HAIR LOSS MEDICATIONS & TREATMENTS

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. 

 

 1. Anthralin

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.  READ MORE.

 

2. Bimatoprost (Latisse)

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. READ MORE.

 

3. Cephalexin

Cephalexin is an antibiotic which is used to treat conditions such as folliculitis decalvans and dissecting cellulitis. READ MORE.

 

4. Ciprofloxacin

Ciprofloxacin is an oral antibiotic used to treat conditions such as folliculitis decalvans and dissecting cellulitis. READ MORE.

 

5. Clindamycin

Clindaymycin is an oral antibiotic used to treat conditions such as folliculitis decalvans. READ MORE.

 

6. Cloxacillin

Cloxacillin is an oral antibiotic used to treat conditions such as folliculitis decalvans. READ MORE.

 

7. Cyclosporine

Ciprofloxacin is an oral immunosuppressive medication which is sometimes used to treat conditions such as lichen planopilaris, alopecia areata, discoid lupus. READ MORE. 

 

8. Dapsone

Dapsone is an oral medication which is sometimes used to treat conditions such as folliculitis decalvans. READ MORE.   

 

9. Diphencyprone

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.  READ MORE.

 

10. Doxycycline

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. READ MORE. 

 

11. Dutasteride

Doxycycline is an oral medication used off-label to treat male pattern hair loss (androgenetic alopecia) and sometimes used 'off label' in other conditions such as frontal fibrosing alopecia. The drug is a 5 alpha reductase inhibitory drug similar to finasteride. Unlike finasteride, dutaseteride is not FDA approved for hair loss. The drug is used in post menopausal women on occasion.  Only a physician knowledgable about this treatment should prescribe to women. READ MORE.

 

12. Finasteride

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. READ MORE.

 

13. Hair Transplantation

 

*** Dr. Donovan no longer provides hair transplantation services in his practice ***

Hair transplants are now performed via follicular unit transplantation in men and women to restore hair density in a natural appearing manner. Follicular unit transplantation is a modern state-of-the art method whereby hairs are removed from the back of the scalp (the "donor" area) and prepared via high magnification microscopes into natural groupings of 1-4 hair follicles (called "follicular units") and transplanted into the front or top of the scalp  (the "recipient" area).  

 

Hair TraFollicular Unit Strip Surgery (FUSS) vs Follicular Unit Extraction (FUE)

Follicular units can be obtain from the back of the scalp (donor area) in two ways: follicular unit strip surgery (FUSS) or follicular unit extraction (FUE). At Donovan Medical, we perform both methods, and both methods have distinct advantages and disadvantages. Dr. Donovan takes great care in discussing these issues with patients during their consultation. Not all patients are ideal candidates for follicular unit strip surgery and not all patients are ideal candidates for follicular unit extraction.   Around the world, FUSS continues to be more commonly performed than FUE.

 

a) Follicular Unit Strip Surgery (FUSS)

The first method - follicular unit strip surgery - involves removing a strip of tissue from the back of the scalp and placing stitches in the area where the hair was removed.  The strip of tissue is then processed by our hair transplant nurses & technicians into individual follicular units.  Individuals with a small area of hair loss may require a 800-1300 follicular units, whereas individuals with large areas of hair loss may require over 3000 follicular units  A small scar forms at the back of the scalp where the hair was removed, but this is easily camouflaged by one's existing hair. The scar appears as a very fine line about half way up the back of the scalp and is therefore sometimes referred to as a linear scar.

 

b) Follicular Unit Extraction (FUE)

The second method - follicular unit extraction - involves removing hairs from the back of the scalp one by one. The technique does not involve use of stitches and does not produce a linear scar. Rather the technique of FUE leads to the formation of very small "micro-scars" that are circular but easily hidden within one's existing hairs. Despite the myths, FUE is not scarless.  It leads to mircro-scars that can not usually be easily seen and therefore allow patients (especially men) to have the option of shaving their heads in the future without showing a linear scar. 

 

Common Reasons for Hair Transplants

 The five most common reasons include:

1. Hair Transplantation for Men with Male Pattern Baldness

2. Hair Transplantation for Women with Female Pattern Hair Loss

3. Hair Transplantation for Traction Alopecia

4. Hair Transplantation for Inactive Scarring Hair Loss Conditions  

5. Hair Transplantation to Camouflage Scars following Facial Cosmetic Surgery 

 

 

13. Hydroxychloroquine (Plaquenil)

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.  READ MORE

 

14. Isotretinoin

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. READ MORE.

 

15. 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. READ MORE.

 

16. Methotrexate

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. READ MORE. 

 

17. Metronidazole

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. READ MORE.

 

18. Minoxidil

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. READ MORE.

 

19. Mycophenolate mofetil (MMF) 

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).  READ MORE

 

20. Pimecrolimus (Elidel)

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.  READ MORE. 

 

21. Pioglitazone

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.  READ MORE.

 

22. 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. READ MORE. 

 

23. Prednisone

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. 

 

24. Rifampin

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.  

 

25. Saw Palmetto

Saw palmetto has been studied for use as a pharmacologic inhibitor of the enzyme 5 alpha reductase. Its benefit in treating hereditary thinning (androgenetic alopecia) still remains unclear. A limited number of research investigations have suggested minor benefit. Despite its classifcation as a natural substance, side effects are possible in both men and women.  READ MORE.

 

26. Spironolactone

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. READ MORE. 

 

 27. Squaric acid dibutyl ester

The use of squaric acid dibutyl ester in treating alopecia areata is identical to that of diphencyprone. READ MORE.

 

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.

 

29. Steroids,  injection forms

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 areatalichen planopilarisfrontal fibrosing alopeciacentral centrifugal cicatricial alopeciadiscoid lupuspseudopelade and traction alopecia.  READ MORE.

 

30. Sulfasalazine

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.

 

31. Tacrolimus (Protopic)

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. READ MORE.

 

 32. Tobacitinib

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. READ MORE.

 

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




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