Tag Archive for: Rogaine

8 Facts That People with Hair Loss Should Know About Rogaine (aka Minoxidil)

Dermatologists often recommend Rogaine as the first line of treatment for many different types of hair loss.  It’s well-tested, relatively inexpensive, and easy to find on drugstore shelves.  However, if you skim through Facebook groups for people experiencing androgenetic alopecia (male and female pattern baldness) and other types of hair loss, you’ll see that people are often hesitant about using Rogaine for a wide variety of reasons.  Whether you’re on the fence, heard a rumor about Rogaine that you’re not sure is true, or just want a little more information before picking up a 3-month supply, you’re in the right place.   We’re here to give you the facts.  

1. Rogaine is FDA-approved to Treat Male and Female Pattern Baldness

In the 1970s, Rogaine, the brand name for the generic medication called Minoxidil, was tested in an oral pill form to treat hypertension.  During research studies, physicians noticed that the medication caused a side effect of regrowing hair that patients had lost.  The discovery led to the development of a topical hair loss formula designed to treat male and female pattern baldness.  In 1986, a two percent topical formula was marketed, and the five percent was made available in 1993.  Rogaine is only available in liquid and foam formulas.  Minoxidil is also available as a pill that is taken orally.  

Currently, Rogaine and Finasteride, a DHT blocker, are the only FDA-approved medications available to treat androgenetic alopecia.  However, Rogaine is often used off-label to treat other types of hair loss, including alopecia areata and scarring alopecias.  

2. Rogaine is Effective

Rogaine has been used for over 30 years and has been thoroughly tested over the years.  Although the exact reason why Rogaine works is still a bit of a mystery, research indicates that the hair loss medication is effective when patients use the medicine as prescribed.  What is known is that Rogaine is a vasodilator, which means that the medication brings oxygen to shrunken hair follicles and enlarges them, allowing new, healthy hair to emerge.  Rogaine may also prolong your hair’s growth phase.  When more follicles are in the growth phase, you’ll see more hair coverage on your scalp.  A study conducted in 2004 by the Journal of the American Academy of Dermatologists indicated that over 90 percent of patients in the study achieved growth or halted hair loss after using Rogaine for one year. (01)

Dermatologists can also combine Rogaine with other hair loss medications to maximize results.  Research indicates that Rogaine combined with Finasteride has better efficacy than Rogaine alone when treating male or female pattern baldness. (02)

3. You may shed hair before new hair begins to grow

You may have heard of the dred shed people get when they first use Rogaine.  Yes, it’s a real thing.  Not all people experience initial shedding, but some do during the first few months of using the medication.  When shedding occurs, it means that the Rogaine is doing its job.  Keeping it simple, Rogaine accelerates the last stages of hair growth when the old hair falls out so that your hair can go through the growth phase faster.  That means you may see more hair loss for a short period before seeing new growth.  Most people notice small changes in three or four months.  It can take up to a year to get complete results.  

4. Certain application techniques make Rogaine more effective

You may have heard about a derma roller before.  It’s a little roller that gently punctures the skin to allow topical products to penetrate the skin deeper than if you apply the products with your hands.  According to research, people with androgenetic alopecia who use a derma roller to apply Rogaine get significantly better results. (03)  If you have another type of alopecia that isn’t male or female pattern hair loss, check with your dermatologist before using a dermaroller.  Dermarollers aren’t recommended for people with scarring alopecias.  

5. Rogaine is available without propylene glycol

Fortunately, topical Rogaine doesn’t have a lot of side effects.  If you do experience irritation, it’s possibly due to propylene glycol in one of the liquid formulas.  Propylene glycol is an active ingredient that contains two different types of alcohol.  If you experience irritation, you can make a couple of easy changes.  The first is to use Rogaine foam rather than liquid.  The foam does not contain propylene glycol.  If you use a compounded liquid formula that includes other medications, such as Finasteride and retinol, you can request that the propylene glycol be omitted.  

6. Yes, it’s true that once you start using Rogaine, you have to continue

Once you begin using Rogaine, you’ll need to continue to maintain the hair you grow.  If you stop using the hair loss product within three to four months, you will most likely lose any newly grown hair.  Your hair will look the way it did before you started using Rogaine.  

