Tag Archive for: finasteride

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.  As of now, Dutasteride is only available as a pill.  

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/

 

 

Worried About Going Bald? Why Men Are More At Risk Than Women.

Unless you were lucky enough to be born with perfect genes, the odds are that you’ll experience hair loss at some point in your life if you’re a guy.   By age 35, about two-thirds of all men begin to notice that their hair isn’t quite as thick as it once was.  Or even more alarming, they start to see a bit of recession on their foreheads.  By the age of 50, that number shoots up to 85 percent. (01)  Yes, women lose their hair too.  But why does it seem like men have noticeable hair loss while women still have their standing weekly appointments to get their hair blown out?  

Androgenetic alopecia affects both men and women.  However, it affects each gender differently.  If you’re wondering why male pattern hair loss seems so much more prevalent, we’re here to fill you in.  We have the facts and tips on what you can do if thinning or recession are stressing you out.  

Why Do Men Go Bald?

There are several reasons why men lose their hair.  The most common is due to androgenetic alopecia, male pattern baldness.  The hair loss condition is genetic.  You can inherit it from either your mother’s or father’s side of the family.  Hair loss begins when testosterone converts to an androgen called dihydrotestosterone (DHT).  DHT attacks the hair follicles and shrinks them during a process called miniaturization.  When the hair follicles miniaturize, a couple of things happen.  First, the hair that is already there falls out.  Secondly, the smaller hair follicles make it more difficult for new hair to emerge.  Newer hair tends to be finer.  Eventually, the follicles close off, leading to thinning and baldness.  While most people think of balding happening to older men, the truth is that male pattern baldness can affect any male after puberty.  It’s not unusual for men in their 20s and 30s to lose their hair.

Does Too Much Testosterone Cause Male Pattern Baldness?

There’s a theory that bald men have more testosterone than men with a full head of hair.  Which would explain why more men than women go bald.  That’s just a myth, though.  The amount of testosterone isn’t what causes male pattern baldness.  The amount of testosterone that converts to DHT is what matters.  If a man has low testosterone levels, but a high percentage of the testosterone he does have converts to DHT, male pattern baldness can result.  

Can Women Go Bald Too?

Women experience androgenetic alopecia too.  It’s called female pattern baldness.  However, women’s and men’s hair loss patterns are different.  Men tend to lose hair in the front of their heads and on top.  Male pattern baldness often starts as an M shape.  If the condition progresses, it can result in a donut shape.  The pattern of women’s hair loss is different, however.  Women tend to lose their hair along the part line.  Although the hair loss can and does spread, women with female pattern baldness usually don’t go completely bald the way men do.  That’s one of the reasons why it seems like men are more affected by genetic hair loss.  

If a Man Loses His Hair Due to Male Pattern Baldness, Can it Grow Back?

Men with androgenetic alopecia can regrow their hair if the hair follicles have not fully miniaturized and are still intact.  It’s also possible to make thinner hair fuller and healthier looking.  Fortunately, there are two FDA-approved medications designed to help.  

Minoxidil Is Easily Accessible

The first is Minoxidil.  You can buy Minoxidil over-the-counter at drug stores and big box retailers that sell pharmaceutical products.  Minoxidil is sold in two and five percent liquid and foam formulas.  Higher percentages, up to ten percent, are available by prescription.  Not surprisingly, research indicates that five percent (02) is more effective in achieving regrowth. Researchers do not know the exact mechanism that makes Minoxidil work.  But, they do know that Minoxidil brings oxygen to the scalp, enlarging hair follicles, preventing miniaturization and hair loss.  

Finasteride Is a First-line Prescription Treatment for Male Pattern Hair Loss

Finasteride is a prescription DHT blocker that has been FDA-approved to treat male pattern baldness.  The medication, marketed initially to treat enlarged prostates, is effective in promoting hair growth and stopping hair loss in men. (03)  Finasteride prevents testosterone from converting into DHT, which can attack and shrink the hair follicles.  Some men, however, are reluctant to try or use Finasteride because it has a reputation for causing sexual side effects.  Using topical Finasteride is a good, often preferred, alternative that allows men to benefit from the medication without experiencing systemic effects.  

