidil or Finasteride.  The study also indicated that more data is needed to determine the optical laser power and wavelength. (07) 

Be Honest About Your Medical History

If your dermatologist recommends Finasteride or any other prescription hair loss treatment, the best thing you can do is be honest about your medical history.  In addition to telling your doctor about any other hormone, heart, or other medications you’re taking, remember to list any supplements. Also, although sharing information about smoking, drinking, or recreational marijuana use may seem embarrassing, remember that your dermatologist has seen and heard it all.  He or she is more concerned with giving you the best hair regrowth options and keeping you safe than passing judgment on your behavior.  

Is Finasteride Right For You?

If you have questions about whether Finasteride is right for you or could potentially interact with other medications you’re taking, let us know.  Our board-certified dermatologists have full medical degrees from accredited universities.  They are available and happy to review your medical history and suggest solutions based on the type of hair loss you are experiencing.  

Resources:

(01) https://www.accessdata.fda.gov/drugsatfda_docs/label/2012/020788s020s021s023lbl.pdf

(02) Note: Recommended doses differ for men and women

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

(04) https://onlinelibrary.wiley.com/doi/10.1111/dth.12246#:~:text=Efficacy%20assessment,combination%20therapy%20showed%20improvement%2C%20respectively.

(05) https://jamanetwork.com/journals/jamadermatology/article-abstract/557305

(06) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3769411/#:~:text=In%20a%20case%20study%20of,total%20number%20of%20anagen%20hairs.

(07) https://pubmed.ncbi.nlm.nih.gov/29270707/

 

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/

 

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/