Other Medications
for Hair Loss |
Helpful Site?
Pass it along! |
These medications have not been evaluated or approved
by the FDA as treatments for hair loss. Listed in
Alphabetical order:
Azaelic Acid: Azaelic acid is a
natural occuring acid found in whole grains such as
wheat, rye and barley. It has been used for years
as an effective treatment for mild to moderate acne
problems, and other skin conditions. Some hair loss
doctors believe that it might have anti-DHT properties
and stimulate hair regrowth due to a 1988 study published
in the British Journal of Medicine. In that study,
researchers combined azaelic acid, zinc ion and vitamin
B6 were strong Type 1 5-alpha-reductase inhibitors,
the enzymes which convert testosterone to dihydrotestosterone,
the culprit behind hair loss.(39)
Although some hair loss doctors took this study at
face value and offer prescriptions online, other doctors
are unconvinced. In a 2005 post on his baldingblog.com,
long time hair transplant doctor, William Rassman,
MD, pointed out that the British study was conducted
"in-vitro," meaning, in the laboratory,
and not "invivo," - in patients.
"The finding in the laboratory is interesting,
but it is a big jump to answering it for people...
I would warn most of my readers that there is a
long stretch to findings in the laboratory and responses
in patients. We have seen cancers killed in the
laboratory and no impact on patients," Rassman
wrote.(40)
Also in that article, Rassman's colleague, Dr. Shapiro,
express his skepticism that results in patients would
mimic those found in the laboratory. "I doubt
that azelaic acid does much for hair growth,..."
Shapiro wrote.
"In spite of this, azaelic acid for hair
loss is available online and mixed in with concentrations
of minoxidil and topical finasteride. Since the
side effects are minor, most men who use it take
a "why not" approach to azaelic acid as
a treatment for hair loss." (40) (Article
continues below ad)
Ketoconazole: Ketoconazole is the
active ingredient in a medicated shampoo (brand name
Nizoral) that is FDA approved for dandruff and seborrheic
dermatitis of the scalp. It comes in 1% and 2% formulations.
The support for it's use to stimulate hair growth
or halting hair loss comes from a 1998 study that
compared 2% ketoconazole to 2% minoxidil. The study
concluded that: "Hair density and size and
proportion of anagen follicles were improved almost
similarly by both ketoconazole and minoxidil regimens."
(41)
The study directed patients to wash their hair 2-4
times a week with ketoconazole shampoo, working it
into the scalp and leaving it in for 3-5 minutes.
By doing this, hair growth and diameter was similar
to the patients who used 2% minoxidil, a proven hair
growth topical medicine.
Following that study, anecdotal evidence comparing
1% and 2% supported the 1998 study and reported the
2% was more effective than the 1%. (One percent is
available over the counter and 2% is only available
by prescription). Another study released in 2005,
this one done on mice, also supported the hair growth
results from the 1998 study.(42)
Hair loss specialist Dr. Richard Lee, MD, of Regrowth
LLC, explains ketoconazole further on his website:
Ketoconazole has been used as an anti-fungal medication
for many years, both topically and systemically.
One of its pharmacological actions is to inhibit
biosynthesis of ergosterols and other sterols, which
damages the cell membrane of fungi. This same pharmacological
action inhibits the synthesis of DHT in the scalp,
which is why ketoconazole shampoo may be beneficial
in the treatment of MPB. Sebum production is testosterone
and DHT dependent. Studies have shown that the use
of a 2% ketoconazole shampoo will reduce the sebum
excretion rate (-6.54%) when used over a six-month
period.(43)
Although the benefits of ketoconazole are still being
debated, it seems harmless to use 2-4 times a week
since men have to wash their hair anyway, as Dr. Lee
also points out. Side effects include mild scalp irritation,
dryness and itching.
Salicylic Acid: Like ketoconazole,
salicylic acid is the active ingredient in anti-dandruff
shampoos, brand names Scalpicin and Neutrogena T Sal.
