Hair Loss Treatments

What is hair loss?

Millions of people face the hair loss problem every year; some people regain back their hair without any treatment while others continue to lose their hair even as they use various treatments. When faced with alopecia, the first thing you must do is see a dermatologist in order to get an accurate diagnosis.

Hair diseases are the main cause of alopecia. Hair disorders can affect the scalp hair and or the entire body hair. Some common factors that play a role in hair loss are hormonal changes, medication, skin diseases, and genetic reasons.

What are the causes of hair loss?

There are many reasons why people lose hair Sudden hair loss is caused by strict diet, diseases, medication or birth. Slow progressive hair loss is caused by more hereditary reasons. However, bad hair care techniques can also play a role in losing hair.

Hair loss caused by hair diseases

• Genetic baldness in men and women (androgenetic alopecia, AGA, FAGE): While genetic baldness in men is highly recognizable by its shape, with female pattern the hairline protects itself but shedding is common and can be easily confused with other causes of alopecia.
• Alopecia Areata: This is an autoimmune disease which is commonly confused with ringworm. In fact, it is a condition where the body attacks the hair follicles itself. Round, coin-shaped patches of hair shedding can be seen on the whole body.
• Cicatricial Alopecia (Scarring Alopecia): This is a a rare cause of permanent loss of hair. This disease damages the hair follicles directly. The treatment involves suppressing the inflammation, reducing the damage of the hair follicle hence avoiding development of larger scar.

Hair loss due to illness

• Diseases – Alopecia may be the first symptom of certain diseases; thyroid dysfunction, anemia, vitamin deficiencies are among the most common causes.
• Cancer treatment – radiation and chemotherapy.
• Scalp fungus – If not well treated, it can cause permanent loss of hair.
• Psychiatric disorders – hair-pulling disorder.

Hormones and stress related causes

• After birth hair thinning.
• During menopause.
• Stress – specific factors that develop stress can cause shedding of hair.

Diet and feeding habits related causes

• Weight loss.
• Increase of some vitamin levels can accelerate alopecia.
• Deficiency in protein intake.
• Psychological eating disorders.

Loss of hair due to medication

• Blood thinners.
• Some Vitamins.
• Blood pressure, gout, depression and heart medication.
• Birth control pills.
• Anabolic steroids.

Loss of hair due to medication

• Blood thinners.
• Some Vitamins.
• Blood pressure, gout, depression and heart medication.
• Birth control pills.
• Anabolic steroids.

Hair Loss Facts

The facts are well stated below:

1. Balding is caused by shrinking of follicles leading to thinning of hair other than massive amounts of hair loss.
2. Hair loss is inherited from the both the mother and fathers side. Not just the mothers side.
3. Hair loss progresses with age and the earlier ones hair loss starts, the more bald you may end up as you age
4. Hair loss is not caused by too much testosterone.
5. Caps or wigs do not cause hair thinning.
6. Androgenic hair loss cannot be treated by shampoo.
7. Both men and women suffer from genetic hair loss
8. Medications like Rogaine, Minoxidil and Propecia only help slow down hair loss.

9. Forty percent of women will have female pattern hair loss by the time they reach menopause. Statistically, hereditary pattern baldness is more commonly inherited from the mother’s side of the family, but hair loss can actually be inherited from the father’s side, the mother’s side, or both.
10. Many think that hair loss can be caused by wearing hats, frequent shampooing, clogged pores, or decreased blood flow to the scalp. These are all myths.

• Wearing hats:Many believe that frequent hat wearing causes hair loss because it “suffocates” the scalp. Hair follicles actually get oxygen from the bloodstream rather than the air, so wearing hats has no effect on hair loss.
• Frequent shampooing:When people notice that their hair is thinning, they often pay more attention to the hair that falls out after shampooing and assume that this is the cause. It is completely normal to lose up to 150 hairs per day, many of which are lost when you wash your hair.
• Clogged pores:If baldness were due to clogged pores, the solution would be to simply clear the pores so the hair could grow. This is not the case.
• Decreased blood flow to the scalp:Decreased blood flow is actually a result of hair loss, not a cause. Growing hair requires a significant amount of blood flow, but once the hair is lost, not as much blood is needed in the scalp.

