Tag Archive for: Spironolactone

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/

 

The Real Story Behind Vitamins that Prevent Hair Loss

I hate to start with a spoiler, but I’m going to start with a spoiler.  Neither vitamins nor supplements are FDA-approved or regulated for any type of hair loss.  Or, for any other health condition for that matter.  This means that information required to establish safety and effectiveness has not been submitted to or approved by the FDA.  Yet, do an Amazon search using the terms “vitamins for hair loss,” and pages and pages of products appear with assurances that the vitamins will help you regrow your hair.  Biotin, keratin, saw palmetto, and proprietary collagen blends are just a few that pop up on the first page, with prices varying from $11 to over $176.  Trying to figure out which ones are effective and worth the investment can make your head spin.   

If your hair is thinning or balding, it’s smart to question whether vitamins will help or if manufacturer promises are too good to be true.  So which ones do dermatologists and hair specialists recommend?  We’re here to answer your questions and set the story straight.  

Get Diagnosed Before You Buy Vitamins to Treat Your Hair Loss

Before you even think about trying any vitamins, you need to start with a diagnosis.  After all, you need to know what condition you’re treating.  Here are the three most common types of alopecia that cause either temporary or permanent hair loss:

  • Telogen Effluvium

Telogen effluvium is a type of temporary hair loss that can occur up to several months after a traumatic or stressful incident.  The condition can be triggered by various events, including high fevers, surgery, certain medications, nutritional deficiencies, and autoimmune diseases.  When physiologic stress occurs, hairs that would normally be in a growing phase are abruptly pushed into a resting phase, resulting in shedding.  The shedding can occur in either small or large amounts.  While hair loss from telogen effluvium can be upsetting in the short term, the long-term prognosis for regrowth is good.  No medication is typically needed.  Hair usually grows back within six months to a year.  

  • Androgenetic Alopecia

Androgenetic alopecia is also known as male or female pattern baldness.  The hair loss condition occurs when too much testosterone converts to an androgen called dihydrotestosterone (DHT).  The condition is genetic and can come from either the maternal or paternal sides of your family.  The hair loss pattern among men with androgenetic alopecia differs from that of women.  Men tend to lose their hair on the front and top of their heads.  Women usually notice their hair loss first along their widening center parts.  Oral and topical medications have been proven to help prevent further hair loss and facilitate growth.  

  • Alopecia Areata

Alopecia areata is an autoimmune hair loss condition that can affect women, men, and children.  Hair loss is usually noticed first in small round or oval patches.  In some cases, hair spontaneously regrows, and in others, the hair loss becomes permanent.  Treatment usually focuses on treating any underlying conditions and using topical and oral medications.

Determining whether you have one of these forms of alopecia is a multi-step process.  Your dermatologist will likely order blood work as part of the diagnostic process.  The lab results will indicate whether vitamin deficiencies could be contributing to your alopecia.  If so, you may benefit from supplementation.  

Vitamins are Helpful When People with Alopecia Have Deficiencies

Much conflicting information exists about the role that vitamins and supplements play when it comes to hair loss.  More research is clearly needed.  The general rule of thumb when it comes to vitamins is to supplement if there’s a deficiency.  Particular deficiencies can be associated with the three types of alopecia we discussed.  Here are the three most common:

Vitamin D

Research has demonstrated that people with telogen effluvium, androgenetic alopecia, and alopecia areata are likely to have vitamin D deficiencies. (01)  The greater the deficiency, the greater the hair loss.  Vitamin D is absorbed into the skin by keratinocyte cells.  The cells process keratin which is found in your hair, nails, and skin.  When your body has a vitamin D deficiency, the keratinocytes in your hair follicles have difficulty regulating the growth and resting phases of the hair cycle.  

Iron

In addition to checking for Vitamin D3 deficiencies, dermatologoists typically check their patients’ iron levels. Iron deficiency inhibits hemoglobin production which produces the oxygen responsible for hair cell growth and repair.  Low iron is a common cause of alopecia and can easily be remedied with a supplement.  

Biotin

People don’t typically have Biotin, Vitamin B7, deficiencies in industrialized countries.  A regular diet typically provides enough nutrients to ensure adequate levels.  However, some research studies have demonstrated that biotin deficiencies often exist in people with hair loss. (02)(03)  Experts have conflicting views on whether biotin supplements are necessary, even when there’s a deficiency.  It’s best to consult with your dermatologist on this one.  

