Medicinal Hair Loss Remedies
Active Substances Used in Medicinal Hair Loss Remedies
FINASTERIDE is a generic name for Propecia and Proscar. Finasteride is an antiandrogen which acts by inhibiting type II 5-alpha reductase, the enzyme that converts testosterone to dihydrotestosterone (DHT). It is used as a treatment in benign prostatic hyperplasia (BPH) and prostate cancer. Additionally, it is registered in many countries for androgenetic alopecia (male pattern baldness). It is, in fact, the first and only FDA-approved pill proven to treat male pattern hair loss on the vertex and middle front of head. The great majority of dermatologists agree that this is currently the No.1 cure for hair loss. Finasteride is used orally and its recommended daily dose for treating male pattern baldness is 1mg versus 5mg for treating BPH. Recognized side effects, experienced by less than 0.5% of patients, include erectile dysfunction and less often gynecomastia (breast gland enlargement). Finasteride is not for use by women and children. It is a prescription drug.
Drug trade names include Proscar (5mg of finasteride) and Propecia (1mg of finasteride), both products of Merck & Co. Merck & Co developed this drug but there are many generic pharmaceutical companies in the world who produce this product, such as Cipla (trade names Fincar and Finpecia), Dr. Reddy's (trade names Finax and Finast), Ranbaxy (trade name Finara), Intas (trade name Finalo), Aleppo Pharmaceutical (trade name Prosteride) and Zentiva (trade name Penester) that sell the drug at a significantly lower price than Merck & Co.
Many snake oil producers often overemphasise finasteride's side effects, trying to lure scared patients to their own scam. Another factor that scares off patients from using finasteride is the fact that they need to see their urologist to get a prescription. This problem can be overcome by using offshore virtual pharmacies but this strategy is illegal in the US and in many European countries.
DUTASTERIDE is the generic name for Avodart, a dual 5-alpha reductase inhibitor. It is used to treat conditions caused by DHT, such as BPH. Unlike finasteride, dutasteride inhibits both types of 5-alpha reductase, but a clinical study conducted by GlaxoSmithKline did not find dutasteride to be more effective than finasteride in treating BPH. The side effects are assumed to be similar to those from finasteride but they might be a bit more severe. Dutasteride is a prescription drug. Clinical trials for dutasteride as a hair loss remedy were resumed in Korea in December 2006 and the study was completed in 2009. The final report on the clinical study results is still pending.
The original drug was developed by GlaxoSmithKline and is marketed under the name Avodart (also Avidart and Avolve). Other trade names include Duagen (RP Scherer Beinheim), Duprost (Cipla), Dutas (Dr. Reddy's) and Dutagen (Ranbaxy) and are usually sold at a lower price than Glaxo’s brand products.
Some patients using 0.5mg of dutasteride daily report improved results versus finasteride, especially in the frontal area of their scalp. Reports of side effects vary significantly - some patients had to abandon their treatment whereas others did not notice any serious side effects. Dutasteride is currently the only existing strong candidate for early FDA approval for treating male pattern baldness. The only FDA-approved medicinal hair loss treatments so far include Propecia (finasteride) and Rogaine (minoxidil). Dutasteride appears to be at least as powerful as finasteride, but it is more expensive (see also: Will Dutasteride Ever Get Approved For Hair Loss?).
MINOXIDIL is the main active ingredient in both FDA-approved topical products for treating hair loss, Men's Rogaine Extra-Strength Solution and Men’s Rogaine Foam. Outside of the US the name Regaine is commonly used for the liquid form of this product. Minoxidil is a vasodilator and it was originally used as an oral drug to treat severe blood pressure. Its bizarre side effects, such as the ability to reverse or slow down the balding process, were accidentally discovered in the late 1970s. Minoxidil promotes enhanced follicular size, resulting in larger hair shaft diameters. It also stimulates and prolongs the growth phase of the hair growth cycle.
Minoxidil is an OTC product and it is available in many generic forms as a 2% solution for women and a 5% solution for men. It is applied to the balding area twice a day per 1ml. Some generic producers are now selling minoxidil solutions containing various other ingredients such as azelaic acid, retinoic acid, aminexil, etc. More recently, topical applications with minoxidil concentrations of up to 15% have appeared on the market. Since there are so many generic producers of minoxidil lotions, they can not be all listed here (see also: Rogaine, Regaine or Minoxidil?).
Minoxidil (together with finasteride and a shampoo containing ketoconazole) belongs amongst the Big 3 hair loss cures. Numerous reviews show that there is some synergistic effect from using minoxidil and finasteride in one regimen.
