Losing Your Hair?
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.
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.