The Ins and Outs of Treating Hair loss
Dermatologist Arash Mostaghimi shares the facts in this treatment-focused Q&A
Today is the last day of National Hair Loss Awareness Month! That flew by. We’re really excited to share a deep dive into hair loss treatments with you as we close out the month. In today’s post you’ll find insights from Dr. Mostaghimi about how treatment has evolved, what type of treatments are available as well as details of how they work to improve hair growth/combat hair loss.
We hope you learned a lot this month about hair loss and feel empowered to manage your own if it’s something you’re struggling with or thinking about. Ultimately we found that the earlier you treat hair loss, the better… and it’s TRUE that hair loss IS treatable. You can always connect with a medical professional to discuss your hair loss questions or concerns by visiting forhims.com or forhers.com. Not only do we have healthcare professionals that can virtually connect with you, but we can also send treatment straight to your front door.
Stay safe & healthy, and may those locks of hair grow!
Q&A with Dr. Arash Mostaghimi
Q: Can you explain how treatment varies for different stages and/or types of hair loss?
A: Although patients often think of hair loss as a diagnosis, hair loss really is a symptom, and it’s critical to work with a physician to identify the specific reason why hair is falling out. Treatments, anticipated results, and the timeline for therapy all depend on the specific disease that you are treating. Some treatments are very specific — for example, finasteride targets a specific enzyme in the body that contributes to hormone-related hair loss, while others, such as minoxidil work through different mechanisms that can help patients with many different causes for their hair loss.
Q: What are common misconceptions about hair loss treatment that you hear from patients?
A: The biggest misconception that I hear from patients is that there is nothing they can do about their hair loss. It’s true that hair loss can be complicated and we don’t have treatments for every patient yet. However, our understanding of hair biology and our ability to treat patients with hair loss is always improving, and in 2020 you have options to treat hair loss that your father and grandfather never had.
Q: How have hair loss treatments advanced in the past few decades?
A: The introduction of medications such as finasteride and minoxidil have given us great treatments for patients with hormonal hair loss. Both of these drugs have been around for decades, and we have great safety and efficacy data for long-term use.
Q: Can you tell us a bit about what minoxidil is and how and when people should use it?
A: Minoxidil is a drug that was used years ago for patients with heart disease. Scientists observed that a side effect of the medication was hair growth, and when they reformulated it as a topical medicine they found that they could safely grow hair by applying it to the skin. Although we have study after study showing that minoxidil is safe and works well across a range of patients, the exact mechanism by which it causes hair growth is still not understood.
Q: Can minoxidil be used by anyone? What’s the difference, if any, between minoxidil solutions for men and for women?
A: Minoxidil can be used by men and women. It has not been studied during pregnancy and should be avoided by women who are expecting. It’s a pretty simple treatment that grows hair where you apply it. Men’s minoxidil is typically 5% concentration while women’s is either 2% or 5%. The higher the concentration the better the medication works. Some people prefer the lower concentration because it is unlikely to give you extra unwanted hairs that sometimes happens if it dribbles outside of the area where you are trying to apply it. Other than the difference in concentration the solutions are the same for men and women.
Q: Can you talk a little about finasteride? How does it help with hair loss?
A: Finasteride is an oral medication that blocks the conversion of testosterone into DHT. DHT is a hormone that leads to hormonal hair loss. Blocking the formation of DHT with finasteride has been shown in large clinical trials to improve hair growth in men with male-pattern (androgenetic) hair loss, and finasteride has been FDA approved for male-pattern baldness since 1992.
Unlike minoxidil, which can be used in men and women, given the hormonal impact of finasteride it has only been studied in men and should not be used by women.
Q: When do you prescribe finasteride to patients? Do you typically try to use over-the-counter treatment before prescribing it, or what’s the process of figuring out who should be leveraging this medication?
A: I prescribe finasteride often in combination with minoxidil or alone for patients who have male-pattern baldness. In hair loss, the earlier you treat the better the results. The best scenario is when you are treating patients who are just starting to have hair loss so you can stabilize their hair count and prevent progression. That said, finasteride can also be used by patients with more significant hair loss as well, with often impressive results. All men who are concerned about hair loss should consult with a physician to see if finasteride is the right choice for them.
Q: In what ways do the Hims & Hers hair shampoos and conditioners impact hair? What are the ingredients that are proven to help with hair loss?
A: These shampoos have active ingredients including saw palmetto extract and pumpkin seed oil that have been shown in clinical trials to help regrow hair. Both of these ingredients help reduce the amount of DHT on the scalp. As mentioned above, DHT is a hormone that has been implicated in hormonally-related hair loss. In addition to these ingredients, these shampoos also include other ingredients such as salicylic acid that helps break down sebum and improve overall scalp health.
Q: Anything else you think would be important to add about hair loss treatments and advancements?
A: If you’re worried about hair loss, have a conversation with a physician to make a diagnosis and see what treatments might work for you. I find that patients get tons of advice (often unsolicited) from an assortment of people: family members, significant others, even random strangers online. Hair loss is not a cosmetic issue, it’s a medical one that can impact your confidence and self-esteem. Ask a doctor for help.
