Seunga (Jasmine) Han, PharmD Candidate
Treating Hair Loss
As mentioned in our previous article, hair loss is a common concern in adults and has significant impact on psychological aspect of an individual such as self-esteem and mood changes.1,2 For those of you who have been struggling through this battle, we’re here to provide you with some list of options and tips associated with them.
Minoxidil, also known as Rogaine®, belongs to the class of medication called piperidinopyrimidines. Though its mechanism of action seems to be unclear, it’s believed to be effective in the treatment of androgenic alopecia (male- and female-pattern hair loss).1
- 2% solution: approved for male-pattern hair loss only
- 5% solution/foam: approved for both male- and female-pattern hair loss
Here’s an important tip for you: minoxidil is most effective when started early before the area becomes completely bald. If you were to apply the product on a daily basis, you can expect to see results within two months, with maximum effects around 1 year.1
Don’t be too alarmed if you notice increased hair shedding, as it’s a common occurrence in the first two months of the treatment. This will go away with time in about few weeks. While minoxidil is well tolerated, some may experience skin irritation on areas where you apply the product due to one of the ingredients called propylene glycol. Since 5% minoxidil foam formulation is free of this ingredient, there is less scalp irritation.1
A word of caution is that, if you have any cardiovascular diseases, it’s worth talking to your doctor due to its effects on heart rate and blood pressure. Additionally, minoxidil is not recommended in pregnant women due to limited evidence; however it seems like there is minimal exposure of the medication in breast milk.1
5-Alpha Reductase Inhibitors
Finasteride works by reversing or stalling the progress of hair loss by inhibiting an enzyme called 5-alpha reductase which is responsible for conversion of testosterone to its derivative. Unlike minoxidil, it takes up to 3-6 months of regular daily use for effects on hair loss and up to 12 months before effects on hair regrowth. Just like minoxidil, the hair growth stops with the discontinuation of the treatment. While it may help with hair loss, it also comes with a catch – it has undesirable side effects such as:1
- Decreased libido
- Decreased semen volume
- Erectile dysfunction.
While these side effects may reduce with time, discontinuation of treatment may or may not reverse these side effects. There is limited evidence for use of finasteride in females and should never be handled by pregnant women or those who may become pregnant due to the risk of feminization of the male fetus. However, there is very low concentration of finasteride in semen, and there is no risk to a fetus through sexual intercourse.1
Dutasteride is another medication in this class of medication and has shown to be effective in males with androgenic alopecia with similar side effects and precautions as finasteride.1
Options For Female-Pattern Hair Loss
For ladies with female-pattern hair loss may be devastated by the fact that there are limited options available for you. Based on current evidence, it seems like while studies are being done on hormone therapy with combined oral contraceptives, cyproterone, drospirenone, flutamide and spironolactone, there is limited evidence to make recommendation.
One Final Note
Followed by a single use of these agents, you could also try a combination of various therapy to increase efficacy. Some studied combinations include:1
- Finasteride plus minoxidil
- Finsteride plus ketoconazole shampoo (nizoral)
- Topical or systemic therapy and transplant procedures
The Bottom Line
Unfortunately, it seems like there isn’t a cure available for hair loss in both males and females. Additionally, there are some precautionaries involved with each treatment options. As a result it’s important for you to consult your health care provider before you start one.
We hope you took away something valuable from this piece. If you have any questions or concerns regarding this article or others, feel free to reach out to us on Instagram, Facebook, or at firstname.lastname@example.org with your feedback. We’d love to hear from you.
- DynaMed Plus