Did you know that there are various types of baldness, and the treatments differ? About half of men and women show some degree of balding by the age of 40. Androgenetic alopecia (AGA) is the most common form of hair loss in both men and women. In men, AGA is known as male-pattern baldness. Hair is lost in a well-defined pattern, beginning above both temples. Over time, the hairline recedes and hair thins on the top of the head, which may progress to partial or complete baldness. In women, the pattern of hair loss differs: the hair becomes thinner all over the head often beginning with the part, and the hairline does not recede. AGA in women rarely leads to total baldness.
Due to the progressive nature of AGA, treatment should be started early and continued indefinitely, since the benefit will not be maintained when therapy is stopped. FDA-approved treatment of AGA includes topical minoxidil for men or women, plus oral finasteride for men. Finasteride blocks the conversion of testosterone to dihydrotestosterone (DHT). When DHT concentrations are decreased in men taking finasteride, there is a progressive increase in hair count. Women may benefit from hormone therapy, and the medication spironolactone may be used as an antiandrogen in women, as opposed to oral finasteride.
However, there are other treatment options that target the different pathophysiologic causes of AGA, which can be compounded with a prescription from your doctor. Studies have shown that compounded topical finasteride 0.25% solution also reduces scalp DHT levels and in comparison with oral finasteride, the topical solution may minimize sexual side-effects linked to a systemic DHT reduction caused by oral finasteride.
Topical melatonin was also found to be a promising treatment for AGA based on laboratory and human research. Clinical studies showed positive effects of topical melatonin solution in the treatment of AGA in men and women. Patients had few side effects, and the topical solution did not raise serum melatonin levels.
Other forms of hair loss are treated differently than androgenetic alopecia, and include:
- Hair shedding (telogen effluvium) which may develop after medication intake, illness, childbirth, and crash dieting.
- Patchy balding (alopecia areata) is found in about 1.7% of the population. Most cases or alopecia areata start during childhood or adolescence and last throughout life.
Therapy for androgenetic alopecia or alopecia areata can be personalized for each individual based on their response to treatment. Our compounding pharmacist will work with each patient and his or her doctor to customize medications to make them easier to use and potentially reduce side effects. Your questions are welcome.