Tag Archive for: Spironolactone

What the Experts Know About Alopecia

Happy Head customer with thinning hair reviewing his progress with our custom topical treatment made my board-certified dermatologists.

Did you know that dermatologists treat more than just skin issues? During their twelve-plus years of training, dermatologists are also taught how to diagnose and treat patients’ hair and nail conditions. That’s why a licensed dermatologist should be your first stop if you’re experiencing hair loss that seems more than the norm. Yes, it’s possible that Covid-19 or the flu temporarily shocked your hair, and it will grow back on its own. However, some types of hair loss require attention. If that’s the case, you don’t want to risk losing valuable time and hair when you could be in treatment.  

So, if seeing hair everywhere but on your head is stressing you out, go ahead and schedule an appointment. Don’t have time to head to an office? Take our online questionnaire and we’ll match you with a dedicated dermatologist to help answer your questions. Don’t worry about your dermatologist thinking you’re crazy or an alarmist. They have seen it all. Meanwhile, here’s a sneak peek at what expert dermatologists know about alopecia and what may be in store for you.  

Alopecia is a Broad Term

Type “alopecia” into Google, and what comes up? Lots of results on alopecia areata. Alopecia areata is one very specific type of alopecia (we’ll talk more about it in a minute). However, there are many different types of alopecia, ranging from there’s nothing you can do but wait for your hair to grow back to it’s time to get on some medication. Alopecia is more of a finding than an actual condition. The word is used by professionals whenever there is some disorder causing hair loss. If you’re losing facial hair, that’s considered alopecia too. So, if your dermatologist uses the word alopecia, don’t worry. It’s a broad term that encompasses many types of hair loss.  

There Are Different Types of Alopecia

Hair loss is not one-size-fits-all. Symptoms and treatments vary based on what type of alopecia you are experiencing. Here’s a primer to help you understand what your dermatologist may look for during your consultation.  

Temporary Hair Loss

Finding hair everywhere but on your head can be upsetting. Before you plan for the worst, though, consider this. Not all hair loss is permanent. Certain medications, illnesses, surgery, and even ultraviolet rays from the sun disrupt your hair’s growth cycle and cause a condition called telogen effluvium. Telogen effluvium is self-limiting, which means that peace will be restored to your scalp once the trigger is removed.  

Insider Advice:  Although hair usually grows back on its own within six months to a year, the waiting game can feel long.  Supplements, thickening shampoos, conditioners, and regular trims can help support healthy hair growth while you wait.  

Genetic Alopecia

Have you ever heard of androgenetic alopecia?  Maybe not, but you’re probably familiar with Male and Female Pattern Baldness (MPB or FPB) which is the same thing.  But wait!  Isn’t that something that only happens to old people?  Well, not exactly.  Anyone who has gone through puberty can experience male or female pattern baldness, a form of genetic hair loss.  As a matter of fact, many people who experience MPB or FPB realize that they started losing their hair before the age of 40. (01)  Androgenetic alopecia is inherited through your family tree and occurs when testosterone converts to a substance called Dihydrotestosterone (DHT).  DHT attaches to your hair follicles and gradually shrinks them until they close up.  Hair falls out in easily distinguishable patterns that can be compared to a Norwood-Hamilton Scale to determine the extent of your hair loss.  

Insider Advice:  Don’t fall for any “grow hair fast” gimmicks.  The most effective way to strengthen and regrow your hair is by using vasodilators and prescription DHT blockers.  Topical or oral Minoxidil, Finasteride, Dutasteride, and Spironolactone are all good options.  Don’t expect miracles overnight, though.  You’ll need to be patient.  It takes six months to a year to see results.  

Autoimmune Hair Loss

Autoimmune diseases occur when your body mistakenly attacks healthy cells in your body. When your hair is involved, your hair follicles are attacked, leaving you scrambling to find ways to fight inflammation that blocks your hair follicles’ openings. Autoimmune hair loss falls into two different categories: Non-scarring and scarring. Alopecia areata is a non-scarring alopecia.  Hair falls out in sporadic round or oval patches on the scalp. In some alopecia areata cases, hair will spontaneously grow back on its own.  

Scarring alopecias behave differently and do what their name indicates. Scars grow over the hair follicles and close them off, leaving doctors and patients to play a game of beat the clock. The goal is to keep hair follicles open and to preserve existing hair before the hair follicles are shrunken to the point where they are closed off.  

Insider Advice: Autoimmune hair loss can be tricky to manage. What works for one person may not work for another. Treatment may also require multiple medications. Be patient through the trial process while your dermatologist determines which combination of medications works best for you.  

