Examining Medicinal Options for Treating Baldness

When it comes to treating baldness, it is medicinal pills and topicals that spring to most peoples’ minds as the options holding the greatest promise. There are also other existing treatment options, such as surgical as well as non-surgical hair replacement, but to date only oral and topical medicinal treatments have been proven to reduce and reverse hair loss naturally. Hair transplant surgery, though providing the best cosmetic results, cannot slow or reverse hair loss. Natural and herbal hair loss treatments seek to mimic medicinal treatments in their mode of action but their effectiveness in treating hair loss has never been confirmed in any clinical study and many of them are associated with hair scams.

The two medicinal treatments that have been approved by the FDA (Food and Drug Administration) in the US for treating hair loss are topical minoxidil (trade name Rogaine or Regaine) and oral finasteride (Propecia). These two hair loss drugs have been also approved by national health supervisory authorities in many other countries around the world. Topical minoxidil is suitable for both sexes, whereas finasteride can only be prescribed to male hair loss sufferers. Minoxidil is a vasodilator, originally used to treat high blood pressure, which was later found to stimulate hair growth when applied topically to the scalp. Its exact mechanism of action is not known.

Finasteride is an antiandrogen drug that was first applied to treat benign prostatic hyperplasia (BPH), also known as prostate enlargement. It acts by inhibiting conversion of the male hormone testosterone to the follicle harming didydrotestosterone (DHT). The discovery of finasteride’s stimulating effects on hair growth led to finding the true cause of hereditary baldness, which are the harmful attacks of DHT on our hair follicles. Since making this discovery, a quest for other alternative DHT blockers has begun, especially amongst antiandrogen drugs and herbs that have, in the past, been used to treat urinary problems.

Dutasteride (trade name Avodart) is an antiandrogen drug similar to finasteride and has been studied extensively for treating hair loss. It is currently undergoing phase III clinical testing for promoting hair growth. It has been approved for treating BPH and is thus available in pharmacies in many countries around the world. Although it has not yet been approved for hair loss by any national health supervisory authority, it is being prescribed by some clinics and doctors to male hair loss sufferers who no longer respond to finasteride. Dutasteride is believed by many to be a more powerful hair loss drug than finasteride but also with more severe side effects.

Flutamide (trade name Eulexin) is a very strong antiandrogen used to treat prostate cancer. It works by binding to the androgen receptors and thus competing with DHT. Oral use of flutamide can cause serious side effects but it is thought that topical applications might have less adverse side effects and could be, in the future, used to treat hereditary baldness. More research is needed to verify such claims.

Spironolactone (trade name Aldactone) is another antiandrogen that works by binding to androgen receptors and thus competing with DHT. It is used in women to treat acne, hair loss and hirsutism (excess body hair) and although there are some generic topical applications for treatment of male pattern baldness containing spironolactone, it has never been approved to treat hair loss in men and should better be avoided.

Aminexil, was developed by L’Oreal to treat baldness in men and women and its molecule is very similar to that of minoxidil. Its mechanism of action is not exactly known and it is thought to be a weaker weapon in the fight against hair loss than minoxidil.

The most promising novel drug under development is called NEOSH101. It happens to be in phase II clinical trials and is supposed to be a hair growth stimulant, distantly related in its actions to minoxidil. Although not expected to become an ultimate cure for baldness, it could improve the chances of hair loss sufferers of regrowing some of their lost hair and could replace minoxidil as a more powerful hair growth stimulant.

The above list of medicinal treatments for hair loss is not exhaustive. There are a number of other drugs that are believed to help treat hereditary baldness, such as superoxide dismutase, ketoconazole, fluridil, alfatradiol, etc. but none of them has ever been proven in any serious clinical study to promote new hair growth and further studies will be needed to evaluate their positive effects on hair loss. Therefore, for the time being, minoxidil and finasteride remain the main weapons in the fight against genetically-determined hair loss conditions in male patients.