7. Stronger formulas do give better results

Rogaine is sold over-the-counter in two and five-percent liquid and foam formulas.  As you might guess, the 5 percent formula is more effective than the two percent for both men and women.  According to a study conducted on men, the five percent formula worked faster and resulted in better scalp coverage than the two percent formula. (04)  Although Rogaine is not sold over the counter at a higher dose, the generic equivalent, Minoxidil, is available by prescription for up to 10 percent and can be prescribed off-label.  Higher doses can cause more irritation than lower doses.  Minoxidil combined with cortisone helps prevent irritation from occurring.  Combining retinol as well helps improve absorption.  

8. Rogaine is safe to use on facial hair too

Some people with forms of alopecia are disturbed when they realize that they have lost hair in their eyebrows, mustache, and beard areas.  Fortunately, Rogaine is effective for facial hair as well as hair on your head.  According to a research study, Rogaine was superior in enhancing beard growth.  Adverse effects were mild. (05)

If you have male or female pattern baldness or another type of alopecia, being able to take proactive steps toward halting your hair loss and stimulating new growth can be empowering.  If you are a bit nervous about giving Rogaine a try, remember that it is a trusted medication with few downsides and many potential benefits.  And our board-certified dermatologists and hair specialists are here to help.  Let us know if we can answer any further questions or be of assistance.

 

Resources:

(01) https://www.jaad.org/article/S0190-9622(03)03692-2/fulltext

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

(03) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3746236/

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

(05) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6691938/

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

 

 

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

 

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/

 

Dermaroller: The Most Helpful Hair Loss Tool You Didn’t Know You Needed

If you’re up-to-date on the latest skincare tools, you’ve probably heard about dermarollers designed to pump-up your skin’s collagen.  You may have even tried one.  But did you know that dermarollers can help rejuvenate your hair too?  Although relatively new to the hair care scene, dermarollers have quickly become a tool of choice, recommended by many dermatologists and hair specialists.  What makes dermarollers so popular for treating hair loss?  Will the trend last?  We’re here to fill you in.  

What is a Dermaroller and What Does it Do?

A dermaroller is a small hand-held roller with about 540 tiny needles on it.  When rolled over your skin or scalp, the dermaroller’s needles create microscopic wounds that stimulate collagen and elastin production.  Collagen keeps your skin firm, elastic, and hydrated.  It’s also needed to build keratin which keeps your hair strong, shiny, and thick.  In addition to building collagen, dermarollers increase blood supply to the hair follicles, enlarging the follicles to allow new growth to emerge.

Why Are We Just Now Learning About Scalp Dermarolling?  Is it New?

Although dermarolling, also known as microneedling, has been around since the 1900s to treat birthmarks, hyperpigmentation, and scars, we started hearing more about the treatment in the late 1990s.  Since then, dermarolling has been studied and found to be effective among patients with alopecia areata (01) and androgenic alopecia.  Patients with alopecia areata have seen positive results when applying triamcinolone after using a dermaroller.  Patients with androgenic alopecia have seen positive results when applying Minoxidil after using a dermaroller. (02)

Are Dermarollers Safe?

Dermarolling is quite safe and easy to do.  Simply wet your hair and then gently roll back and forth with the dermaroller, left and right, for just a few minutes.  Make sure that you keep the dermaroller moving.  Holding a dermaroller in one place in one area could cause scarring.

Can I Do Microneedling at Home?

The microneedling that’s referenced in this article can be done at home. All you need is a dermaroller. The number of times that you use your dermaroller each week will depend on the length of the needles you are using and whether you are using your dermaroller to apply medication. Patients should always consult with their dermatologists to develop a treatment protocol since alopecia type, medications, hair density and other factors vary from person to person.

Other types of microneedling are performed in a dermatologist’s office. You may have heard of Protein Rich Plasma (PRP) treatments which are often done in conjunction with microneedling. During a PRP treatment, a patient’s blood is drawn and placed into a centrifuge machine. The blood is spun at a high rate so the components are separated. The platelets are then extracted and injected into the scalp. When PRP is combined with microneedling, topical anesthetic is applied first, medical-grade dermarollers are used, and then PRP is applied last. PRP treatments can only be done in a doctor’s office.

Which Dermaroller Should I Buy?