Facial Hair Loss

If you’re losing facial hair, it’s nothing to be ashamed of. It’s a real thing called alopecia barbae, and it’s usually autoimmune related. Alopecia barbae can cause hair to fall out in small round patches in men’s beards or mustaches. Hair can spontaneously regrow, or patches may stick around for a while. It’s difficult to predict the condition’s path.

Insider Advice: Don’t feel like you have to live with facial hair loss. Many of the treatments used to treat scalp hair loss can be used on your face too. These treatments may include steroids, topicals such as Minoxidil, or, in extreme cases, a class of medications called JAK inhibitors that calm the immune system.  

Give Yourself Time to Grieve, Then Move On

It’s only natural to go through a grieving process, regardless of the type of alopecia you’re battling. For some people like Congresswoman Ayanna Pressley, hair can be part of your “brand,” something you’re known for. When that hair is gone, you can feel like you’re losing part of your identity. That’s completely normal. Although nobody wants to have any form of alopecia, keep in mind that the awful feeling you get during your diagnosis won’t last forever. Over time, you and the people surrounding you will get used to your new look.

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

If you have difficulty accepting your new normal, try giving yourself a time frame. Say something like, “Self, it’s been a while since I’ve been happy. ’m giving you one more week to be down in the dumps, and then I’m making an appointment for a new haircut.  Then, I’m moving on.” If that doesn’t work for you, a support group or counseling may be what you need to get in the right frame of mind. 

So let’s recap what experts know about alopecia. You’d be surprised how many people suffer from hair loss before consulting a dermatologist. If you think your hair is thinning or balding, get an expert opinion. Your hair woes may be nothing to worry about, or there may be something that can be treated. You won’t know unless you talk with a professional.  

Tight on time? Happy Head can help. Our board-certified dermatologists are available to help answer your pressing questions and help you regrow your hair. Remember one-size-fits-all treatments are a thing of the past, so let’s create a custom treatment that’s formulated to your needs. Fill out our short questionnaire and add a few photos to get started.

Resources

(01) https://pubmed.ncbi.nlm.nih.gov/9865198/

Are These Ordinary Things Damaging Your Hair?

It’s not surprising that elements like chlorine and salt water can make your hair look dry and frizzy.  Or that flat irons, hair dryers, and other heat styling can cause heavy-duty breakage.  Bleach and highlights, well, no surprise there, either.  You’re probably careful about avoiding these known troublemakers, especially if your hair is thinning or balding.  After all, you want the hair that’s remaining to stay as healthy as possible.  It’s difficult to avoid things you don’t know can damage your hair, though.  You don’t know what you don’t know.  So, we’re here to fill you in on some very ordinary things that could wreak havoc on your tresses.  

Hard Water Can Cause Bad Hair Days

Finding the right shampoo and conditioner is usually top of mind when it comes to hair care.  But do you ever think about what kind of water you’re using to wash your hair?  Is the water coming out of your showerhead hard or soft?  Hard water isn’t harmful, but it can be harsh on your hair.  

First, let’s talk a little bit about what hard water is.  When you look at water, you usually see a clear liquid.  What you can’t see is the concentration of minerals and chemicals in the water.  The concentration of minerals, specifically calcium and magnesium, determines your water’s hardness.  The higher the amount of calcium and magnesium, the harder the water.  You may be unable to tell if your water is hard or soft.  A couple of signs that it’s hard are if your drinking glasses get cloudy or your hands still feel slippery after you’ve washed them with soap and water.  

Now, what does hard water mean for your hair?  One research study found that hard water can actually damage your hair. (01)  When hair samples were washed in hard water versus distilled water for 30 days, the distilled water samples were thicker and less crumpled looking.  If your hair is dull, brassy, has a green hue, breaks or tangles easily, check your water. 

If you discover that your water is hard, there are some things you can do to protect your hair.  One option is to use a vinegar rinse  or clarifying shampoo once a week.  Another option is to install a showerhead with a filter.  Whole house water softener filtration systems are also available.  Filters and water softening systems reduce the mineral concentration in the water, leaving your hair softer and silkier.  

Addicted to Hairspray or Gel?

Most of us were not born with that perfect hair we see in ads.  You know what we mean, that glossy, thick hair that falls exactly into the right place, even in the rain and wind.  So, we resort to the next best thing.  Hairspray or gel that freezes our hair in place and gives us that extra hold.  It works, right?  But is it really good for you?  

Hairspray or gel probably won’t make your hair fall out.  They could, however, dry out your hair and cause breakage.  Alcohol, ethanol, parabens, and fragrances tend to cause the most damage.  Also, formulas that clog your hair follicles could make it harder for new hair to grow.  If you can’t live without something to give your hairstyle a little extra hold, look for products that contain all-natural and hydrating ingredients such as argan oil and biotin.  