KETOCONAZOLE is the main active ingredient of the Nizoral shampoo (1% or 2%) and it is often used for the treatment of yeast and other fungal infections of the scalp and dandruff. It is also believed to help remove sebum deposits from the skin. However, as it has anti-androgenic and anti-inflammatory properties, it is also often used in combination with other treatments to treat hair loss in both men and women. One study has shown 2% ketoconazole shampoo to be as effective as minoxidil 2% for hair regrowth, indicating that Ketoconazole works as an anti-androgen, reducing the DHT present in the scalp. Nizoral shampo is freely available in pharmacies in most countries. Ketoconazole is also available as a topical foam, marketed under the name KetoMousse. In clinical studies, this foam proved to be a superior mechanism of delivery to the shampoo. Nizoral (containing ketoconazole) is often mentioned as the third component of the Big 3 cures for treating male pattern baldness. It is recommended as a complementary treatment to patients with dandruff and itchy sensitive scalp.
AMINEXIL is a molecule developed by L'Oreal and it is very similar to minoxidil. Aminexil, used as a topical in concentrations of 1.5%, is believed to counteract hardening of the hair follicle, allowing the hair to grow freely. This restores the lifespan of the hair so that it no longer falls out prematurely. Tests have shown that prevention of baldness requires a treatment with aminexil twice a year for six weeks. Aminexil is freely available in pharmacies in Europe. Spectral DNC, produced in the US, was the first generic product that combined the benefits of minoxidil and aminexil. Aminexil is very easy to apply, dries quickly and it is not aggressive to the skin. It is recommended to conduct aminexil treatment twice a year as suggested by its manufacturer.
FLURIDIL is the main active substance of Eucapil, a new cosmetic product for topical use, developed by Biophysica in the US. Male pattern baldness is associated with DHT binding to the androgen receptor in hair follicles. Current treatments include preventing the creation of DHT (finasteride) and preventing DHT from binding to the receptor (spironolactone). Fluridil is claimed to represent a new method of treatment. According to its manufacturer, Interpharma Prague, fluridil blocks activity in the androgen receptor itself. Eucapil was approved as a cosmetic hair care agent for topical use in the Czech and Slovak Republics and can therefore be employed as such in all other EU countries. It is, though, not yet approved for sale in North America and Asia.
Dr. Sovak is one of the inventors of fluridil but a US firm Biophysica holds the patent rights. Dr. Sovak also happens to be one of the founders and chairman of the board at Interpharma Prague, the manufacturer and marketer of this product. All available studies on fluridil were done by Dr. Sovak. An independent view has yet to be made. User references are few and so far mixed.
SUPEROXIDE DISMUTASE - (SOD) is an enzyme widely distributed in the human body that converts the oxygen radical (called superoxide) to hydrogen peroxide, thus playing a critical role in the defence of cells against the toxic effects of superoxide. SOD is used in some cosmetic products to reduce free radical damage to skin and hair and to stimulate skin regeneration and hair growth. SOD is effective only in the form of a topical application. Copper peptides are substances frequently used in cosmetic products as SOD mimetics for their ability to activate SOD.
COPPER PEPTIDES are the main active ingredient in Tricomin and Folligen. Copper peptides improve the skin's antioxidant defences by activating superoxide dismutase (SOD), a protein which detoxifies free radicals and is the body's primary antioxidant defence. Normally SOD lacks enough copper to be active and copper peptides, by supplying nutritional copper to SOD, increase its activity. It is claimed that copper peptides, when applied using appropriate chemical vehicles and when in the appropriate concentration, can thicken vellus hair into thick terminal hairs, increase hair follicle size and regenerate scalp skin, creating a healthier environment for scalp hair growth. There is neither sufficient nor convincing scientific evidence to prove that copper peptides are an efficient new hair growth stimulant. Copper peptides are relatively expensive but can be used sparingly as a complementary treatment alongside some of the more aggressive topicals to relieve irritation of the scalp.
ALFATRADIOL is the main active substance of Pantostin and Ell-Cranell alpha (0.03% of alfatradiol). Alfatradiol is claimed to be a DHT blocker. Although this product is recommended by many dermatologists in Germany for treating hereditary baldness, it is a very weak DHT blocker. It should be avoided by male patients and preference given to other more powerful treatments.
SPRIRONOLACTONE, marketed under the trade name Aldactone (as well as Novo-Spiroton, Spiractin, Spirotone, or Berlactone), is a diuretic used to lower high blood pressure. In addition, it possesses anti-androgenic properties as it binds to the androgen receptor in the hair follicle and thus prevents it from interacting with DHT. Hence, spironolactone is also used to treat acne, hirsutism (excess body hair) and hair loss in women. Male patients should exercise caution when using this product, and if at all, they should only use topical applications (see also: Use of Topical Sironolactone in Treating Male Pattern Baldness).
FLUTAMIDE is a non-steroid antiandrogen primarily used to treat prostate cancer. It is a prescription medicine. Flutamide competes with DHT and testosterone to bind to androgen receptors and, therefore, it is thought that it could be beneficial in treating hereditary baldness. It is a very powerful antiandrogen and its oral use can cause severe side effects, especially in men, where it can lead to a variety of sexual disorders. Oral flutamide is used for excessive facial hair growth in women and sometimes also to treat female hair loss. It is believed that flutamide could also be applied topically to treat baldness in males. Further studies are needed to evaluate the efficacy and safety of flutamide as a topical agent in treating androgenetic alopecia.