Topical Therapies for Hair loss

Dr. Sharon Orrange
Dr. Orrange is an Associate Professor of Clinical Medicine in the Division of Geriatric, Hospitalist and General Internal Medicine at the Keck School of Medicine of USC.
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Hair loss is a big deal for men and women. Many of you, however, are wary of taking a pill every day for hair loss. Topical treatments for hair loss are a good option and help you avoid some of the potential side effects that come with a daily pill. Turns out there is exciting news in topical therapies for hair loss, so let’s see what topical therapies really work:

1.  Old Faithful.  Minoxidil (Rogaine) is the current standard treatment for hair loss and works for both men and women. The way it works to prevent hair loss is not known. Minoxidil prolongs the duration of the hair cycle and increases miniaturized hair follicle size in addition to maintaining and thickening preexisting hair. Minoxidil shows its maximum effect at 16 weeks, so if its not doing anything by then, maybe move on. Remember too—the 5% formulation of minoxidil works better than the 2%. If you stop using it, you will shed all the gains within 4 to 6 months.

2.  What’s good for the eyelashes . . . The Prostaglandins.  You’ve already heard of Latisse, used to grow longer thicker eyelashes. The buzz around latanoprost and Latisse (bimatoprost), which are both prostaglandin analogues, started when folks using them for glaucoma noticed their eyelashes were growing. Recent studies showed a significant increase in hair density in men treated with latanoprost 0.1% . So now, bimatoprost (Latisse) is being studied for hair loss and may eventually be more effective than minoxidil. Cool new thing.

3.  Not ready for prime time but Europe already biting.  Fluridil is a new topical anti-androgen that has been shown to increase hair growth in 80% of men who use it. Sexual function and libido were normal in the Fluridil group and it is being used throughout Europe but is still awaiting approval in the US.

4. An Anti-fungal does what?  Surprise! It works for hair loss. Ketoconazole (Nizoral) is an antifungal used for the treatment of seborrheic dermatitis and dandruff. In a recent study hair growth was improved almost similarly by both ketoconazole and minoxidil regimens. The mechanism by which ketoconzole improves hair growth is unclear (sounds familiar right) but may be attributable to anti-inflammatory effects that are found in the balding area and activity against microflora of the skin by Malassezia.

5. Ladies, meet spironolactone.  Spironolactone works for hair loss by inhibiting an enzyme that helps make testosterone. In a study of 60 female patients with hair loss, topical spironolactone 1% was found to be effective in promoting hair growth. Men, we just don’t know yet if this is safe for you. Women, game on.

6. Sleep and hair.  Melatonin has long been known to modulate hair growth and comes in a topical solution. After 6 months of treatment with a melatonin solution there was a statistically significant increase in hair growth but only in the Occiput region (back of head) and not the frontal region. Hmmm.

Worth a try right?

“Bald is the new black” 〜 Gail Porter

Dr O.

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