7 Treatments For Hair Loss And Baldness

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Hair loss and baldness can be an embarrassing disease to have. Before pursuing hair loss treatment, talk with your doctor about the cause of your hair loss and treatment options. 

Medically Reviewed by Dr. K on 17 Dec 2021.

7 Treatments For Hair Loss And Baldness

Because systemic treatments (pills or other forms of treatment that impact your whole system) may interfere with your body’s natural androgen levels, doctors are hesitant to prescribe them. The doctor will first want to know if the hair loss is caused by an excess of androgen in the system or a hypersensitive “over-response" to normal androgen levels. As a result, doctors often choose topical therapies that are administered directly to the scalp.

As chronic androgenetic alopecia may damage many hair follicles, it’s essential to start treatment as soon as possible once hair loss starts. After chronic hair loss, anti-androgens may help prevent additional damage and promote some hair regeneration from dormant but still viable follicles. If the androgens aren’t kept in control in some other manner, stopping treatment will result in hair loss restarting. While using anti-androgen medicines, it’s essential to keep your vitamin and mineral levels in check.

A list of treatments for hair loss in women may be found below. For female pattern hair loss, there is currently just one FDA-approved treatment. The FDA has not authorised others for this use, but they have been approved for other uses and are used to treat hair loss “off-label."

Although the efficacy of these agents and techniques vary from person to person, many women have said that utilising these treatments has improved their hair and self-esteem. Therapies that target both the cause of hair loss and the stimulation of hair growth have the most excellent chance of being successful.

Minoxidil (Rogaine)

Minoxidil was initially prescribed as a pill to treat high blood pressure (an antihypertensive). Patients who were treated with minoxidil experienced excessive hair growth (hypertrichosis) as a side effect. Further studies revealed that topically applying a minoxidil solution to the scalp may also promote hair growth.

When administered topically, the quantity of minoxidil absorbed into the bloodstream via the skin is typically little enough to produce internal adverse effects.

Minoxidil, widely available in generic form and under the brand name Rogaine, seems the same precautions apply for women with diffuse androgenetic alopecia than males. Because the FDA has not authorised the use of the greater dosage in women, the product labelling advises that women only take the 2% concentration of minoxidil, not the 5%.

If administered under the guidance of a dermatologist, many doctors would recommend 5% for women with androgenetic alopecia. According to small clinical studies, the 5% minoxidil solution is considerably more successful than the 2% solution in maintaining and regrowing hair in women with androgenetic alopecia.

Clinical trials of mainly white women aged 18 to 45 years with mild to moderate hair loss found that 19% had moderate regrowth and 40% had little regrowth after eight months of taking minoxidil. 7 % who used a liquid without active minoxidil (a placebo) during the same period experienced significant hair regrowth, while 33% reported little regrowth.

Androgen Receptor Inhibitors

  • Spironolactone (Aldactone)

Spironolactone, also known as Aldactone, belongs to the potassium-sparing diuretics family of medicines (often called water pills). Spironolactone is a medication that is used to decrease fluid in the body without causing potassium loss. It’s also used to treat potassium shortage, hypertension (high blood pressure), oedema (swelling), and hyperaldosteronism (a hormonal condition).

Spironolactone has two anti-androgen effects. First, it reduces testosterone production in the adrenal glands and ovaries. Second, it inhibits androgen activity by inhibiting dihydrotestosterone (DHT) from attaching to the androgenetic receptor.

  • Cimetidine (Tagamet)

Cimetidine, marketed under the trade name Tagamet, is a kind of histamine blocker used to treat gastrointestinal ulcers. The histamine-blocking effect stops the stomach from generating too much acid, enabling the ulcer to heal. Cimetidine has also been found to prevent dihydrotestosterone from binding to follicle receptor sites, making it a potent anti-androgenic agent.