According to Dr. Ben Behnam, board-certified dermatologist, hair specialist and co-owner of Los Angeles-based Dermatology and Hair Restoration, the key to selecting a dermaroller is to get the correct needle size. “When dermarolling, you don’t have to go very deep to get results,” said Behnam. “I recommend just 0.25, which is very shallow. Many people read online that a 1.5 depth is recommended, but in my opinion, that’s too deep. Nobody needs a roller that strong. Rollers with needles that are too long hurt, and they can damage the hair follicle. You certainly don’t want to damage areas where your hair is thinning or balding.”

Using a Dermaroller to Apply Minoxidil (Rogaine), Finasteride, and other Topical Medications Gives Better Results

A study conducted in 2013 compared patients with androgenic alopecia who used a dermaroller to apply Minoxidil to patients who did not use the roller. Not surprisingly, patients who used the roller achieved more growth. The dermaroller creates tiny holes in the scalp that allows the Minoxidil, Finasteride and other topical medications to penetrate deeper than they otherwise would. The medicine works more effectively.

If you’re using Minoxidil or any other topical hair loss treatment on your frontal hairline, Dr Behnam recommends using the topical about two inches behind the hairline to prevent getting the medicine on your face.

Can a Dermaroller be Used on Facial Hair?

Although no research studies have been conducted on patients using dermarollers on their mustaches or beards, there’s enough evidence to indicate it’s worth a try. We know that Minoxidil is effective for hair growth and that dermarolling increases absorption. In addition to boosting collagen and keratin production, dermarolling may help improve blood flow to the area.

Keep in mind that you may notice some redness after using the dermaroller on your mustache or beard area. This irritation should disappear after a few days. If you experience bleeding, you may be using too much pressure. See if using less pressure helps.

Here are some other tips for facial dermarolling:

  • Start with clean skin and facial hair
  • Wait until acne has cleared up before dermarolling to prevent irritation or infection
  • Use the least amount of pressure needed
  • FIll-in each cheek with air as you do when shaving to get a flatter surface for dermarolling
  • Get a consistent pattern by moving the dermaroller back and forth in horizontal, vertical and diagonal lines

How Much do Dermarollers Cost?

Microneedling sessions at a dermatologist’s office can be very expensive, costing anywhere from $200 – $700 per session or more. Using a dermaroller at home, however, saves time, money and gas. Dermarollers designed for home use are similar to the ones dermatologists use, but have smaller needles. As we’ve discussed though, smaller needles can still pack quite a punch. Dermarollers used at home are very budget-friendly. The average price of a good stationary unit ranges anywhere from $15 to $30. A good quality electric unit costs $100 – $200 depending upon the features included.

Should You Test out a Dermaroller on Your Scalp?

So, here’s the takeaway.  A dermaroller is an inexpensive hair growth tool that increases the effectiveness of topical treatments among patients with androgenic alopecia and alopecia areata.  As with any medical treatment, you should always check with your dermatologist before buying or using a dermaroller.  Although dermarolling is an easy, low-risk at-home treatment, it is not recommended for scarring alopecias.   

Always make sure that you buy your dermroller from a trusted source.  As with any other hair tool, make sure that you keep your dermaroller clean according to the package instructions.  Finally, use your dermaroller as recommended, and be careful not to overuse it.  More won’t give you better or faster results.

Resources:

(01) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3996798/

(02) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3746236/

 

 

 

When Women Get Male Pattern Hair Loss


Female pattern hair loss can progress from a widening part to overall thinning.

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.

If you’re a Woman, How do you Know if you Have Male Pattern Baldness?

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)

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 Minodixil 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:

  • Retinol, Minoxidil, and Finasteride 
  • 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/

 

Hair Loss Reversal 101: What You Need to Know

If you’re experiencing hair loss, you’re not alone.  According to the American Hair Loss Association, at least two-thirds of all American men will have noticeable hair loss by the time they turn thirty-five.  Women account for forty percent of all Americans experiencing hair loss. (01) Those numbers are much higher than you thought, right?

Sure, most people expect to get some gray hair, wrinkles, and a few extra pounds as they age, but hair loss?  That’s not usually part of the plan.  We can color our hair, use Botox for our wrinkles, and spend some extra time at the gym.  But what can be done about a receding hairline?  More than you think.

There are Different Types of Hair Loss

The first step is to understand the different types of hair loss.  All hair loss is not the same, so not all hair loss will respond to the same treatment.  We’re here to give you a crash course.

