Androgenetic alopecia, commonly referred to as genetic pattern baldness, is an extremely common condition that accounts for more than 95% of hair loss cases in both men and women. It occurs when hair follicles in specific regions of the scalp have inherited a degree of sensitivity to dihydrotestosterone (or DHT), a by-product of the androgen testosterone. In these patients, exposure to DHT, which is naturally produced in the bodies of both men and women, causes the hair follicles to shrink, gradually producing finer and more delicate hairs until they stop producing hair altogether. Currently there are only two drugs that have been FDA approved to treat androgenetic alopecia: Minoxidil and Finasteride, which are commonly known as Rogaine® and Propecia® respectively. Each of these two medications approaches the problem of androgenetic alopecia in distinctly different ways.
Minoxidil, when applied to the scalp, increases the size of shrunken hair follicles and keeps them in the growth phase longer, effectively counteracting the typical progression of androgenetic alopecia. The exact mechanism through which it accomplishes this effect is not yet entirely understood, but we do know that minoxidil only counteracts the symptoms of pattern hair loss; it does not address the underlying causes. Even though it has been shown to slow or even halt hair loss in up to 60% of patients, making it an indispensable part of any hair maintenance regimen, it is far less effective at actually re-growing hair in areas where the hair growth cycle has completely stopped. Rogaine® needs to be applied directly to the scalp twice a day and we generally recommend that patients use only the Extra Strength version (which contains 5% minoxidil rather than the standard 2%) as it is noticeably more effective. At The Griffin Center, we can also custom formulate special blends of prescription topical medications to enhance the effectiveness of minoxidil and specifically address individual patients’ needs.
Finasteride (Propecia® and Proscar®)
Finasteride, unlike minoxidil, works directly on the source of androgenetic alopecia by inhibiting the enzyme 5-alpha reductase, a chemical that plays a key role in converting testosterone to the follicle-destroying DHT. It has been clinically shown to successfully halt the progression of hair loss in 86% of men, with 65% of those experiencing a “substantial” increase in hair growth. However, studies are still inconclusive as to whether it is similarly effective in treating pattern hair loss in women. Moreover, finasteride has not been specifically approved by the FDA for use on women, as it is unsafe for those who are pregnant or who are trying to conceive, although it can be used to treat women who are past child-bearing age or who are not interested in becoming pregnant. Ultimately, because the causes of women’s hair loss are frequently more complex and varied, other treatments need to be included in a woman’s hair restoration regimen. Finasteride is marketed in two forms: Propecia®, which contains 1mg of finasteride, and Proscar®, which contains 5mg. Both need to be taken orally only once per day, making them potentially more convenient for patients than a topically applied remedy. Finasteride has also been reported, in fewer than 2% of cases, to cause some sexual side effects in men. We frequently supplement the use of finasteride with advanced non-surgical hair loss treatments, like Red Light Laser or Platelet Rich Plasma Therapy, in order to help give our patients the best possible results.
Hair loss treatments are constantly evolving, so if you have questions about your individual hair loss or would like to find out what form of treatment might be best for you, please contact The Griffin Center to schedule an appointment. Don’t forget to follow us on Facebook, Twitter, and Google+ to get the latest news or ask questions about hair restoration and research.