MEDICINES FOR HAIR LOSS AND SCALP HEALTH
SOME HELPFUL READING
Q: How important is it to understand the products and treatments that I am considering?
A: Medicines prevent, treat or manage many conditions and are a common intervention. They may be used alongside other interventions e.g. nutrition, exercise, micro-needling, to support an overall pathway plan for a client.
The Root Cause Clinical standard is person-centred, that is, we believe it is important to provide you with knowledge that will allow you to make a decision on whether to follow a specific treatment, and to ensure you always have a choice. It is a personal choice whether to opt for a prescribed medicine or not.
As part of our service, we work with a pharmaceutical partner, and collectively we consider your individual needs if you wish to progress a prescription option.
As with all medicine, there are positive benefits, and there are also potential risks that may be minor such as a mild stomach upset, or more serious such as increased risk of liver damage. Most treatments taken accurately have low risks due to the low dosage and topical application.
It is important to consider all benefits and potential risks, and this is why it is really important to inform us fully of your current health and symptoms. We rely on your pre-consultation survey data and your consultation to help ensure we provide the most appropriate recommendations.
Q: What exactly is a contraindication?
A: In healthcare, an indication is a symptom that allows a treatment to be regarded as desirable. For example, a headache may indicate using paracetamol.
A contraindication then is a symptom that may make treatment risky or less effective. For example, this may include taking other medicines or treatments, or if you have a specific health condition, for example, heart issues. There can be drug interactions so any over-the-counter or prescribed medicines must be considered alongside the recommended approach. It is therefore essential to update your trichologist if anything has changed in your health or lifestyle, and of course complete the survey as fully and as honestly as possible.
Q: I am about to begin a treatment or prescription, how quickly will it work?
A: Your trichologist can provide you with typical responses to taking a specific treatment or prescription, but everyone is different! You may experience a slight worsening of your symptoms initially, or you may experience side effects, for example, tingling on the scalp, or hypersensitivity.
It is really important you are aware of any changes when you begin any treatment or prescription, and update your trichologist as soon as possible particularly if you are anxious or concerned.
Q: What are the benefits and potential risks of treatments given for hair loss and scalp health conditions?
A: If you are prescribed any treatments from Root Cause Clinical, our pharmaceutical partner will provide comprehensive details of the drugs contained within the treatment.
However, we also want you to provide you with a brief overview of the treatments before you make a decision and we have outlined the most common treatments below. Clearly some potential risks are minimal, but everyone is different, and it is important to be aware of these before you make a choice or if you decide to progress with a treatment but start to show these symptoms so you can quickly stop treatment and seek advice.
Most of the treatments we prescribe are topical, which means that the medicine is localised to specific areas, rather than systemic through your digestive system. It is also important to recognise the treatments offer very low dosages of ingredients which immediately reduces potential risks. But the critical thing here is to remember everyone is unique, our genetic make-up will determine how effective any treatment may be.
If you wish to discuss and obtain more information please do contact us and we can facilitate a call with our pharmaceutical partner directly. Conversations are an important part of our service to you.
MINOXIDIL
Benefits
Minoxidil increases the blood flow to the hair follicles. This stimulates follicles to anagen (growth) phase.
Watch our video explainer HERE.
Contraindications
We would not wish to prescribe to:
- anyone with uncontrolled blood pressure
- those taking vasodilators e.g. hydralazine
- scalp conditions such as sunburn
We would discuss with the client if they are pregnant or lactating.
Potential Risks
Risks are low due to the low dosage we prescribe, so some of the common risks reported here relate to high usage and include:
- hypersensitivity
- headaches
- chest pain
- rash
- weight gain
- increased hair shedding/ changes in hair colour and texture
- hypertrichosis (hair growth over the body)
- pruritus (itching)
- dermatitis
- peripheral oedema (excess fluid)
DUTASTERIDE/ FINASTERIDE
Benefits
This is a strong DHT* blocker, and is often used for conditions such as androgenetic alopecia.
It can improve the terminal-to-vellus hair ratio.~
*DHT is an androgen associated with the growth of body hair. But it can also make you lose your hair faster and earlier.
~Vellus hair is short, fine hair that begins development in childhood, it helps regulate body temperature and sweat. Terminal hair is thicker, longer and darker, can grow in areas such as the underarms it can protect the body, regulates body temperature as well as protecting the body from sun and germs.
Contraindications
We would not wish to prescribe to:
- Pregnant women or those planning a pregnancy
- Women with previous history of breast cancer
- Patients with suicidal thoughts
Potential Risks
Risks are low due to the low dosage we prescribe, so some of the common risks reported here relate to high usage and include:
- impotence
- decreased libido
- ejaculation disorders
- breast disorders
ESTRADIOL
Benefits
This is a DHT* blocker which helps to slow down miniaturisation of the hair.
