Trying More-Conventional Hair Loss Treatments

1. Try 5-alpha-reductase inhibitors

The main drug treatment for men’s hair loss are the 5-alpha-reductase inhibitors Proscar and Propecia, which are trade names for finasteride. 5-alpha-reductase inhibitors are anti-androgens and block their activity on hair follicles to prevent male and female pattern baldness.

• 5-alpha-reductase inhibitors used to treat men are less often used for women because of adverse effects of lowering androgen levels in women. The drugs are never prescribed to women hoping to become pregnant due to adverse effects to the fetus.

2. Try minoxidil

Another drug used to increase hair growth is minoxidil (Loniten, Vitadil-2A), which was originally prescribed to lower blood pressure. Minoxidil is generally less effective than finasteride, but it can be applied directly to the areas of hair loss.

• 2% minoxidil is more commonly prescribed to women because it can be applied to the areas of hair loss and has fewer side effects. In fact, it appears that minoxidil works better for more women than men. Many dermatologists also use 5% topical Minoxidil off-label for hair loss in women as it works better with fuller hair than 2% topical Minoxidil.

3. Try hormone replacement therapy for hair loss in women

In women, hormone replacement therapy with estrogen and progestin can be helpful (progestin is the synthetic form of progesterone). In Europe, a synthetic estrogen, ethinyloestradiol is combined with cyproterone acetate to treat women’s alopecia. This is not available in the U.S. But the safest form of bioidentical hormone replacement is bioidentical estrogen and progesterone through a naturopath.

4. Use non-surgical hair replacement

For non-surgical hair replacement (wigs, extensions, weaves, hairpieces, and toupees), most professionals recommend carefully looking at what is available. One recent survey indicated that over 70% of people were unhappy with the service provided by hair replacement salons.

• Hair replacements are based on a support of polymers, meshes, or a combination of the two. There are differences in cost, comfort, look, feel and how they are attached. The hair can be natural human hair, animal hair, or synthetic fibers.
• They can be semi-permanently attached with an adhesive or by weaving it into natural hair, but this is not often recommended because you cannot properly clean the scalp underneath unless it it professionally removed and then reattached. Since this should be done at least every 5-7 days, it can be costly and time-consuming.
• Using the semi-permanently attached hair replacement means you will need to get two replacements—one to wear while the other is being maintained.
• Other recommended methods of attachment include double-sided tape or metal clips. In this case, home care and maintenance is all that is required.

5. Look into surgical hair replacement

At this time, the only type of surgical hair replacement recommended by the American Hair Loss Association (AHLA) is harvesting your own androgen-resistant hair. This hair is then transplanted into the areas of hair loss. Getting hair transplants from donors would necessitate lifelong anti-rejection medications, which is too risky.