Medical Treatment

Medical hair restoration is used to prevent or slow down the progression of hair loss. Medical hair restoration comes in many forms including medications or products such as creams, ointments, lotions and supplements. However, it can be tough to know which products can improve hair loss and are also approved by the US Food and Drug Administration (FDA).

FDA Approved Medications for Hair Loss

Finasteride (Propecia) and minoxidil (Rogaine) are the only two medical treatments approved by the FDA for hair loss. It is crucial to start treatment as soon as androgenetic hair loss has been diagnosed since these products work to maintain and thicken existing hair rather than re-grow hair after it is already lost. Each of these products work well on their own but some hair loss specialists may recommend combining the treatments for the most optimal outcome. Before starting any medical hair restoration treatment, patients should develop a good understanding of how the product works and speak to a hair loss specialist to see which treatment might be right for them.

Minoxidil is better known as Rogaine. Minoxidil tablets were initially used for the treatment of high blood pressure but was noted to cause hair growth in unexpected places. Further studies led researchers to incorporate minoxidil in the form of a lotion and apply it directly to the scalp for the treatment of hair loss. Minoxidil has several proposed mechanisms of action including a vasodilatory effect, or widening of the blood vessels, followed by angiogenic (formation of new blood vessels) properties. There is evidence that minoxidil may enhance follicular cell proliferation by prolonging the anagen phase or possibly shortening the telogen phase. Eventually, Rogaine became the first drug approved by the FDA for the treatment of male pattern baldness. Hair growth occurs after applying the treatment for several months. However, patients must continue to use the product to maintain the results.

Finasteride is the generic name for Propecia and Proscar. Finasteride was initially developed by Merck Pharmaceuticals to treat benign prostatic hyperplasia (BPH) which is otherwise known as prostate gland enlargement. However, hair growth was noted as one of the side effects. Finasteride inhibits the enzyme alpha-reductase which is responsible for converting testosterone into dihydrotestosterone (DHT). Elevated DHT is responsible for hair miniaturization and baldness. Therefore, lowering the DHT level can prevent or slow the progression of hair loss. Eventually, finasteride became the first oral medication approved by the FDA for hair loss and the most effective treatment for baldness in men. Like Rogaine, it can take 3 months to begin seeing a difference with this treatment and it must be continued. Otherwise, the results will falter over a six to nine month period.

Other Medications for Hair Loss

Dutasteride (Avodart) was initially designed to treat the symptoms of BPH by reducing the risk of urinary blockage due to an enlarged prostate. This medication is known to inhibit both Type I and Type II forms of 5-alpha-reductase enzymes which are responsible for the conversion of testosterone to DHT. While the Type I form of the enzyme is found in the scalp and sebaceous glands, the Type II form is predominantly found in the hair follicle. Although finasteride rates higher than Rogaine for effectiveness, finasteride only inhibits the Type II form of the enzyme. This makes the dual effect of dutasteride even more potent. Although dutasteride is well tolerated when prescribed at doses up to 0.5 mgs a day, increased potency can elevate the occurrence of adverse side effects such as a mild or moderate decrease in libido. Dutasteride has a serum half-life of approximately 4 weeks which accounts for the persistent suppression of DHT long after dutasteride has been discontinued. Therefore, men who are using this treatment should not donate blood until at least 6 months after the last dose.

Spironolactone (Aldactone) was also marketed as a high blood pressure medication used to reduce the chance of a heart attack or stroke. Spironolactone is a potassium-sparing diuretic but was later recognized to have an anti-androgen effect. This treatment is often used in women who suffer from excess levels of testosterone. Spironolactone causes a reduction in the production of androgens in the adrenal glands and ovaries. It also hinders the action of androgens that are produced. Spironolactone also inhibits dihydrotestosterone (DHT) from binding to its androgenetic receptor which reduces the harmful effect of testosterone on the hair follicle. Essentially, spironolactone prevents the existing DHT in the body from causing further hair loss.

Herbals for Hair Loss

Saw palmetto is an herbal supplement that can treat numerous medical conditions such as hair loss, BPH and bladder infections. The small berries have been used by Native Americans as food and medicine for hundreds of years. Saw palmetto also blocks 5-alpha-reductase enzyme which keeps the testosterone from converting to DHT. Since saw palmetto is believed to act similar to finasteride, these two products should not be taken together.

Pumpkin seed oil is a natural treatment that also has the ability to block the action of 5-alpha-reductase. Pumpkin seed oil contains phytosterol (beta-sitosterol) which can reduce the damage caused by DHT by inhibiting the alteration of testosterone to DHT.

Vitamins and Minerals

There are some over the counter products, containing vitamins and minerals, that can help combat hair loss. However, most of these vitamins and minerals are already consumed when a person eats a normal, healthy diet. When a person is not deficient in the particular vitamin or mineral, the supplements will not alter the course of hair loss. Nevertheless, supplements such as Biotin, Iron and Zinc can help to maintain a healthy head of hair. Biotin assists with hair growth and a lacking of this essential element can result in fragile hair and nails. A severe deficiency in iron can result in hair loss but lab work will be needed to determine the degree of deficiency. Zinc is another element that plays a role in the development of healthy hair. However, most people in North America consume an adequate amount of Zinc. Therefore, additional Zinc supplements will not improve their condition.


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