Thinning Hair: Is There Hope?

Hair thinning and hair loss has been a problem for people over the ages. In this discussion I will only address hereditary hair loss. While areas of complete hair loss are seen much more commonly in men, thinning of the hair is common with aging in both men and women. Because there has not been an adequate treatment for extensive hair loss in men, there exists an extensive industry devoted to hair transplantation, wigs and other hair substitutes. Hair loss is distressing to many men, but it is even more distressing to women, probably because hair in women plays more of a role in sexual attraction than it does in men. Also, the range of treatments for women is significantly less than for men.

The first effective medical treatment for thinning hair was minoxidil (Rogaine). The mechanism of action is not well understood, but the medication, which was initially developed as a blood pressure medication, dilates peripheral blood vessels. This could be one of the causes of its effect on hair, but other suggested mechanisms include stimulating resting hair cells to go into the growing phase, or affecting the metabolism of androgens (male hormones) in the scalp, resulting in reduced androgen effect. The observation that eunuchs did not loose their hair, established the role of androgens in hair loss. Unfortunately Rogaine does not produce cosmetically significant improvement in most individuals.

More recently there have been developed chemicals (finasteride {Proscar}) that block certain activities of the male hormone and reduce hair loss. This produces some reduction in the rate of hair loss, but the effects are slow to appear. This medication generally is not used in women who are capable of becoming pregnant, because it can cause fetal genital deformities if a woman using it is pregnant with a male fetus.

Finally there has been the recent development of a new class of products, the topical prostaglandins, that enhance hair growth. This is best exemplified by the release of Latisse, which promotes the growth of eyelashes. This is a cosmetically noticeable effect in most individuals. Women have also used it succesfully on thin eyebrows. There have been a number of prostaglandin containing products released claiming to enhance eyelash growth. There is also at least one product, Revitalash Hair, that is a foam that is designed for use on hair. The manufacturers of these other products have attempted to avoid the expense of FDA regulation by only claiming that their product appears to make hair look thicker. They have not done any studies to prove that their products change hair growth, because if the results were positive, their products would be classified as drugs, rather than as cosmetics. Nevertheless the developer of Revitalash Hair says their product will have no benefit on areas where the hair is absent but it will frequently be of benefit where the hair is thinning, both in men and women. As a user of Revitalash Hair, I can confirm that it has produced a visible improvement, noticeable to me and my staff, in areas where my hair was thinning. Like all of these other products, it must be used continuously for the effect to persist.

Gerald N. Bock, MD

California Skin & Laser Center

Stockton & Lodi, CA

Comments

[cosmetic surgery]

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[female hair loss]

thanks for sharing your knowledge. from your post, i really do hope that there's a hope for thinning hair.