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Losing Your Hair?

Hat Head?

Treating Female Pattern Baldness

While many products promise to restore lost hair, only two are FDA-approved drugs that have been shown to do so: Rogaine and Propecia. Both interfere with the follicle destruction triggered by DHT. However, these androgen-blocking drugs cannot be used during pregnancy, and for this reason, says Kobren, drug companies are reluctant to market them to women.

A 2% minoxidil solution is approved for use in women by the FDA and is available in drugstores without a prescription. It's a liquid that must be applied to the scalp twice daily. A 5% solution is also available for men but is neither approved for use in women, nor proven to be more effective for them. Therefore, women should likely resist the temptation to buy the stronger formula thinking that more is better.

Keep in mind, too, that if you take the minoxidil route, you'll have to stick with it. "The biggest reason women fail with this treatment is because they stop using it too soon," says Marty Sawaya, MD, PhD, dermatologist and principal investigator of clinical research at Alopecia Research and Associated Technologies in Ocala, Fla. "Women need to adjust their expectations -- they aren't going to look like Lady Godiva in two weeks." Sawaya says women may see some improvement in three months but will need to use the drug for an entire year for full results to show. And to maintain whatever improvement occurs, women need to continue to use minoxidil once a day for life, or the new growth will fall out.

Propecia, the second FDA-approved treatment, is taken in pill form. However, it is not approved for use in women because it may cause birth defects. In fact, the FDA requires warnings against its use in women who are or may become pregnant. Still, doctors often find that Propecia works for women too, says Greene. "Many doctors do prescribe Propecia off-label to women with hair loss, especially those past menopause," he says.

Sawaya, however, warns against the practice for women of childbearing age. "In almost every clinical trial I have worked on, women will say they are on birth control and aren't planning to get pregnant, but every time we find that one or two do get pregnant anyway," she says. Because of the risk of birth defects, she feels women of childbearing age should not take Propecia or even handle it.

What's more, there appears to be no advantage to taking this drug -- it hasn't been proven any more effective than topical minoxidil. And Propecia also takes up to a year to make a significant difference and must be taken for life.

Hair-Transplant Surgery

Another option that women like Tracy might consider is hair-transplant surgery. In this treatment, a strip of donor hair follicles is taken from an area of the head not affected by thinning. The strip is then cut into very small grafts, containing just a few follicles each, which are then implanted into small cuts made in the areas of thinning. If all goes well, the transplanted follicles establish a new blood supply and the hair grows. The treatment may take several sessions to relocate enough hair to adequately cover the desired areas, and final results won't be seen for at least a year.

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