WELLESLEY, Mass. - Jan. 12, 2021 - Millions of men and women around the world experience varying levels of hair loss at different stages of their lives. While there are several non-invasive oral and topical treatment options available, these do not stop hair loss or regrow hair in everyone. Premier Dermatology, a Wellesley dermatologist offering cosmetic and medical hair restoration solutions, offers helpful information about topical and oral hair restoration products and how they work.
Minoxidil is the medication found in over-the-counter (and some prescription) topical hair restoration products, which are typically sold as shampoos, liquids and foams. It is an FDA-approved medication and has been shown to stimulate hair growth for both men and women and is currently the only FDA approved treatment for female pattern hair loss in women. It works by dilating (opening up) blood vessels in the scalp, increasing blood flow (and nutrients) to hair follicles. Minoxidil is known by a few different brand names and is available in 2% and 5% strengths. Recently, some providers have begun prescribing low doses of oral minoxidil to encourage hair regrowth in females. Although many individuals may find this more convenient than topical therapy, additional data and larger studies to establish both efficacy and safety are needed before adopting this as an oral treatment.
Finasteride is a medication that is most commonly prescribed to men who have hair loss or an enlarged prostate. It works by blocking the conversion of testosterone into dihydrotestosterone (DHT) and DHT is the hormone responsible for male pattern hair loss. For hair loss, pre-clinical trials did not show efficacy in women at the 1mg daily dose; however, there is some literature on the use of a 5mg daily dose of finasteride in the treatment of female pattern hair loss. This treatment is mostly reserved for post-menopausal women or women with specific hormone imbalances because finasteride is a known teratogen. This means that if a pregnant woman takes finasteride there may be abnormal sexual development of a male fetus/infant.
On the Horizon: Dutasteride.
Dutasteride is also a 5 alpha-1 reductase inhibitor that is FDA approved for treatment of enlarged prostate, but not for treatment of male pattern hair loss in the United States. In Asia it is sold as Avodart and is prescribed more commonly than finasteride for hair restoration. Both finasteride and Dutasteride have the same mechanism of action; however, Dutasteride appears to be a more powerful inhibitor of the testosterone to DHT conversion at lower doses, making it a potentially more effective treatment.
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