Choosing a Medication for Hair Loss Treatment

Medically reviewed by Femi Aremu, PharmD

Hair loss, referred to clinically as alopecia, can be a distressing experience that can negatively impact your self-esteem and overall mental health. However, several medications are available to treat hair loss. These treatments differ in dosage forms, side effects, and the time they take to work.

The causes of hair loss can vary widely and include genetics, aging, side effects of certain medications, or other factors. The first step is to talk to your healthcare provider to determine the possible causes.

This article will discuss the causes of hair loss, the medications available for treatment, and what you should expect when taking them.

Causes of Hair Loss

There are several potential reasons why you might be losing your hair. The following are genetic and medical-related hair loss conditions that can be treated with medication.

Androgenetic Alopecia

"Androegenic alopecia" is the medical term for what is commonly known as male-pattern hair loss and female-pattern hair loss,. This type of hair loss results from inheriting genes that cause hair follicles to shrink and eventually stop growing.

This type of hair loss can start as early as your teens but usually emerges later in adulthood. Several medications can help treat it.

Alopecia Areata

Alopecia areata is a condition in which the body’s immune system attacks hair follicles and prevents growth. The term "alopecia areata" directly translates to “patchy hair loss” and is characterized by patchy bald spots. Although there is no cure, there are treatment options that can help manage the symptoms.

 Tinea Capitis

Tinea capitis, or scalp ringworm, is hair loss caused by a fungal infection. This type of hair loss is most commonly seen in children. It is characterized by hair falling off in circular patches, which can grow back over time. Treatment for this type of hair loss centers around treating the active fungal infection.

Other Causes

In other cases, hair loss may be caused by:

• Aging

• Certain medications, like cancer treatment

• Stress

• Hair damage

• Hormonal imbalances

• Vitamin deficiencies

• Certain health conditions, like thyroid disorders

Sometimes, hair loss medications are not always the right route for treatment. Speak with your healthcare provider about determining the exact cause of your hair loss.

What Medications Help Treat Hair Loss?

Options are available out there that can help manage and reverse hair loss. The following are medications you should talk to your healthcare provider about if you are seeking treatment.

Rogaine (Minoxidil)

Rogaine was originally developed as a medication for blood pressure. When it was first being studied, doctors observed hair regrowth in those taking it.

For this reason, Rogaine was developed as a topical formulation and is now approved by the Food and Drug Administration (FDA) for androgenic alopecia. It has also been used off-label to treat other hair loss conditions, such as alopecia areata.

This medication comes in two different strengths and is an over-the-counter (OTC) medication, meaning you do not need a prescription from a healthcare provider.

Since Rogaine is applied topically, there are very few side effects associated with this medication. Most commonly, you may experience dermatitis (skin inflammation), hypertrichosis (abnormal hair growth), or headaches.

As with most hair loss medications, don't expect to see hair growth overnight. After starting Rogaine, it can take a few months to notice changes.

Propecia (Finasteride)

Propecia is a prescription-only medication that is FDA-approved for androgenic alopecia in males.

Propecia works by targeting the protein that converts testosterone into dihydrotestosterone (DHT), a more potent form of testosterone. DHT is responsible for causing hair follicles to shrink, resulting in hair loss.

In studies with Propecia, those who took the medication maintained or increased the number of visible scalp hairs and noticed improvement in their hair in the first year. This improvement was also maintained through the remaining years of treatment.

Propecia is available only as an oral tablet. While Propecia generally is a well-tolerated medication, with few side effects experienced in the males studied, side effects seen in study subjects were:

• Breast tenderness and enlargement

• Problems with ejaculation

• Testicular pain

• Allergic reactions, including rash, itching, hives, and swelling of the lips and face

If getting screened for prostate cancer, tell your healthcare provider that you are taking Propecia. Propecia is known to affect blood levels of prostate-specific antigen (PSA), a lab value that is looked at during prostate cancer screening. Lower levels of PSA may present an unclear picture to your healthcare provider and cause inaccurate readings.

You should not take this medication if you are a female. In fact, if you are pregnant, you should not come in contact with Propecia as the active ingredient can cause birth defects.

