Hair loss (medically known as alopecia) is a symptom of several underlying medical conditions. While most people are concerned about hair loss from the head, it can also occur in other parts of the body.
The most important step in hairloss treatment is correctly identifying the underlying cause and put a stop to further loss. Specialist dermatologists are the hair loss specialists and are best equipped to identify the cause of hairloss and treat it correctly. Attention can then be directed at attempting to restore hair that has been lost.
What causes hair loss?
There are numerous causes for hair loss including stress, autoimmune diseases, infections (fungal, bacterial and viral), as well as nutritional deficiencies.
The first step in treating alopecia is making the correct diagnosis so that the correct treatment can be started to stop it getting worse.
Hair loss is often incorrectly diagnosed and several months of progressive loss can occur before realising the diagnosis and treatment is wrong. It is important to get the correct diagnosis in the first instance with a dermatologist.
While there are numerous causes for alopecia, by far the most common causes are:
- Female pattern hair loss (FPHL)
- Male pattern hair loss (MPHL)
The majority of people will experience FPHL or MPHL to some extent, however, the severity and age of onset is variable. While these are commonly thought of as hormonal-related hair loss, a hormonal role in FPHL is uncertain.
What to expect from a hair loss appointment?
Your first appointment will be an in-depth consultation to review your past medical history and the history of your hair to uncover potential associated diseases or other signs. This may include checking other areas of the body to look for signs of diseases that may present alongside alopecia. In particular, this will be looking for nail abnormalities and hair loss at other sites.
A scalp biopsy may be performed to confirm the diagnosis in unusual or rapidly progressive cases to ensure there is no other cause for the alopecia.
We will review your particular concerns, lifestyle, and preferred treatment options. If your condition is complicated, we may arrange more in-depth investigations or reviews with our dermatologists.
Women
For women, we will also be looking for signs of elevated androgen levels, such as acne or abnormal hair elsewhere (hirsutism). If we are concerned about elevated androgens, we will typically request blood tests for:
Men
Male pattern hair loss is almost always unrelated to blood levels of testosterone, so blood testing is not required. Rather, hairloss is often related to increased sensitivity of hair-follicles to normal levels of testosterone. 1Demark-Wahnefried, W., Lesko, S.M., Conaway, M.R., Robertson, C.N., et al. (1997), Serum Androgens: Associations With Prostate Cancer Risk and Hair Patterning. Journal of Andrology, 18: 495-500. 10.1002/j.1939-4640.1997.tb01964.x,2Cipriani R, Ruzza G, Foresta C, Veller Fornasa C, Peserico A. Sex hormone-binding globulin and saliva testosterone levels in men with androgenetic alopecia. Br J Dermatol. 1983 Sep;109(3):249-52. doi: 10.1111/j.1365-2133.1983.tb03538.x
What are the hair loss treatment options?
There are numerous purported treatments available on the market. Many claim to support hair health, and they can be expensive. We only recommend therapies that have proven efficacy in peer-reviewed, published medical studies.
The difficulty with hair loss treatment is that it can take up to 6 to 12 months to notice improvement, as regrowing hair is a slow process. This is another reason why establishing the correct diagnosis is very important from the start so that years of progressive reduction are not wasted with incorrect remedies.
Minoxidil
Minoxidil is effective for both FPHL and MPHL. Minoxidil was initially developed to treat ulcers before it was found to help with high blood pressure and alopecia. It appears to work by stimulating the growth (anagen) phase of the hair cycle and enlarging previously miniaturised follicles. Minoxidil is often combined with other treatments to improve efficacy.3van Zuuren EJ, Fedorowicz Z, Schoones J. Interventions for female pattern hair loss. Cochrane Database Syst Rev. 2016 May 26;2016(5):CD007628. doi: 10.1002/14651858.CD007628.pub4,4Bergfeld W, Washenik K, Callender V, Zhang P, Quiza C, Doshi U, Blume-Peytavi U. A Phase III, Multicenter, Parallel-Design Clinical Trial to Compare the Efficacy and Safety of 5% Minoxidil Foam Versus Vehicle in Women With Female Pattern Hair Loss. J Drugs Dermatol. 2016 Jul 1;15(7):874-81
Antiandrogenic treatments
