It would be easy if all the different types of hair loss were treated similarly. But they are not. One type of hair loss may be treated completely differently from another type of hair loss. In alphabetical order below, Dr. Donovan outlines the different types of medications for hair loss. These handouts are prepared specifically for patients of Dr. Donovan's practice.
This is a a topical medication often used off-label for promoting hair growth in those with alopecia areata. Anthralin can sometimes be used with other treatments such as minoxidil. Hair growth can be seen in about 8-12 weeks, but can occur as early as 5 weeks.
Bimatoprost is FDA approved for helping promote longer eyelashes. It can sometimes be used 'off-label' for treating eyelash loss in individuals with alopecia areata and for promoting eyebrow growth in a whole range of different conditions.
Cephalexin is an antibiotic which is used to treat conditions such as folliculitis decalvans and dissecting cellulitis.
Ciprofloxacin is an oral antibiotic used to treat conditions such as folliculitis decalvans and dissecting cellulitis.
Clindaymycin is an oral antibiotic used to treat conditions such as folliculitis decalvans.
Cloxacillin is an oral antibiotic used to treat conditions such as folliculitis decalvans.
Ciprofloxacin is an oral immunosuppressive medication which is sometimes used to treat conditions such as lichen planopilaris, alopecia areata, discoid lupus.
Dapsone is an oral medication which is sometimes used to treat conditions such as folliculitis decalvans.
Diphencyprone (or "DPCP") is a topical medication which is sometimes used to treat conditions such as alopecia areata. DPCP is applied to the scalp in order to cause irritation and an allergic response. In some ways, this “fools” the immune system into mounting a response against the DPCP chemical rather than against the hair follicle. This helps the hair to regrow in many patients.
Doxycycline is an oral medication which is sometimes used to treat conditions such as lichen planopilaris, frontal fibrosing alopecia, folliculitis decalvans and central centrifugal cicatricial alopecia. The medication is an antibiotic, and closely related to tetracycline. Despite its role as an antibacterial agent, it can also be used to reduce inflammation in many types of immune based hair diseases.
Dutasteride is an oral medication which is sometimes used "off label" in the treatment of androgenetic alopecia in men and post menopausal women as well as frontal fibrosing alopecia in post menopausal women. Those dose is typically 0.5 mg per day. The drug blocks the production of a hormone known as dihydrotestosterone or “DHT.”
Finasteride is an oral medication which is FDA approved to treat male pattern hair loss (androgenetic alopecia) at a dose of 1 mg per day. The drug blocks the production of a hormone known as dihydrotestosterone or “DHT” and helps approximately 90 % of men to either halt hair loss or increase hair density.
13. Hair Transplantation
*** Dr. Donovan no longer provides hair transplantation services in his practice ***
For a link to hair transplantation about how modern hair transplants are performed, click here
Hydroxychloroquine (sometimes referred to to under it's popular trade name“Plaquenil”) is a type of anti-inflammatory medication used to treat some types of hair loss such as lichen planopilaris and sometimes discoid lupus and frontal fibrosing alopecia.
This is a type of vitamin A pill. It is rarely used for certain types of scarring hair loss conditions, such as folliculitis decalvans and dissecting cellulitis.
16. Low level laser therapy (LLLT)
In recent years, many studies have shown that LLLT based laser treatment with red light wavelengths can help promote hair growth. Nowadays, a number of devices are available on the market. No head to head comparative studies have been done to show one laser device is more effective than the other.
Methotrexate is a tablet which is used to “reduce” the activity of the immune system. Unlike many pills, methotrexate is used only once per week. It is used for many hair loss conditions such as alopecia areata, discoid lupus, frontal fibrosing alopecia and lichen planopilaris.
Metronidazole is a type of antibiotic medication. Interestingly, it can also help to stop inflammation and is therefore occasionally used in condition such as lichen planopilaris.
Minoxidil is the first FDA approved treatment for hair loss. It is applied directly to the scalp. Despite its use for nearly 30 years, the exact means by which it promotes hair growth is not completely understood. Minoxidil, however, does not affect hormones.
Mycophenolate mofetil is a medication which reduced inflammatory - it is a type of immunosuppressive medication. It is sometimes used 'off-label' for scarring hair loss conditions such as discoid lupus and lichen planopilaris and rarely frontal fibrosing alopecia (FFA).
