Ross Medical Hair Restoration, Inc
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The drug Propecia (FDA approval in 1997) has been shown to slow down or stop hair loss caused by male pattern baldness. It does so by inhibiting an enzyme called 5-Alpha Reductase, which is responsible for the conversion of testosterone to dihydrotestosterone, or DHT. The working theory is that most, if not all, hair loss due to male pattern baldness is a result of DHT binding to its receptors on susceptible follicles and inhibiting their growth. Since DHT receptors are mostly found on follicles on the top of the head, this is the area where the DHT causes the hair to fall out. Propecia lowers the total body DHT levels, thereby reducing the inhibition caused by DHT (double negative equals a positive). The end result reduces or prevents hair loss for most males.
Propecia is a hair loss treatment that is only available by prescription, but it is safe and well tolerated by men. It is taken once daily, and side effects are rare. The most frequent side effect is a possible decrease in libido. Studies have shown this to occur in less than 2% of patients taking the medicine, and these effects disappear when Propecia is stopped. Although this medication has been marketed as a hair restoration product, it is the opinion of RMHRI that the practical usage for this medication is to prevent further hair loss. Regrowth of lost hair is rare, but the reduction of hair loss is usually substantial.
Rogaine (FDA approval in 1988) is the only other medication which has gained FDA approval for the treatment of hair loss. It is available as a clear liquid solution, and more recently as a mousse-like foam, which is applied directly to the scalp twice daily. This hair loss solution has been proven to be safe and well tolerated. Minoxidil was used to treat hypertension prior to its use as a hair loss treatment. Its ability to stop hair loss and grow small hairs was subsequently seen as a side effect. After this discovery, it began being marketed as a hair restoration product in its topical form. While minoxidil can stimulate increased blood flow to the scalp, this is unlikely to be the mechanism by which it grows hairs. The more likely scenario is that it activates some cellular receptor which still remains a mystery. Unfortunately, the hairs which may grow as a result of applying minoxidil are usually very small and have a tendency to shed soon after the medication is stopped. On a more positive note, minoxidil can be used to treat female hair loss in addition to male pattern baldness.
Dutasteride is a newer medication with the potential to slow or stop hair loss. Currently, it is available in the U.S. only as a treatment for BPH (Benign Prostatic Hypertrophy) under its trade name of Avodart. This medication is in the process of being reviewed by the FDA for the treatment of hair loss. Dutasteride has a similar mechanism as finasteride, except dutasteride blocks both type 1 and type 2 DHT enzyme production, while finasteride only blocks the type 2 form. Therefore, pending the decision of the FDA, dutasteride may represent a superior alternative to finasteride as a hair loss solution. Lastly, in various other countries, the diuretic spironolactone and the antiandrogen cyproterone acetate (CPA) have been used as hair restoration products. Again of note, neither of these medicines have been approved by the FDA as hair loss treatments and are not recommended as such. They are included in this text simply to be thorough.
Many ad campaigns preach the benefit of various miracle hair loss solutions such as topical ointments, extracts and creams. Many of these products are one day wonders and disappear soon after they arrive on the market. Theoretically, it seems possible that there may be some concoctions that could work to reduce hair loss as topical solutions. However to date, none are FDA approved hair loss treatments.
To learn more about products that may help to slow or stop your hair loss, San Diego residents can contact RMHRI to schedule a free consultation. In the privacy and comfort of our La Jolla office, Dr. Ross will discuss your situation and determine the best hair loss solution for you.