It may sound hard to believe but according to official statistics of the national health institute 35% of adult men and 25% of adult women suffer from genetically determined form of hair loss. These statistics only include the patients with hereditary hair loss also known as pattern baldness. They do not include alopecia areata patients or patients with other forms of either temporary or permanent hair loss not induced by dihydrotestosterone (DHT) effects. DHT is known to be the main culprit in causing hereditary hair loss. This natural metabolite of the male hormone testosterone, which is also being produced by female bodies, is the main culprit in causing genetic hair loss. This discovery was made incidentally in the 1990s in patients treated with finasteride (Proscar) for enlarged prostates. They started growing thicker and healthier hair and a few years later finasteride became approved for treating hair loss in men under the trade name Propecia. This medication became the first hair loss pill ever approved by the US Food and Drug Administration but it is suitable only to male patients. According to the latest research women could also benefit from using this drug but it could have negative effects on their bodies, especially if they became pregnant.
Armed with this knowledge the hair scientists started looking for new drugs that could mimic the activity of finasteride and one day become used for treating hereditary baldness. The second such drug that has undergone clinical testing for treating hair loss is dutasteride. This medication is also known under its trade name Avodart used to treat enlarged prostates. At the moment dutasteride happens to be in the last, fourth stage of clinical testing in South Korea for treating hair loss in men after being subjected to three phases of clinical testing both in the US and in Korea. Dutasteride is believed to be more powerful DHT blocker than finasteride due to its ability to inhibit both isotopes of the enzyme 5-alpha reductase which converts testosterone in DHT. The aim of the Korean study is to confirm this assumption and also to explore potential side effects it could cause to the patient. Similarly to finasteride, this drug cannot be used to treat female hair loss patients.
Female hair loss is specific in that it is diffuse and thus much harder to recognize in its early stage than male pattern baldness. In men it is only follicles on the top of their scalp that are affected by harmful effects of DHT. These follicles gradually lose their ability to produce hair whereas follicles at the back of the scalp and on sides usually remain unscathed and can be used for transplantation to the bald areas. They then preserve their resistance to DHT. In women hair loss is diffuse which means that any hair follicle around their entire scalp can be affected by DHT attacks but it only loses ability to produce one or two hairs but rarely all hairs. So it will always be able to grow at least one hair. However, if seemingly healthy hair follicle is transplanted to the thinner area it can at some time in the future start shrinking and lose one or two hairs so that the efficiency of hair surgery is being reduced. This is the main reason why women do not make very good candidates for hair transplantation. Add to that their inability to use finasteride or dutasteride and you better understand why female hair loss is more difficult to treat than hair loss in male patients.
However, there is at least one drug that can be successfully used for treating female pattern baldness. Its name is spironolactone or Aldactone and it is a diuretic with strong antiandrogenic properties which is being prescribed off-label to treat other health conditions in women such as hormonal acne, hirsutism as well as female pattern baldness. Its mechanism of action is to inhibit the conversion of testosterone to DHT and to block its activity at receptor sites in hair follicles. It is thus a very strong antiandrogen with feminizing effects and can only be used to treat hair loss in women and is unsuitable to men. It is considered as the weapon of the last resort for women suffering from hereditary hair loss and it is usually being prescribed to them only after all other treatments such as minoxidil have failed to deliver satisfactory results. In order to order spironolactone online female patients need to secure a prescription from their doctor.
There is yet one other treatment that needs to be mentioned when discussing the treatment options for hereditary hair loss. Its name is minoxidil or Rogaine and it is a topical application containing either 2% (women) or 5% (men) of minoxidil in form of a lotion, cream or a foam. When it comes to treating female hair loss the foam seems to be the most suitable option (as well as for men) because it enables the patient to avoid possible negative side effects, it is very easy to apply, dries fast and leaves practically no traces in hair. This treatment, however, is not based on counteracting the harmful effects of DHT and it should, therefore, be better combined with one of the aforementioned antiandrogenic treatments in order to achieve the best possible results. One thing that should be noted at the end is that patients are supposed the cover the whole cost of hair loss medications themselves as health insurance companies consider baldness as a lifestyle condition and do not reimburse the cost of its treatment.