Anyone who loses more than 100 hairs a day and who loses more hair than grows back suffers from hair loss. If those affected consult a doctor, he will probably inquire about the previous duration and course of the hair loss. In order to rule out diffuse hair loss, for example, he must also ask about previous illnesses or infections and about medication. In women, hair loss can also be due to causes such as an underactive thyroid, pregnancy and iron deficiency.
Hereditary hair loss is easy to diagnose based on where it occurs. It is not a disease in the causal sense, which is why no treatment is necessary from a purely medical point of view. However, since many of those affected suffer greatly when their hair falls out, there are a number of products on offer that are intended to help those affected. For many of the remedies, however, there is a lack of scientific evidence that their ingredients can stop hair loss or even allow new hair to sprout.
Therapy in men
The two active ingredients finasteride and minoxidil as well as dietary supplements against hereditary hair loss are currently approved in Switzerland. However, specialists can rarely predict whether a therapy will bring the desired success. What all the remedies have in common is that they only take effect after a few months. When treatment is stopped, hair loss generally returns.
- Finasteride: The active substance finasteride intervenes in the conversion process of the male hormone testosterone (technical term: 5α-reductase inhibitor, see causes) and is commercially available in Switzerland in the form of film-coated tablets. Men over the age of 18 should take one pill once a day to combat hair loss. Finasteride is also used - albeit in higher doses - to treat a benign enlarged prostate. The drug has some unwanted side effects like decreased libido, impotence, erectile dysfunction, ejaculation dysfunction, breast tenderness, breast enlargement and skin rash. According to recent studies, one in a hundred men suffers from impotence for several years after stopping finasteride therapy. Finasteride is not suitable for children, adolescents and women.
- Minoxidil: The antihypertensive drug minoxidil is prescribed for the topical treatment of hereditary hair loss for both men and women. However, the dosage varies depending on gender. Sufferers apply the solution or foam locally to the scalp twice a day. It is often observed that a few weeks after the start of the treatment, the hair falls out more, this phenomenon decreases again over time. A hair-preserving effect only sets in after months. Common undesirable side effects are local reactions such as itching and headaches. During treatment, it must also be noted that minoxidil has a vasodilating effect and is considered an antihypertensive agent.
- Alfatradiol: The active ingredient from the group of 5α-reductase inhibitors is usually applied externally as a solution once a day. Possible undesirable effects include local reactions on the scalp, mainly caused by the excipients. In Switzerland there are no finished medicinal products with alfatradiol on the market, the active substance is only available as a so-called extemporaneous formulation. In Germany, preparations for external use are available.
The extent to which a treatment is successful seems to depend on when therapy is started. The sooner, the better, is the motto here. Once bald spots have formed, it is almost impossible to revive the stunted hair roots.
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| treatment of hair loss in men and women |
Therapy in women
In principle, the same applies to success against hereditary hair loss in women as in men: the earlier the treatment is started, the greater the chance that it will work.
- Minoxidil: The antihypertensive drug minoxidil is applied topically to the scalp twice a day as a 2% solution. According to studies, this can stop the progression of hair loss in women over the age of 18 and improve hair density. It is often observed that a few weeks after the start of the treatment, the hair falls out more, this effect wears off again over time. Women of the Mediterranean type should be careful with the minoxidil treatment - they can react with increased hair growth on their face.
- Antiandrogens (e.g. cyproterone acetate, spironolactone, dienogest, drospirenone, chlormadinone): The active ingredient group of antiandrogens is also said to be successful against hereditary hair loss in women, but is only prescribed to women with androgenization, i.e. symptoms of masculinization. The active ingredients are combined with contraceptive estrogens such as ethinyl estradiol and are taken orally like other contraceptives.
- Estradiol hair spirit: The hair spirit can be produced in Switzerland as an extemporaneous formulation in pharmacies on prescription. In Germany, solutions containing alfatradiol, a 5α-reductase inhibitor, are commercially available. Nothing is known about its effectiveness.
There are also countless other medicines, cosmetics such as caffeine shampoos and dietary supplements on the market. Most of these preparations and mixtures have not been proven to actually help.
- Burdock root oil: The warmed oil is massaged into the scalp in the evening, which improves blood circulation in the skin and follicles and is said to stimulate new hair growth. Unpleasant side effect: The hair that has been oiled in this way has to be wrapped in plastic film or a towel to protect the bed linen. However, this should increase the effect of the oil.
- Saw Palmetto Extract: Saw palmetto extract is derived from the fruits of the plant native to Florida. The extracts are available as tablets and solutions. They should not only help with hair loss, but also with prostate problems.
- Thymus preparations: Thymus peptides such as Thymuskin are mainly used in the form of shampoos.
- Vitamin H: Biotin (vitamin H) comes in tablets and capsules and is said to improve hair growth and structure.
- Mixtures: Certain hair conditioners contain a mix of different nutrients and are usually available in capsule form or as a shampoo. B vitamins and cystine are often included. In some cases, clinical effectiveness has been demonstrated, but many products lack proof of effectiveness.