People for thousands of years have been looking for treatment for hair loss. Ancient Chinese and Indian medical systems have herbs which were and still are used to treat hair loss. It is reported that the father of medicine, Hippocrates, even used a mixture of chemicals including bird dung to treat hair loss. While some of these herbs have science and studies to indicate that they may help to treat hair loss, it is always adviseable to speak with a physician before undertaking any treatment plan. Some of the treatments can interfere with other medicines which are taken.

There are currently three medications approved by the US FDA for treating hair loss: minoxidil, finasteride, and bimatoprost.

Minoxidil and Finasteride

Topical minoxidil (Rogaine®) and oral finasteride (Propecia®) are the only treatments for male patterned baldness that have been approved by the US FDA. Their use is indicated in men older than 18 years with mild to moderate hair loss. Several well controlled studies have proven the efficacy of these medications.  After 3-6 months of use, slowed hair loss, stabilization, or increased scalp coverage can be appreciated with either medication and results are clearly evident by 1 year.

Dense regrowth is uncommon and neither medication can regrow hair in completely bald areas. Early intervention, when thinning is first noticed and hairs are incompletely miniaturized, produces the best results.  Treatment must be continued indefinitely to maintain the benefits. Stopping treatment results in a return to pretreatment status by 6 months with minoxidil and by 12 months with finasteride. Minoxidil is available as both an oil and foam. Both are available over the counter. Finasteride is only available by prescription.

For female pattern baldness, 2% topical minoxidil is the only FDA-approved medication. Its use is indicated in women older than 18 years with mild to moderate hair loss.  Women who are pregnant or nursing should not use minoxidil.

Bimatoprost

The latest treatment approved for hair loss by the US FDA is bimatoprost (Latisse™). The medication was originally approved as a treatment for glaucoma under the trade name Lumigen®. Latisse is approved for growing eyelashes of the upper eyelids. Currently, Latisse is only available by prescription from a physician. Side effects are mild and include irritation and redness. Discoloration of the skin have been reported but usually resolve after the medication is stopped. Discoloration of the iris has been reported with Lumigen® but not in the initial studies with Latisse™ but can be permanent. It can take several months to see results and once the medication is stopped, the results will disappear. For more information, consider a consult with Dr. Verret.

Recently, low level laser therapy (LLLT) has gained popularity as a non-surgical hair loss treatment. The technology has been used for quite some time with success to aid in wound healing and treat chronic pain. Some of the initial studies into LLLT 50 years ago showed that it could cause hair growth but the side effect was forgotten for many years. There are several LLLT devices in use including those for home application and those which can be used in a physician's office. Just like other non-surgical hair loss treatment options, look to slow or stop the progression of loss and not necessarily hair regrowth. For more information about LLLT, please check out Dr. Verret's chapter in his book, Patient Guide to Hair Loss & Hair Restoration, on LLLT.

Hair replacement systems, often referred to as toupee's or wigs, can be a good option for patients with extreme hair loss, those with a temporary hair loss, or those wishing a quick solution. Hair systems can appear very natural but can often cost large sums of money. It must be remembered that hair systems will require replacement at regular intervals (often every 3-6 months), routine maintenance, and require specialized fitting. As a quick non-surgical hair loss treatment, hair replacement systems work well.