Because there are many factors that can contribute to or even cause hair loss in women, it is often tricky to tell if you will respond to an oral medication. That’s where we come in! All it takes is a consultation with our Medi Tresse team to perform a physical exam, discuss your options and evaluate your blood tests to determine the root cause of your hair loss or thinning.
In the past, our practice mainly focused on treating hair thinning and loss through topical prescriptions, laser therapy, and platelet-rich plasma therapy. More recently, there has been more interest in oral medications to treat hair loss in women. Recent articles have highlighted the use of oral minoxidil, spironolactone and finasteride, and we are hearing from increasing numbers of patients asking whether or not they might benefit from them.
Currently, the only oral prescriptions available to treat female hair loss are used “off-label,” meaning they are not yet FDA-approved for their use to treat female hair loss. In the past, these medications were only shown to be effective in treating Androgenic Alopecia (male and female pattern hair loss), but more comprehensive studies have recently shown some potential benefit with Alopecia Areata as well as Scarring Alopecia.
The medications in question are Spironolactone (aka Aldactone), and Finasteride (aka Propecia). Spironolactone works by blocking androgens (or hair loss-inducing hormones), while Finasteride inhibits a pesky little enzyme that converts the hormone testosterone into a metabolite called DHT. This causes progressive shrinkage of the hair follicle in a process called miniaturization.
Although this mechanism of action has shown to be very helpful, especially for men, it is not always as effective for women. As women, not only do we have other hormones circulating in our bodies, but we may have other reasons why our hair is thinning or falling out, so this process isn’t as straightforward as it is with men. From stress and genetics to hormonal imbalances and the use of hair styling products, determining the cause of hair loss for women is, as you can imagine, a bit more complex.
Furthermore, because these two medications affect the activity of our hormones, Finasteride is only recommended in women who are post-menopausal, and women who take Spironolactone should be on some form of contraceptive if they are of child-bearing age.
Over the years, many different treatments have been recommended in the treatment of female pattern hair loss (FPHL), a progressive thinning of hair in women. The prevalence of FPHL increases with age, affecting 50 percent of women during their lifetimes, according to the National Center for Biotechnology Information.
The only treatment currently approved by the FDA is topical minoxidil (brand name Rogaine). Minoxidil is a drug that was initially introduced as a treatment for high blood pressure. However, those who took it also noticed a nice side effect; they started to grow hair in places where they had lost it. Since then, it has been a primary treatment for hair loss in men and women.
There are other possible treatments for hair thinning as well, including low-level laser therapy, platelet-rich plasma, and hair transplantation. Finasteride, as we said above, is an off-label treatment for hair thinning in women. There have been some positive results reported in terms of hair restoration but research has shown that higher doses are required in women to be effective, and it is contraindicated in women with breast cancer.
Finasteride, a class of medications known as 5-alpha reductase inhibitors, is designed to treat receding hairlines or balding in men by blocking male hormone production in the scalp that prevents hair growth. It’s taken once a day as a tablet and could take up to six months to improve.
As stated above, higher doses are usually required in women and results are usually not quite as dramatic as those seen in men.
Spironolactone, a class of medications called aldosterone receptor antagonists, is another hair loss treatment offered in tablet form. Like Finasteride, it decreases the production of hormones contributing to androgenetic alopecia. While it is FDA-approved for treatment of fluid retention caused by liver and kidney disease, it is not yet approved for female pattern hair loss due to alopecia – a type of hair loss associated with the overproduction of male sex hormones.
Spironolactone is sometimes prescribed when other treatments, mainly minoxidil, do not work. It can be added to both topical as well as oral minoxidil for an added benefit. It usually won’t work for female hair loss when non-hormonal causes are to blame, such as stress, nutritional deficiencies, or chemotherapy.
Hair loss in women is more prevalent than you may assume. About one-third of women experience hair loss at some time in their lives; for post-menopausal women, as many as two-thirds suffer from bald spots or hair thinning, according to Harvard Medical School. It can be much more deeply distressing to women than men, as it’s not as socially acceptable as it is for males.
That’s why researchers are hard at work to find a cure or at least effective treatments that can provide relief for both women and men.
When it comes to specific treatments, such as Spironolactone or Finasteride, the main goal is to determine whether or not they are right for each individual. Knowing the cause of the thinning is the first step. It’s important to not only identify whether or not your hair loss is due to androgenetic alopecia, but to also try to determine if these medications are worth a shot if you do! Here at Medi Tresse, part of our evaluation often includes looking at bloodwork.
The results of these blood tests can tell us a lot about your hormones and often help determine a possible cause for your hair thinning or loss. Anything from not enough iron in the blood stream to infections to nutritional deficiencies to hormonal changes can spur hair loss and thinning. By evaluating the test results, we can help you determine if you would be a good candidate for the above medications.
It’s time to take action regarding your hair loss or thinning. If you have more questions about Spironolactone or Finasteride, or would like our team to evaluate your blood tests to determine a cause for your hair loss, schedule your appointment now. It’s quick, it’s easy, and we have many locations to choose from.