Contraindications
We would not wish to prescribe to:
- known, past or suspected breast cancer
- known or suspected oestrogen-dependent malignant tumours e.g. endometrial cancer
- undiagnosed genital bleeding
- untreated endometrial hyperplasia
- previous or current venous thromboembolism e.g. deep venous thrombosis
- known thrombophilic disorders
- active or recent arterial thromboembolic disease e.g. angina
- acute liver disease, or a history of liver disease if liver function tests have failed to return to normal
*DHT is an androgen associated with the growth of body hair. But it can also make you lose your hair faster and earlier.
Potential Risks
Risks are low due to the low dosage we prescribe, so some of the common risks reported here relate to high usage and include:
- breast enlargement/ pain/ tenderness/ secretion
- fluid retention
- mood change
- change in libido
- headache
- dizziness
- anxiety
- weight change
- gastrointestinal upset
- menstrual changes
- pelvic pain
- urinary tract infection
- vaginal infections and discharge
- vaginitis
- breakthrough bleeding
- chloasma
- skin reactions
- hypertension
- cardiovascular effects
- contact lens irritation
- hepatic impairment
- asthenia
- muscle spasm
- back pain
- chest pain
- pain in extremity
- abnormal biochemistry or haematology results
ENSTILAR
Benefits
This contains a vitamin D analogue (comparison) which helps conditions such as androgenetic alopecia.
Contraindications
We would not wish to prescribe to:
- erythrodermic psoriasis
- pustular psoriasis
Potential Risks
The most common risks associated with this treatment include:
- pruritus (itching)
- skin exfoliation
SPIRONOLACTONE
Benefits
This is a DHT* blocker which helps to slow down miniaturisation of the hair.
Contraindications
We would not wish to prescribe to:
- addisons disease
- significant kidney problems
- hyperkalaemia (raised blood potassium levels)
- water tablets (potassium sparing diuretics)
- potassium supplements
- eplerenone
Potential Risks
Risks are low due to the low dosage we prescribe, so some of the common risks reported here relate to high usage and include:
- gynaecomastia (enlargement of breasts in males)
- electrolyte disturbance
- malaise
- weakness
- drowsiness
- gastrointestinal upset
- dizziness
- headache
- changes in libido
- erectile dysfunction
- confusion
- menstrual disorders
- change in vaginal secretions
- breast pain
- skin reactions
- acute renal failure
- alterations in voice pitch
- muscle spasms
- paraesthesia
MELATONIN
Benefits
This stimulates follicles to anagen (growth) phase of hair.
Contraindications
We would not wish to prescribe to:
- pregnant/ breast feeding
- certain autoimmune conditions
Potential Risks
Risks are low due to the low dosage we prescribe, so some of the common risks reported here relate to high usage and include:
- drowsiness
- headache
LATANOPROST
Benefits
This improves hair density.
Contraindications
We would not wish to prescribe to:
- treated or untreated ocular hypertension
- raised intra-ocular pressure in open-angle glaucoma
- active herpes simplex keratitis
We would discuss with the client if they are pregnant or lactating.
Potential Risks
Risks are low due to the low dosage we prescribe, so some of the common risks reported here relate to high usage and include:
- growth or darkening of eyelashes and vellus hair
- iris discolouration
- conjunctival hyperaemia
- eye irritation
- punctate keratitis
- blepharitis
- eye pain
- photophobia
- conjunctivitis
CLOBETASOL
Benefits
This helps reduce swelling and irritation caused by inflammatory type hair loss.
Contraindications
We would not wish to prescribe to:
- scalp infections
- hypersensitivity to clobetasol or other corticosteroids
Potential Risks
Risks are low due to the low dosage we prescribe, so some of the common risks reported here relate to high usage and include:
- cushingoid changes
- adrenal suppression
- local skin reactions
- atrophy
- striae
- telangiectasia
- mild depigmentation
- hypertrichosis
- pruritus
- acne
- folliculitis
- dermatitis
PROSTAQUINON
Benefits
This helps increase blood flow to the hair follicles.
Contraindications
There are no known contraindications.
Potential Risks
There are no potential risks known and associated with this treatment.
This is a general information sheet to support your decision making during your treatment pathway but does not replace personalised medical guidance – we would always encourage you to discuss any concern with your trichologist and/ or doctor and/ or our pharmaceutical partner.
No question is daft – our trichologists would be delighted to hear from you!
JANUARY 2024