Treatment for Male Pattern Baldness Often Requires a Combination of Prescription Medications

If you’re starting to see thinning or bald spots and are worried about losing your hair, don’t wait to seek treatment.  As mentioned, you want to act while your hair follicles remain active.  A combination of medications are typically used at the same time.  Minoxidil and Finasteride are often prescribed together.  Minoxidil, a vasodilator, enlarges the follicles, while Finasteride stimulates growth. (04)  Depending on your particular case, your dermatologist may also recommend Retinol to help absorption, Cortisone to eliminate irritation or other medications.  Liquid formulas that combine multiple medications into one are available if you’re concerned about taking multiple medications and side effects. 

Customized Hair Loss Treatments Can Be Modified

Keep in mind that treatment for male pattern baldness isn’t one-size-fits-all.  It may take some trial to determine which combination of medications works best for your body’s chemistry.  Finasteride is typically the first-line treatment since it’s highly effective.  However, some men find that Dutasteride, a more broad-spectrum DHT blocker, works better for them.  The key is to remember that once you start treating your hair loss and find a solution that works, you’ll need to keep using it.  If you stop treatment, any growth will be lost.

No, you can’t change your genetic makeup, but you can treat your hair loss.  If you have questions about what medications are right for you, contact us.  Our board-certified dermatologist will review your case and recommend the best way to start regrowing your hair.

 

Resources:

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

(02) https://pubmed.ncbi.nlm.nih.gov/12196747/

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

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

 

Is Caffeine the Next Hair Loss Solution?

 

If you’re losing your hair, you may be rethinking your diet.  After all, diet does affect the quality of your hair.  We know that processed foods and too much alcohol aren’t recommended if you are experiencing hair loss.  If you’re one of those people who can’t get your day started without a steaming hot cup of coffee, though, you may be excited to learn what you thought was a vice may actually help you.  Yes, it’s true.  Researchers have been studying the effects of caffeine on male and female pattern hair loss.  So, here’s the million-dollar question.  Is caffeine the secret weapon to fighting genetic hair loss?  Grab a cup, find a comfortable chair, and keep reading.  

Caffeine:  Drink or Drug?

You’re probably very familiar with caffeine found in coffee, tea, chocolate, some sodas, pain relievers, and other over-the-counter medications.  But, this may come as a surprise to you. Caffeine is categorized as a drug by the FDA.  The reason why is that caffeine stimulates the nervous system.  That causes you to be more awake after downing a cup of coffee, tea, or energy drink such as Red Bull that contains caffeine. Caffeine is also found in many pain relievers, over-the-counter medications, and supplements.  Research shows that when caffeine is added to ibuprofen and other common analgesics, patients experience a higher level of pain relief. (01)  Caffeine increases the absorption and strength of the medication.  Patients with migraines are often told that caffeine can help relieve their symptoms.  

What’s the Connection Between Caffeine and Your Hair?

If you are experiencing androgenetic alopecia, you may be wondering whether caffeine can contribute to your hair loss.  The good news is that you don’t have to go into panic mode.   Caffeine won’t make you lose more hair.  Dr. Ben Behnam, board-certified dermatologist, hair specialist, and founder of Happy Hair hair loss solutions, doesn’t mind when his hair loss patients indulge in coffee or tea.  Although he recommends avoiding energy drinks and processed foods, he gives thumbs up to caffeine.  

Does Caffeine Stimulate Hair Growth?

Not only is caffeine not harmful, research indicates that caffeine can help patients who are experiencing male or female pattern hair loss.  In one study,, concentrations of .001 percent and .005 percent caffeine led to growth of hair follicles preserved in test tubes. (02)  Another study on the effects of caffeine contained in cosmetics discovered that caffeine acts as a DHT blocker. (03)  As a stimulant, caffeine can also increase circulation to your hair follicles, allowing it to work similarly to Minoxidil. (04)   

Can You Substitute Caffeine for Hair Loss Treatments if You Have Male or Female Pattern Hair Loss?

