At NYU Langone, dermatologists who specialize in hair loss and scalp disorders have treated thousands of people with all types of hair loss. They often recommend medication to help prevent further hair loss and, whenever possible, to regrow hair.
Topical minoxidil stops hair from thinning and stimulates new hair growth.
This medication can help people with many different types of hair loss, including: male and female pattern hair loss, which is also known as androgenetic alopecia; alopecia areata, an autoimmune disease in which the body’s immune system attacks healthy tissues, including the hair follicles; telogen effluvium, in which hair falls out all over the scalp due to an interruption in the body’s cycle of hair production; anagen effluvium, or rapid hair loss resulting from medical treatment; hypotrichosis, which is a rare condition in which very little hair grows on the scalp and body; and some forms of cicatricial, or scarring, alopecia.
The way this medication works is not well understood, but many people see significant results. Although it is available without a prescription, you may have better results if you use it while seeing a dermatologist. He or she can diagnose the exact cause of hair loss and determine whether a 2 percent or 5 percent concentration of minoxidil is right for you. The dermatologist can also show you how to apply it correctly.
Available as a foam or a liquid, minoxidil is applied directly to the scalp, twice a day for best results. It may take four months to a year for hair to noticeably thicken. Increased shedding may initially be observed soon after the medication is begun and may continue for a month or two.
After six months, dermatologists assess how well the medication is working by counting the number of new hairs on the scalp and comparing current photographs with those taken at the start of treatment. If you like the results, treatment can continue indefinitely. Hair loss often recurs if treatment is stopped.
Side effects are rare but may include scalp redness and irritation and the growth of facial hair.
Oral finasteride is a prescription medication for men who have male pattern hair loss, or androgenetic alopecia. Finasteride slows the rate of hair loss and stimulates new hair growth by inhibiting the body’s production of a hormone that destroys hair follicles. This medication is taken once a day by mouth and is most effective when taken at the same time each day.
Finasteride starts to work after about four months, but you may not notice significant hair growth for as long as a year. Your dermatologist measures this progress after six months to determine whether to continue treatment. If the medication is working, treatment may continue for as long as new hair growth is desired. Hair loss may recur if the medication is discontinued.
Medications that inhibit androgens—sex hormones that damage or destroy hair follicles—may stop hair loss in female pattern baldness, also known as androgenetic alopecia. Antiandrogen medications are available by prescription only and include spironolactone and oral contraceptives, or birth control pills, that contain estrogen. Antiandrogens usually start to work after four months. Long-term treatment is necessary to prevent hair loss from recurring.
Antiandrogens can produce side effects, including irregular menstrual periods and drowsiness. Women who are trying to become pregnant should not take antiandrogens.
Some types of hair loss are caused by an autoimmune disease and are treated differently than hormonally induced hair loss. With an autoimmune condition, the body’s immune system attacks healthy organs and tissues, including the skin. Sometimes the body destroys healthy hair follicles.
Corticosteroid medications are used to treat people with alopecia areata, lichen planopilaris, and discoid lupus erythematosus. These immune system suppressors can counteract the effects of an autoimmune disease, allowing hair to grow. Steroids are available as topical solutions or injections, and all require a prescription. Dermatologists determine which type of treatment is most appropriate based on your age and severity of symptoms.
For children who have been diagnosed with alopecia areata, a topical steroid cream can be applied to the skin or scalp. For adults, the doctor may inject steroids into the skin or scalp. As many as 80 injections may occur during one appointment.
Steroid treatments can take place every four to six weeks, and you may see hair regrowth in one or two months. If your hair doesn’t grow, or if you can’t tolerate needles, a dermatologist may prescribe corticosteroid to be taken by mouth for 8 to 10 weeks. If it doesn’t have a visible effect after six months, this treatment should be stopped.
Topical and injected corticosteroids have side effects, including scalp irritation that may lead to a rash, thinning skin on the scalp, and a red or puffy face. Corticosteroid medication taken by mouth may make the body’s immune system less capable of fighting a bacterial or viral infection.
If a fungal infection called tinea capitis, or scalp ringworm, is the cause of hair loss, a dermatologist prescribes an antifungal medication to be taken by mouth daily. Often, it takes one or two months before you can see results, and treatment usually lasts for several months in order to fully eliminate the fungus. If treatment begins soon after symptoms appear, most people see excellent hair regrowth.
Side effects of antifungal medications can include rash, diarrhea, and upset stomach.
Many types of hair loss are treated with a combination of medications for optimal results. Dermatologists at NYU Langone may add antibiotics to a treatment regimen to prevent the immune system from attacking healthy hair cells or antimalarial medications to reduce inflammation in the scalp.
Your dermatologist provides information about these options and discusses the possible benefits and risks before recommending treatment.