By: Shea Lenniger, Contributing Writer
Acceptance and Commitment Therapy: Therapy that helps a trichotillomania patient accept hair-pulling urges but without actually acting on them.
Anthralin: This thick cream is applied daily to hair and then should be rinsed off after a few hours or so. Although it’s typically used for psoriasis, the ointment can be used to grow hair for alopecia areata sufferers. Effects are typically visible within 8 to 12 weeks of daily use.
Anti-Androgens: Anti-androgens, such as spironolactone, can help treat hair loss. This can be effective since androgens, such as testosterone, can accelerate hair loss in women. Anti-androgens are therefore usually prescribed with oral contraceptives to women suffering from hair loss to aid with the hormonal imbalances.
Antibiotics: These are prescribed to prevent infection if a patient has any open sores on their scalp due to infection, injury, or traction alopecia.
Biologics: Biologics are currently being tested for alopecia totalis, as they contain certain proteins that dampen the immune system and potentially stop the inflammatory response thought to cause alopecia. These are administered by injections to suppress immune activity, allowing hair to regrow.
Biotin Supplements: Biotin deficiency has been linked to hair loss in some cases, so supplementing this vitamin will only benefit those with this deficiency. For those without a deficiency, taking biotin will likely not elicit any hair changes or benefits at all.
Contraceptives: Birth control pills decrease the number of androgens that a woman produces, and therefore can potentially help treat alopecia in women. Note that only low androgen index birth control pills should be used with the intention of treating hair loss. High androgen index pills can worsen hair loss. Consult your physician to determine which pill is best for your needs.
Corticosteroids: Monthly injections can be administered to the scalp to benefit cases of alopecia areata. Pills are also used as well as ointments but are proven to be less effective forms of corticosteroids. They are thought to suppress the immune system and stop the inflammatory response which incites alopecia.
Diet and Nutritional Changes: Essential nutrients such as Vitamin D, Zinc, and Iron are critical for healthy, strong hair. Physicians can test for deficiencies that may be causing brittle hair or hair loss.
Finasteride: This prescription pill, sold under the names Propecia and Proscar, reduces male pattern baldness. It’s meant to be taken once daily and works by blocking dihydrotestosterone (DHT) in men. Blocking the conversion of testosterone to DHT can prevent further hair loss in men who have genetic predispositions to balding.
Follicular Unit Extraction (FUE): Similar to FUT (see below), except that the hair follicles themselves are removed and replaced in the balding spots. Note that infections and scarring are potential side effects of these procedures.
Follicular Unit Transplantation (FUT): This is a highly effective, although invasive method for treating pattern baldness. It requires surgeons to remove a small strip of the patient’s scalp and divide it into tiny grafts. The grafts are then planted in small slits in the scalp in the areas of missing hair. Thus, hair regrowth looks more natural in these follicular units, rather than simply placing an entire strip over the patchy spots.
Habit Reversal Training: Primary behavioral therapy treatment for trichotillomania where a patient feels the urge to pull out their hair and instead substitutes hair pulling for a different response. (Ex. Clenching fists to help to redirect your hand from pulling hair)
Hair Transplantation/Grafting: This procedure is conducted in a dermatologist’s office, in which a portion of a patient’s hair-bearing scalp is removed and transplanted to a balding spot. Micrografts include 1 to 2 hairs per graft, slit grafts use between 4 and 10, and punch grafts contain 10 to 15. Strip grafts use long, thin sections of about 30 to 40 hairs. Surgeons inject a local anesthetic to the scalp for comfort during the procedure.
Iron Supplements: Another reason for hair loss could be attributed to an iron deficiency. Your physician can test your blood iron level and determine whether or not a supplement would be beneficial. Vegetarians, women who suffer from heavy menstrual bleeding or those who have a history of anemia will most likely benefit from iron supplements.
Laser Treatment: Laser therapy can help reduce inflammation in hair follicles. Further research is required, but low-level laser therapy has been determined safe and effective in treating male pattern baldness.
Minoxidil: This cream, sold under the name Rogaine, should be applied twice daily directly to the scalp. It stimulates hair growth but won’t restore the full density of hair. It’s available in both a 2% and 5% solution and can be used by both men and women. Effects will appear after a few months of use and require continuous use after that to continue the benefits.
Photodynamic Therapy (PDT): This process uses oxygen and light in a photochemical reaction to attack cancer cells. This was originally thought to aid in hair regrowth, but multiple studies have recently found that no hair regrowth occurred in their patients.
Platelet Rich Plasma: While the research for this is in its very early stages, this hair loss treatment involves mixing a small amount of the patient’s blood with a serum. The mixture is then injected into the scalp.
Prevention Techniques: Changing hairstyles, such as avoiding wearing tight hairstyles overnight, or refraining from using chemicals or heat can drastically improve hair health and strength. Looser hairstyles can prevent the negative effects of traction alopecia.
Retin-A: This prescription acne medication has been effective against hair loss in some cases, particularly when combined with minoxidil. However, a common side effect is extreme scalp irritation, which can worsen hair loss.
Scalp Reduction: This involves the removal of non-hair-bearing skin from a patient’s scalp so that the remaining healthy hair sites can be stretched to fill in the balding patches. It is typically used to cover bald patches on the top and back of the head but is not very beneficial for frontal hairline balding or recession. The patient’s scalp is injected with local anesthetic in order for the surgeon to remove a bald scalp segment. Surrounding skin is loosened and gently stretched to be stitched together. This procedure often happens along with hair grafting.
Spironolactone: This pill, commonly sold as Aldactone, blocks the hormones responsible for hair loss. It is most commonly used for female pattern baldness.
Squaric Acid Dibutylester (SADBE)and Diphencyprone (DCPC): These topical treatments are rubbed onto the scalp weekly. The chemicals cause a harmless allergic reaction on the scalp, usually causing brief redness and irritation, but stimulate hair growth as a result.