What about sea salt sprays?  They’ve become popular for adding volume and texture.  Are they okay since salt is a natural ingredient?  Yes and no.  In moderation, sea salt spray is fine.  Too much, however, will have the same drying effect as you get when swimming in the ocean.  Salt strips the moisture out of your hair.  

Stressed Out?  Here’s An Excuse to Treat Yourself to a Massage.

It’s not surprising that stress takes a toll on our minds and our bodies.  Headaches, digestive issues, heart disease, and more have all been linked.  This one may surprise you, though.  Hair loss can be directly related to stress.  Think about it.  When you get stressed, your body reacts involuntarily by getting tense.  Your blood vessels constrict, and there isn’t as much oxygen flowing to your scalp and hair follicles as usual.  And when your hair follicles don’t feel the love, they can’t sustain or produce healthy hair.  The technical term is called telogen effluvium.  Fortunately, stress-induced hair loss can resolve itself over time.  Meanwhile, a good massage, 30 minutes a day with a meditation app, or a brisk walk may be just what the doctor ordered.

Avoiding Your Barber or Stylist

Growing your hair out?  Too busy to get in for a haircut?  You may want to squeeze in time for an appointment.  When you go too long between visits, you can end up with split ends.  Split ends mean that your hair is more likely to break higher up near the shafts.  The longer you wait between cuts, the higher the damage to your hair strands.  Trims every four to six weeks will help keep your hair healthier and stronger.  

It May Be Time to Change Your Pillowcases

This one may seem far fetched but stay with us.  Switching to silk pillowcases may help keep your hair healthier.  If your pillowcases are cotton, the fibers could be rough.  If that’s the case, your hair rubbing against the fibers could cause tangling and breakage.  You know what it takes to get a knot out of your hair.  Extra brushing and yanking leads to breakage.  The fibers themselves could also cause breakage.  Cotton is known for absorbing oils as well. Silk pillowcases do a better job of allowing your hair’s natural oils to stay on your head where they belong rather than on the pillowcase where they could cause acne.  

Yet Another Reason to Quit Smoking

If you’re a smoker, you probably don’t want another lecture on quitting.  You’ve heard it all, or so you thought.   Did you know that smoke from cigarettes can damage your hair follicles?   When you smoke, your body is exposed to toxic chemicals, including formaldehyde and arsenic.  These and additional toxins damage the structure of your blood vessels. Some of those blood vessels affect your heart.  Other vessels lead to your head and scalp.  When the blood vessels are exposed to the toxins and shrink, the blood flow to your hair follicles is reduced.  That means new, healthy hair can’t be produced.  Existing hair may fall out.  

Your Genetics May Be Working Against You

If you notice that your hair is thinning or balding, you may be experiencing androgenetic alopecia, male or female pattern hair loss.  It’s a genetic condition that affects a large percentage of the population.  Men who experience the condition see a receding hairline.  Women usually notice a widening part.  Hereditary hair loss can occur any time after puberty, so even people in their 20s may be affected.  The best way to know for sure is by checking with your dermatologist.  If it turns out that your hair loss is due to androgenetic alopecia, medications including Minoxidil, Finasteride, Dutasteride, and Spironolactone are available to stop the shedding and stimulate hair growth.  The medications help enlarge shrinking hair follicles and prevent your hormones from converting to androgens that cause hair loss. 

Can Damaged Hair be Repaired?

If damage is already done, is there anything you can do to repair your hair?  Take heart.  All is not lost.  First, stop using any offending products.  If the damage is stems from smoking, stress, or other behavior, lifestyle changes will help.  If your hair is thinning or balding, it’s always good to consult with your dermatologist.  As mentioned, you may be experiencing male or female pattern hair loss or another type of alopecia that can be managed with the right treatment.  

Not sure what’s damaging your hair?  Our hair growth experts are here to help.  All of our doctors are board-certified dermatologists experienced in diagnosing and treating conditions that affect your hair.  They’ll be able to help you figure out if your hair is damaged from something you might not be aware of or if you have a form of alopecia that can be treated. We also offer customized treatments ranging from thickening shampoos and conditioners to prescription hair regrowth formulas.  Best of all, you can order from your couch and receive your delivery at your front door.   Get started now!

 

Resources:

(01) https://pubmed.ncbi.nlm.nih.gov/30034190/

Is Minoxidil (Rogaine) Safe for Women?

