There are mainly two FDA approved medications that are used to prevent hair loss.
Propecia is a drug that acts by preventing the conversion of testosterone to dihydrotestosterone by preventing an enzyme called 5 alpha reductase. It is taken orally as a 1mg pill. There is sufficient evidence to suggest that it slows down hair loss and stops miniaturisation. The consensus among the medical community is to use 1mg every day. However I do believe that there is room for manipulation with the dose. The average serum half-life of Propecia is 5-8 hours. There is evidence that 1mg Propecia suppresses serum DHT for 7 days – hence the effects of Propecia should last more than 24 hours. Whilst prescribing Propecia, the advice I give my patients is that based on the evidence, the molecule could be equally effective if taken every alternate day.
Minoxidil is a topical solution used for the prevention of hair loss. It acts by increasing the blood supply to the scalp. It is applied topically twice a day. It comes in strengths of 2% and 5%. There are stronger versions of Minoxidil which the manufacturer claims can be used once a day.
There are a variety of products available in pharmacies which claim to stop or reduce hair loss, some more successful than others. Probably the most popular product is Minoxidil.
Originally used in tablet form as a medicine to treat high blood pressure, it was noticed that some patients being treated with Minoxidil experienced excessive hair growth as a side-effect. Further research showed that by applying Minoxidil in solution form directly to the scalp, could prove to be beneficial to those experiencing topical hair loss.
Propecia is an oral medication manufactured by Merck. Propecia acts by blocking the conversion of the male sex hormone testosterone to a metabolite called Dihydrotestosterone (DHT). DHT is a hormone responsible for male pattern baldness. Propecia acts by inhibiting the action of an enzyme called 5 alphareductase. Studies have shown that men who suffer hair loss have high levels of 5 alphareductase in and around the follicles.
Propecia causes a significant drop in both scalp and blood concentrations of DHT. Studies have shown that DHT levels decrease by up to 68.8% and testosterone levels increase by up to 9.1% in men who take 1mg of Propecia a day.
Propecia was initially marketed for prostate enlargement as Proscar which is 5mg of Finasteride (the active molecule in Propecia). In 1998 the Food and Drug Authority (FDA) approved 1mg Finasteride for use in male pattern baldness. Studies have shown that 80% of men taking 1mg Finasteride either kept their hair or grew more.
In the crown more than 30% showed moderate improvement and 5% showed significant improvement in hair quality. However only 4% of men showed moderate improvement to the hair in the front. Also, hair counts were increased mostly in the crown.
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Could something as basic as hair loss nutrition really contribute to excess shedding of hair? Does nutrition have an important role to play in helping hair to regrow?
Modern diets can be blamed for a number of nutritional deficiencies that may contribute to hair loss.
These nutritional inadequacies affect all aspects of health and well-being but do they have any relevance to hair loss specifically?
The answer is yes - poor nutrition can cause hair loss because the body will ration out nutrients in the order of vital organs first, and hair last. Improved nutrition will not result in new hair growth, but it will minimize shedding and support other treatments that encourage regrowth.
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Here are a few steps that can help prevent hair loss.
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