Should You Take Vitamins if You Don’t Have a Deficiency?

Even if you don’t have a deficiency, it’s tempting to take vitamins to see if they will help regrow or thicken your hair.  More isn’t always better though, especially in this case.  Taking too many supplements or the wrong type of supplements can create issues.  For example, extra vitamin A or vitamin E can cause hair loss, which is what you are trying to prevent in the first place.  

Prescription Medications Are Often Used With Vitamins to Get Better Results

If your dermatologist doesn’t think that you are a good candidate for vitamin supplementation, prescription medications may be a good alternative.  This is especially true if you have been diagnosed with male or female pattern baldness.  Medications commonly prescribed include:

Minoxidil (FDA Approved)

A vasodilator designed to enlarge the hair follicles so you can start to regrow your hair.  

Finasteride, Proscar, Propecia (FDA Approved)

A medication that blocks the conversion of testosterone into DHT that attacks your hair follicles.

Dutasteride, Avodart (Not FDA Approved)

A DHT blocker prescribed as a second-line medication if Finasteride does not give the desired results.

Spironolactone (Not FDA Approved)

A DHT blocker prescribed only to women as a second-line medication if Finasteride does not give the desired results.

Minoxidil and Finasteride are both available in oral and topical formulas.  Topicals are often preferred, especially among men, because they do not cause sexual side effects such as lower libido.  Topical medications have been proven to be just as effective as oral medications.

The most effective hair loss plans often combine vitamins and other over-the-counter treatments with prescription medications. Vitamin D, Minoxidil, and Finasteride would be a logical combination if a person with androgenetic alopecia has a vitamin D deficiency.  Prescriptions that effectively combine multiple topical medications into one are available and are convenient and easy to use.  

Some Supplements Have Shown Moderate Improvement in Hair Loss

Although they are supplements rather than vitamins, there has been a lot in the news lately about pumpkin seed oil, saw palmetto, and rosemary oil.  While not quite as effective as Finasteride, these supplements have demonstrated a significant increase in hair growth. (04)  These supplements may be a good adjunct therapy when combined with prescription hair loss medication.

Curcumin, the active ingredient derived from turmeric, is known as a natural anti-inflammatory.  Interestingly, curcumin did not improve hair growth on its own, but it did give positive results when combined with Minoxidil.  The hypothesis is that the curcumin helped the Minoxidil better penetrate the scalp.  However, more research still needs to be conducted.  

Garlic gel, derived from onions, scallions, shallots, leeks, and chives, doesn’t live up to the hype.  Users did not see a significant difference in hair growth.  

As with any product you try as a hair loss solution, make sure to consult with your dermatologist first.  Even products that seem innocuous can have side effects or contradict other medications.  Your dermatologist is the best person to evaluate your treatment plan and determine the best mix of prescription and over-the-counter options.  

What To Do If Vitamins Aren’t the Answer to Your Hair Loss

Vitamins can be helpful if your bloodwork indicates that you have certain deficiencies.  If not, proceed with caution.  Even the most effective supplements aren’t typically as strong as prescription medications to slow hair loss and stimulate growth.  If you need an alternative solution for your thinning or balding hair, Finasteride, Minoxidil, and other medications are effective and are available by prescription.  For more information about your options, contact us.  Our board-certified dermatologists and hair specialists are available to answer your questions and make recommendations based on the type of alopecia you have.  We can even customize a formula to meet your specific needs.

Resources:

(01) https://pubmed.ncbi.nlm.nih.gov/34553483/

(02) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4989391/#:~:text=Biotin%20deficiency%20was%20found%20in,risk%20factors%20for%20biotin%20deficiency.

(03) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6388561/

(04) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6388561/

(05) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6388561/

 

DHT Blockers: Fight Hair Loss with These Powerful Weapons

Men are willing to do just about anything besides see a doctor.   Given a choice, 72 percent of men would rather clean the bathroom, mow the lawn, or do any other household chores. A lot of men aren’t even getting their yearly check-ups. (01)   So when it comes to hair loss, not many guys are rush to the dermatologist for a diagnosis and medication.  But they should.  

The most powerful hair loss weapons against male pattern baldness are only available by prescription.  Sure, there’s an endless number of products sold over-the-counter claiming that they work, but the reality is that they aren’t powerful enough to get the job done.  This is true for women who have female pattern baldness too.   