Antiandrogenic treatments such as finasteride are one of the most well-established therapies for MPHL. More recently, it has also shown benefits for FPHL. However, many have requested a preference to avoid finasteride.5Manabe M, Tsuboi R, Itami S, Osada SI, et al; Drafting Committee for the Guidelines for the Diagnosis and Treatment of Male- and Female-Pattern Hair Loss. Guidelines for the diagnosis and treatment of male-pattern and female-pattern hair loss, 2017 version. J Dermatol. 2018 Sep;45(9):1031-1043. doi: 10.1111/1346-8138.14470 Women also have the option of treatment with spironolactone and cyproterone acetate.6R. Sinclair, M. Wewerinke, D. Jolley, Treatment of female pattern hair loss with oral antiandrogens, British Journal of Dermatology, Volume 152, Issue 3, 1 March 2005, Pages 466–473, doi: 10.1111/j.1365-2133.2005.06218.x,7Burns LJ, De Souza B, Flynn E, Hagigeorges D, Senna MM. Spironolactone for treatment of female pattern hair loss. J Am Acad Dermatol. 2020 Jul;83(1):276-278. doi: 10.1016/j.jaad.2020.03.087
Platelet-rich plasma
Platelet-rich plasma (also known as PRP treatment) can improve alopecia by utilising growth factors from platelets to modulate the hair cycle and regrowth of hair.8Dubin DP, Lin MJ, Leight HM, Farberg AS, Torbeck RL, Burton WB, Khorasani H. The effect of platelet-rich plasma on female androgenetic alopecia: A randomized controlled trial. J Am Acad Dermatol. 2020 Nov;83(5):1294-1297. doi: 10.1016/j.jaad.2020.06.1021,9Alves R, Grimalt R. Randomized Placebo-Controlled, Double-Blind, Half-Head Study to Assess the Efficacy of Platelet-Rich Plasma on the Treatment of Androgenetic Alopecia. Dermatol Surg. 2016 Apr;42(4):491–7. doi: 10.1097/DSS.0000000000000665
Photobiomodulation
Previously known as low-level laser therapy (LLLT), photobiomodulation is a newer treatment that has proven to be beneficial in several studies.10Jimenez JJ, Wikramanayake TC, Bergfeld W, Hordinsky M, Hickman JG, Hamblin MR, Schachner LA. Efficacy and safety of a low-level laser device in the treatment of male and female pattern hair loss: a multicenter, randomized, sham device-controlled, double-blind study. Am J Clin Dermatol. 2014 Apr;15(2):115-27. doi: 10.1007/s40257-013-0060-6,11Suchonwanit P, Chalermroj N, Khunkhet S. Low-level laser therapy for the treatment of androgenetic alopecia in Thai men and women: a 24-week, randomized, double-blind, sham device-controlled trial. Lasers Med Sci. 2019 Aug;34(6):1107-1114. doi: 10.1007/s10103-018-02699-9,12Faghihi G, Mozafarpoor S, Asilian A, Mokhtari F, Esfahani AA, Bafandeh B, Nouraei S, Nilforoushzadeh MA, Hosseini SM. The effectiveness of adding low-level light therapy to minoxidil 5% solution in the treatment of patients with androgenetic alopecia. Indian J Dermatol Venereol Leprol. 2018 Sep-Oct;84(5):547-553. doi: 10.4103/ijdvl.IJDVL_1156_16,13Liu Y, Jiang LL, Liu F, Qu Q, Fan ZX, Guo Z, Miao Y, Hu ZQ. Comparison of low-level light therapy and combination therapy of 5% minoxidil in the treatment of female pattern hair loss. Lasers Med Sci. 2021 Jul;36(5):1085-1093. doi: 10.1007/s10103-020-03157-1
Mesotherapy
This is also a newer treatment, with studies recently demonstrating significant benefits. Mesotherapy involves using needles to create small holes in the skin to deliver topical medication deeper into the tissues. This may be an alternative for those who want to avoid the systemic side effects of oral medications.14Tang Z, Hu Y, Wang J, Fan Z, Qu Q, Miao Y. Current application of mesotherapy in pattern hair loss: A systematic review. J Cosmet Dermatol. 2022 Oct;21(10):4184-4193. doi: 10.1111/jocd.14900
Microneedling
Microneedling may be an option, as some studies have shown benefits, however, the evidence is not clear about whether this is beneficial for alopecia.
Other hair loss treatment options
Several other supplements and remedies are marketed for alopecia. However, these lack evidence for their efficacy, including: biotin, iron, green tea, caffeine, and ginseng.15Blumeyer A, Tosti A, Messenger A, Reygagne P, Del Marmol V, Spuls PI, Trakatelli M, Finner A, Kiesewetter F, Trüeb R, Rzany B, Blume-Peytavi U; European Dermatology Forum (EDF). Evidence-based (S3) guideline for the treatment of androgenetic alopecia in women and in men. J Dtsch Dermatol Ges. 2011 Oct;9 Suppl 6:S1-57. doi: 10.1111/j.1610-0379.2011.07802.x
What are the benefits of hair loss treatment?
Effective treatment can result in the regrowth of lost hair, however, results will vary between individuals. We also aim to halt, or at least slow, the progression of alopecia.
What about other treatments?
There are countless other treatments advertised for alopecia which are sometimes quite expensive but lack evidence that they work.
At Anue, we only offer hair loss treatments that have been demonstrated to be effective with published, peer-reviewed medical studies.
Hair loss Treatment with Anue
We believe our clients deserve access to expert, evidence-based hair loss treatments. That is why we offer our services by our trusted team, supervised by renowned specialist dermatologist, Dr. David Lim.
By using refined techniques, qualified professionals, and high-quality products, we aim to make you look and feel your best. Our hair loss treatments are safe and effective at helping you achieve your goals.