Salicylic acid comes from willow bark and is similar
to aspirin. Besides being used in anti-dandruff shampoo's,
it also used in some skin care medications for acne
(exfoliator), psoriasis, calluses, corns and warts.
It is also used a pain and fever reducer.(43)
Salicylic acid has no known hair regrowth or anti-DHT
characteristics on it's own. However, since the shampoo
version can remove dead skin cells, and loosens and
breaks up dandruff, it might allow other topical anti-DHT
medications to penetrate the scalp more easily.(43)
Spironolactone: Spironolactone is
in a class of drugs called potassium-sparing diuretics
and it is prescribed for many different purposes including
heart failure, hypertension, and hirsuitism in women
(excessive facial hair growth). It has also been prescribed
off label for decades as an anti-androgen hair loss
treatment primarily for women.
A topical 5 percent Spironolactone cream is available
on the internet. Hair loss doctor Richard Lee, MD,
writes:
Spironolactone is effective in protecting the follicles
from DHT because it (1) inhibits the synthesis of
DHT, (2) converts testosterone in the scalp to estrogen,
and (3) blocks the androgen receptor sites on the
hair follicles, effectively preventing even circulating
DHT from attaching to the receptor sites. As a result,
the follicles are protected from miniaturizing and
have the potential to mature again to their normal
size...Topical spironolactone does not cause shedding.
Because it metabolizes totally and rapidly in the
skin where it is applied, there are no systemic
effects. (44)
Dutasteride: Dutasteride is a medication
prescribed to treat an enlarged prostate otherwise
known as benign prostatic hyperplasia (BPH). Dutasteride
is in a class of medications called 5-alpha reductase
inhibitors, the same family of drugs in which finasteride
is a member. Finasteride is the main ingredient in
Propecia, a pill commonly prescribed for hair loss
treatment. Finasteride prescribed for BPH is known
as Proscar, and comes in a larger dosage. Both Finasteride
and Dutasteride work by preventing testerone from
converting to dihydrotestosterone (DHT), which is
the main culprit for genetic hair loss. It does this
by blocking the enzyme 5-alpha reductase from manipulating
normal testosterone into DHT.
In the United States, dutasteride is sold under the
brand name, Avodart by GlaxoSmithKline. Other names
include: Avidart, Avolve, Duagen, Dutas, Dutagen,
and Duprost.
"Dutasteride is the first 5-alpha reductase
inhibitor (5ARI) that inhibits both the type 1 and
2 isoenzymes of 5AR. These enzymes are responsible
for converting testosterone to dihydrotestosterone
(DHT) in the prostate and other tissues, and DHT
has been proven to play a key role in the development
and progression of BPH." - GlaxoSmithKline
Press Release, Aug. 12, 2002 (55)
Dutasteride can also be prescribed to treat male
pattern hair loss although the FDA has not given specific
approval that dutasteride can treat male pattern hair
loss. When a medication is prescribed for something
else than the FDA has allowed for a company's marketing
claims, this is known as off-label.
The manufacturer, GlaxoSmithKline, completed a Phase
I and II study of dutasteride for hair loss, but suddenly
and unexpectedly, called off the trials in 2002 and
no one really knows why. However, these trials were
restarted in Korea in 2006 and were completed in January
of 2009. The results of this study have not been released
yet. However, some early speculation is that it does
offer a superior hair count in comparison to finasteride.
(56,57)
The promise and hope behind dutasteride over finasteride
is that it blocks or inhibits BOTH isoforms of 5-alpha
reductase, while finasteride only works on one.
Whether or not dutasteride is clinically proven to
be more effective than finasteride, remains to be
seen. However, the general belief is that it offers
matching efficacy in comparison to finasteride.
Side effects of Dutasteride include:
- inability to have or maintain an erection
- decrease in sex drive
- difficulty ejaculating
- breast tenderness or enlargement (Gynecomastia),
)
Saw Palmetto: For a full report
on it's effectiveness, see Saw
Palmetto for Hair Loss Treatment
|