If your hair is thinning or balding, a DHT blocker may be just what the doctor ordered.  Read on to learn more about what DHT is, why DHT is causing your hair loss, and why DHT blockers may be the solution to your hair loss issues.  

What is DHT?

Dihydrotestosterone (DHT) is a sex hormone, known as an androgen.   Androgens are typically produced in males’ testicles and women’s ovaries.  The adrenal glands also produce androgens.  DHT is a little different than other androgens, because it is converted from testosterone.  Men naturally have more testosterone in their bodies than women, however, an enzyme called 5-alpha reductase (5-AR) converts about ten percent of testosterone in all adults to DHT.  

How Does DHT Cause Hair Loss?

When too much testosterone converts into DHT, the excess amounts of DHT interfere with your hair’s growth cycle.  The hair follicles miniaturize, make existing hair fall out, and prevent new hair from breaking through.    

Will a Blood Test Tell Me If I’m Producing Too Much DHT?

It seems logical that DHT levels can be monitored since testosterone levels can be checked.  That’s not the case, though.  DHT levels may fall within the normal range on a blood test but still be elevated enough to cause male or female pattern baldness.  This is especially true if your body is sensitive to DHT.  When testosterone levels increase, DHT has the potential to be an even bigger problem.  

Can I Prevent Androgenetic Alopecia?

Unfortunately, there isn’t a way to predict whether or not you’re going to lose your hair.  Androgenetic alopecia, male and female pattern baldness, is genetic.  If a family member on either your maternal or paternal side has gone bald, there’s a chance that you could too. The only catch is that you don’t have a way of knowing whose or which genes you inherited.  

Men on testosterone replacement therapy or get testosterone injections often ask if the medication will contribute to their hair loss.  Depending on the patient’s sensitivity, the supplemental testosterone could cause an increase in DHT leading to increased hair loss.  

Is Overproduction of DHT Just a Guy Problem?

When people think of androgenetic alopecia, men typically come to mind.  Bruce Willis, The Rock, Matthew McConaughey, Jeff Bezos are all prime examples.  You don’t see too many bald or balding female celebrities.  The reality is that a significant number of women are affected although the number isn’t as high as it is for men.  One research study found that out of 954 patients diagnosed with pattern baldness, 23.9 percent were women. (02)  Women typically have a lower level of testosterone; however even when lower levels of testosterone convert to DHT, hair loss can occur.  

What Can You Do to Reduce the DHT Levels in your Body?

The most effective way to reduce your DHT level is to use a DHT blocker.  If you’ve been dealing with hair loss issues for a while, you’re probably well aware of the overwhelming number of over-the-counter (OTC) hair loss options.  It’s not unusual for patients to spend a lot of time and money with these products before giving up and turning to their dermatologists for prescription options. 

Prescription DHT blocking medications reduce the amount of 5a-reductase enzyme, which converts testosterone into DHT in your body.  Here are the DHT blockers most commonly prescribed by dermatologists and hair specialists:

Oral & Topical Finasteride 

Finasteride is one of the most well-known DHT blockers.  The medication was FDA approved in 1992 under the name Proscar to treat enlarged prostates and five years later under the name Propecia to treat androgenetic alopecia.  Although both men and women can use Finasteride, it is not recommended for use in women who are or could become pregnant.  

Oral Finasteride is highly effective as a hair loss treatment.  One research study found that 80 percent of participants who took Finasteride saw an increase in hair growth. (03)  However, some people who take oral Finasteride report undesirable sexual side effects, including decreased libido.  A good solution is using topical Finasteride rather than oral.  Topical Finasteride has been proven to be as effective as oral without the side effects in many studies. (04)  

Topical Finasteride Combined With Minoxidil

Minoxidil is not a DHT blocker, but it has an important role in hair growth for people with male and female pattern baldness.  Minoxidil is what’s called a vasodilator.  It enlarges the blood vessels so more oxygen reaches the scalp.  As a result, it makes the hair follicles bigger so new hair can emerge.  Minodixil and Finasteride are a dynamic duo when used together to fight hair loss.  The Finasteride prevents the testosterone from converting into DHT while the Minoxidil ensures that your scalp is conducive to new hair growth.  A research study conducted in 2020 found that the combination of Finasteride and Monoxidil was safe and more effective than monotherapy. (05)

