Hair Loss Treatment

JAMA. 1976 Jun 14;235(24):2622-3.

Alopecia ( hair loss ) in crash dieters.
Goette DK, Odom RB.

Nine patients experienced profuse hair loss two of five months after starting a vigourous weight reduction program resulting in weight loss of 11.7 to 24.75 kg. Telogen counts of 25% to 50% were observed. Regrowth of hair occurred within several months. Three patients had experienced hair loss closely following a successful weight reduction program on several occasions. Rigorous caloric restriction with subsequent inadequate energy supply of the hair matrix is thought to be the cause for the precipitation of the telogen effluvium of the crash dieter.

Health News. 1999 Oct 25;5(13):4.LinksWhere's the hair?
Sawaya M.
University of Miami School of Medicine, USA.

PMID: 10582510

Review of hair loss and hair loss treatment

J Am Acad Dermatol. 2002 Nov;47(5):733-9.

Hair loss in women with hyperandrogenism: four cases responding to finasteride.

Shum KW, Cullen DR, Messenger AG.

Oral finasteride, a type II 5 alpha-reductase inhibitor, has been shown to increase hair growth and slow progression of thinning in men with androgenetic or male pattern balding (Hamiliton type) but has no affect on hair regrowth in postmenopausal women with female pattern hair loss (Ludwig type). We describe 4 cases of hair loss with characteristics of both male and female patterns in women with hyperandrogenism in which finasteride has improved or stabilized the alopecia. Improved hair growth was seen after 6 months, 1 year, 2 years, and 2.5 years, respectively. The finding that finasteride treatment improves pattern hair loss in women with hyperandrogenism but does not affect those postmenopausal women with female pattern hair loss without hyperandrogenism supports the concept that not all types of female hair loss have the same pathophysiology.

J Drugs Dermatol. 2005 Sep-Oct;4(5):637-40

Effective treatment of female androgenic alopecia (pattern hair loss) with dutasteride.

Olszewska M, Rudnicka L.

Dihydrotestosterone is the main molecule responsible for androgenic alopecia. Finasteride, which reduces transformation of testosterone into dihydrotestosterone and decreases dihydrotestosterone activity, is approved for treatment of androgenic alopecia in men. We describe the case of a 46-year-old woman with androgenic alopecia, non-responsive to minoxidil, who initially benefited from finasteride. Due to only limited improvement after finasteride and persisting profound psychological distress resulting from androgenic alopecia, another 5-reductase inhibitor, dutasteride, was introduced. Clinical evaluation and trichogram were applied for assessment of dutasteride efficacy in this patient. Additionally, mean hair diameter was monitored by means of computer dermoscopy. After 6 months of therapy, significant improvement was observed and after 9 months the clinical diagnosis of androgenic alopecia could no longer be made in this patient. No side effects were observed. In conclusion, theoretical data and our experience in this case show that dutasteride might develop into a true alternative in treatment of androgenic alopecia.

Ther Umsch. 2002 May;59(5):217-22.

Diffuse hair loss in women

hair loss blog

Trüeb RM.
Dermatologische Klinik, UniversitätsSpital Zürich.

The complaint "Doctor, I am losing my hair" represents a particular challenge to the physician, and involves making a specific diagnosis, selecting an appropriate therapy, and expressing empathy for the patient's anxiety. Diffuse hair loss in women was formerly classified as an entity of its own. Since the identification of female pattern hair loss, most cases have been recognized to be due to androgenetic alopecia, often during phases of life characterized by fluctuations of sexual hormone levels or in connection with intake or cessation of hormonal therapy. The most difficult differential diagnosis includes androgenetic alopecia, chronic telogen effluvium, and psychogenic pseudo efflvuium. Androgenetic alopecia is due to androgen-induced, non-synchronized, progressive shortening of the hair growth cycle and gradually leads to thinning of the central scalp area. Idiopathic chronic telogen effluvium typically occurs in women, starting abruptly without a recognizable initiating factor, and involves the entire scalp area with increased shedding of telogen hair. It is believed to be due to synchronization phenomena of the cyclic hair growth. Psychogenic pseudo effluvium affects fashion-oriented, self-conscious women suffering of a discrepancy between the actual state of their hair and idealized expectations. Later the problem of age-related hair thinning oft becomes a surrogate for the more generalized problem of senescence. Rational therapy of androgenetic alopecia aims at blocking the androgen effect on hair follicles with estrogens and antiandrogens or at pharmacologically reversing vellus hair transformation with topical minoxidil. In contrast, women with idiopathic chronic telogen effluvium should be reassured that their problem is rather a state of exaggerated "hair shedding" than of actual "hair loss".