You may be familiar with Minoxidil that’s used to treat thinning hair and bald spots.  The medication was initially tested, marketed, and FDA-approved for men with male pattern baldness.  If you’re a woman experiencing hair loss, you may wonder if Minoxidil is safe and effective for you too.  After all, Minoxidil is available under the brand name Rogaine over the counter at most big box retailers and pharmacies.  It’s easy to buy and use.  

Dermatologists Often Recommend Minoxidil to Their Female Patients

Minoxidil is safe, and it’s the medication most often recommended to women by dermatologists to treat their hair loss conditions.  Before you run to the store, though, there are a few things you should know.  

Minoxidil Is FDA Approved for Women

If you’re considering using Minoxidil to treat your hair loss, you’ll be happy to know that the five percent topical foam and solution was FDA-approved for women in 2014.  The medication was used off-label for women before it was approved.  Why is FDA approval notable?  Because it means that the manufacturer proved that its product is safe and effective for its intended use.  FDA approval also means the product is manufactured to federal quality standards.  

Higher Doses of Minoxidil are Available by Prescription

Oral and topical Minoxidil doses above five percent are available to women but only off-label by prescription.  Don’t be concerned about using prescription medication off-label, though.  The FDA knows that medical providers do that.  Off-label means that dermatologists may prescribe a drug for use that isn’t approved when the provider determines that the medication is medically appropriate.  

Minoxidil Is Used to Treat Female Pattern Baldness and Other Hair Loss Conditions

Minoxidil is most often recommended and prescribed to treat androgenetic alopecia, commonly known as female pattern baldness.  Female pattern baldness occurs in women who are genetically predisposed to hair loss.  When women experience this condition, they typically see hair loss along their parts first.  Over time, the part widens as the hair in the area continues to thin and fall out.  While men who experience male pattern baldness can lose all of their hair over time, women typically don’t.  Women are more likely to see diffuse thinning on the crown of their heads.  

Minoxidil is often prescribed for other hair loss conditions as well.  Dermatologists often recommend Minoxidil to their female patients with alopecia areata, frontal fibrosing alopecia, lichen planopilaris, and other types of alopecia.

Minoxidil is Available to Women in Different Forms and Doses

Liquid & Foam Rogaine

If you go to the store, you’ll find foam and liquid Minoxidil in two and five-percent formulas.  Minoxidil is the same as Rogaine.  You may also find generic store brands of Minoxidil under names such as Equate and Kirkland Hair Regrowth Treatment, which contain the same active ingredients.  

Initially, only two percent formulas were marketed for women.  However, research indicates that higher doses are more effective for treating female pattern hair loss.  Although both two and five percent solutions increased hair growth, the five percent demonstrated statistical superiority over the two percent. (01)  When choosing between the liquid and foam, you may want to consider foam that does not contain propylene glycol which can be an irritant to some women. 

Oral Minoxidil

Oral Minoxidil is an alternative to topical and is available by prescription.  The medication is effective in regrowing hair in women with female pattern baldness. (02)  Oral Minoxidil was initially tested in higher doses to treat high blood pressure.  When used to treat genetic hair loss, much lower doses are prescribed.   

Minoxidil with DHT Blockers

The most effective treatments attack hair loss from different angles.  Women often use Minoxidil simultaneously with DHT blockers such as Finasteride or Spironolactone.  Minoxidil enlarges the hair follicles, while Finasteride or Spironolactone prevents testosterone from converting to DHT.  When DHT is blocked, it can’t bind to the receptors in your hair follicle so your hair won’t be at risk.  

Customized Topical Minoxidil Formulas

Treatments for female pattern baldness may differ from woman to woman.  What works for one may not work for another, which is why customized formulas are often best.  The most effective treatments attack hair loss from different angles.  A benefit of customized formulas is that Minoxidil can be prescribed up to 10 percent, which is significantly higher than what’s available over the counter.  Retinol can be added to increase absorption, and cortisone can be added if necessary to prevent irritation from higher concentrations of Minoxidil. Many women also like the convenience of having all of the hair loss medications they need to be compounded into one formula rather than having to take or use multiple medications.       

Minoxidil Side Effects are Usually Minimal

Minoxidil users usually don’t experience many side effects.  Topicals can cause some redness, flaking, and irritation.  However, eliminating propylene glycol usually resolves the issue.  Oral Minoxidil was originally tested and marketed to treat high blood pressure.  Because oral medications are systemic, side effects such as a fluctuating heart rate are possible.  Side effects are rare, though.  Doses of oral Minoxidil prescribed for hair loss are typically significantly lower than for high blood pressure.  

