DermHelpCentral

Oral Minoxidil for Alioecia: A Systematic Review

This systematic review from the 2020 International J of Dermatology is helpful.

There is no one protocol and the dosages range from 1.25 mg a day to 5 mg twice daily.  In women, often in conjunction with 25 mg of spironolactone.  There are no randomly controlled double blind studies.  It would make sense to start at 1.25 to 2.5 mg a day and give it three months before changing anything.  The only side-effect mentioned in the studies looked at for this afticle was some increase in facial hair,

Download Minoxidil IJD Sustematic Rev 2020

The article concludes" "Oral minoxidil is a safe and successful treatment of androgenic alopecia and Alopecia Areata. In addition to its therapeutic benefits, practical advantages over topical minoxidil stem from improved patient compliance."

Oral Minoxidil for Alopecia

A growing group of dermatologists is offering low-dose minoxidil pills, the treatment remains relatively unknown to most patients and many doctors. It has not been approved by the Food and Drug Administration for this purpose and so is prescribed off-label — a common practice in dermatology.

It is used for. male and female pattern hair loss and also for telogen effluvium.  At the low doses employed, it is safe and has few side-effects.

Here is the NY Times article on this treatment: Download An Old Medicine Remedies Hair Loss for Pennies a Day Doctors Say - The New York Times

 

 

Common Causes of Baldness

Hair loss (alopecia) is categorized as scarring (with permanent destruction of hair follicles) or nonscarring.
Nonscarring alopecia is the most common form of hair loss and can be classified as patterned, diffuse, or focal, based on the distribution of hair loss.

The Journal of the American Medical Association had a helpful Patient Page on non-scarring alopecia inj August 2022.  Here's the link: Download Common Causes of Baldness JAMA

Excellent Review of Male and Female Pattern Hair Loss

Male and Female Pattern Hair Loss: Treatable and Worth Treating

Nina L Tamashunas , Wilma F Bergfeld

Cleve Clin J Med. 2021 Mar 1;88(3):173-182.

Pattern hair loss is the most common type of hair loss in both men and women. Scalp hair is typically affected in a characteristic distribution without other scalp or dermatologic findings. Early recognition and treatment can help halt its progression to preserve as much hair as possible. Both pharmacologic and nonpharmacologic treatments have proven helpful.

Free Full Text.

Wilma Bergfield has been a top hair researcher for 40 years!

Post-Finasteride Syndrome

Reports of physical, sexual and psychologic side-efects from the use of, and even discontinuation of finasteride, have been in the news.  It's hard to tell hype from reality.  A 2019 report in the British Medical Journal is quite helpful.  See PDF   Download Post Finasteride Syndrome

Pulse dexamethasone for adult alopecia totalis and universalis

Pulse corticosteroid therapy with oral dexamethasone for the treatment of adult alopecia totalis and universalis 

Download Dexamethasone A. Totalis

What Not To Say To A Woman With No Hair

In a culture that associates women's hair with beauty, health and desirability, losing it can be a a momentous prospect. Women can experience hair loss for a variety of reasons: through medical issues, cancer treatment, the aging process or a surprisingly common condition called alopecia areata.

This is an essay written by a young woman who has had alopecia universalis for over 10 years. Carly Severn's article.

Four Women with Alopecia Universalis

"Four bald women walk into a bar. The mission is to sort out the many times we have been mistaken for one another. And to compare notes about what it is like to be a woman living with alopecia universalis in New York."

This fine experiential article appeared in the July 30, 2015 NY Times.  It speaks by and of the people with the disease and that is important.

Short YouTube, "My Alopecia Story", by Helen Phillips  who developed alopecia universalis at age 11.

New Stratagems in the Quest for Hair

This is a nice review of treatments for balding.  It focuses on Latisse (which is only approved for growing eyelashes (!) -- but now is being used for small portions of scalp -- especially frontal hairline.  The article is well-written and worth perusing for any patient interested in this area.  See Quest for Hair.

Alopecia Areata, NY Times

WARNING: THIS IS NOT ABOUT PEOPLE WITH JUST A FEW BALD PATCHES - BUT DEALS WITH THE MUCH RARER UNIVERSALIS FORM. 

From the NY Times article: "Alopecia areata (AA) is an autoimmune disease that causes the body to attack its own hair follicles. AA, which is a different disorder than normal male-pattern baldness, affects nearly 2 percent of the global population and has no universally effective treatment. Its progression is unpredictable and can range from a few bald patches to a completely hairless scalp to the loss of every hair on a person’s body — known as alopecia universalis (AU). Sometimes the hair regrows, sometimes it does not, and sometimes it grows in only to fall out again years later." 

Only a small number of people with AA progress to total hair loss or the universalis variant.  The NY Times had an excellent intro to AA (with an emphasis on AU) in the July 6, 2010 issue. Times Article: A ‘Forest Fire of Hair Loss,’ and Its Scars. This has the link to the multimedia "Patient Voices" or you can link directly here at: Voices of Alopecia.