How is hair fall treated?
Millions of men
and women worldwide are affected by hair loss (alopecia), which can cause
extreme anguish and affect overall psychological wellbeing.
There are many types
hair lossof, each with different causes, so correct diagnosis by a doctor with
specialised knowledge and expertise in hair loss is essential.
Depending on
the cause, up to 80% of people with limited hair loss will have spontaneous
hair regrowth over several months and don’t require treatment. Some people may
have relapses or have to wait several years for hair to return to normal.
In others –
especially those with large areas affected by hair loss – hair never regrows.
Treatment for
the most common form of progressive hair loss – called male and female pattern
baldness (androgenetic alopecia/female pattern hair loss) – focuses on
preventing hair loss, enhancing hair growth and covering bald areas of the
scalp.
While
researchers are continually working to develop new drugs and advanced surgical
procedures to reverse the appearance of pattern hair loss, there is not yet a
permanent cure.
Beware of
various alternative products and potions claiming to offer a miracle cure!
Make sure to
discuss your own needs, concerns and the emotional impact hair loss has on you
with your doctor.
Here are the five most common hair loss
treatment options:
1. Finasteride
(Finpecia or Propecia) 1mg. This oral tablet is taken once daily. Only available on prescription. Not a cure for hair loss.
Uses
(androgenetic alopecia)
How it works
Finasteride blocks the enzyme that converts testosterone to
dihydrotestosterone (DHT) in the follicle. As the main culprit in
androgenetic alopecia, DHT causes a shortening of the growth phase and thinning
of the hairs.
Effectiveness
Clinical trials have shown Finasteride to be highly effective. It
stops hair loss in 99% of men within a year.
A third have a slight increase in hair while a third show marked
improvement in hair growth.
In medical practice, the drug slows hair loss in most men and reverses hair miniaturisation in some.
Benefits
Shrinking the prostate gland in men susceptible to an enlarged prostate
is a beneficial side effect. Can be used alone or in conjunction with other
hair loss treatments including surgery.
Drawbacks
Only works over the long term when used daily and consistently.
Stopping the drug is likely to lose any hair gained within 12 months of
discontinuing medication. Not approved for use by women. May cause sexual side
effects e.g. decreased sexual desire (less than 0.5%).
2. Minoxidil
(Regaine) 2% topical medication. (5% dosage more effective, but only 2%
dosage available in South Africa without a prescription).
USES:
Minoxidil solution is applied topically to the scalp skin twice
daily.
It is used to treat both male and female pattern baldness (androgenetic
alopecia).
Also available in foam formulation (used only once daily).
Generic forms available
under other brand names and it is also included
as ingredient in some over-the- counter products.
How it works
Minoxidil's mode of action is not completely understood. It appears to
prolong the anagen (growth) phase of the hair follicle.
Effectiveness
Results of its effectiveness in slowing or halting hair loss to some
degree in men and women range from 50% to 80% of those treated at both 2% and
5% formulations.
Only about 20% of patients report new hair growth. More
effective when applied to defined areas of hair loss.
Benefits
No prescription needed for 2% dosage. Achieves excellent results in
stabilising and improving hair growth when used daily and consistently. Most
effective with correct diagnosis, and when used as part of a doctor-guided hair
restoration programme.
Drawbacks
Less effective when applied to large areas of hair loss. Usually
ineffective for some who continue to lose hair.
The more effective 5% solution is unavailable in South Africa on
prescription but has a significantly higher incidence of side effects e.g.
contact dermatitis.
3. Steroids
(e.g. cortisone) – available in injection and topical application.
USES
Alopecia Areata (condition in which immune cells destroy hair
follicles).
How it works
Steroids are usually injected into bald patches every 4-6 weeks until
hair growth is complete.
Effectiveness
Good outcome for injected steroid treatment when hair loss process present for less than one year. Limited success with topical steroids applied to the skin.
Benefits
Results may already be visible within a month of starting a course of
injections.
Drawbacks
Ineffective in adults affected by alopecia areata for a long period of
time. Painful – may need anaesthetic cream before injections.
4. Platelet-Rich
Plasma (PRP) or Stem Cell therapy
Minimally invasive, non-surgical treatment. In South Africa this
procedure, called Follicular Regener-8 Hair Loss Program
(FR-8) is offered by the Medical Hair Restoration Clinic.
USES
Treats hair loss and thinning hair in both men and women.
Effective for androgenetic alopecia (genetic balding) and other types of hair
loss including Alopecia areata (AA) and Alopecia universalis (AU).
How it works
A specialist draws 120ml of patient’s own blood, similar to blood taken
for a routine lab procedure. Blood is placed into a sophisticated
centrifugation technique centrifugal machine that separates the protein-rich
platelets from other components. These are then injected directly into the
sparse recipient area to promote hair growth. Most effective when used in
combination with other transplant procedures.
