The FDA has only approved two drugs for the treatment and management of androgenic alopecia. These include:
(1) Minoxidil (Rogaine)
(2) Propecia (Finasteride)
Although manufacturers of laser hair growth devices also claim to have received FDA clearance, this has only been issued for the area of safety, as opposed to effectiveness. This is why such products are being sold commercially with the ability for hair loss sufferers to use them in the comfort of their own home.
The range of treatment options through the use of medications is quite limited. However, many doctors will prescribe other drugs off label for patients with pattern baldness if they deem it safe to do so. This practice is legal in the United States. Physicians are allowed to use their expertise to help patients through their own discretion.
One example is the use of Spironolactone. This drug is mainly used to treat high blood pressure in order to prevent heart attacks, strokes and kidney problems. It can also be used as a diuretic and to address the excess production of a hormone called aldosterone.
How Would Spironolactone Help With Hair Restoration
Within the context of restoring hair, Spironolactone is only recommended for use by women. The risk of certain side effects makes it an inappropriate option for men. Examples include:
(1) sexual dysfunction
(2) gynecomastia (male breast enlargement)
Spironolactone has a unique chemical structure. This enables it to occupy the androgen receptors on the hair follicles of those who are genetically predisposed to androgenic alopecia.. Therefore, it is able to prevent DHT (dehydrotestosterone) from binding to these protein receptors. And this can be valuable for preventing the miniaturization of these hair structures.
Spironolactone and Female Pattern Baldness
Unlike men, hair loss in women is often due to a much wider range of dynamics. In male pattern baldness, the central pathway involves the breakdown of testosterone into dehydrotestosterone. The DHT which results from this, prevents normal levels of nutrients from being absorbed by the follicles. These hair growing structures shrink. And the shafts which emerge with each new growth cycle becomes thinner and thinner until follicles are no longer able to produce hair.
While these processes also occur in women, the effect of hormones plays a much larger role. Usually, this results in global thinning across the head.
In some women, hair loss is primarily due to high levels of androgens and the DHT pathway. If this is the case, Spironolactone may be prescribed off label for the purpose of restoring hair growth.
A doctor may even recommend the simultaneous use of Rogaine to supplement the overall hair restoration effects. 2% is the concentration that is considered safe for most women. However 5% may be used under the direction of a dermatologist.
Incorporating Rogaine into a hair loss treatment regimen can offer a more comprehensive strategy for addressing female pattern baldness. Minoxidil works as a vasodilator. This helps increase the availability of oxygen to the scalp to fortify the hair follicles and help them recover more of their ability to grow new hair.
The overall effectiveness of any medication for hair loss is usually contingent on whether or not the intervention is undertaken during the earliest possible stages of the condition.
Dr. Sanusi Umar is a pioneer in hair transplant surgery and is widely published and recognized in his field. Dr. Umar is certified by the American Board of Dermatology and the founder of DermHair Clinic in Los Angeles, CA.