Can hair loss products stop you from going bald?
Scientific studies claiming "a cure to baldness is close to reality" frequently make the news.
Many people who have used Rogaine, Propecia, and similar hair loss treatments report success, but how effective are currently-available products and prevention methods, really?
It's estimated that some 70 per cent of men (and surprisingly, 40 per cent of women), experience some form of hair thinning on the scalp in their lives.
Balding usually is the result of male or female pattern baldness, known scientifically as androgenic alopecia. This type of balding results from the testosterone derivative Dihydrotestosterone (DHT), which shrinks hair follicles making it difficult for them to survive. This can happen to both men and, though to a much lesser extent, women too.
Like so many things, androgenic alopecia is genetic. There is limited evidence to suggest that some foods can increase or speed up hair loss, however. Research from India has shown that fried foods can increase oil and gland activity, which speeds up the development of testosterone to DHT. The insulin spike experienced from sugar consumption may also have the same effect.
University of British Columbia research has shown that changing your shampoo can be beneficial in slowing hair-loss. Anti-dandruff shampoos containing the antifungal ingredient Ketoconazole which can reduce conversion from testosterone to DHT. A separate study from Belgium confirmed this DHT reduction resulted in 17 per cent less hair loss over six months with a Ketoconazole-containing shampoo.
In Eastern medicine, head massage (either administered professionally or by yourself whilst applying shampoo in the shower) is a popular technique to stimulate blood flow to the scalp's surface, but no Western studies have looked at its effectiveness.
Hair loss drugs
Now let's look at the two most popular drugs for hair loss treatment and prevention: Rogaine and Propecia.
Rogaine, which is a branded product containing the active ingredient Minoxidil, started out as a drug for high blood pressure. Loniten, as it was then called, had an unexpected side effect: The thickening of hairs (and the increase of hair growth) after several months of use, owing to increased blood flow and nutrition to follicles.
Many clinical trials later, Rogaine was launched as numerous studies have proven its effectiveness – in some studies around 50 per cent of men have seen positive results, in others up to 85 per cent have.
However, there's a big caveat in the majority of Minoxidil studies. Most are done on younger men who have only been experiencing hair loss for up to five years. It appears not to be very effective for older men who have been losing their hair for decades, as it does not work on permanently damaged follicles or large areas of lost hair.
Rogaine, or the similar brand Regaine, must be applied topically every day, and anecdotally the active ingredient seems to stop working eventually for some people. Users must also budget $50-60 per month for the drug; a fee that is indefinite as hair loss will continue if treatment stops.
First treatment on market
Propecia, the branded product containing Finasteride, was the first hair loss treatment product on the market and is still recommended as a first-line treatment (that is, you should try it before a Minoxidil product).
Rather than stimulating blood flow, it inhibits the conversion of testosterone to DHT. Finasteride decreases DHT concentrations by up to 60 per cent, and is proven useful at actually stopping hair loss, giving hair a better chance to grow in its place.
Taken orally, Finasteride products have produced similarly positive results as Minoxidil (around 50-80 per cent success rate), though no long-term studies have been done on men over 41.
While Minoxidil products are available without a prescription at pharmacies, Finasteride products are prescription-only. The former is scientifically proven to regrow hair, the latter is best used to prevent hair loss in the first place. Though the expense can be prohibitive, both drugs can be taken together if your doctor believes that is your best course of action.
Also, both men and women can use Minoxidil products, but only men can be prescribed Finasteride drugs. It will take four to six months to see results, and if no change is seen by then, other courses of action – such as "hair transplants", i.e. follicular unit transplantation or follicular unit extraction – can be considered.
Written by Lee Suckling. First appeared on Stuff.co.nz.