Hair Loss Treatments
Hair loss treatment options are almost limitless on the market. How do we know which one works and which one doesn’t? Every product has their claims, and testimonials. I would like to present you unbiased scientific and clinical study results, and recommendations from scientists.
Minoxidil first used for treatment of high blood pressure in 1970s. Minoxidil acts as a vasodilator by opening potassium channels. Hair growth was actually side effect of minoxidil.
Mechanism of Action
Minoxidil shortens the telogen phase of hair growth and prolongs the anagen phase. It also increases the blood flow to hair follicles. There are other hypothesis about minoxidil mechanism of action, but nothing was actually accepted as a consensus.
According to a clinical study on 31 men with androgenic alopecia, as a result of a 5-year follow-up, hair regrowth peaks at 1 year with a slow decline, and new hair was maintained after 5 years. 5% minoxidil showed a significant hair growth increase compared placebo. Minoxidil works better to maintain and thicken the existing hair.
Minoxidil After Hair Transplant
Studies show that, using minoxidil after hair transplant reduces the regular shedding and reduces the new hair growth time from 9 months to 1-2 months. Dermatologists agree that using minoxidil after hair transplant provides better outcome.
Minoxidil and Tretinoin
Tretinoin may enhance the efficacy of minoxidil. Tretinoin, when used in conjunction with minoxidil, increased minoxidil absorbance by 3-fold. Using 0.01% tretinoin with minoxidil once a day, shows same results as using minoxidil alone twice a day.
The more recent the hair loss, the more success patients will have. Product should be used for at least 6 months to reach the optimum effects of minoxidil. If patients stop using minoxidil hair growth stops and they lose the hair they were meant to lose genetically.
Finasteride molecule inhibits type II 5-alpha-reductase enzyme, thus reduces DHT levels in scalp. 5-alpha reductase enzyme converts testosterone to dihydro-testosterone (DHT). DHT is responsible for hair loss. The optimal dose of finasteride for androgenic alopecia is 1mg/day.
According to clinical studies 90% of men taking finasteride showed significant hair growth after 1-2 years and maintained new hair growth after 5 years.
To read finasteride effect on prostate cancer click here. There is a little evidence that finasteride may have a negative effect on sperm count and morphology. 2% of men showed sexual side affects including libido decrease, erectile dysfunction, and ejaculation disorder compared with 1% in the placebo group.
1mg/day finasteride shows successful hair growth in 9 out of 10 patients in 3 months. Patient should use for at least 6-9 months to see optimum results.
Dutasteride works similar to finasteride. However dutasteride inhibits bot type I and type II 5-alpha reductase. Dutasteride is three time potent than finasteride inhibiting type II 5-alpha-reductase.
Dutasteride is approved by FDA for 0.5mg/day dose. Brand name for dutasteride is Avodart. Dutasteride works better than finasteride, but because of the concerns about side effects FDA approval for treating androgenic alopecia is on hold.
Dutasteride has the same side effects as finasteride, but more potent and more often.
Even though the efficacy is proven, we can’t recommend dutasteride use for hair loss.
Ketoconazole is an antifungal which has been used for seborrheic dermatitis treatment. Ketoconazole shampoo use in conjunction with minoxidil shows better hair growth than minoxidil alone. To read further information and product review for ketoconazole click here.
There are numerous products for laser therapy on the market. Various laser combs are being sold all over the internet. Unfortunately laser comb name is associated with scam. Most of the laser combs just shines red lights. The only laser comb device that has FDA approval is HairMax laser comb.
Saw palmetto naturally inhibits 5-alpha-reductase, and blocks DHT production. Clinical studies show increased hair growth in 6/10 men with mild to moderate hair loss. Saw palmetto can be found in various hair loss treatment products. To read a product review click here.
Biotin can help increasing thickness of nails, but studies show no effect on follicle activity.
Company claims removal of sebum containing DHT, but doesn’t claim to block DHT. There is no studies showing efficacy of Nioxin.