Dutasteride

Dutasteride, also known as Avodart, is another DHT blocker originally developed to treat enlarged prostates.  It is also a 5-alpha reductase inhibitor.  Although Finasteride and Dutasteride work similarly, the medications have some differences.   Whereas Finasteride is FDA-approved to use for hair loss, Dutasteride can only be used off-label.  It has not yet been FDA-approved.  Finasteride is usually highly effective in treating androgenetic alopecia and is typically used as a first-line medication.  In cases where patients need an extra boost, Dutasteride can be helpful.  Research has shown that men who used Dutasteride for 24 weeks had thicker hair than men who used Finasteride. (06) 

Spironolactone

Spironolactone is FDA approved to treat high blood pressure, heart failure, and fluid retention due to kidney and liver diseases.  It is not FDA-approved to use for hair loss and is used off-label for women.  Spironolactone typically isn’t prescribed to men because it can cause feminizing side effects.  Like Finasteride and Dutasteride, Spironolactone slows down androgen production.  The medication has been found to be both safe and effective. (07)

How Do DHT Blockers Work?

Now that you have a better idea of what DHT blockers are available, the next question that needs to be answered is how do they work?  The mechanics behind the prescription medications approved or used as DHT blockers are similar.  First, preventing testosterone from converting to DHT inhibits the miniaturization of the hair follicles.  Secondly, when the levels of scalp DHT are lowered, the number of hairs in the anagen phase are maintained or increased.  Think of anagen as the active phase of the hair growth cycle.  This is when the cells in the roots of your hair divide rapidly and form new hair.  Elongating the anagen stage gives your hair more time to grow.  

Get More Information On Prescription DHT Blockers

If you’re experiencing androgenetic alopecia and want more information on DHT blockers, contact us.  If, like many, you haven’t yet been to a dermatologist, free phone consultations are available with board-certified dermatologists and hair specialists.  

Formulas are available for men and women and can even be customized based on your specific needs.  We are happy to remove or add ingredients as needed and appropriate.  You can also see before and after photos of our patients.  You can get an idea of what you can realistically expect to see after using Happy Head hair loss solutions that block the DHT causing your alopecia.

Resources:

(01) https://newsroom.clevelandclinic.org/2019/09/04/cleveland-clinic-survey-men-will-do-almost-anything-to-avoid-going-to-the-doctor/

(02) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5312176/

(03) https://pubmed.ncbi.nlm.nih.gov/15316165/#:~:text=In%20the%20clinical%20evaluation%20at,the%205%25%20topical%20minoxidil%20group.

(04) http://www.bioline.org.br/pdf?dv09011

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

(06) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6388756/

(07) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3769411/

 

What You Need to Know about Smoking and Hair Loss

If you’re a smoker, you’re probably already well aware of why you should quit. Between your family using every scare tactic in the book and chilling public service announcements featuring people suffering from various types of cancers and lung diseases, you know the risks more than anyone. Beating the addiction is hard, though.  In fact, it’s so difficult that 80 percent of people who try to quit smoking on their own start again within a month. (01)

Just in case you need a little more incentive to kick the habit for good, consider this: according to several research studies, nicotine can induce hair loss.  Sure, you know how harmful cigarettes and vapes are to your body, but you probably didn’t expect to go bald from them.  What else do you need to know about the effects of smoking on your hair?  Keep reading, and we’ll fill you in on the latest.  

Nicotine Accelerates Hair Loss

Not only can continual use of nicotine lead to a heart attack, but it is also believed that smoking may be responsible for accelerating hair loss.  One study found that 85 percent of men who smoked had a form of androgenic alopecia, male pattern baldness.  Among the men in the non-smokers’ group, only 40 percent exhibited signs of male pattern hair loss.  The difference in hair loss was significant.  The study used the Hamilton-Norwood Scale, which categorizes hair loss on a scale of one to seven, with one being the least amount of hair loss.  In the smoker group, 71 percent had grade III or grade IV hair loss.  However, in the non-smoker group, only ten percent of the participants reached grade III or IV. (02)

Smoking Ages Your Scalp 

So the next question is, why do experts believe smoking leads to hair loss?  You know how smoking is known for giving people leathery alligator skin?  It has the same effect on your hair.  The reason why stems from a few different factors.  

  • Smoking reduces the blood flow to your hair follicles.

When you smoke, your blood vessels constrict, limiting how much blood flows to your organs.  Over time, the continual constriction stiffens the blood vessels and makes them less elastic.  When this happens, your cells don’t get the amount of oxygen and nutrients needed to thrive.  When your hair follicles are deprived of oxygen, miniaturization occurs, disrupting your hair’s growth cycle.  The hair follicle shrinks and eventually blocks the growth of new hair.   