Don’t abandon your Minoxidil, Finasteride, or other prescription hair loss treatments just yet.  More research needs to be conducted on the most effective amount of caffeine and the best delivery method.  Low to moderate amounts of caffeine are safe; however, you would need to ingest a large amount of caffeine to prevent genetic hair loss. Yes, you can buy caffeine pills, but they come with many potential side effects, including high blood pressure, increased urination, and heartburn.  

What About Using Caffeine Topically to Treat Hair Loss?

Another option to try caffeine to treat male or female pattern hair loss is applying it topically.  One research study indicated that a .2 percent topical caffeine solution worked almost as effectively as Minoxidil. (05)  Caffeinated shampoos are an option.  When selecting a shampoo, however, keep in mind that the concentration of caffeine will most likely not be as high as the formula used in the study.  Many shampoos do not include the concentration of caffeine on their ingredients list.  Another option is a coffee rinse.  Again, there isn’t a guarantee that a coffee rinse will work, but if you try it, make sure that the coffee you use is completely cool before you pour it into a spray bottle and spray it on.

Other Hair Loss Treatments

If experimenting with caffeine isn’t for you, other hair loss treatments are worth using.  Prescription medications have been proven to be the most effective for treating male and female pattern hair loss and other forms of alopecia.  FDA-approved Minoxidil and Finasteride are first-line treatments for male and female pattern hair loss and produce measurable results in many people.  Minoxidil enlarges the hair follicles so hair can grow healthy and strong.  Finasteride is a hormone blocker that prevents testosterone from converting to dihydrotestosterone (DHT).  Minoxidil and Finasteride are often used at the same time.  Although Finasteride works for most, some people need to step-up to Dutasteride, a more potent DHT blocker.  Women who need a stronger prescription may try Spironolactone, another pill with a different formulation that is also stronger than Finasteride.  Combination topical prescription medications are also available and more convenient than using multiple medications.  

To sum up, research indicated that caffeine may be a viable hair loss solution.  However, if you’re thinking about using caffeine to prevent hair loss and to grow new hair, look carefully at the percentages of caffeine in the product you plan to use.  Odds are that the concentration won’t be high enough to prevent further hair loss and stimulate regrowth.  Additional research and product development still needs to occur.  

In the meanwhile, if your hair is thinning or balding and you would like to start treatment, customizable Happy Head hair loss solution may be just what the doctor ordered.  Contact us so that one of our board-certified dermatologists can review your case and determine whether you would be a good candidate for our topical prescription hair loss medication.  

 

Resources:

(01) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6485702/

(02) https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1365-4632.2007.03119.x

(03) https://pubmed.ncbi.nlm.nih.gov/23075568/

(04) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5804833/

(05) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5804833/

 

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

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

Why is Propecia Prescribed?

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

Is Propecia a New Hair Loss Medication?

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

How Does Propecia Treat Androgenetic Alopecia?

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

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

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

Does Propecia Effectively Treat Hair Loss?

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

Can You Combine Propecia With Other Hair Loss Medications?

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

How Long Does it Take Propecia to Work?

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

Does Propecia Have Any Side Effects?

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

Can Women Take Propecia?

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

Are There Alternatives to Propecia to Treat Androgenetic Alopecia?

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

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

 

Resources:

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

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

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

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

 

Can Female Pattern Hair Loss be Reversed?

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

Female Pattern Hair Loss Is Common

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

Too Much DHT Causes Hair Loss

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

What we do know is that an androgen called Dihydrotestosterone (DHT) is to blame.  Just as men have small amounts of estrogen, women have small amounts of testosterone.  Hair loss begins when some or a lot of that testosterone is converted to DHT.. DHT interrupts your hair’s growth cycle.  The androgen miniaturizes the hair follicles, which means that the hair follicles shrink.  Existing hair in miniaturized follicles thins or falls out.  New hair can’t break through.