The Term Alopecia Encompasses More Conditions Than Most People Realize

When people think of alopecia, they usually think of alopecia areata, the type that Massachusetts Representative Ayanna Pressley and actress Jada Pinkett Smith have.  However, if you use Dr. Google, you’ll see that WebMD defines alopecia areata as an “autoimmune disorder that causes your hair to come out, often in clumps the size and shape of a quarter.”  The definition is accurate, but not all hair loss is alopecia areata. Alopecia is an umbrella term for many different hair loss conditions.

There’s a Difference Between Non-Scarring and Scarring Alopecia

Alopecia falls under two broad categories:  non-scarring and scarring alopecia. There’s a big difference between the two types.

When people have non-scarring hair loss, their hair just falls out.  No redness, scaling, flaking, itching, or burning occurs. The alopecia can come on fast and furiously, leaving people holding clumps of hair in their hands, or gradually over a long period of time.

Scarring alopecia is a different story.  Also known as cicatricial alopecia, scarring alopecia is an inflammatory condition that occurs in otherwise healthy people. The hair follicle is destroyed and replaced with scar tissue.  The hair loss can happen over time and go unnoticed, or it can happen quickly, causing symptoms such as severe itching and burning. (02)  Speed is essential when it comes to treating scarring alopecias.  The goal is to slow or stop further hair loss and promote hair regrowth in unaffected areas.

What Type of Alopecia Do You Have?

Many different types of hair loss fall under the categories of non-scarring and scarring alopecia.  Once you know what type you have, your dermatologist will work with you to develop a treatment plan.

Examples of Non-scarring Alopecia

Telogen Effluvium

Telogen Effluvium is a form of temporary hair loss caused by stress, severe chronic illness, high fever, childbirth, thyroid disorders, major surgery, dieting, certain medications, etc.  Telogen Effluvium usually resolves itself over time.

Androgenic Alopecia

Also known as male and female pattern baldness, androgenic alopecia is a genetic condition experienced by up to 50 percent of men and women. (03)  Experts believe that pattern baldness is due to an excessive androgen dihydrotestosterone (DHT) response which causes hair follicles to miniaturize.  When the hair follicles shrink, hair loss occurs.  Androgenic alopecia typically causes frontal hair loss in men and diffuse hair loss at the crown and top of women’s heads.

Alopecia Areata

If your hair falls out in clumps around the size and shape of a quarter, you may have alopecia areata.  This condition is an autoimmune disorder that occurs when your body attacks its own hair follicles.  With alopecia areata, hair loss is unpredictable and can happen anywhere on your body.  Sometimes the condition resolves itself.  However, it can also reoccur without notice.  Many research studies are currently underway to understand the cause and effective treatment. (04)

Traction Alopecia  

Constant pulling on hair due to tight ponytails, buns, braids, cornrows or dreadlocks, hair extensions, weaves, and more can cause traction alopecia.  This condition, that’s common among actresses and models, can cause small bumps that resemble pimples.  Fortunately, traction alopecia can be reversed if you stop pulling your hair back.

Examples of Scarring Alopecia

Lichen Planopilaris

Lichen Planopilaris is the most common type of scarring alopecia.  Although it can affect both genders, lichen planopilaris is more likely to affect women aged 40 to 60 than men. (05)  Redness, itching, burning, and tenderness can accompany frontal or other pattern hair loss.

Central Centrifugal Cicatrical Alopecia (CCCA)

CCCA is found almost exclusively among black women aged 30 to 55 year-old.  The cause is still unknown and is being researched.  Women who experience CCCA experience inflammation and associated hair loss in the crown area. (06)

Effective Hair Loss Treatment Complements Your Diagnosis

After your dermatologist determines the cause of your hair loss, he or she will discuss treatment options with you.  Keep in mind that hair reversal treatments are not one-size-fits-all.  In some cases, “cocktails” which combine specific medications and protocols may be needed. Just to give you an idea of what’s out there, here are some of the most frequently used medications and treatments:

Minoxidil (Rogaine)

Minoxidil, also known as Rogaine, is available over-the-counter as a topical foam and liquid and by prescription as an oral pill.  Minoxidil is a vasodilator reduces miniaturization of the hair follicles and elongates the growth phase.

Minoxidil has proven to promote growth among men and women with male and female pattern hair loss.  Minoxidil is also often recommended to patients with scarring alopecia to promote growth in unaffected areas.

Once you start using Minoxidil, you need to continue. When you stop using the medication, any new hair that grows will most likely be shed.