  • Breathing in smoke can damage your hair’s DNA.

Smoke causes environmental effects that inhibit hair growth.  DNA contains genetic material that serves as our hair’s building blocks.  When carcinogens from cigarette smoke damage the DNA, keratin, a protein that makes-up 95 percent of your hair, cannot be produced. 

  • Smoking causes inflammation. 

Smoking stimulates follicular inflammation, a key feature in male and female pattern hair loss.  In a 2020 research study on androgenic alopecia, approximately 71 percent of biopsy samples of patients with male or female pattern baldness showed signs of inflammation. (03)

  • Smoking decreases estrogen levels.

It is well documented that smoking decreases estrogen levels in women, which can lead to earlier onset of menopause.  When estrogen levels drop, hair grows slower and thinner.  Lower estrogen levels also lead to an increase in androgens which cause female pattern baldness. (04)

  •  Smoking prematurely turns your hair gray.

In an observational research study, people who smoked were two and a half times more likely to have gray hair before age 30 than non-smokers. (05)  The study mentioned that the cause of premature graying is not yet known.  One hypothesis is that melanocytes, the cells responsible for producing color, are damaged in people who smoke.  

If You’re Thinking About Getting a Hair Transplant, Stop Smoking

Many reputable dermatologists and hair specialists refuse to perform hair transplants on patients who smoke.  The reason why is because oxygen is critical to the survival of transplanted follicles and helping the wounds heal.  Smoking causes poor blood circulation, which could result in the death of the skin tissue on the scalp and even post-operative infections. (06)  Another reason why is because nicotine in the blood vessels increases bleeding and inhibits clotting during the healing process. 

Vaping Can Cause More Damage Than Traditional Cigarettes 

What about vaping?  It’s safer than smoking cigarettes, right?  Not exactly.  Vaping has skyrocketed in popularity across all ages groups in the past few years due to the sweet taste and lack of stale smell. What many people don’t realize, however, is that JUUL, MarkTen Elite, PAX Era, and most other types of e-cigarettes contain more nicotine than traditional cigarettes.  

Although no studies are available, anecdotally, one can make the connection that nicotine from vape pens is equally harmful, if not worse, for your hair than traditional cigarettes.  Regardless of the source, nicotine has been proven to cause oxidative stress, which can impair your hair’s growth and cause hair loss. (07)

The Jury is Out on Marijuana

Recreational marijuana is currently legal in 19 states, Washington D.C., and Guam. (08)  Marijuana must not be harmful if it’s legal, right?  Well, the jury is out.  A study conducted in 2007 by the University of Debrecen indicates that the THC in marijuana can lead to hair loss. (09) 

Marijuana contains cannabinoid compounds.  Tetrahydrocannabinol (THC) and Cannabidiol (CBD) are the most well-known.  THC is the main psychoactive compound.  It’s the one that makes people feel high.  CBD is derived from hemp plants and does not cause a high or lead to addiction.  When it comes to your hair, THC is the troublemaker.  According to the study, the THC in marijuana can attach to receptors in your body, including your hair follicles, which causes hair loss.  Not much research has been conducted since to qualify or negate the study.  

We believe that the study is accurate because marijuana and other drugs can be detected in hair samples for up to 90 days prior to the test. (10)  It makes sense that if the THC attaches to the follicles and sticks around for a while, it could cause damage.  

Treatment is Available to Reverse Hair Loss Caused By Smoking

Treatment is available if you’re experiencing hair loss from cigarettes, vapes, or marijuana,.   The first step is to stop smoking to prevent further damage.  The next step is to consult with a dermatologist who is also a hair specialist.  Although many hair loss remedies are available over the counter, the most effective ones are only available by prescription.  A variety of medications can be prescribed to stimulate regrowth including:

Minoxidil

As mentioned previously, smoking can cause androgenic alopecia in people who are predisposed.  When people get male or female pattern hair loss, their hair follicles shrink.  Minoxidil enlarges miniaturized hair follicles to allow stronger, healthier hair to go to the surface of your scalp.  

Finasteride 

People who smoke and have male or female pattern baldness produce a chemical called Dihydrotestosterone (DHT) that is converted from testosterone. DHT attacks the hair follicles and causes the hair to fall out.  Finasteride is a DHT blocker that prevents testosterone from converting to DHT.  

Spironolactone

Sprionolactone is a DHT blocker.  The medication works similarly to Finasteride but is a bit stronger.  