Myths About Female Pattern Hair Loss

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

  •  Vitamin Deficiencies 

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

  • Birth Control Pills 

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

  • Antidepressants

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

There’s No Age Limit 

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

Patterns of Hair Loss Are the Key to Diagnosis

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

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

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

Treatments for Female Pattern Hair Loss

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

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

Potential Side Effects from Hair Loss Medications

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

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

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

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

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

 

Resources:

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

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

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

 

 

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

 

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

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

How Much Hair Loss is Too Much?

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

Gradual Hair Loss

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

Sudden Hair Loss

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

Both Gradual and Sudden Hair Loss Requires Medical Attention

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

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

What Type of Doctor Treats Hair Loss?

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

Trichologist

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

Holistic Medicine Doctors (Naturopaths)

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

Dermatologist

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

Why Self Diagnosis is a Bad Idea

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

How a Hair Loss Doctor Makes a Diagnosis

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

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

Treatment Options Available Through Hair Loss Doctors

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

Minoxidil 

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

Finasteride

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

Dutasteride

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

Spironolactone

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

Combination Treatments

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

Protein Rich Plasma (PRP)

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

Hair Transplant Surgery

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

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

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

Need a Hair Loss Doctor?  We Can Help.

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

Resources:

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

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

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

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

 

Does Oral Minoxidil Live Up to the Hype?

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?  That’s what everyone wants to know.  

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

What’s the Big Deal About Oral Minoxidil?

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

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

What is Minoxidil?

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

Why is Oral Minoxidil Prescribed Off Label?

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

How is Oral Minoxidil Usually Prescribed to Treat Hair Loss?

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

What are the Side Effects of Oral Minoxidil?

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

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

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

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

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

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

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

Finasteride (Propecia)

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

Dutasteride (Avodart)

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

Spironolactone

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

Topical Medications

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

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

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

How Do I Get a Prescription for Oral Minoxidil?

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

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

What You Need to Know About How to Take Finasteride

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

What is finasteride?

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

How does Finasteride work? 

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

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

What types of hair loss can finasteride treat? 

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

What should you tell your doctor before taking finasteride? 

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

  • Liver disease
  • Abnormal liver tests
  • Prostate cancer
  • An allergy to finasteride

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

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

How should I take oral finasteride?

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

How should I apply topical finasteride? 

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

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

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

What if a dose is missed? 

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

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

What should I do when too much finasteride is taken? 

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

What finasteride side effects may occur? 

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

Other rare side effects that may occur with finasteride are: 

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

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

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

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

What other information should I know?

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

How long does finasteride take to work? 

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

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

Finasteride and Then Some! 

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

 

Resources: 

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

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

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

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

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

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

 

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

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

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

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

Female Hair Loss No Longer Carries a Stigma

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

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

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

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

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

Hair Loss and Mental Health are Closely Intertwined

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

Diagnosing Hair Loss Requires a Specialist

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

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

People with Androgenetic Alopecia Can Regrow Their Hair

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

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

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

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

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

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

Fast, Easy Access to Prescription Hair Loss Treatments is Available

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

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

Minoxidil or Finasteride: Which Treatment is Better?

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

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

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

What is Minoxidil?

You may have heard of Minoxidil, which is sold OTC under the brand name Rogaine in two and five percent liquid and foam.  Rogaine is available at retail stores such as Walgreen’s and CVS and online.  Stronger Minoxidil formulas are available, but only with a doctor’s prescription.

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

How Does Minoxidil Work?

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

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

Does Minoxidil Have Any Side Effects?

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

What is Finasteride?

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

How Does Finasteride Work?

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

Does Finasteride Have Any Side Effects?

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

What’s the Difference Between Minoxidil and Finasteride?

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

Can You Use Minoxidil and Finasteride at the Same Time?

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

Does it Matter Which Form of Medication You Use?

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

How Do I Know What Dosages I Need?

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

Which Treatment Option Should I Try First?

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

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

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

 

Resources:

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

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

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

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