Finasteride (Propecia, Proscar)

Finasteride is a 5 alpha-reductase inhibitor originally designed to treat enlarged prostates.  The medication, available both as a pill and a topical solution, blocks the conversion of testosterone to dihydrotestosterone (DHT), a hormone that inhibits hair growth.

Clinical studies have found Finasteride to be highly effective in reversing hair loss in both men and women with scarring and non-scarring alopecias. (0708)  Topical Finasteride is often used to treat androgenic alopecia, while oral is typically recommended for scarring alopecias.

Finasteride is only available by prescription and is not recommended for women of childbearing age.  Check with a board-certified dermatologist to see if you are a good candidate for the topical or oral treatment.

Corticosteroids

Topical or injected steroids are often used to treat hair loss that is induced by autoimmune diseases such as alopecia areata and lichen planopilaris.  The corticosteroids allow hair to grow by inhibiting the autoimmune disease.

Steroid treatments are only available by prescription and should be surprised by a qualified dermatologist.

Platelet-rich Plasma (PRP) Injections

PRP injections have become a popular treatment for healing wounds and regrowing tissue such as tendons, ligaments, and muscles.

PRP has regenerative properties and has been primarily tested on patients with androgenetic alopecia. (09)  When injected into the scalp, PRP is believed to stimulate hair growth by increasing blood flow to the hair follicles and increasing the size of the hair shaft.

As the name suggests, PRP injections are made from platelets derived from your blood.  Blood is first drawn, and then spun at super high speeds to separate the blood components.  The resulting plasma is highly concentrated.

PRP use is still in its early stages and can be expensive.  Research also indicates that PRP is most effective when used with Minoxidil, Finasteride, and other hair growth treatments.

Biotin

Biotin, also known as Vitamin B7 or Vitamin H, has become a familiar hair growth supplement.  Sold in supplements or as an ingredient in hair care products, Biotin is promoted as a way to make your hair grow longer and healthier.

Does it work?  Well, the jury is out.  Not enough research has been conducted to say yeah or nay. (10)  It won’t hurt you to try a new shampoo that contains Biotin, but there’s no evidence to indicate that it will help.  Biotin deficiency is rare. (11)  Most people get adequate amounts through their regular diets.

Many Biotin supplements sold are not FDA approved, and high concentrations of Biotin can interfere with the results of some lab tests. (12) As with any oral supplement, check with your doctor before testing it out.

Hair Transplants

Hair transplant procedures and techniques continue to improve over time.  Rather than using noticeable plugs, today’s surgeries move hair strips or carefully selected hairs from one area to another to promote growth that looks natural.

When determining whether a patient is an ideal candidate for a hair transplant, dermatologists consider several factors, including:

  • Type of hair loss
  • Degree and pattern of baldness
  • Patient age
  • Hair color
  • Donor hair density
  • Patient expectations

Although hair transplants are expensive and time-consuming, they are an effective, reliable, and safe way to get lasting results.

It’s Important to Set Realistic Expectations When Treating Alopecia

We’re fortunate to live during a time when hair loss research is prolific, and the list of hair replacement options is growing.  Whether you’re 25 or 55, you don’t have to live with bald spots, a receding hairline, or thinning hair, even if your genetics or immune system are working against you.

The first step is to find a board-certified dermatologist and hair specialist you trust and get diagnosed.  He or she will help you select the right treatment option for your type of alopecia and lifestyle.  Remember to set realistic expectations for your hair regrowth.  Treatments don’t work overnight, so be patient and track your progress over time.  After all, small signs of stubble today can lead to a fuller head of hair tomorrow.

Resources:

(01) https://www.americanhairloss.org/

(02) https://rarediseases.org/rare-diseases/cicatricial-alopecia

(03) https://www.ncbi.nlm.nih.gov/books/NBK430924/

(04) https://www.aad.org/public/diseases/hair-loss/types/alopecia

(05) https://www.ncbi.nlm.nih.gov/books/NBK470325/

(06) https://jamanetwork.com/journals/jamadermatology/fullarticle/2768748

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

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

(09) https://www.health.harvard.edu/blog/platelet-rich-plasma-does-the-cure-for-hair-loss-lie-within-our-blood-2020051119748

(10) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5582478/

(11) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5582478/

(12) https://www.fda.gov/medical-devices/safety-communications/update-fda-warns-biotin-may-interfere-lab-tests-fda-safety-communication