Medication Therapy
Medication Therapy
Treatment
Both male and female pattern balding is caused by hair follicles being oversensitive to the hormone, dihydrotestosterone (DHT). This causes the hair to become thinner and shorter over time. Effective treatment for pattern (hereditary) balding should involve the use of medications that reduce the level of DHT to stop further hair miniaturisation.
How it works?
How it works?
Finasteride is primarily a medication for male pattern baldness. It is not a commonly used medication in females – mainly because there hasn’t been any consistent beneficial effects. The use of finasteride in females may only be limited to conditions like hirsuitism and polycystic ovary syndrome. Finasteride works by partially inhibit the enzymes that convert testosterone into DHT, hence reduce production of DHT.
Why we use Medication Therapy?
Why we use Medication Therapy?
At a dose of 1mg taken once a day, Finasteride has been shown to reduce the levels of DHT in the scalp by 60%. In clinical trials this has had the following effects:
Stops hair loss in 86% of males
65% of men report a significant increase in hair growth
These positive effects can be seen in the first year or two when starting treatment.
Who is suitable for Medication Therapy?
Who is suitable for Medication Therapy?
Finasteride is approved for men aged 18-41 who have mild to moderate male pattern hair loss, but it is widely used in men over 41. Finasteride is not indicated in women, and it is contraindicated in women who are or might potentially become pregnant because it might cause abnormalities of the external genitalia of a male fetus.
Expected result
Expected result
Finasteride can begin to show results after 3-6 months. Results may take longer to show in some men; therefore, it is important to be patient and not stop the treatment too early on. It’s recommended you stick with treatment for 1 year before measuring the final result.
It is crucial to stress that no changes in hair density over time is not a treatment failure but rather a treatment success. Because with medication therapy, the goal is to stabilize the hairline and prevent further hair loss.
- Treatment Time – Continuous Unless there is a contraindication
Preparation & Aftercare
Preparation
Preparation
Here at The Hair Institute, we offer comprehensive hair assessment performed by our experienced hair loss doctor. You will be required to complete our detailed hair health questionnaire and a thorough physical exam to determine the underlying cause of your hair loss. You might also need further tests such as blood test, scalp biopsy, light microscopy to uncover other possible disorders of scalp.
During treatment
During treatment
Once the medication therapy has commenced, your doctor will arrange regular follow up to monitor any side effects and also adjust medication to ensure you get the optimal result from the treatment you received.
Aftercare
Aftercare
If medication is well tolerated and your hairline also become stabilized, you may continue to take medication to retain its benefit (for as long as you wish to maintain your hair). Further ongoing care will also need to focus on the management of general health and lifestyle.
FAQ
Have further questions or want to learn more?
What is the benefit of using medical grade compression stockings?
- Increasing speed of blood flow – the stockings compress the major veins in the legs and reduce their diameter, thereby increasing the velocity of the flow.
- Reversing venous hypertension – When blood pools because of venous insufficiency and veins “pop-out” on the skin surface, pressure is put on the vein walls in these areas, called venous hypertension. Compression stockings support the walls, preventing them from overstretching, effectively reversing the hypertension.
- Supporting the calf-muscle pump – The calf-muscle pump is a collection of muscles in the legs that help circulation when they contract by squeezing blood along the veins toward the heart. Compression helps amplify and support this process
- Improving lymphatic drainage and preventing swelling – Compression supports lymphatic drainage of a chronic build-up of fluid and swelling in the limbs.
When should you take finasteride?
Finasteride is a medication you usually take once a day. The decision to start finasteride really depends on you. If you are concerned about your hair loss and you have been diagnosed with androgenic alopecia (male pattern baldness) then finasteride is a medication that can prevent further hair loss and help you grow thicker hair.
If you are planning on having a family soon then Finasteride might not be the medication you choose to have. Other treatment options like Minoxidil could be your first line treatment. After you have finished having children you can then think about adding in or swapping to Finasteride.
What are the side effects of Finasteride?
As with all medications there are of course some side effects of Finasteride. The two main side effects you ought to know about are:
- Low mood
- Sexual Dysfunction (2.1-3.8% of males)
For patients who do unfortunately suffer from these side effects – rest assured most patients recover well if they stop the medication. Interestingly, some patients recover despite continuing the medication- this suggests that the medication did not cause the side effect in the first place.
If you are worried about these side effects it is important you discuss them with your hair loss doctor as there are other treatment options available to you. This includes the option of taking the medication on alternate days.
What are the medication treatments available for female pattern hair loss?
The first-line treatment for female patter hair loss is topical Minoxidil. Unlike male pattern baldness, females can’t take medications such as finasteride to prevent DHT from acting at the hair follicle. This is because finasteride, in trials so far, hasn’t shown safe clinical evidence to prevent hair thinning and promote hair thickening.
Other treatment options that you can consider include Laser Therapy and PRP injections.
Some women who don’t respond to minoxidil may benefit from the addition of the anti-androgen drug spironolactone (Aldactone) for treatment of androgenic alopecia. This is especially true for women with polycystic ovary syndrome (PCOS) because they tend to make excess androgens. Doctors will usually prescribe spironolactone together with an oral contraceptive for women of reproductive age. (A woman taking one of these drugs should not become pregnant because they can cause genital abnormalities in a male fetus)
Is it safe to take Finasteride long-term?
Taking Finasteride over longer periods is considered to be safe – many men take the medication on a daily basis for years without experiencing any issues or problems. Like all medication, however, less than 4% of people will experience side effects – these tend to happen within the first six months and in the vast majority of people resolve on stopping Finasteride.
Does Finasteride work without Minoxidil?
Yes, Finasteride can work without Minoxidil – up to 90% of men will experience improvements in hair loss by taking Finasteride alone. However, most clinical studies have proven that Finasteride is most effective when taken in combination with Minoxidil. This is due to the fact that Minoxidil helps to increase blood flow to your hair follicles which improves the intake of Finasteride into these areas. This process increases the effectiveness of Finasteride inhibiting DHT and preventing male hair loss.
Can Finasteride make you tired?
No, Finasteride does not cause drowsiness. However, there are rare cases (less than 4% of the people who take it) where Finasteride can cause other side effects, such as erectile and ejaculation issues. However, these are almost always temporary and stop on cessation of the medication.