Retinoids

Retinids are often used in conjunction with Minoxidil and Finasteride to increase absorption of medications that treat androgenic alopecia.

In many cases, combinations of these medications are most effective in promoting hair growth among former smokers.  For example, Minoxidil combined with Finasteride and Retinol for absorption has been proven more effective than Minoxidil alone.  

Quitting is the Best Way to Preserve Your Hair

 

If you’re really worried about losing your hair, the best route is to quit smoking.  Kicking the habit isn’t always easy, but it’s worth it. You’ll look better and your health will improve. 

 

According to the American Cancer Society, the best strategy is to quit one day at a time.  A day turns into a week, a week turns into a month, the months turn into years, and before you know it, you’ll have broken the habit.  Sure, it sounds simple, but we realistically know it’s not.  Here are some other helpful tips:  

  • Stay busy and spend time in public places where smoking is prohibited
  • Replace the feeling of holding a cigarette or joint with a paper clip, marble, or coin
  • Chew gum or eat lollipops as a substitute
  • Avoid places, activities, and people that you associate with smoking
  • Exercise
  • Create a support system of family members and friends who you can call when you have a craving

 

Many good resources and programs are available to help you as well.  Here are three that we recommend.  All of these organizations provide trusted information and support.

American Cancer Society 

If you’re considering quitting, you don’t have to do it alone.  During The Great American Smokeout annual event, thousands of people commit to a smoking cessation program on the third Thursday in November.

American Lung Association

The American Lung Association offers a Lung Helpline & Tobacco Quitline staffed by licensed registered nurses, respiratory therapists, and certified tobacco treatment specialists.  The staff is a wealth of knowledge and can help connect you with a support group, find a doctor, and even answer questions about health insurance.

National Cancer Institute

Smokefree.gov, sponsored by the National Cancer Institute, offers free tech programs to help you go smokefree.  One innovative program is a texting service that gives encouragement, advice, and tips to help you quit.  The organization also offers apps that allow you to tag locations and time of day you need support, as well as social media support.

If you are a current or former smoker and your hair is thinning or balding as a result, Happy Head is here to help.  Contact us so we can review your history and customize a prescription-grade hair loss solution for you.

 

Resources:

(01) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2928221/

(02) https://onlinelibrary.wiley.com/doi/10.1111/jocd.13727

(03) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7667670/

(04) https://www.karger.com/Article/Abstract/68894

(05) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3673399/

(06) https://pubmed.ncbi.nlm.nih.gov/7484781/

(07) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2758082/

(08) https://www.usnews.com/news/best-states/articles/where-is-marijuana-legal-a-guide-to-marijuana-legalization

(09) https://faseb.onlinelibrary.wiley.com/doi/epdf/10.1096/fj.06-7689com

(10) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5396143/

 

Why Self-diagnosing Your Hair Loss is a Bad Idea

“When did you graduate from medical school?” my husband asks me on a regular basis.  I didn’t, but I am a self-proclaimed expert in the medical field anyway.  Why wouldn’t my Google education make me highly qualified to diagnose the whole family’s symptoms and illnesses?  Evidently, I’m not the only one self-diagnosing.  A survey conducted in March 2020  indicated that nearly one-third of all Americans do their own medical research. (01)

Being your own doctor can work against you though.  In fact, when I first started losing my hair, I didn’t even think to have it checked.  Based on what I read, postpartum hair loss is normal, and I had two babies in two years.  I would never in a million years have guessed that I had alopecia.  However, knowing what I know now, I do not recommend waiting to consult with a medical professional if you’re noticing an unusual amount of hair loss.  Treating hair loss early helps you prevent further shedding and even regrow your hair.  Here are seven more reasons why you should schedule an appointment with a board-certified dermatologist and hair specialist if you’re concerned about the amount of hair you’re losing. 

Reason #1:  Dermatologists are familiar with hair loss patterns associated with specific hair loss conditions.  

