Despite the quackery and cons that exists, there are some treatments that have undergone clinical trials with impressive results. Could one or both of these treatments be for you?
One of the most well known products aimed at men with thinning hair is the Alpecin range of shampoos. Though this product has the potential to make hair look and feel thicker it's worth noting that Alpecin's original claim to "actually help reduce hair loss" was dismissed in 2018 by the Advertising Standards Agency as unsubstantiated and misleading. (1)
I shared my thoughts on this shampoo several months ago, which is linked here.
With male pattern baldness being such a personal issue for men there's little wonder the market attracts all manner of charlatans peddling their snake oil. Don't be drawn in by the carefully constructed strap lines and advertising spin.
I've done some research to cut much of the bunkum away and to reduce the list of products to those that DO comply with Advertising Standards Agency criteria. The following statement is quoted from the Advertising Standards Agency's website.
"The only two authorised treatments for Androgenetic Alopecia (male pattern baldness) are Finasteride, an anti-androgen therapy, and Minoxidil. Minoxidil is available in two forms: as an external treatment (between 2% and 5% solution), available in chemists or as a stronger prescription-only medicine. Clinical trials have demonstrated both those products to be effective in improving hair growth." (2)
What is Finasteride (Propecia)?
Finasteride (Propecia) is drug developed by Merck to inhibit the enzyme which metabolises testosterone into dihydrotestosterone, or DHT for short. As mentioned in the first post of this series DHT has the effect of shrinking hair follicles on the head, leading to hair loss. Finasteride is commonly branded under Propecia (1mg) and Proscar (5mg) and also available as a generic product through Lloyds Pharmacy. (3)
Embarking on this journey is a long haul, and the treatment can take several months before results begin to show. The battle for your hairline can only be won by taking the medication on an ongoing daily basis. Ending the treatment will see the reversal of effects after 6 to 12 months. In short, you will need to continue the treatment for as long as you want your hair.
What Are the Results?
Finasteride isn't a magic pill with the effect of turning back time and furnishing your head with youthful locks, but there are good results in the majority of cases. Each person will respond uniquely to the medication with varying degrees of success.
Clinical trials showed positive results after taking Finasteride for 5 years. (4)
In preventing further hair loss:
After 1 year 86% showed no further hair loss.
After 2 years 83% showed no further hair loss.
After 5 years 65% showed no further hair loss.
In increased growth:
After 1 year 48% showed increased growth
After 2 years 66% showed increased growth
After 5 years 48% showed increased growth; 10% lost hair compared to initial baseline.
Maximum hair count was seen after the second year from which point hair count gradually reduces.
What To Expect When Taking Finasteride
According to the British National Formula (BNF), you are likely to see results in the first 3 to 6 months. (5)
How Do I Get It?
Finasteride is available by prescription only, so a discussion with your GP is in order.
How Much Does is Cost?
Top end, this treatment will cost £660.00 per year.
Branded Finasteride like Propecia is expensive at £55 per month for a 4 week pack, or £35 per month for 24 week pack.
Non-branded Finasteride is cheaper at £39 per month for a 4 week pack, or £23 per month for 24 week pack.
A cheaper alternative is to talk with your GP about being prescribed 5mg tablets and cut the tablets into 5 equal pieces using a tablet cutter.
Are There Side Effects?
As with all drugs, there are some side effects. Being a treatment that reduces the amount of the sex hormone, DHT, in the body it stands to reason that this area is most affected. Clinical trials conducted over a period of 5 years showed only 3.8% of the 945 patients experienced reduction in libido, erectile dysfunction and ejaculate. Finasteride can also have psychological effects, resulting in depression and suicidal thoughts. More info here.
What is Minoxidil?
Minoxidil was originally developed as an orally-taken treatment for high blood pressure. Patients taking Minoxidil began growing body hair, and it made sense that applying minoxidil directly to a bald scalp might cause hair to grow in this area too.
Regaine is perhaps the biggest name out there using Minoxidil as a treatment for male pattern baldness.
What Are The Results?
The effects of Minoxidil can be seen after 2 months with the greatest results, though moderate, seen from five months to two years, with a gradual decrease in efficacy after that. The effects of the drug wear off as soon as you stop using the treatment. And if you do restart using it, in most cases you will not regain the hair that was lost. Minoxidil is effective on approximately 60% of men.
What To Expect When Using Minoxidil
Minoxidil should be applied to the scalp twice daily and is only effective if it is in direct contact with that particular area of the head. It usually works best when applied to the crown, but is also effective when used on the front of the scalp, as long as there is some fine (miniaturised) hair in the area.
How Do I Get It?
Regaine contains a sufficiently low enough dose of Minoxidil so can be bought without prescription at most high street pharmacies or online.
How Much Does It Cost?
Approximately £200 per year.
Are There Side Effects?
A compromise has to made here between how much value you place on your hair compared to the efficacy of the treatments and the cost. The least costly option is Regaine at £200 per year with a 60% chance of seeing results. The most costly option is going belt and braces and using both Propecia and Regaine at £860 per year.
I know what you're thinking. You're thinking, "After 3 years of medication I could have had a hair transplant for the same amount of money." You could, but a hair transplant isn't a once for all fix. Once going down the transplant route you will need one or both of these treatments too.
Which ever way you approach it, the battle for the hairline requires a lot of commitment and an ongoing expense. So before parting with hard earned cash give some thought to whether you can commit long term practically and financially.
Posts in this series:
3. Treatments for Hair Loss