Effectiveness
Blood platelets and plasma are rich in various growth factors (GF’s)
and cytokines (biologically active molecules). While PRP has the ‘potential’ to
stimulate and repair hair growth, this procedure is ‘not proven or approved’,
according to the International Society of Hair Restoration Surgery (ISHRS).
Benefits
Simple, quick and painless. No recovery or down time period.
Claims to have enduring, long-lasting effects.
Drawbacks
Procedure can take up to three months to show results. Many patients
have shown immediate improvement in hair growth and thickening. Booster
treatments needed every 3-4 months.
5. Hair
transplantation surgery
(Lateral Slit Technique)
USES
Male and female pattern baldness (androgenetic alopecia/female pattern
hair loss)
How it works
Tiny individual micro and mini follicular units not affected by the
hair-loss process are relocated from the sides of the head (donor area) into
the area of bald skin (recipient site). Transplanted hair needs to be cut,
washed and styled like normal hair.
Effectiveness
Transplanted hair follicles (roots moved from their original location
to a donor area) act in the same way as they did in their original site.
Thus, they will continue to grow and not fall out due to pattern
baldness because hair in this area is not sensitive to the male hormone DHT.
Benefits
Fairly simple procedure using local anaesthesia. Transplanted follicles
start to grow 3-4 months after surgery.
Transplanted hair won’t ever fall out - it originates from the donor
area on the sides of the scalp.
Drawbacks
Expensive. Takes 10-12 days before stitches can be removed post
surgery. Full results apparent only 8-12 months later.
Hair loss is a lifelong process – further procedures may be necessary
to fill in ongoing hair loss.
6. Follicular transfer is a more advanced form of hair transplant surgery,
which uses a sophisticated restoration robotic system called ARTAS to
transplant hairs in groups of 1-4 hairs as they grow naturally.
This minimally invasive procedure creates increased hair thickness with
a natural pattern and appearance.
Unfortunately it is expensive (up to R150, 000) and is not widely
available since only a few surgeons worldwide have mastered or have experience
in all aspects of the technique.
Other treatments
There are many products (shampoos, lotions) and supplements on the
market that claim to reduce or reverse hair loss. Some work and some don't, and
outcomes often depends on the individual and the cause of hair loss.
There are also home-use devices that promise to stimulate hair growth,
such as hair loss laser bands, brushes and combs.
One of the best ways to preserve your hair and health is to life a healthy lifestyle. As a start, take a look at the role of a healthy diet in preventing hair loss.
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Sources:
1. A randomized clinical trial of 5% topical Minoxidil versus 2%
topical Minoxidil and placebo in the treatment of androgenetic alopecia in men.
Olsen EA1, Dunlap FE, Funicella T, Koperski JA, Swinehart JM, Tschen EH,
Trancik RJ. J
American Academy of Dermatology.
2. Efficacy and safety of finasteride therapy for androgenetic
alopecia: a systematic review Mella JM, Perret MC, Manzotti M, Catalano HN,
Guyatt G. Efficacy and safety of finasteride therapy for androgenetic
alopecia: a systematic review. Archives of Dermatology 2010; 146(10): 1141-1150.
3. The Finasteride Male Pattern Hair Loss Study Group – A world-wide
study group includes amongst others (South Africa – J Cilliers, Cape Town; M
Sher, Johannesburg; G Todd, Cape Town). 2002. Long-term (5-year) multinational
experience with Finasteride 1 mg in the treatment of men with androgenetic
alopecia. European Journal of Dermatology 12:38-49.
4. International Society of Hair Restoration Surgery, 7 Innovative techniques
for hair transplantation
http://www.ishrs.org/article/7-innovative-techniques-hair-transplantation
5. Treatments for male-pattern baldness, Dr Maria Bonnici, International Journal of
Aesthetic and Anti-Ageing Medicine http://content.yudu.com/web/1wzd1/0A1radk/PRIMEIntVol6Issue1/flash/resources/18.htm
6. Med hair Cape town, Hair restoration surgery
http://www.medhair.co.za/treatments/hair-surgery-options/restoration-surgery/
7. International Society of Hair Restoration Surgery, Hair loss cures and
treatments, http://www.ishrs.org/content/hair-loss-cures-and-treatments
8. South African Hair Foundation, Causes of hair loss, http://southafricanhairfoundation.co.za/causes_hair_loss.htm
9. Dermatology times, Managing female pattern hair loss: What works?
http://dermatologytimes.modernmedicine.com/dermatologytimes/content/tags/alopecia/managing-female-pattern-hair-loss-what-works?page=full
10. Med hair Cape
town, Hair
loss can affect anyone at any age,
http://www.medhair.co.za/blog/hair-loss-articles/platelet-rich-plasma-or-prp/ Image Courtesy by: Adobe Stock & Google
