Treatments for female pattern hair loss

Treatment of Hair Loss in Women

Today we gonna look at treatment options for treating female pattern hair loss, the use of topical and oral minoxidil, and where this fits in in the whole ecosystem of hair loss.

This is not a treatment as much as the management of hair loss because we can never fully treat female pattern hair loss. When the hair is in a similar sort of issue with men, once the hair is gone it’s gone.

We’re trying to stabilize hair loss and that’s what we’re trying to do with therapy or non-medical therapy we’re trying to stabilize the hair loss.

We can’t cure hair loss

Today what we’re going to talk about is stimulation therapy. The first thing is that we can’t cure it.

If people come in thinking they can take something for three months or six months to solve the problem and never have a problem again I’m sorry that’s not possible.

I say to my patients:

If you have high blood pressure or arthritis nobody can cure these things all we can do is manage them and if you’re unlucky enough to be in that category of getting the problem then early treatment is essential.

Because we’re much better at preventing hair loss than we are at regrowing hair in women who’ve lost a lot of hair. Women tend to panic about this pretty early on.

We do see a lot of women come to us and early in the condition which is important because once we’ve made the diagnosis which we talked about by doing blood tests as well as clinical examination once we’ve made the diagnosis then it becomes about management.

Stimulation Therapy

The single most probably important thing we’re going to treat all of our women with is stimulation therapy.

What we mean by stimulation therapy is we’re going to apply some technology to the hairs that say: work harder, grow thicker, grow longer, stick around longer that’s the goal here.

It still means you can have shaded hair, you’ve still got hair because every hair in your head has to shed, the idea is to get them as healthy as possible.

We explained the causes of female pattern hair loss, we talked about genes and we talked about the hormonal causes. We said that treatment or management has targeted that but this particular stimulation therapy doesn’t.

We’re aware of that, we’re not affecting hormonal levels or doing anything of that, what we’re trying to do is just to make them stay strong and as long as is possible under the circumstances.

So if we’re going to talk about our stimulation therapies the two principles:

• Minoxidil
• Minoxidil Solution

Minoxidil

We’ll start off with Minoxidil which of course we’ve talked about with men before, this can be provided as a lotion which you can buy over the counter at your chemist.

Minoxidil comes in two strengths 5% and 2%.

The 5% works quicker than the 2% the women’s one. If you see it in a pink box it just means they marketed in a pink box if they don’t have any pink boxes left with the 5% then buy the blue one. I find people go around looking for the pink box, the color of the tackling makes no difference to it.

I’m getting kinda controversial and telling you that what’s written on the box is wrong. The topical 5% Minoxidil lasts 21 hours on the skin and I only recommend people to use it once a day.

Minoxidil comes in two versions

• Lotion
• Foam
• Oral

Minoxidil lotion

It comes in a lotion which has a kind of a slightly greasy feel to it which some women don’t like because it mocks up their hairstyling color.

Minoxidil foam

It comes in a foam which is less greasy and again some women don’t like it necessarily because it still interferes with their styling options but this form is a lot easier to illustrate it’s easier to use an electrolyte and it also absorbs faster.

How fast our skin absorbs Minoxidil?

The short answer is the foam Minoxidil absorbs in 10 minutes the solution lotion takes 60 to 90 minutes.

As a practical point if you’re using Minoxidil and applying it to the hair makes absolutely no difference whatsoever. It needs to be applied to the scalp.

The hair as we talked about before is actually dead the actual bit of the hair that’s outside the skin is just like a rope. Applying any Minoxidil directly into the hair is not going to stimulate that hair.

What you need to do is apply it to the scalp. If you’re using either the liquid or the foam which is a lot easier to handle squeeze a little bit into their cap, use your finger or cotton and just apply it on the area, into the scalp.

Minoxidil is available over the counter to the chemist. So it’s a chemist line it’s not very expensive if you can use the generic versions, you can use the official versions that makes not a little bit of difference at all. That’s the way a lot of people use it for the women that are having trouble using it like that.