Minoxidil Can Cause Initial Shedding

If you’ve been researching Minoxidil for your hair loss, you may have heard about the “dread shed” that can occur when first using Minoxidil.  Yes, some women find that they lose more hair at first.  The reason why is because Minoxidil speeds up your hair’s growth cycle.  The resting phase occurs faster than it otherwise would.  Everyone doesn’t experience an increase in shedding.  However, If you do shed initially, don’t panic.  Your hair’s growth cycle will regulate within a few weeks.  

Trying Minoxidil is the Best Way to Determine Whether it will Work for You

It would be nice if there were a way to know whether Minoxidil will help regrow your hair.  A response test has been designed and marketed to do just that.  The test measures the amount of sulfotransferase enzyme activity in plucked hair follicles to predict whether or not Minoxidil will be effective. Research indicates that the sulfotransferase activity predicts treatment response with 93 percent sensitivity and 83 percent specificity. (03)  There’s a catch, though.  

The test will only help determine if women will respond to two or five percent topical Minoxidil.  The test does not indicate whether or not women will potentially respond to higher topical dosages or to oral Minoxidil.  It also does not indicate whether Minoxidil will be effective when used with a DHT blocker such as Finasteride or Spironolactone.  The best way to know if Minoxidil will work is by trial.  It typically takes six to twelve months to see results. 

If you have been diagnosed with female pattern baldness and are thinking about trying Minoxidil, here’s the takeaway.  Minoxidil is safe for women to use and has been proven to be an effective treatment for many.  Minoxidil often works best with Finasteride, Spironolactone, or another DHT blocker.  A topical with a percentage higher than five or oral Minoxidil will require a prescription.  If you have more questions about whether Minodixidl is right for you, Happy Head’s board-certified dermatologists can help.  Contact us and our hair growth experts will help select the best solution for you, without a visit to the doctor’s office. 

 

Resources:

(01) https://pubmed.ncbi.nlm.nih.gov/15034503/

(02) https://pubmed.ncbi.nlm.nih.gov/32851744/

(03) https://pubmed.ncbi.nlm.nih.gov/24773771/

 

Your Holiday Hair Loss Guide

‘Tis the season for parties, spending time with family and friends, and traditional holiday meals.  It’s the most wonderful time of the year, right?  Well, not for everyone.  Some people dealing with hair loss find that the holidays bring a whole new level of angst about their appearance.  You may plan to visit friends and family members you haven’t seen since last year, or even longer.  And, for sure, you’ll end up in some of those pictures posted on Facebook or Instagram.  Finding the perfect outfit is one thing, but trying to camouflage your thinning or balding hair is a whole different story.  Is that even possible?  Before you RSVP “no” to your next invite and pull out the flannels, take a deep breath and check out the following tips.  You can find joy during the holidays, even when battling male or female pattern baldness or another type of alopecia.     

Give Yourself a Break

It can be hard to accept that your looks are changing.  You may not look like you did last year.  Or, even like you did a few months ago.  That’s okay.  It’s time to stop comparing the new you to the old you.  You’re probably harsher on yourself than others would be.  When you see balding, thinning hair in the mirror, others may not even notice or care.  They’re more likely to remember the funny story or joke you told.  It’s true.  While someone may remember what you look like, research indicates that others are more likely to remember how you make them feel when you’re around. (01)  Do the best you can to turn off your inner critic, and remember that how you interact with others makes you uniquely attractive, not your hair.   

Go Out and Stay Involved

Arg.  Every time you look in the mirror, it seems like there’s more hair missing.  You’re grumpy and don’t feel like talking to or seeing anyone.  How can you go out looking like that?  So, instead of going to your friend’s holiday party, you put on your baggiest sweats and start binge-watching Dahmer while downing a pizza.  Good idea, right?  Nope.  According to the American Psychological Association, that’s the worst thing you can do. (02)  Social isolation can not only affect your sleep, but also cause depression and lower your immunity.  It can have long-lasting psychological effects.  You’re better off rallying and forcing yourself to go to the party.  Socializing will get your mind off your hair loss, even if it’s for a bit.  Talking to other people will also help you feel less alone and put you in a better mood.  

De-stress

Controlling stress is important for everyone’s health and well-being.  It’s especially important if you’re dealing with hair loss.  If you’re already experiencing male or female pattern baldness or another type of alopecia, you definitely do not want stress-induced hair loss too.  The holidays are a particularly tricky time for managing stress, though.  Family drama and searching for the perfect gift when there’s limited inventory can push anyone over the edge.  The good news is that there are ways to manage.  Here are some ways to help you de-stress:

1. Get enough exercise

Get outside or to the gym if your hair loss is giving you the holiday blues.  Physical activity not only makes your body feel better, but it’s also good for your mind.  Exercising may help increase your endorphins, putting you in a better mood after.  Bonus is that exercise increases the blood flow to your scalp.  This means that more oxygen and nutrients are helping kick your hair’s growth phase into full gear.  

