Non Surgical Hair Loss Treatments?
Hair loss is a progressive and changing condition. Although hair transplant surgery may be able to restore hair where it is “lost”, this procedure does not address the ongoing thinning. Although no medication can stop the process of genetic hair loss, there are medications that can slow it down and improve the overall appearance of the scalp.
Finasteride is an FDA-approved oral medication that treats genetic male hair loss. It’s sold under the names Propecia or Proscar in the US. Finasteride blocks the conversion of Testosterone to Dihydrotestosterone, or “DHT”, which is the hormone that causes hair loss. Finasteride is often cited as the most effective of all “preventive” medications. Young patients with a lot of hair to keep for many years are particularly vulnerable. Finasteride can be very effective for the right patient. However, there have been concerns about its possible side effects. A medication such as finasteride can have a wide-ranging and systemic impact because it alters the hormone profile. Side effects of finasteride can include brain fog, gynecomastia (breast growth), and many other conditions. Most concerning are the possible sexual side effects. These include decreased sexual drive (“libido”) and changes in ejaculation. According to the official study by the pharmaceutical company, sexual side effects are only seen in 2% of patients. They disappear after discontinuing the medication. A large Japanese study found that less than 1% of patients experienced these side effects, and that they disappeared after discontinuing the medication. Patients seem to have a higher incidence of these symptoms and some claim that they continue even after discontinuing the medication. Some even claim they last forever. Although it is not clear whether these effects are “psychological” and “physiological”, patients have reported persistent effects. The best data is clearly the objective information from studies that have been reviewed by the US FDA. However, it is crucial for patients who are considering taking the medication to evaluate all the possible “pros” as well as “cons” to determine if the medication is right for them.
Importantly, finasteride should only be prescribed for male patients. DHT is an important hormone in fetal development and can lead to serious birth defects. All women over the age of 18 must not come in contact with finasteride, even if they aren’t trying to have children. Although some doctors may recommend finasteride to post-menopausal females, it is generally not recommended for all females.
Some pharmacies and clinics now offer a topical finasteride solution. The topical solution is applied directly to the scalp, as opposed to the oral pills. The producers and users of topical finasteride want to reduce or eliminate the severity of the full-body side effects. Topical finasteride is not well-studied nor proven safe or effective for human consumption. It is difficult to create solutions that penetrate the scalp. Additionally, it is unclear how finasteride can be transported through the skin – even if it is accompanied with a suitable penetrative device. There are not many companies that make topical finasteride. Therefore, the solutions and the concentrations of finasteride in them can vary widely. Topical finasteride users claim it is less effective than the oral medication, or they experience side effects. This suggests that people who experience less efficacy may be using a solution that is not capable of reaching the hair and working on its follicles. Those experiencing side effects could have been using a medication that can reach the scalp but is still “systemic” and causing widespread side effects. Doctors who treat hair loss do not recommend topical finasteride.
Topical minoxidil is the only approved preventive medication for hair loss. Minoxidil is sold under the name “Rogaine” in the US. It comes as a topical or liquid solution that can be applied to the scalp up to twice daily. Minoxidil was initially used to treat high blood pressure. The mechanism that slows down progressive hair loss is not fully understood. Minoxidil is reported to have a variety of effects by patients. Some patients experience a noticeable slowing down of hair loss and thickening (thinning of hairs in the crown and mid-scalp). Others report only minor benefits and say that minoxidil creates more of an “haze” of short, fine, colorless hair on their scalp. This is not a visible cosmetic benefit. Patients report that minoxidil can cause hair loss and a dependence. They also notice a rapid decrease in the amount of progress they made after quitting the drug. Minoxidil is available in both male and female forms and is the best treatment for female hair-loss sufferers. Minoxidil can also be taken as an oral tablet or in high-concentration topical form. However, they are both susceptible to more serious side effects and should not be used for hair loss treatment.
Vitamins and Supplements
You can search online for “hair loss medication” to find hundreds of “miracle” solutions. However, most of these herbal or natural treatments do not have any effect on hair quality or hair loss. Many claims claim that they can alter the hair follicle cycle, fight the causes of progressive hair loss, and even activate an unknown growth factor. Most of these claims are unproven and often false. Companies can make whatever claims they want about herbal supplements. Some vitamins, such as the well-known biotin, can make your hair grow faster or look healthier. However, no one has proven that these supplements are effective in preventing hair loss. Your hair will need the right supplementation. A good diet and a daily multivitamin are enough. You can expect to shrink your wallet and not see your hair grow if you go beyond this.
