Many people are not candidates for hair transplantation. In addition, even those that are surgical candidates, may need to address the issue of ongoing hair loss. Non-surgical treatments for hair loss include topical treatments, oral medication, and laser devices.
Minoxidil (brand name Rogaine) is a FDA-approved direct stimulator of hair growth. It works in 88-90% of individuals with androgenetic alopecia to slow down the progression of hair loss, rethicken hairs that have thinned, and regrow hairs that have not been permanently lost. We recommend using the 5% foam once daily for both men and women. The solution is just as effective; however, it contains a potential irritant and some complain that it is too greasy.
Finasteride (brand name Propecia) is FDA-approved in men alone. However, it may be indicated in post-menopausal women with androgenetic alopecia. It blocks the effects of dihydrotestosterone on the hair follicle. It works in up to 92% of users to stop the progression of hair loss and can also rethicken and regrow hair. 1-2% of men may experience sexual side effects.
Spironolactone is a a diuretic that functions as an anti-androgen medication in women. At high doses, it can block hormonal influences on hair loss in women. It is not typically used as monotherapy for hair loss, but usually to adjunct to minoxidil. At these higher doses, women can experience irregular periods, muscle cramps, increased potassium, and lightheadedness. Therefore, we typically start at lower doses to gauge tolerability. Low-level laser light stimulation devices can also stimulate hair thickening and regrowth. There are many devices on the market, in addition, I typically recommend it as an adjunct to other more well-studied treatments, such as minoxidil and finasteride.
Platelet Rich Plasma (PRP) is a preparation taken from a patient’s own blood, in which the platelets are enriched in concentrated plasma. The therapy was originally used for injections into damaged joints in the orthopedic field. Now it is being used by cosmetic dermatologists and plastic surgeons for overall facial rejuvenation. Recently, hair specialists have been trialing the therapy in patients who are balding. Animal studies show that PRP increases dermal papilla cells, which are decreased in individuals with balding. Potent hair growth stimulators, Fibroblast growth factor-7 and Beta-catenin, are also increased by PRP treatment. Learn more about this treatment.