Minoxidil Oral form

The third way we give Minoxidil out these days is in oral form. We do it in a capsule because there is no tablet really that has the right dose in it for women.

There is a tablet out there but you want to cut it down into at least quarters if not fifths which is really technically demanding.

So under the circumstances, if you’re going to use oral Minoxidil and save yourself the hassle of applying it to the scalp you can get it compounded at a compounding pharmacy and they’ll make it up into the dose.

What is the daily dose of oral Minoxidil for women?

We use 5% of the solution, in women we tend to use between about half a milligram to one milligram of minoxidil per day once a day as a capsule.

The sooner you start the oral Minoxidil the better off you’re going to be. The main improvement in using Minoxidil is in the shaft diameter, the numbers go up a little bit it’s the shaft diameter. If you’ve got hairs there you want them to be thicker hairs and that’s the best way.

The first thing is we had a lot of patients, we talked them through and they start on Minoxidil and they come back and go: I hate it, it made my hair loss worse.

That’s actually true and you must be aware of that because what it’s doing is stimulating the hair to grow and part of that stimulation process may be ejecting that existing hair that’s coming towards the end of its cycle and a new hair coming back in its place.

In those scenarios, you’re getting more of the negative effects and you’re not hanging around for the good effects which are going to happen 3 months down the track.

So you have to persevere and we do want our patients that there is an initial phase where they may notice a little bit of extra shedding.

Typically happens 4 to 6 weeks after you start the medicine. And it lasts 4 to 6 weeks, so if you can steel yourself to get through that phase I’ll think of it as good hairs pushing out all week hairs and so temporary phase that lasts about 6 weeks. Don’t panic and don’t stop. The really important thing is to do it.

If you are going to stop after 6 or 12 months because it’s working, that’s fine because if you stop and then you go oh my goodness 4 to 6 weeks later I’ve got some increased shedding that tells you it worked.

It’s quite acceptable to stop and we sometimes ask our patients to stop to see if making it because if you stop it and not much changes maybe it wasn’t doing much for you. We do think that in terms of women that we can increase their hair shaft diameters and their numbers it’s about a 50/50 play. Using Minoxidil topically we can get improvement.

Which is better the topical version and the oral version of Minoxidil?

The short answer it’s which one you got better compliance for. I will say about the oral tablet has a more systemic effect, so you may notice hair stimulation everywhere.

This is why we use a low dose, whereas with the topical version it’s going to act exactly where you’ve applied it so that’s something to be mindful of.

Laser Therapy

We have to be very specific about what we’re talking about here. There are laser devices in the marketplace for hair stimulation they were in through a different pathway to minoxidil so they can be used in combination and as we’ve all found both of us have found some of our patients feel that they want to use a non-chemical as one treatment and this is a perfect way to do that.

How does laser therapy for hair loss in woman works?

The laser is done at a very specific wavelength which is in the red light wavelength so it’s a lower frequency and it was also done at low power.

The only thing that really can happen to the scalp is heat. There’s no danger to burning, you shouldn’t lose it lasering the hair off or anything it’s just applying energy at a particular frequency that is going to stimulate the existing hair to grow.

That’s in essence what it really does, is it stimulates energy production inside the cells. It’s kind of like turbocharging any energy production.

That’s quite a different pathway from the way Minoxidil works. This is about re-energizing these weakening hair cells.

Laser therapy for different kinds of users even healing users have been around for a long time. The evidence has only been in the last 5 to 10 years about this significant benefit potentially it plays in stimulating hair.

Yes, there are lots of different lasers out of the marketplace and there are a lot of different opinions about how they should be used. I think what we’re going to try and do is distill it down for you as to what we think is the most beneficial for you. We’re not recommending a particular brand or anything, what we’re saying is that using a laser can stimulate the hair.

In-home laser devices

There are very expensive devices where you go to a clinic and they will apply the laser for you obviously compliance is an issue having to go to someone do it.

