Androgenetic alopecia, also known as male or female pattern baldness, is a common form of hair loss in both men and women. Over 80 million people in the United States alone suffer from this type of hair loss. There are likely many environmental and genetic factors that contribute to this condition, and the risk of hair loss also increases with age, so the number of people dealing with androgenetic alopecia is only expected to rise. While the exact mechanism of this hair loss is unknown, researchers know that androgens, particularly dihydrotestosterone (DHT), play a crucial role in this form of hair loss. Luckily, there are several different treatment options available to those who are suffering.
There are two current FDA approved treatments for this condition – minoxidil and finasteride. Minoxidil, also known as Rogaine, is probably the most well-known treatment for androgenetic alopecia. Minoxidil began as an oral antihypertensive agent, and was found to regrow hair in thinning areas for patients taking it for hypertension. Eventually, the drug was approved as a topical treatment option for hair loss for both men and women. Minoxidil works as a vasodilator, which increases blood flow. It is suspected that minoxidil helps with hair growth by partially enlarging hair follicles, and by making nutrients more available to the hair follicle.
The other approved treatment, finasteride, also originally began as a drug used for a different condition. It was originally used to treat benign prostate hyperplasia, or BPH, and was also found to combat androgenetic alopecia. Finasteride works by targeting DHT synthesis, which decreases DHT production. DHT is strongly associated with the development of androgenetic alopecia. While finasteride is shown to have great results, it is not the best choice for women of reproductive age due to a high risk of birth defects. Oral finasteride for men is also known to cause erectile dysfunction, gynecomastia, and decreased libido. For this reason, a combination of topical finasteride and minoxidil is frequently used, and is shown to have equivalent results to oral finasteride alone.
There are several other treatment options with promising results that have not yet been approved to treat androgenetic alopecia. These include ketoconazole, spironolactone, and latanoprost. Ketoconazole, an antifungal, has been considered as an agent to aid treatment in combination with oral finasteride. It has been found to have antiandrogenic properties, and can also reduce inflammation in the skin. Spironolactone is a diuretic with antiandrogenic properties, and is most commonly used in women with androgenetic alopecia. Latanoprost is used in eye drops to treat glaucoma, and many patients experienced elongated eyelashes and eyebrows. Small studies have found that using it topically on the scalp significantly increased hair density and growth, however, larger studies must be performed in order to truly determine its efficacy.
Hair loss can be extremely stressful and confusing. Reach out to your pharmacist today for more information about treatment options.
This content was originally provided by Taylor Chafouleas PharmD candidate 2021.
Jones, M. C. (2018). Treatment Options for Androgenetic Alopecia. U.S. Pharmacist, 43(8), 12-16. Retrieved December 13, 2020, from https://www.uspharmacist.com/article/treatment-options-for-androgenetic-alopecia
MedlinePlus. (2020, August 18). Androgenetic alopecia. Retrieved December 13, 2020, from https://medlineplus.gov/genetics/condition/androgenetic-alopecia/