11. Certain drugs can cause hair loss. Many of them are used to treat:

• Cancer
• Arthritis
• Depression
• Heart problems
• High blood pressure

12. Thyroid imbalance and iron deficiency are reversible causes for hair loss.
13. Hair loss can be easily treated.

Surgical hair restoration involves scarring that can be difficult to hide. Dr. Wise offers two methods of non-invasive hair restoration at his practice.

The NeoGraft© Automated FUE (follicular unit extraction) Hair Transplant System for hair restoration provides the following advantages over other procedures:

• No scarring
• Little to no discomfort
• Quick recovery time
• Greater safety and efficiency

There are several types of hair loss:

• Hereditary hair loss
• Male pattern baldness
• Female pattern baldness
• Androgenetic alopecia

Hair Loss Treatments Turkey

• Minoxidil and generics

It is a topical (applied externally) medication that treats hair loss in men and women. It is applied directly to the scalp each day and it results in hair growth stimulation and prevents the thinning of hair. This medication can take six months to a year to produce visible results.

• Oral medication

The most common oral medications are diuretics that remove excess of the water from the body. This blocks androgen production and prevents hair loss.

• Hair transplant

It is a surgical procedure in which hair follicles are moved (transplanted) from one part of the scalp to another part where the hair is thinning or receding. A hair transplant is a procedure in which a plastic or dermatological surgeon moves hair to a bald area of the head. The surgeon usually moves hair from the back or side of the head to the front or top of the head.

• Laser treatment

The theory of laser treatment for hair loss is that the low-dose laser treatments invigorate circulation and stimulation that encourages hair follicles to grow hair. Laser devices are used at home for hair loss treatments. They work by emitting laser light of low intensity to stimulate hair growth.

Advantages of Laser Treatment

• it’s noninvasive
• it’s painless
• there are no side effects
• it increases hair strength

Hair Medical Treatments

Medical treatment plays an important role in stopping and treating the hair loss. It is more beneficial to start medical treatment in the early stages of hair loss. Androgenetic hair loss is the most common type of hair loss in men.

In this type of hair loss follicles shrink (miniaturize) with time, an effect caused by the DHT hormone. The hair loss in both men and women appears in a pattern; some follicles are susceptible to the effects of miniaturization, while the follicles at the back and sides are more stable.

Finasteride (Propecia) and Minoxidil (Rogaine) are FDA approved drugs for treating androgenetic hair loss. Finasteride acts by blocking the transformation of testesterone hormone to Dihidrotestesterone. Finasteride or Propecia reduces hair loss by inhibiting the production of DHT, thereby delaying hair loss. Finasteride is not effective in treating hair loss in women. Minoxidil directly stimulates hair growth.

Minoxidil or Rogaine boosts hair growth by improving blood flow hence nourishing the hair follicles. Minoxidil improves hair growth in both men and women. Finasteride is more effective than Minoxidil in the treatment of hair loss. Both drugs should be used for at least 6 months to be able to see their effect.

Some of the currently used hair loss treatment medication;

• Finasteride Propecia tablets
• Minoxidil solution
• Dutasteride
• Aldactone
• Oral contraceptives
• PRP treatment
• Bimoprost (latisse)

Finasteride (Propecia, Proscar)

Finasteride is a oral inhibitör that competitively inhibits the 5-alpha-reductase type 2 enzyme, and thereby inhibits conversion of testosterone to DHT. The drug has no affinity for the androgen receptor and does not interfere with testosterone action.

