Hair Loss
Treating Hair Loss
Hair loss or Baldness involves the loss of hair where it often grows, especially on the head. The most common form of baldness is a progressive hair thinning condition called androgenetic alopecia, commonly referred to as male pattern baldness (MPB) or female pattern baldness (FPB). For many years, scientists thought that MPB was caused by the predominance of the male sex hormone, testosterone. While testosterone is at the core of the balding process, it is now known that Dihydrotestosterone (DHT) a metabolite of testosterone, is the primary agent responsible for premature hair loss.
Testosterone converts to DHT with the aid of the enzyme Type II 5-alpha reductase, which is held in a hair follicle’s oil glands. The level of DHT binding to the receptors in the scalp hair follicles is of major concern in terms of the underlying cause of hair loss. DHT reduces the growth phase of the hair follicle causing them to shrink. Simultaneously, the galea aponeurotica membrane in the scalp thickens, becoming inelastic and restricting blood circulation. Eventually, the follicle atrophies to a point where hair growth is no longer possible. The normal rest-grow cycle of the hair follicle is altered and follicles remain dormant for the majority of the time. As a result, hairs fall out at the same rate, but are not replaced. Eventually, all the hairs revert to the rest phase and a bald spot, or baldness results.
Other causes of hair loss include:
- Stress
- Medications such as those used in the treatment of high blood pressure, high cholesterol, other heart problems, cancer, acne and birth control pills.
- Hormone imbalances – low or high thyroid, adrenal imbalances
- Fungal infections
- Nutritional deficiencies – Vit D and/or iron deficiencies
Commonly used Treatments
Minoxidil is one of the most common forms of treatment for hair loss which stimulate hair growth in individuals with androgenetic alopecia. The mechanism by which minoxidil stimulates hair growth is not known but is thought to have a direct effect on the hair follicle to sustain the anagen phase of the hair cycle. It has also been shown to have a vasodilatory effect on the scalp. Minoxidil is a direct acting peripheral arterial dilator that reduces blood pressure by decreasing peripheral vascular resistance.
Retinoic Acid promotes hair growth in combination with minoxidil. Experimental evidence suggests that retinoic acid itself may play a significant role in hair growth in addition to increasing the absorption of the minoxidil.
Many substances have shown to block the action of 5-alpha reductase, blocking DHT production and thus overcoming the cause of hair loss. Substances such as azelaic acid, progesterone, ketoconazole, spironlactone and saw palmetto are increasingly used to prevent DHT production and thus help overcome hair loss.
Treatments Available through our Laboratory:
Minoxidil/Azelaic Acid/Arginine Hair Lotion – Over the Counter
This combination generates new hair growth more effectively by using a combination of drugs with complementary modes of action. Firstly, 5% Minoxidil appears to work by gradually enlarging and lengthening hair follicles that that have been gradually shrinking. Secondly, a potent inhibitor of 5-alpha-reductase has been included to prevent the formation of DHT, which prevents further hair loss by addressing the cause of the problem. Finally, Arginine is also included which helps increase nitric oxide production which is used by the hair follicle to maintain and promote new hair growth,This triple action is more effective than the single ingredient treatments currently on the market. The lotion (1ml) must be used morning and night for 2 to 4 months to see evidence of new growth and up to 6 months to get a proper estimate of weather it will work for you. It must be continually used to be effective. Once treatment has ended the hair will return to its original state in about 3 months.
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Prescription Range of Hair Loss Products
More potent mixtures are available however legally require a script for supply. These include:
- Retinoic Acid may be used alone or in combination with minoxidil and azelaic acid. It has been shown to increase cell turnover thus increasing the rate of hair growth. It has also been shown to increase the absorption of Minoxidil making it even more effective, allowing the hair to grow even faster. Retinoic acid may increase sensitivity to sunlight so extended periods of sun exposure should be avoided. If sensitivity to light is a problem it may be overcome by using this preparation at night while the preparation mentioned above can be used for the morning applications.