Cimetidine has shown encouraging effects in trials of women with androgenic alopecia. It has been used to treat excess facial hair development (hirsutism) in women. Because high dosages are required to produce results, males should avoid using cimetidine to cure hair loss because it may have feminising effects, including sexual side effects.

  • Cyproterone Acetate

Cyproterone acetate is used to treat intense sexual aggressiveness in males and decrease excessive sexual desire. It’s also used to treat severe hirsutism in women of reproductive age, as well as androgenetic alopecia. Cyproterone acetate works by preventing dihydrotestosterone (DHT) from attaching to its receptors.

Cyproterone acetate is not available in the United States. Doctors consider it one of the final choices for treating female pattern hair loss due to its possible toxicity and long-term adverse effects. Every medication has the potential for side effects other than those listed on the label. Contact your doctor if you notice an unusual or bothersome side effect.

Estrogen and Progesterone

Women with androgenetic alopecia who are going through menopause or whose oestrogen and progesterone levels are low for various reasons may benefit from oestrogen and progesterone tablets and creams.

source - dreamstime

Oral Contraceptives

Birth control tablets may be used to treat androgenetic alopecia in women because they reduce the generation of ovarian androgens. However, keep in mind that whether a woman uses contraceptive pills simply to prevent contraception or to treat female pattern baldness, the same precautions apply. Smokers aged 35 and above who use the Pill, for example, are at a greater risk of blood clots and other severe problems.

Consult your doctor about your medical and lifestyle history. Contraceptive pills exist in various hormonal formulations, and your doctor may help you choose the one that’s best for you, switching tablets if necessary until you’re physically and emotionally comfortable with it.

Hair loss should only be treated with birth control tablets with a low androgen index. Birth control tablets with a high androgen index may induce hair loss by initiating it or allowing it after it has been caused by something else. 

Ketoconazole (Nizoral)

Ketoconazole is a prescription-only topical medication that is presently used to treat fungal infections. It prevents the adrenal gland and reproductive organs from producing testosterone and other androgens (in women, the ovaries).

These anti-androgenic properties may aid in the treatment of hair loss. The Nizoral shampoo includes 2% ketoconazole and treats various scalp problems and androgenetic alopecia in conjunction with other treatments. Over-the-counter versions are now available, although they may not be as effective as the prescription dosage of 2%. There aren’t any noticeable negative effects.

Finasteride (Propecia, Proscar)

Finasteride prevents the synthesis of follicle-damaging dihydrotestosterone by inhibiting the enzyme 5-alpha reductase in the hair follicle (DHT). Hair follicles shrink as a result of DHT, making it harder for healthy hair to survive.

Finasteride was first used to treat the prostate gland under the brand name Proscar. It came in 5-milligram tablets. The first pill approved by the FDA for men’s hair loss was a 1 mg version called Propecia, which hit the market in 1998.

It works well for most men to prevent hair loss and stimulate regrowth, and it may also work for some women, though women should not take it if they are pregnant. Also, due to the potential of birth abnormalities in a male child, women should not get pregnant while taking the medication. While using finasteride, less than 2% of men have transitory sexual adverse effects, such as erectile dysfunction and libido issues. These negative effects, on the other hand, do not occur in women. Discover the difference between finasteride and minoxidil.

Cyproterone Acetate with Ethinyloestradiol (Diane 35, Diane 50)

In Europe, these contraceptive pills are recommended for women with androgenetic alopecia under the trade names Diane 35 and Diane 50. Both forms of this contraception are now unavailable in the United States.

Cyproterone and estradiol, an oestrogen, are combined in the medication. Diane, 35 and Diane, 50, both include 2 mg of cyproterone in them. Diane 35 has 0.035 mg of estradiol in it, while Diane 50 has 0.050 mg.

They operate by inhibiting the effects of masculine hormones that are frequently seen in women. Although the medication may halt future hair loss and stimulate hair regeneration in as little as a year, it must be taken regularly to maintain regrowth and eradicate hair loss.

Breast soreness, headaches, and a reduction in libido are all possible adverse effects.

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