2. Sleep

Not only does sleep calm and restore your body, but it can also help hair growth.  Your body produces melatonin primarily at night.  Some studies even suggest that melatonin supplementation helps promote hair growth among people with male and female pattern hair loss. (03)

3. Pamper yourself

We’re going to put this out there.  Sometimes the best way to relieve stress is to pamper yourself.  Whether that’s a massage, listening to holiday music, or reading a book doesn’t matter.  Whatever makes you let go and relax works.  

4. Set a budget and stick to it

It’s easy to get burdened with extra debt and associated worries about how you will pay for all of those gifts during the holidays.  Prevent that from happening by setting a budget and making sure that you stick to it.  

5. Set a schedule

So much to do and so little time.  The holidays will be here before you know it.  How are you going to get everything done in time?  Writing your to-dos down will help you manage your time and expectations.  You’ll find time for the most important tasks, and you might even schedule some downtime.  

6. Accept imperfections

Acknowledge that the holiday may not go as planned, and remember that imperfections are healthy and normal

7. Remember what’s important

Keeping perspective when you’re stuck in a long line or annoyed with a relative can go a long way toward keeping you calm.  Will another 10 minutes really change your day?  Does it matter that your sister wants to bring stuffing instead of pie?  

8. Be patient

You can’t change others’ behavior, but you can choose how you respond.   If a situation gets tense, take a few deep breaths and focus on an appropriate response versus a quick reaction.  

Get a New Do

Maybe you’ve been letting your hair grow out, hoping to cover the balding or thinning areas.  Or, perhaps you’ve been afraid to cut your hair because you’re worried it might not grow back.  The holidays are the perfect time to visit your stylist and try out a new look.  Remember, androgenetic alopecia is the most common form of hair loss.  Millions of people are experiencing the same condition you are.  Your barber or stylist probably has a few tricks to help you get party-ready. 

Consider Treatment Options for Your Hair Loss

Accepting that your hair is thinning or balding isn’t easy, especially when you’re active and social.  The good news is that you don’t have to accept your fate.  The best way to deal with hair loss is by fighting it.  Fortunately, medications with high efficacy have been tested and are available.  

The most effective hair loss treatments are vasodilators and DHT blockers. Minoxidil is a vasodilator, which increases blood flow to your scalp and hair follicles.  More oxygen enlarges the hair follicles allowing existing hair to remain stable and healthy.  It also allows new hair to emerge.  

Prescription DHT blockers serve a different purpose.  Male and female pattern baldness occurs when testosterone converts to Dihydrotestosterone (DHT).  DHT is what attacks your hair follicles and makes your hair fall out.  DHT blockers prevent the conversion.  The most commonly prescribed DHT blockers are Finasteride, Dutasteride, and Spironolactone.  Because Minoxidil and  DHT blockers treat hair loss from different angles, the two medications are often used simultaneously.  Retinol may be prescribed as well to increase the absorption of the other medications.  If irritation is a concern, low doses of cortisone can be added.  All-in-one topical formulas prevent side effects and can be more convenient than oral medications.

Research Alternative Hair Loss Solutions

Prescription medications are a great choice for many people; however, there are alternative hair loss solutions that can help camouflage your hair loss and give your confidence a boost.

Hairpieces

Looking for a quick fix?  Today’s hair pieces come in a wide variety of materials, textures and styles.  Testing them out can be fun and can give you a fresh new look that will make you ready to rock the room.

Scalp Concealer

Some people with male and female pattern baldness swear by cover-up sprays and powders.  The tint of color is just enough to conceal balding or thinning areas.  A wide variety of colors are available to make a good color match, and the concealers are designed to be long-lasting.  

Hair Transplants

If your hair loss is stressing you out and you don’t have the patience to wait for other treatments to work, you can always treat yourself to a hair transplant.  Hair transplants are surgical procedures where healthy hair is moved from the back of your head to the front.  Hair transplant practices have evolved over the years and produce a more natural look than ever before.  Transplants can be pricey and aren’t usually covered by insurance since they’re considered cosmetic procedures.

Talk About It

It’s normal to be upset about losing your hair, but if your hair loss is starting to interfere with your holiday plans, you may need a support system.  Using a therapist, meeting up with a group locally, or even joining a Facebook group for people with alopecia can help you feel less alone and develop coping skills.  Finding a way to talk about your feelings may be one of the best gifts you give yourself this holiday season.

