Hair Loss in Women: Treatments
Since birth control pills decrease the production of ovarian androgens, they
can be used to treat women's androgenetic alopecia. Keep in mind, however, that
the same cautions must be followed whether a woman takes contraceptive pills
solely to prevent contraception or to treat female pattern baldness. For
example, smokers age 35 and older who take the Pill are at higher risk for
blood clots and other serious conditions.
Discuss your medical and lifestyle history thoroughly with your doctor.
Contraceptive pills come in various hormonal formulations, and your doctor can
determine which is right for your specific needs, switching pills if necessary
until you are physically and emotionally comfortable with the formulation.
Only low-androgen index birth control pills should be used to treat hair
loss. High androgen index birth control pills may contribute to hair loss by
triggering it or enabling it once it has been caused by something else. See Causes
for more information about oral contraceptives and hair loss.
Available as a topical treatment by prescription, ketoconazole is currently
used to treat fungal infections. It curbs the production of testosterone and
other androgens by the adrenal gland and reproductive organs (in women, the
These anti-androgenic effects can be used to help treat hair loss. Nizoral
shampoo contains 2% ketoconazole and is prescribed not only for the treatment
of scalp conditions, but also in combination with other treatments for
androgenetic alopecia. A 1% version is now available over-the-counter, but it
may not be as effective as the 2% prescription strength. There are no
significant side effects.
Finasteride (Propecia, Proscar)
The drug finasteride inhibits the enzyme 5-alpha reductase in the hair
follicle, thereby inhibiting the production of follicle-harming
dihydrotestosterone (DHT). DHT shrinks hair follicles and makes it difficult
for healthy hair to survive.
Finasteride was first marketed under the brand name Proscar to treat the
prostate gland. It was available in 5 mg pills. In 1998, a 1 mg version with
the brand name Propecia entered the market as the first pill approved by the
FDA for men's hair loss.
It works quite well to prevent hair loss and trigger regrowth for most men,
and it may work for some women, although women must not take it if they are
pregnant. Also, women should not get pregnant while on the drug because of the
risk of birth defects in a male infant. Less than 2% of men have transient
sexual side effects, including erectile and libido difficulties, while taking
finasteride. However, in women these side effects do not occur.
Cyproterone Acetate with Ethinyloestradiol (Diane 35, Diane 50)
Sold under the brand names Diane 35 and Diane 50, these contraceptive
tablets are prescribed in Europe for women's androgenetic alopecia. Currently,
both versions of this contraceptive are not available in the U.S.
The drug is a combination of cyproterone and estradiol, an estrogen. Both
Diane 35 and Diane 50 contain 2 mg of cyproterone. Diane 35 contains 0.035 mg
of estradiol, while Diane 50 contains 0.050 mg.
They work by blocking some of the actions of male hormones commonly present
in women. Although it's possible for the drug to stop further hair loss and
trigger regrowth of hair within about a year, it needs to be used on an ongoing
basis to maintain regrowth and eliminate hair loss.
Possible side effects include breast tenderness, headaches, and decreased
Published on March 1, 2010