Medical therapy

Effective ways of combatting hair loss

Even just a few years ago it was very difficult to obtain effective medication against hair loss - there just were not very many medicines available on the market. This situation has since changed, with a large range of different medicines now available. Treating hair loss through medication can lead to already lost hair growing again, though it is just as important to stop or at least reduce hair loss. An important part of any medication for hair loss therefore involves not unduly overstressing existing hair in an attempt to preserve it, i.e. taking preventive measures against hair loss.

Drug-based treatment has a major influence on any subsequent surgical intervention, and the results of medication can often be so good that patients decide against a hair transplant. Or the results of the drug-based treatment are so good that only minor surgery is necessary. At the time of writing there are two medicines available on the pharmaceutical market which can be recommended for treating hair loss: Minoxidil (Rogaine®) and Finasteride (Propecia®).


Minoxidil

(Rogaine®)

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Finasteride

(Propecia®)

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OTC

(Over-The-Counter drugs)

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Minoxidil (Rogaine®)

Minoxidil (Rogaine®)

Originally developed as an oral medicine for reducing blood pressure, it was observed that this vasodilator drug had an interesting side effect: it encouraged hair growth. The drug was first introduced in the USA in 1988 under the name Rogaine and in Europe under the similarly protected brand name Regaine. It is available as a lotion and contains Minoxidil.

The lotion is offered as a 2 %, 5 %, 12 % or 15 % solution, whereby a higher percentage achieves a greater effect. The 2 % solution is available in European pharmacies without a prescription, whereas the solutions with higher percentages require a prescription. The difference becomes clear when considering that the 5 % solution is 45 % more effective than the 2 % one. Minoxidil should however only be used in the 5 % (or higher) solution in consultation with one’s doctor.

Convincing results

In contrast to many other medicines used to combat hair loss, the Minoxidil lotion contains no hormones at all. It has no negative effect on hormonal activity and can therefore be applied to various kinds of hair loss without problem.
Minoxidil (Rogaine®) is suitable for use in both men and women. Results show that in 80 % of cases hair loss is more or less stopped, with hair growth being clearly stimulated. 8 - 30 % of users were pleased with the results. However no new hair growth occurs on completely bald patches. Very good results were achieved with patients - both men and women - who had only been suffering from hair loss (mainly at the top of the head) for the last 5 - 10 years.
To achieve long-term results, Minoxidil needs to be applied directly to the scalp twice a day (morning and evening). Best results are achieved when hair has just been washed, i.e. when the scalp is wet. The treated areas of the scalp become “addicted” to Minoxidil, with hair loss restarting once the treatment is stopped.

This is also the case when a combination of medicines is used. Androgenetic hair loss can be counteracted to a certain extent by the lotion, but not completely prevented. A combination of the Minoxidil lotion with other drugs such as Finasteride is often used to treat androgenetic hair loss. Studies and experience have shown that this combination is more effective than when applied separately.

Minor side effects when using Minoxidil

When Minoxidil is correctly used, i.e. topically and not orally, it is a very safe agent whose only possible side effects are dry skin, irritation, dizziness and headache. A slight increase in body hair and increased beard growth can occur, as, even when applied topically, small amounts of the lotion can get into the bloodstream.
When taken orally it can cause unwanted hair growth of body hair. Certain doctors are of the opinion that people suffering from heart or vascular conditions may be endangered by Minoxidil.

Better tolerated and easy to use - Rogaine Foam

A new application form, Rogaine Foam, has recently become available on the US market. This is easier to use and is preferred by patients. Unlike Rogaine solution, the foam does contain any propylene glycol, an agent that commonly causes irritation.
The foam consists of a 5% Minoxidil solution and targets men, though it can also be used by women. We will inform you as soon as Rogaine Foam becomes available on the European market.


Finasteride (Propecia®)

Finasteride (Propecia®)
In most cases hair loss is hereditary, with the so-called DHT (dihydrotestosterone) playing a major role. DHT is produced with the help of the enzyme 5α-reductase out of the male testosterone hormone. It influences the growth phase of hair, contributing to the gradual demise of the hair roots. Finasteride suppresses the 5α reductase enzyme, without affecting the male hormone testosterone. Finasteride does not naturally exist in the hormonal balance, and its intake slows the action of the enzyme and decreases the concentration of DHT in the scalp. The demise of further hair roots is reduced, with already dead hair roots being stimulated to produce new hair.

Finasteride: usage and side effects

Finasteride is a prescription-only drug suitable for the treatment of both men and women. Generally speaking, Finasteride tablets need to be taken once a day over a 3 - 6 month period before any visible effect can be seen. To achieve best results, Finasteride needs to be taken permanently. It is recommended that a doctor be regularly consulted during treatment.

Prescription drugs can unfortunately have negative side effects. Those of Finasteride are only minor, and generally speaking toleration is very good, with any side effects only occurring during the actual treatment. The vast majority (96 %) of patients do not suffer from any side effects. Clinical studies show that a mere 3.8 % of men treated suffer from sexual side effects (decreased libido, erectile dysfunction, reduced ejaculation), all of which disappear completely after the patient stops taking the drug, even after longer-term use.

Successfully fighting hair loss

86% of men participating in a study of Finasteride drug treatment and showing hair loss in the crown area noted no further hair loss or even perceived new hair growth. Studies also show that some 50% of participating men noted they had more hair within 12 months. A third study, in which men with a receding hairline and hair loss on the top of their heads participated, showed increased hair growth in 37% of all participants.


Topical Finasteride

Although topical Finasteride is not FDA approved yet, there have been several studies resulting in the effectiveness of topical Finasteride being very similar to oral Finasteride but with fewer side effects. Any additional information about topical Finasteride can be provided by the clinic.


Over-The-Counter drugs (OTC)

NOT VERY EFFECTIVE AGAINST HAIR LOSS!

Most substances against hair loss available on the market are prescription-only. Nevertheless a number of pharmacies, drugstores and supermarkets sell over-the-counter products supposed to stimulate hair growth and at the same time counteracting any deficiencies causing hair loss. Such products are not drugs.

For example, products promise to reactivate damaged hair follicles. Other products - shampoos and hair water - claim that the vitamins contained in the products renew hair. Other ingredients in dietary supplements or cosmetics (for example, tinctures or sprays), are supposed to prevent or stop hair loss. These include caffeine, hops, ginseng or other ingredients, all of whose effectiveness is unproven. The effect of these prescription-free products in preventing hair loss is only partially proven or completely unproven. Even if their descriptions appear plausible and the products come from reputable companies, there are no significant success stories attributable to prescription-free products.
 

Dermatologist & Hair surgeon – a winning combination for hair loss

Important to recommend and clearly proven its efficiency with every type of hair loss is a visit to a dermatologist, who will provide the patient with further advise. This includes also the consideration of a dermatologic and aesthetic surgeon, who could competently consult the patient and help him through a hair transplant surgery.