If the idea of stopping your hair loss and regrowing your hair brings you happiness and joy, what are you waiting for?  It’s time to get more information on customized hair growth solutions.  The best part about our prescription-grade solutions is that ingredients can be added or removed based on your particular needs.  Get started now and check out our special edition holiday pack.

Resources:

(01) https://pubmed.ncbi.nlm.nih.gov/25750481/

(02) https://www.uvu.edu/news/2020/04/04072020_isolation_mental_health.html#:~:text=The%20American%20Psychological%20Association%20reports,have%20long%2Dlasting%20psychological%20impact.

(03) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3681103/

 

7 Reasons Why Your Hair Is Falling Out (And How to Stop It)

It’s easy to fall down a rabbit hole when doing internet research.  A pimple can turn into cancer or flesh-eating disease in minutes.  The same thing can happen when you lose your hair.  First, you see a few strands of hair on the shower floor.  Then, you find hair all over your towels and pillowcases.  Worst of all, you’re starting to see receding, thinning, or balding areas.  Before you know it, you’re online typing “Why is my hair falling out?” into the search bar.  In no time, you’re convinced that you have some rare, fatal illness that’s making your hair shed.  The truth is that there are some simple explanations for why you may be losing your hair.  Although we don’t recommend self-diagnosis (we’ll talk more about that later), here are the most common reasons your hair may fall out.  

1. You Can’t Fight Genetics

If one of your parents or relatives experienced thinning or balding hair, you might be next in line.  Male and female pattern baldness, androgenetic alopecia, is passed from generation to generation and can stem from either side of your family.  Male pattern baldness accounts for 95 percent of hair loss in men. (01)  Although genetic hair loss is typically considered a “guys issue,” androgenetic alopecia is the most common cause of hair loss in women also.

How do you know if your hair loss is hereditary?  There are some tell-tale signs, namely specific patterns of hair loss.  Men usually see their hairline receding into an “M” shape.  The circular area on the back of their heads thins and expands to create an “O” shape.  Men can go bald from the condition.   Women, on the other hand, don’t usually go completely bald.  Instead, they get diffuse thinning that begins on the part line and expands out.  

If your hair loss is hereditary, early action with the right medication can help slow down or stop your hair loss and help regrow new hair.  Minoxidil is a well-known option that prevents or reverses the miniaturization of the hair follicles.  It allows existing hair to remain healthy and new hair to grow.  DHT blockers are often needed in conjunction with Minoxidil to prevent testosterone from converting to DHT and attacking your hair follicles.  The most commonly prescribed DHT blockers are Finasteride, Dutasteride, and Spironolactone for women.  

2. You’re Having an Autoimmune Response 

Some types of alopecia are due to an autoimmune disease called alopecia areata.  Before you freak out, though, consider this.  Your lifetime risk of experiencing alopecia areata is only 2.1 percent. (02)  Alopecia areata causes circle-shaped patches of hair loss on various parts of your scalp.  Hair can spontaneously regrow without any treatment.  However, some people experience relapse.  Alopecia areata is diagnosed via visual examination, blood tests, and possibly a small biopsy.  

First-line treatments may include corticosteroids and Minoxidil.  A psoriasis medication called Anthralin or Oluminant, a new medication that was recently FDA approved, may be prescribed for more severe cases.  

3. You’ve Had Surgery or Been Sick

You may not realize that surgeries requiring anesthesia and illnesses that cause high fevers can cause a temporary type of alopecia called telogen effluvium.  Some people who had severe cases of Covid were affected.  When there’s a rapid increase in stress levels in your body, your hair goes into a type of shock called telogen effluvium.  Telogen effluvium speeds up your hair’s growth cycle and pushes it into the resting stage.  During the resting stage, your hair falls out.  The disruption is temporary, though, and usually only lasts for a few months.  After that, your growth cycle gets back on track, although it may take a few months more to see regrowth.  

4. You’re Stressed Out

If you’ve been under a lot of pressure at work or are experiencing a breakup, the stress could take a toll on your hair.  During a 2021 study, researchers discovered that a particular stress hormone called corticosterone can impair the stem cells needed to promote hair growth in mice.  When mice were subjected to mild stress for many weeks, corticosterone levels increased, resulting in telogen effluvium. (03)  Life happens, and you can’t always get rid of your stressors, so finding ways to manage your stress may help if you  notice hair loss.  Exercise, deep breathing, meditation, progressive muscle relaxation, and connecting with others are good ways to unwind and help your body reset its hair growth cycle.  