- Spironalactone 2% liquid or 5% lotions are also available. These are an anti-androgen which binds to androgen receptors in the scalp thus preventing testosterone and DHT from binding to their receptors. In addition it also reduces the production of DHT from testosterone thus effectively treating the cause of hair loss. Due to its instability with minoxidil we recommend to use a seperate spironolactone hair lotion rather than combining it with other ingredients. When applied together no such problem occurs
- Progesterone also inhibits 5-alpha-reductase and may be used in a hair lotion for extra effects.
- 7.5% Minoxidil is also available however it will require a script.
For more information on our prescription range of treatments contact us for details.
Finasteride – Prescription Required
Finasteride is a 5-alpha-reductase inhibitor which has approved for use in men. It does not benefit women with hair loss. Finasteride helps prevent miniaturisation of existing hair follicles and also assist in the recruitment of miniaturised hair follicles to become terminal hairs (larger and thicker). Finasteride (1mg) is a tablet that manufacturers recommend should be taken daily however some evidence suggests lower doses less frequently may be just as effective. It must be taken for a period of 3 months or more before any benefit is seen and it must be continued in order to maintain any benefits.
An increasing number of men are suffering from the side effects of Finasteride long after therapy has been discontinued. These side effects include erectile dysfunction, low libido, fatigue, etc. Several theories exist which may explain why this occurs however there is not a definitive answer yet. We have helped rebalance several men’s hormones after they had been disrupted due to this drug. Therefore you should weigh the risks before comensing such therapy.
Nutritional Recommendations
The amino acid L-lysine has been found to inhibit the 5-alpha-reductase enzyme and requires a 700mg daily dose. Beta sitosterol is another natural enzyme inhibitor requiring 300mg a day – click here to order. The amino acid L-arginine helps increase nitric oxide production which is used by the hair follicle to maintain and promote new hair growth. It requires 900mg a day for this effect.
Iron deficiencies may cause hair loss and if tested and found to be below optimal levels supplementation should be considered using an organic form of iron such as ferrous fumerate or iron amino acid chelate.
Adrenal support may be required in some patients as the increase in testosterone can result from adrenal fatigue as the body attempts to utilize an alternate energizing hormone.
Hair Loss Caused by Hormone Imbalance
Hair loss may be due to a hormone imbalance or deficiency. The hormonal imbalances can include:
* In some cases it can be caused by an overproduction of androgenic hormones. Excess body fat may store androgens such as DHEA and testosterone which cause hair loss. If appropriate weight loss should be considered to reduce testosterone and DHEA levels thus returning normal hair growth. Anti-androgens may also be used in these cases and may include: progesterone, spironolactone, cimetidine, cyproterone and finasteride.
A popular product in these cases is the minoxidil/azelaic acid mixture mentioned above mixed with spironolactone added for increased effectiveness.
* Estrogen replacement may also help to counteract the excessive androgen effects on hair follicles. However in rare cases the extra estrogen may be converted into testosterone by 5-alpha-reductase and thus exacerbate the problem.
To avoid this a low dose estradiol hair lotion is available which is applied directly on the scalp thus minimising the chances of converting into testosterone.
* If a women’s progesterone levels decrease the body responds by increasing the adrenal hormone androstenedione, an alternative precursor for sex hormone production. This hormone has androgenic properties causing hair loss. By restoring progesterone levels through supplementation the level of androstenedione will return to normal and hair growth should return in four to six months in most women. However in rare cases progesterone supplementation may exacerbate further hair loss possibly due to an increased production of testosterone. Levels should be monitored to ensure this does not occur.
Again, to avoid this bioidentical progesterone hair lotion is available which is applied to the scalp for a targetted action and less chance of conversion into testosterone
* Low thyroid function (TSH<2) may also cause hair loss. Thyroid function should be tested to determine if it is the cause. If so thyroid hormone supplementation will return normal hair growth after several months.
As you can see hair loss is an individual matter and hormones should be monitored to determine the exact cause so the treatment received is appropriate.
In order to arrange a consultation or alternatively to obtain more information you can contact us.
All treatments mentioned in this article are available through our laboratory. Refer to our on-line pharmacy to order now or alternatively refer the ordering information page to view the various ordering methods available.
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