Avodart (Dutasteride)

Avodart is a similar medication to Propecia. However, while Avodart works the same way that Propecia does, it is not FDA-approved to treat androgenic alopecia. It is used off-label to treat hair loss in males.

Like Propecia, pregnant people should not take or handle Avodart. Tell your healthcare provider you are taking this medication if you ever get screened for prostate cancer, as Avodart can also affect your PSA levels.

Aldactone (Spironolactone)

Aldactone is a prescription-only diuretic medication that can be used off-label for hair loss. It works by slowing down the production of sex hormones that are responsible for causing hair loss. As an antiandrogenic drug, it can help treat hair loss from hormonal or androgenic causes.

Because of the side effects it can have on males, oral Aldactone is only recommended for use in female-pattern hair loss.

The following are side effects that you may experience while taking oral Aldactone tablets:

• Dizziness

• High potassium levels

• Breast tenderness and enlargement

• Menstrual changes

On average, it takes at least six months to see a noticeable difference in hair loss after starting spironolactone.

Choosing the Right Medication

Choosing the right medication to manage your hair loss may be a difficult task. It is important to talk to your healthcare provider and work with them to help choose the best medication for you.

There are many factors to consider, such as the type of hair loss you have, whether you'll need a prescription, which dosage form you prefer to take, and how long the medication will take to work.

The following chart summarizes important information regarding each medication discussed in this article.

Are There Any Supplements for Hair Loss?

In addition to medications, certain supplements may also be helpful for managing hair loss and hair regrowth.

In particular, low levels of vitamin D, biotin (vitamin B7), and iron have been linked to hair loss. However, no data supports using biotin supplements to promote hair growth.

In studies looking at vitamin D levels and individuals with androgenic alopecia, more people with androgenic alopecia also had low levels of vitamin D compared to people without androgenic alopecia. It is generally recommended for people with low levels of vitamin D to be supplemented with vitamin D.

Iron is the most common nutritional deficiency, particularly in females. While the possible role of iron in hair loss has not been identified, it is common for women experiencing hair loss to also have low iron levels.

In people with hair loss who also have low iron levels, it is recommended to supplement them with iron. In addition to iron, it is important to make sure your vitamin C levels are in a normal range, as vitamin C aids in iron absorption.

Some evidence suggests that zinc supplements may help reduce hair loss. One study among women with hair loss found that 50 milligrams (mg) daily of zinc improves hair thickness. Still, there isn't enough research to warrant taking a zinc supplement if you do not have a deficiency.

Summary

Hair loss can be difficult to manage, bringing up negative emotions and impacting your quality of life. There are different types of hair loss, but androgenic alopecia is the most common type that can be treated with medication. Rogaine and Propecia are medications approved by the FDA, whereas Avodart and spironolactone are prescribed off-label.

Vitamin deficiencies, such as low vitamin D levels and low iron levels, can also cause hair loss. In these cases, adjusting your nutrition or taking supplements may help.

Hair loss medications have different dosage forms and side effects and can vary in how long they take to work. If you are interested in hair loss treatment, you and your healthcare provider can work together to decide on the best option for you.

Frequently Asked Questions

Can vitamin deficiencies cause hair loss?

Yes, certain vitamin deficiencies can cause hair loss. Deficiencies in vitamin D, iron, and biotin (vitamin B7) have been linked to hair loss. Supplementation with vitamin D, biotin, and iron is recommended only if you are deficient in any of these vitamins and are experiencing hair loss.

What medications cause hair loss?

Chemotherapy medications are commonly associated with hair loss. While not all chemotherapy medications cause hair loss, some are very common such as Cytoxan (cyclophosphamide), Adriamycin (doxorubicin), and Taxol (paclitaxel). Other medications like isotretinoin, antidepressants, beta-blockers, and antiepileptic drugs can also cause hair loss.

Are hair loss medications safe?

Hair loss medications, for the most part, are generally safe. Topical hair loss medications, particularly, are safe to use, with only a few local side effects. Oral medications for hair loss may cause some side effects, such as breast tenderness and dizziness. Certain hair loss medications, such as Propecia, should not be handled by pregnant people.

Read the original article on Verywell Health.