“Hair Loss Shampoos”
The “hair loss shampoo” market is much like herbal hair-loss supplements. It’s a highly unregulated industry full of unsubstantiated claims. Many “hair loss” shampoos have ingredients that are not proven to be beneficial. Many shampoos claim to increase hair thickness by containing caffeine, herbal supplements or proteins. These ingredients are not only unproven and ineffective, but also make it nearly impossible for shampoos to penetrate the hair and reach the follicles. Ketoconazole may be the best hair loss shampoo out of all the options. Ketoconazole can be used as an anti-fungal or anti-inflammatory agent. It can be applied to the scalp to reduce inflammation that is associated with the progression of hair loss. The inflammation can be reduced, which may result in a slower hair loss process and healthier scalp overall. These claims have not been reviewed or approved by any regulatory bodies. However, many patients use ketoconazole based shampoos (“Nizoral”) in combination with proven treatments minoxidil (and finasteride). This trio is affectionately known as the “big three” preventive hair loss treatments. Many patients believe that ketoconazole-based shampoos are a crucial component of a successful regimen. Ketoconazole, as minoxidil, can cause a dry and irritating scalp. Patients with sensitive scalps, such as those with naturally dry scalps, may not be able tolerate it.
Dermarolling is a popular online treatment. A patient uses a roller with small, sharp pins that measure 0.5mm to 1.5mm in diameter and rolls it over their scalp. The sharp pins can penetrate the skin by rolling the device over the scalp, causing small injuries. The derma-rolling process can cause significant bleeding depending on how vigorously the roller is rolled and the depth to which the pins penetrate. Dermarolling is based on the physiological of wounding, wound healing. The body releases growth factors when the skin is injured by a cut or burn. Some research suggests that these growth factors can also stimulate hair follicle activity, and promote hair growth, similar to PRP. A 2013 study that compared dermarolling with minoxidil to a control group found a significant difference in wound healing. This led to a surge in patients who recommend dermarolling. However, dermarolling results can be inconsistent. Dermarolling is not recommended for hair loss. It may be accepted for dermatological problems like acne scarring, but it is still not well-researched. Many doctors believe that dermarolling can cause fibrosis, or scarring under the skin, which could lead to hair loss. Dermarolling is considered an experimental treatment, and therefore is not recommended by many hair loss specialists.
Low Level Laser Therapy (LLLT)
Low-level Laser Therapy (LLLT) is similar to PRP and dermarolling. It was first used in other areas before it was applied to hair loss. LLLT was first proposed as a treatment for shrinking tumors in the 1960s and 1970s. Although it wasn’t proven to shrink tumors, doctors began to believe that it could have other benefits. They started using it to treat pain, arthritis, wound healing and nicotine addiction. Cool “laser light”, which is emitted by low intensity diodes, is used to treat the skin during LLLT. It works in a similar way as common “laser pointer” devices. LLLT’s theory is that the light emitted by the devices penetrates the skin, stimulating cell function. There is very little to no barrier to laser treatment. Many people are shady about LLLT’s abilities and make outrageous claims about it. The evidence that LLLT can treat many things is not strong. It is claimed that it works only at certain light wavelengths, and any other range of light is ineffective. Multiple studies have not shown any benefit, even for wavelengths that are “correct”. This is also true for LLLT, which can be used to treat hair loss. Many “experts” extol the benefits of laser hair loss treatment. However, research conducted in 2015, 2014 and 2015 did not find any statistically significant benefits. Some studies suggested that there might be a positive correlation, but this was only a tentative conclusion. This has not stopped many device manufacturers from making laser “hats and helmets” that can be worn at home. It also hasn’t stopped medical manufacturers from selling “complex” laser devices for doctors to use in their clinics. Although some doctors believe in laser therapy, and offer it to their patients, there is no consensus that it is a reliable or effective treatment. Patients can use the devices with little concern about potential side effects, as the FDA approved the marketing of the device in 2007 for safety (but not efficacy) The potential for positive effects is small and inconsistent. Also, the treatment is not yet proven to be effective.