Which non-surgical treatment for androgenetic alopecia is the best?

Androgenetic alopecia is also known as male pattern baldness or female pattern hair loss. This is the most common type of hair loss in both men and women. Any hair loss can be a difficult situation to handle and navigating the treatment landscape can be confusing. An internet search for “treatment for hair loss” returns over 50 million entries! This post is a brief introduction to the approved and safe non-surgical methods for treating hair loss in men and women.

Rogaine® (generic name: minoxidil) is the only FDA- and Health Canada approved medication for female hair loss, while finasteride (Propecia®) and minoxidil are approved for use in men. Low level laser therapy is cleared by the FDA and Health Canada as hair loss treatment for both men and women.

Minoxidil is a topical medication that comes as a solution or foam. The 2% solution is applied twice daily and the 5% foam is applied once daily. While both show similar results, using the foam may be easier, with less disruption to daily grooming routines, and less itching and dandruff as compared to solution.¹ In clinical trials, both formulations, 2% solution and 5% foam, resulted in significantly higher hair counts after 3-6 months.

Finasteride is a well-known treatment for male pattern baldness and has been used for nearly 25 years. It is only approved for men, as it is works by decreasing the levels of androgen hormones (dihydrotestosterone). In clinical trials, patients reported improvement in hair loss and hair appearance. Significant increases in hair counts were seen after 1 and 2 years of treatment with finasteride, while those patients in the control group continued to experience hair loss.^2,3

Low level laser therapy (LLLT) is non-invasive, with devices in the shape of helmets and combs. LLLT is safe and can be used in-office or in the privacy of your home. This treatment option can be attractive to people who do not wish to take medications. Clinical trials have shown that LLLT is effective, with increases in hair counts after 6 months of use similar to that seen with medications.^4–6

Research has shown that the medications discussed above and laser therapy all show benefits to patients with hair loss, with an increase in hair count occurring with at least 3 months of minoxidil use and at least 6 months of finasteride or laser therapy. Individual results may vary, and some patients in clinical studies did not experience very much hair growth. To answer the question posed in the title is going to depend on the extent of your hair loss and what your treatment goals are. In all cases, consultation with a hair loss specialist will be necessary to determine the most appropriate treatment option for you.

Article written by: Dr. K.A. Foley, Mediprobe Research Inc.

References

1. Blume-Peytavi U, Hillmann K, Dietz E, Canfield D, Garcia Bartels N. A randomized, single-blind trial of 5% minoxidil foam once daily versus 2% minoxidil solution twice daily in the treatment of androgenetic alopecia in women. J Am Acad Dermatol 2011;65:1126–34.e2.
2. Kaufman KD, Olsen EA, Whiting D, Savin R, DeVillez R, Bergfeld W, et al. Finasteride in the treatment of men with androgenetic alopecia. Finasteride Male Pattern Hair Loss Study Group. J Am Acad Dermatol 1998;39:578–89.
3. Leyden J, Dunlap F, Miller B, Winters P, Lebwohl M, Hecker D, et al. Finasteride in the treatment of men with frontal male pattern hair loss. J Am Acad Dermatol 1999;40:930–7.
4. Jimenez JJ, Wikramanayake TC, Bergfeld W, Hordinsky M, Hickman JG, Hamblin MR, et al. Efficacy and Safety of a Low-level Laser Device in the Treatment of Male and Female Pattern Hair Loss: A Multicenter, Randomized, Sham Device-controlled, Double-blind Study. Am J Clin Dermatol 2014;15:115–27.
5. Lanzafame RJ, Blanche RR, Bodian AB, Chiacchierini RP, Fernandez-Obregon A, Kazmirek ER. The growth of human scalp hair mediated by visible red light laser and LED sources in males. Lasers Surg Med 2013;45:487–95.
6. Lanzafame RJ, Blanche RR, Chiacchierini RP, Kazmirek ER, Sklar JA. The growth of human scalp hair in females using visible red light laser and LED sources. Lasers Surg Med 2014;46:601–7.

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