Oral finasteride (1 mg daily) is FDA approved oral medication which is effective in the treatment of balding in men. It halts hair loss in 90% of patients, and partial hair regrowth occurs in 65% of those receiving finasteride. For greater efficacy, the combination of oral finasteride (1 mg once daily) and topical minoxidil can be considered.

For the treatment of male androgenetic alopecia, the recommended dose of finasteride is 1 mg per day. The medication may be taken with or without food.

Possible finasteride side effects include reversible loss of libido, reduced volume of ejaculate fluid, and erectile dysfunction, which occurs in ~2% of men. There are reports of long-lasting sexual dysfunction (post-finasteride syndrome),but its incidence is unknown. Further reported rare side effects of finasteride are alteration of mood/depression; gynecomastia; testicular pain; hypersensitivity reactions.

Patients under treatment with finasteride should be aware of reduction of prostate-specific antigen, which is important in prostate cancer screening in men.

Minoxidil (Rogaine)

Minoxidil, is the first FDA approved medication for the treatment of hair loss. Topical minoxidil is available without a prescription as 2% solution, 5% solution, and 5% foam. is a topical minoxidil solution is applied directly to the scalp in concentrations of 5% (for men) and 2% (for women).

Minoxidil promotes hair growth by increasing the duration of anagen, shortening telogen, and enlarging miniaturized follicles. The pathophysiologic mechanism through which minoxidil influences follicular structure and follicular cycling is unclear,

Patients utilizing minoxidil for androgenetic alopecia should be advised of the following:

• Minoxidil solution is to be used for an indefinite time. Once stopped, any hair regrowth eventually will be lost, often over the course of several months.
• Minoxidil is a scalp treatment, not a hair treatment, and must be used exactly as prescribed for maximum benefit.
• Men should apply 1 mL of minoxidil 5% solution(2% for women) or one half of a capful of the 5% foam twice daily to involved areas on a dry scalp. The solution can be spread lightly with a finger; massage is not needed.
• Hair shedding may occur at the initiation of treatment and is thought to occur as a result of the stimulation of telogen follicles to reenter the anagen phase . The increased hair loss usually resolves within two months. Patients should be warned of this side effect to prevent the premature discontinuation of treatment.
• Minoxidil must be used twice a day for at least four months prior to evaluating the initial response to therapy. Hair shedding may occur at the initiation of treatment and usually decreases within two months. Hair growth may be seen within four to eight months and stabilizes at 12 to 18 months. Thus, a full year of treatment is recommended before assessing treatment efficacy.

The main side effect of topical minoxidil is hypertrichosis, mostly from local spreading or excessive continuous topical application. The other side effects are contact dermatitis and irritant dermatitis. When given systemically, minoxidil has antihypertensive properties, but neither 5% nor 2% minoxidil solution alters systolic or diastolic blood pressure, pulse rate, or body weight when applied topically. Nevertheless, due to the potential for systemic absorption when the scalp skin barrier is not intact, caution should be used in patients with cardiovascular disease.

Dutasteride

Dutasteride is a combined type I and type II 5α-reductase inhibitor. A dose of 0.5 mg/day leads to a greater reduction in serum and scalp DHT levels than does finasteride at 5 mg/day.

Compared with finasteride, dutasteride is three times more potent of an inhibitor of 5-alpha-reductase type 2 and 100 times more potent of an inhibitor of 5-alpha-reductase type 1 These suggests that dutasteride may be a more effective therapy.

Dutasteride is not approved by FDA but ıt has been demonstrated to be effective in several randomized, double-blind, placebo controlled trials in androgenetic alopecia so It is prescribed by some clinicians as an off-label treatment for androgenetic alopecia.

Dutaseride has comparable side effects (sexual dysfunction, decreased libido...) as finasteride.

Like finasteride, dutasteride is now becoming popular treatment option in AGA, due to its good response shown by various randomized control studies and meta-analysis. Also, in most of these studies, dutasteride was found to be better than finasteride with comparable adverse effects. Therefore, dutasteride could become a treatment of choice for AGA in near future.