5. Your Hair Needs Some TLC

Do you know why Ariana Grande first started wearing her signature high ponytail?  It was because her hair was damaged by the dye she used while filming the series Victorious.  Yes, harsh chemicals and hairstyles, such as tight braids pulling on your scalp can make your hair break or fall out.  Straightening treatments, including Brazilian blow-outs, are also very harmful.  If your hair is suffering, there are still things you can do to make it healthy again and prevent further hair loss.  A hair mask or deep conditioning treatment can bring some moisture back.  A haircut can remove dead ends.  If your hair is falling out due to traction alopecia, hair loss caused by pulling on your hair too much, don’t despair.  Your hair will grow back once you stop damaging it.  If you find that your hair isn’t growing back, be sure to check with your dermatologist.  

6. You’re Experiencing Side Effects From A Medication

Hair loss isn’t one of the side effects usually listed on medications, and it’s relatively rare, but it can happen.  Antidepressants, certain nonsteroidal anti-inflammatory drugs (NSAIDs), thyroid medications, steroids, and hormone replacements can be culprits.  If you think one of your medications could be to blame, don’t stop taking it.  Always consult with your doctor before making any changes.  

7. Your Lifestyle Could Use Some Improvement

We’re human, and we all have some vices.  But iif you’re concerned about your hair falling out, it may be time to rethink your lifestyle.  Let’s start with smoking.  Smoking could affect your hair by causing vasoconstriction and damaging your hair follicles.  If you’re prone to androgenetic alopecia, it can also make you produce more DHT. (04) 

Then there’s alcohol.  There isn’t any scientific evidence out there that indicates that drinking alcohol affects your hair.  Excessive drinking, however, can cause or contribute to medical issues that could affect your hair.  Remember how we talked about stress causing telogen effluvium?  Alcohol in excess could become a stressor if it affects your overall health.  

You may also want to evaluate your diet.  Certain foods can increase testosterone, which can potentially convert to DHT.  Processed and sugary foods are an example.  Too much sugar can cause your body to produce more insulin, increasing androgens.  According to Dr. Ben Behnam, board-certified dermatologist and founder of Happy Head, people who are concerned about hair loss should also choose their protein carefully.  Caged chickens produce more testosterone due to the stress of being held captive.  It’s best to choose free-range chicken.  Whey protein is also an excellent source of protein, but choose the type you use carefully.  Whey protein isolate is highly processed and can contribute to hair loss, while whey protein concentrate supports hair health and regrowth.  

Early Hair Loss Treatment is the Best Hair Loss Treatment

Now that we’ve shared the most common reasons why our patients experience hair loss, we want to go back to why we don’t recommend self-diagnosis.  The key to reversing hair loss is catching it early and beginning treatment while your hair follicles are still viable.  You could lose valuable treatment time If you diagnose yourself and are wrong.  Be sure to visit your dermatologist for an exam.  

We’re Here to Help

If you don’t have access to a dermatologist or have questions about whether hair loss treatment is right for you, we’re here to help.  Simply answer some brief questions designed to help us better understand your hair loss concerns, and a board-certified dermatologist and hair specialist will be assigned to your case.  

 

Resources:

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

(02) https://www.naaf.org/alopecia-areata

(03) https://www.nih.gov/news-events/nih-research-matters/how-stress-causes-hair-loss

(04) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9069908/#:~:text=Smoking%20may%20lead%20to%20hair,enhancing%20senescence%20and%20hormonal%20effects.

 

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.

Is There a Genetic Test that Can Predict Hair Loss?

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

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

Can Alopecia Really be Inherited?

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

What’s the Link Between Genetics and Pattern Baldness?

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

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

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

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

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

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

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

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

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

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

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

Are There Other Causes of Hair Loss Besides Genetics?

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

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

Can You Prevent Hereditary Hair Loss?

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

Can You Reverse Hereditary Hair Loss

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

 

Resources:

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

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

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

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

 

Everything You Need To Know About Finasteride Interactions

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

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

Finasteride is a Leading Treatment for Male and Female Pattern Baldness

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

Finasteride Increases the Testosterone Levels in Your Body

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

Finasteride Interactions are Uncommon

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

Avoid Interactions with Other Medications by Using Topical Finasteride Versus Oral 

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

Some Medications Make Finasteride Work More Effectively

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

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

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

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

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

Alternatives to Finasteride

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

Dutasteride

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

Spironolactone

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

PRP

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

Hair Transplant Surgery

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

Low-light Laser Therapy (LLLT)

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

Be Honest About Your Medical History

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

Is Finasteride Right For You?

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

Resources:

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

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

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

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

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

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

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