Only 2 drugs currently have US Food and Drug Administration (FDA) approved indications for treatment of androgenetic alopecia:
: Appears to lengthen the duration of the anagen phase (the active growth phase of hair follicles), and it may increase the blood supply to the follicle. Regrowth is better at the top of the head than in the front areas and is not noted for at least 4 months. It is used as a 2% or a 5% solution that rubs into the scalp and the 5% solution may work better. However, if the treatment is stopped the baldness returns. It works better in patients who just starting having the alopecia and who have small areas of hair loss.
: It can only be used in men and is better for balding at the top of the head. If the treatment is stopped the baldness returns. It cannot be used in women who are still able to have children because it can result in ambiguous genitalia in male babies and it does not seem to be effective in women. The doses are about 1 mg daily by mouth.
Minoxidil use for several months can result in an eye condition known as central chorioretinopathy
(an eye disease that lead to temporary visual impairment) , which can go back to normal after 1 months of not using the drug.
Finasteride has no known side effects in men, according to several studies, but it cannot be used in women who are still trying to have children because it may produce fetal genital malformations.
Every patient is unique and only the doctor can evaluate and determine the best treatment.
Some drugs that are not approved by the FDA but may be helpful are:
: In women with androgenetic alopecia.
: In women.
: Is currently in study.
0.1% is currently used to treat glaucoma and using it results in an increase of eyelashes. Some studies have shown that this medication could be useful for stimulating hair follicle activity and treating hair loss.
Follistatin, a human cell derived medication is also in study.
Also, low-level laser light therapy, a red light hairbrush–like device has shown some good results.
Surgical treatment of androgenetic alopecia has good cosmetic results. The main problem is covering the bald area with donor plugs (or follicles) sufficient in number to be effective. Micrografting produces a more natural appearance than the old technique of transplanting plugs.
It is important for the patients with androgenetic alopecia to be evaluated for treatable causes of “telogen effluvium” (diffuse hair shedding, often starting suddenly) like anemia or hypothyroidism, especially in patients who had a rapid progress of their disease or a sudden start of the disease.
The following treatment options are recommended for women by some experts:
Spironolactone and cyproterone acetate
These treatments are most effective when started early.