While hormonal, hereditary pattern hair loss is not easy to treat, there are now many more options than in the past.
TOPICAL TREATMENTS
Topical Minoxidil (Rogaine, over-the-counter)
This treatment should be the initial step for most patients. Patients can apply this scalp treatment two hours prior to bedtime and massage it into their scalp. The side effects can include shedding (first 2-8 weeks), scalp itching/flaking (less with 5% foam), or facial hair growth
ORAL PRESCRIPTION TREATMENTS
Oral Spironolactone
This medication is often preferred due to its extensive use and safety record for women with acne, hirsutism, polycystic ovarian syndrome. The side effects may include headache, fatigue, orthostatic hypotension (lightheadedness with standing up); hyperkalemia (high potassium); breast tenderness, decreased libido, menstrual irregularities; theoretical risk of feminization of male fetus (avoid in pregnancy). For patients over age 45 or with history of heart or kidney disease, there is a need to check potassium levels at baseline, 2 months, and then every 3-6 months afterwards.
Oral Finasteride
For patients that do not tolerate or prefer to avoid Spironolactone or have a poor response, another option is oral finasteride. Because the side effects in women include feminization of a male fetus, it is not recommended for women of child-bearing potential.
Oral Minoxidil
If the patient dislikes the daily application of topical minoxidil or experienced irritation with topical minoxidil, oral minoxidil is another effective option. Very low-dose oral minoxidil is increasingly prescribed as it has been shown to be effective for many women and the very low dose minimizes side effects.
OTHER TREATMENT OPTIONS
Platelet Rich Plasma (PRP)
Blood is drawn and centrifuged to yield a yellow liquid containing concentrated platelet and growth factors. This liquid is then injected into the scalp to stimulate hair growth. The regimen involves 3 monthly treatments and then every three to six months afterwards for maintenance. PRP is a relatively new treatment. PRP can be used in combination with other treatments. The long term results can vary for each patient. PRP is generally well tolerated with minimal side effects. Side effects can including burning during the injection, bleeding after treatment, scalp discomfort, redness, swelling or headaches.
Low-Level Laser Therapy (LLLT)
This procedure is known as photobiomodulation. There is some evidence of efficacy in small studies. This treatment can be used in addition to medications and PRP. The procedure works by shining specific wavelengths of light on the scalp to stimulate hair production in affected cells.
Hair Transplantation
Hair transplant surgery is an option for those who do not respond well to other treatments. This is a surgical procedure that moves hair follicles from one part of the scalp to bald or thinning areas. It is less useful for women with diffuse hair loss.
SUMMARY
In conclusion, female pattern hair loss often requires long-term treatment, as there is no permanent cure. Treatment should be tailored to each patient depending on their individual needs. PRP, oral medications, topical treatments and low level laser therapy are options. Hair transplantation is also an option for those who do not respond well to other treatments. It is important to discuss all of these with your doctor and find the best treatment for you. Maryland Laser Skin and Vein is here to help you find the best treatment for your hair loss. Please don’t hesitate to contact us with any questions or concerns.