Thinning Hair? Our Compounding Pharmacy Can Help! – November 2016

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Thinning Hair? Our Compounding Pharmacy Can Help!

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. Studies have shown that compounded topical finasteride 0.25% solution also reduces scalp DHT levels in men and, in comparison with oral finasteride, the topical solution may minimize sexual side-effects linked to a systemic DHT reduction caused by oral finasteride. Finasteride is not used in women as it can cause birth defects.

Women may benefit from hormone therapy because progesterone prevents the conversion of testosterone to DHT. The medications azelaic acid and spironolactone may be used to block DHT in women, as opposed to finasteride. Azelaic acid and spironolactone can be compounded as topical preparations.

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. There is a strong link between vitamin D deficiency and hair loss. Ask us about compounded topical vitamin D gel. Therapy with the thyroid hormone T3 also may help.
  • Patchy balding (alopecia areata; AA) is found in about 1.7% of the population. Most cases of alopecia areata start during childhood or adolescence and last throughout life. Topical immunotherapy is the best documented treatment so far for severe and refractory AA. Dinitrochlorobenzene (DNCB), squaric acid dibutylester (SADBE), and diphencyprone (DPCP) are topical contact allergens used for this purpose. Ask our pharmacist for more information.

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’s medical provider to customize medications to make them easier to use and potentially reduce side effects. Your questions are welcome.



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