Your dermatologist has spent countless hours studying and memorizing the different types of hair loss.  Many times, just looking at patients’ hair loss patterns gives your dermatologist clues as to where to start with a work-up to get a diagnosis.  Common hair loss conditions and associated patterns are:

  • Androgenic alopecia (men) – Receding hairline and gradual thinning on top
  • Androgenic alopecia (women) – Widening of the part 
  • Alopecia areata – Patchy or circular bald spots on the head, eyebrows, or beard
  • Telogen effluvium – Overall thinning due to sudden hair loss
  • Fungal infection – Scaly patches that spread over the scalp
  • Alopecia totalis – Full-body hair loss

If your dermatologist suspects that you have androgenic alopecia, known as male or female pattern baldness, he or she may use the Norwood scale, a scale of 1 to 7, to track the progression of your hair loss.  The scale helps your dermatologist recommend the best possible treatment options to prevent further hair loss and stimulate growth based on the amount of recession or thinning you have.  

Reason #2:  Your doctor can determine the severity of your hair loss

Losing a certain amount of hair is normal and is part of the hair growth cycle.  How do you know if the amount you’re seeing in the sink or shower is too much?  You don’t.  However, once your dermatologist has an idea of your hair loss pattern, he or she has a number of tools and tests he or she can use to determine the extent of your hair loss.  The most common are:

Pull Test

A pull test is pretty much as the name indicates.  During the test, your doctor will gently tug on small sections of hair from parts of your scalp.  Usually, the litmus test is six or more strands.  If you lose that much, your hair loss is active.  

Scalp Biopsy

A scalp biopsy, also known as a punch biopsy, is often used to determine what type of alopecia you have. It allows pathologists to see inflammation and can distinguish whether the alopecia is scarring or non-scarring.  To take the biopsy, your dermatologist numbs the area and uses a pencil-sized device to remove a small amount of tissue that is sent to a lab for analysis. The incision is closed with a couple of small stitches.   

Trichometric Analysis

If your dermatologist wants to analyze your scalp and hair, he or she may do a trichometric analysis using a small handheld device with a high-definition camera.  The device magnifies images by up to 100 times so your hair, hair follicles, and scalp can be seen in great detail.  The tool shows how much hair is covering your scalp, and the diameter of each hair strand.  Dermatologists often use this camera to monitor progress after you begin treatment.  

Fungal Culture

If your dermatologist suspects that your hair loss is due to a fungus in your hair or scalp, he or she may run this test.  Fungal cultures determine if a condition called tinea capitis, scalp ringworm, is causing your hair loss.  During the test, a small sample of skin or hair is sent to a lab for incubation.   

Reason #3:  Your vitamin levels may need to be checked

Often one of the first questions dermatologists often ask new patients is whether they have recently had a routine blood test.  The reason why is because simple vitamin deficiencies can cause hair loss.  Fortunately, if this is the case, supplements will usually solve the problem quickly and easily.  The two most common vitamin deficiencies that cause hair loss are vitamin D and iron.  

Studies have shown that vitamin D has anti-inflammatory properties and affects the hair cycle. (02)  When your body has a vitamin D deficiency, regulation of the hair follicles is challenging.  Growth and shedding cycles are disrupted causing your hair to suddenly fall out.

Iron deficiency stunts the production of hemoglobin which transports oxygen to the cells in your body, including the cells that make your hair grow.  The hair follicles lack the nutrients they need to thrive.  With an iron deficiency, hair sheds and thins, giving the appearance similar to androgenic alopecia.

 

Reason #4:  Your hormones may be out of whack

 

Your dermatologist may also run blood tests to check for hormonal imbalances.  Hormone imbalances can cause hair to get dry, brittle, thin, or fall out altogether.  The only way to know if this is the case is to have your levels checked.  

Contrary to popular belief, high or low testosterone is not an indicator of hair loss.  Research has continually demonstrated that there is not a link between serum androgen levels and androgenic alopecia. (03)  Instead, male pattern baldness could be linked to an androgen sensitivity or high androgen density. 

Factors that can affect your hormone levels include:   

Menopause

Estrogen levels fall before, during, and after menopause while testosterone levels inversely increase.  During the process, the testosterone converts to dihydrotestosterone (DHT) which attacks your hair follicles, and makes your hair fall out.  

Stress

Stress is a bigger contributor to hair loss than most people realize.  When you are stressed out, your body creates cortisol which disrupts the function and regulation of your hair follicles as well as your hair growth cycle.  

Pregnancy

During pregnancy, estrogen levels rise, causing your hair to get fuller and thicker. After the baby is born, however, those levels drop rapidly, making the excess hair shed.  It can take a while for your estrogen levels and hair loss to balance out.  

Thyroid

Both hypothyroidism and hyperthyroidism have been linked to alopecia.  In a 2013 study, patients aged 21-40 with thyroid disfunction were likely to have diffuse alopecia and alopecia areata.  Patients older than 40 were more likely to have alopecia areata and androgenic alopecia. (04)  The findings confirm the importance of checking thyroid levels when there is a hair loss issue.  

