Hair loss is a common condition that affects both men and women. About 80 million men and women in the United States have some degree of hair loss by age 50. For many people, hair loss can be distressing and affect self-confidence and quality of life. The good news is that for most types of hair loss, there are treatment options available. This article provides an overview of the most common causes of hair loss and whether prescription medications are available to treat them.
What causes hair loss?
There are various factors that can lead to hair loss, including:
Androgenetic alopecia
Also known as male or female pattern baldness, androgenetic alopecia is the most common type of hair loss. It is caused by a combination of hormones (androgenic hormones like testosterone) and genetics. In male pattern baldness, hair recedes at the temples and crown. In female pattern baldness, the hair thins all over the head. Androgenetic alopecia cannot be cured, but medications are available to slow its progression.
Alopecia areata
An autoimmune disorder that causes patchy hair loss. It can occur at any age but often starts in childhood or young adulthood. There is no cure, but some treatments such as steroid injections can help regrow hair. However, the hair loss often recurs.
Telogen effluvium
A condition in which hairs prematurely enter the resting phase (telogen) of the hair growth cycle, causing increased shedding. It can be triggered by childbirth, illness, stress, weight loss, medications, or other factors. Hair usually regrows within 6-9 months.
Nutritional deficiencies
Not getting enough protein, iron, zinc, vitamin D, and other nutrients can lead to hair thinning and loss. This type of hair loss is usually corrected once nutritional deficiencies are addressed.
Medications
Certain medications used to treat conditions like high blood pressure, heart disease, arthritis, and depression can sometimes cause hair thinning as a side effect. Switching medications under a doctor’s guidance may stop hair loss.
Medical conditions
Diseases like lupus, diabetes, thyroid disorder, and anemia can cause hair loss. Treatment of the underlying condition can help stop further hair loss.
Hairstyles and treatments
Tight hairstyles that pull on the hair over time and harsh chemical hair treatments like bleaching can damage the follicles and cause permanent hair loss. Avoiding these styles and treatments can prevent further damage.
What prescription medications treat hair loss?
There are two main prescription medications approved by the U.S. Food and Drug Administration (FDA) to treat hair loss:
Minoxidil
The brand name version is called Rogaine. It is available over-the-counter in 2% and 5% solutions. It works by stimulating hair follicles and promoting regrowth. Minoxidil is approved to treat androgenetic alopecia and works best at regrowing hair in the crown/vertex area. It does not work for other types of hair loss.
Finasteride
The brand name version is called Propecia. It comes as a tablet that must be taken daily. It works by blocking the hormone DHT which contributes to hair loss in androgenetic alopecia. It only works for male pattern baldness and has not been proven effective for female pattern hair loss.
Here is a comparison of the two medications:
| Medication | Brand Name | Form | Use | Effectiveness | Side Effects |
|---|---|---|---|---|---|
| Minoxidil | Rogaine | Topical solution | Androgenetic alopecia | Regrows hair in about 40% of men and women | Scalp irritation, unwanted facial/body hair |
| Finasteride | Propecia | Oral tablet | Male pattern baldness | Regrows hair in about 66% of men after 2 years | Decreased libido, erectile dysfunction |
These medications do not work for all types of hair loss. They are not effective for alopecia areata, telogen effluvium, or hair loss from medical conditions. They also work best to regrow hair when started early when hair loss first begins.
Other prescription treatments
While minoxidil and finasteride are the only FDA-approved medications for treating androgenetic alopecia, some other drugs may be used off-label to treat other forms of hair loss:
Steroid injections
Corticosteroid injections into the scalp can help regrow hair in patches of alopecia areata. However, injections alone are less effective for extensive hair loss. They are often used together with other treatments.
Immunosuppressants
Medications that suppress the immune system may be prescribed for alopecia areata, particularly severe cases. They include medications like cyclosporine, methotrexate, and oral corticosteroids (steroids by mouth). However, the risks often outweigh the benefits for long-term use.
Hormone replacement therapy
Anti-androgens and estrogen replacement may be an option for some women with female pattern hair loss. However, hormone therapy can increase the risk of health problems like stroke, blood clots, and breast cancer.
Nutrient supplements
Doctors may recommend supplements like biotin, vitamin D, zinc, or iron if tests show a deficiency is contributing to hair loss. This helps restore normal hair growth.
Other treatments for hair loss
In addition to medications, other non-drug treatments for hair loss include:
– Minoxidil combined with other topical treatments like spironolactone or retinoids
– Low-level laser light therapy (LLLT)
– Microneedling
– Hair transplants – a surgical procedure to graft hair follicles from the back of the scalp to areas of thinning hair
– Platelet-rich plasma (PRP) therapy – injections of a concentration of a patient’s own platelets to stimulate hair growth
– Reducing stress, eating a balanced diet, and leading a healthy lifestyle
Should you see a doctor for hair loss?
It’s a good idea to see a dermatologist or doctor who specializes in hair loss if you are experiencing:
– Sudden hair loss or bald spots
– Widespread thinning hair
– Hair loss along with scalp itching, pain, or burning
– Hair loss after starting a new medication, illness, or life event like childbirth
– Ongoing hair loss that does not resolve on its own after 3-6 months
A doctor can examine your scalp, review your medical history, and any medications you take to try to pinpoint the underlying cause. Blood tests may be done to check for conditions like thyroid disorders, nutrient deficiencies, or inflammation. If an underlying cause is found, treating it can stop or reverse hair loss.
Your doctor may recommend minoxidil, finasteride, or other treatments based on the type and pattern of hair loss. They can also determine if you are a candidate for hair transplant surgery. Early intervention provides the best chance of regrowing hair or slowing further hair loss.
Conclusion
Hair loss is a distressing condition that affects millions of men and women. The most proven prescription medications for treating hair loss are minoxidil and finasteride. Minoxidil can help regrow hair in both men and women with androgenetic alopecia, while finasteride works only for male pattern baldness. Other drugs may be used off-label for conditions like alopecia areata or female pattern baldness. However, their effectiveness is limited. The treatments work best when started early in the course of hair loss before it progresses. Seeing a dermatologist or hair loss specialist is recommended to determine the cause and discuss all treatment options available. With an individualized treatment plan, many people can regrow hair or prevent further hair thinning and loss.