Pimecolimus is a non steroid topical cream that is used to stop inflammation in many types of inflammatory hair loss conditions such frontal fibrosing alopecia.
Pioglitazone (Actos) is an oral medication that is used for treatment of type 2 diabetes. Interestingly, it has also been found to help patients with lichen planopilaris – even those who do not have type 2 diabetes.
23. Platelet rich plasma
Platelet-rich plasma, (shortened to PRP) is increasingly being used in hair loss around the world. PRP has been used by physicians since the 1990′s in various areas of medicine. PRP treatments involve using a small amount of the patient’s own blood to generate an injectable form of hair treatment. PRP contains many growth factors that stimulate hair follicles.
Prednisone belongs to a class of medications called corticosteroids. Drugs like prednisone are commonly used to reduce the activity of the immune system. Usually, the drug is prescribed in situations where the immune system is too active - such as autoimmune conditions. The actual dose of Prednisone will vary depending on the type of hair loss being treated. In most situations, oral corticosteroid medication are recommended for short periods of time (a few weeks to a few months). Prednisone is sometimes prescribed for a few months in patients with alopecia areata and lichen planopilaris. Used carefully, cautiously and for short periods, the medication can be very helpful.
Rifampin is an antibiotic medication. It is a well known medication for treating tuberculosis but interestingly can be used in many other conditions -such as the hair loss condition folliculitis decalvans.
Ruxolitinib (also known by the name “Jakafi” and "Jakavi") is a newer medication now approved for use in various blood disorders). In fact, the drug is formally approved by the FDA for patients with moderate to severe rheumatoid arthritis. Ruxolitinib is presently being investigated for potential use in treating alopecia areata.
Spironolactone (sometimes prescribed under the name Aldactone) is an oral tablet that helps inhibit the effects ‘androgen’ hormones. The drug is sometime used to treat hair loss in females. One research investigation from Australia suggested that it helps halt hair loss in about 35-40 % of female patients and led to an improvement in hair density in another 35-40 % of female patients.
28. Steroids, topical forms
Topical formulations of corticosteroids include steroid lotions, creams, gels, foams, ointments and shampoos. A variety of different strengths are available form the very weak hydrocortisone strength (so called class VII) to the very strong clobetasol strength (so called class I). Topical formulations of steroids are used for a range of hair loss conditions that have inflammation - including alopecia areata alopecia, frontal fibrosing alopecia, lichen planopilaris, discoid lupus, central centrifugal cicatricial alopecia.
Read more about topical steroids: Clobetasol for Hair Loss
Cortisones are medications which act to reduce inflammation. The injection forms are a key part of the treatment for many types of hair loss, including alopecia areata, lichen planopilaris, frontal fibrosing alopecia, central centrifugal cicatricial alopecia, discoid lupus, pseudopelade and traction alopecia.
Sulfasalazine is a medication which is commonly used in treating inflammatory bowel disease and rheumatoid arthritis but has been shown to be helpful in a proportion of patients with the hair loss conditions called alopecia areata. Your doctor will advise how this is to be used. Baseline blood tests will be ordered BEFORE you start sulfasalazine (complete blood counts, kidney and liver, folate, B12 levels, urinalysis with microscopy, G6PD). Blood tests will be checked every few weeks for a couple of months, then less often afterwards.
Tacrolimus ointment (also known by the brand name Protopic) is a "non-steroid" topical treatment. Like topical steroids, tacrolimus helps to reduce inflammation and is often even used together with topical steroids. Tacrolimus is used topically in several scarring hair loss conditions.
Tofacitinib (also known by the name “Xeljanz”) is a newer medication now approved for use in rheumatoid arthritis (RA). In fact, the drugs is formally approved by the FDA for patients with moderate to severe RA. Tofacitinib is presently being investigated for potential use in treating alopecia areata.
33. Tumor necrosis factor inhibitors (TNF inhibitors)
TNF is a chemical (cytokine) that is often produced in great amounts during inflammation. TNF blocking medications helps stop the action of TNF. These include medications such as etanercept (Enbrel), adalimumab (Humira), and infliximab. These drugs are used in a limited number of hair disorders, including dissecting cellulitis