Reason #5:  You could have a scalp infection 

A number of scalp infections can cause hair loss.  These infections can easily be confused with various types of alopecia, but once treated, hair typically regrows.  Examples include:

Ringworm

Ringworm is a fungal infection that forms scaly, raised, red patches.  Itching is a common complaint among patients with scalp ringworm and is typically treated with anti-fungal medications.  

Scalp Psoriasis

Psoriasis is an autoimmune condition that causes thick red patches, and sometimes scaling.  There isn’t a cure, but proper management can help prevent hair loss.

Seborrheic Dermatitis

Seborrheic dermatitis causes dandruff in adults, characterized by dry, flaky skin, and typically does not cause hair loss.  Shampoos and topical medications are often recommended. 

Lichen Planus

Lichen planus causes inflammation and can leave tiny red bumps on your scalp.  The cause is not known for certain, although autoimmune dysfunction is one of the possible causes.  Topical creams are often used to treat symptoms, but in many cases, lichen planus will disappear without treatment.  

Your dermatologist has been trained to address and treat all of these infections.

Reason #6:  Sometimes you need an outside perspective

When your dermatologist takes your medical history, he or she may be able to identify bad habits that are affecting your hair and contributing to your hair loss.  Some of these habits may include:

  • Smoking
  • Poor diet filled with processed foods
  • Stress
  • Tight buns, ponytails, braids, or other hairstyles that can pull on your hair and cause traction alopecia
  • Compulsively pulling on your hair (trichotillomania)

Reason #7:  The most effective medications are only available by prescription

Hair loss products are similar to skincare products in that very few over-the-counter (OTC) products are truly effective.  If you have a graveyard of barely or partially used tubes and containers under your bathroom sink, you get the picture.  The reality is that besides Minoxidil which is sold OTC as Rogaine in a 5 percent formula, you’re wasting your money on OTC hair loss products.  You’ll need a doctor to write a prescription.  Some of the most effective and widely used prescription hair loss medications that your doctor may prescribe are:

Minoxidil

Designed to enlarge the hair follicles and prevent miniaturization.  Used to treat a broad spectrum of hair loss conditions.  

  • Sold OTC in foam and liquid formulas
  • Available by prescription in higher dose pills and topical formulas

Finasteride

Prevents testosterone from converting to DHT, which attacks the hair follicles and causes hair loss.  Often used to treat male and female pattern hair loss.  

  • Available only by prescription
  • Reported sexual side effects such as lower libido by some users
  • Used by both men and women, but not recommended for women of childbearing age
  • Topical formula is proven to be equally as effective as the pill without the undesirable side effects since it is not systemic.  

Retinol

A derivative of Vitamin A that improves the absorption of Minoxidil, Finasteride, and other medications that stimulate hair growth.

  • Typically not used as a stand-alone hair loss solution
  • Low OTC doses not as potent as prescription doses

Spironolactone

A DHT blocker used to treat female pattern hair loss.

  • Available only by prescription
  • Safe for women who have not been through menopause

When to see a doctor

In a 2015 study conducted by the National Library of Medicine, nearly one-third of people surveyed reported avoiding the doctor, even those with major health problems. (05)  The result was later detection, reduced survival rates, and more suffering than necessary.  You won’t die if your hair falls out, but why lose your hair if you don’t have to?  If you are experiencing hair loss, be sure to seek medical treatment from a licensed dermatologist.   Early medical intervention not only prevents further hair loss but in many cases, can help you regrow your hair.  

If you have hair loss concerns and if accessibility and/or affordability is an issue, visit us at happyhead.com.  You will have the opportunity to consult with one of our board-certified dermatologists and hair specialists.  No insurance or co-pay is required.  You only pay for the product if deemed necessary and appropriate.

Resources:

(01) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7084283/#:~:text=Surveys%20suggest%20that%20a%20large,self%2Ddiagnose%20using%20online%20information.

(02) https://pubmed.ncbi.nlm.nih.gov/34553483/

(03) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7432488/

(04) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3746235/

(05) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4351276/#:~:text=People%20often%20avoid%20seeking%20medical,survey%20reported%20avoiding%20the%20doctor.&text=Even%20individuals%20with%20major%20health,12%20avoid%20seeking%20medical%20care.

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/