There are a lot of in-home devices as well but the key here is that if you’ve got the right frequency and that’s important have you got the right number of diodes. What you want to do is you want to apply it evenly over the entire scalp. You don’t want just a bit here and a bit there.

What is the difference between laser devices?

The difference in devices will be the number of diodes that they have within the device and also the frequency that you use it as well.

How often a laser device is used for hair loss in women?

It doesn’t need to be used every day, doesn’t even need to be used all day every day, generally, the recommendation is about 35 to 40 minutes 3 times a week is what we found is the sweet spot.

It’s not just us, the literature has shown is actually the recommended frequency of using it. Again you have to use it if it’s it’s in the cupboard it’s not going to help at all because some of these devices are quite expensive. It has to be on for a reasonable amount of time.

We don’t recommend a device like a laser comb. You’re gonna have to be sitting there combing your hair for 35 or 40 minutes which is not a practical thing. We quite like the cap devices.

Cap laser Devices

The thing about a cap device is that it’s for in-home use or even when you’re walking the dog, reading a book, cooking a meal, derivatives you want to do. It’s on a rechargeable battery pack which allows you the option to be mobile with it as well.

They do come with different numbers of lasers and diodes. This is like a cap device and it fits underneath a baseball cap. Inside the cap, you’ve got these multiple diodes and it’s attached to a battery pack, which is recharge or a battery pack and you just walk around with that. You can carry on with your day-to-day activities while this is taking effect.

Consistency is the key

The two key points mentioned so far that I want to talk about again to reiterate is that if you’re using a cap device.

We want you to use it 3 times a week and we want you to use it for between 30 and 45 minutes.

If you find it heats your head up and you’re feeling a bit hot then switch it off for 5 minutes take it off put it back down when your scalps cool down and keep going as long as you get to that 30 to 45 minutes. If you do less than that you’re really not giving yourself a chance to get the full expression of the benefit of it.

Those 30 to 45 minutes 3 times a week are the key.

If you’re we’re not against the idea of you sitting under dome devices in clinics the problem is you’re not going to get the frequency.

For example in Australia, the clinics ask her to come in once a week, once every two weeks, once a month because they know they’re not going to come in more frequently. I mean I’m sorry people that’s really not going to do the job.

Diodes are important in a laser cap

The other thing that is worth understanding about the laser devices is that the diodes aren’t all the same. Yes, the wavelength is the same yes the power output overall is the same but the diodes have different effects.

If you were plotting a chart of the different devices upon a scale some of them are down and some of them up.

For example, if you have a device with 80 diodes in it at low power it’s going to be on the low part of the stimulation curve, if you’ve got a device with over 200 to 300 diodes in it with a higher power coming out of that diode then you’re going to be at the upper end of the level and that makes a difference as well.

That might sound complicated but we have plotted the different devices that we know there’s a big variation between them in the amount of energy and the amount of laser energy they provide to the hair follicle. Getting some advice on it rather than just buying something from the internet, I think that’s probably helpful.

If you go and search online there are a plethora of devices at various different price points. I think like most things in life you kind of get what you pay for.

I think there are better ones on the market than others and it’s pretty hard to get something under $1000. That might sound like a big investment but here’s the thing again it could go to a good company they have a good policy.

The ones that we tend to use have for example a 70% money-back guarantee if you don’t like it in the first 12 months. Parts and labor are guaranteed for 3 years. So as other devices are guaranteed for 1 year.

Like normal consumer things you need to look for better quality devices because they are going to provide you with a better quality result. Without squeaking any individual one I can tell you that if you get advice from people who have had experience with patients who know what the results are going to be you’re going to do better.

The science behind it is very good, there are good data but the thing that I don’t mean to harp on about it but sometimes you hear these slow crushing stories about people who spend a lot of money on the device and then live it in there and don’t use it.

You need to use it and use it regularly and it’s going to be a long-term thing and that’s why these things are designed to be mobile and conspicuous underneath the baseball cap. The data is excellent it can really help if used properly and in combination with other therapies.