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Alopecia

How is it treated?

Male Balding

For many men, male balding is not a serious problem (though most would prefer to keep their hair!) However, some men are bothered by hair loss and are keen to do something about it. The treatment options include:

  • Hair styling, such as clean shaving the head, hair weaving or hair pieces;
  • Minoxidil lotion. This will help to slow down or stop hair loss and may produce some new hair growth. It works best when used in early balding - it will not regrow hair on a bald scalp. Treatment must be continued to maintain the benefits. Minoxidil lotion can be bought from pharmacies and is not available on the NHS;
  • Finasteride tablets. Finasteride interferes with the effect of male hormones on hair follicles and halts or slows the balding process in over eighty per cent of men. About two thirds of men taking finasteride experience some regrowth of hair. Like minoxidil lotion, finasteride works best in the early stages of balding and the benefits will be lost within a few months if treatment is stopped. This type of drug is not available on the NHS;
  • Surgical intervention to transplant hair from the back of the head to the crown of the head or, more radically, flap-surgery in which an area of scalp is transplanted from one area of the head to another.

Female Pattern Hair Loss

For women, the cosmetic appearance of their hair is generally more important to their self-esteem than in men, and women are more likely to want treatment. The treatment options include:

  • Hair cosmetics, hair styling - a good hairdresser can be helpful;
  • Minoxidil lotion. About two thirds of women will get some increase in hair growth with minoxidil lotion. This takes six to twelve months to achieve and treatment has to be continued to maintain the response;
  • Drugs that block the action of male-type hormones can help in some women but they are not licensed for treating hair loss. Finasteride is not approved for use in women;
  • Hair transplantation can help in selected cases.

Alopecia Areata

There are several different treatments for AA but none is very effective and none cures the disease. In people who are minimally affected, the hair is likely to regrow on its own and no treatment is needed. In others, treatments such as topical (locally applied) creams, solutions rubbed into the scalp and steroid injections/creams can be used but these have a limited success. For women with extensive AA a wig or hairpiece is often the best option. Wigs tend to be less suitable for men.

Emotional and psychosocial stress can be caused to individuals and the support organisations can be very helpful.

Additional Information

A NHS leaflet, HC11 - Help with health costs, giving information about prescription of wigs is available at Web: http://www.dh.gov.uk/assetRoot/04/07/80/85/04078085.pdf or can be ordered from Department of Health, PO Box 777, London SE1 6XH Tel: 08701 555455 Fax: 01623 724524.

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Medical text written July 2005 by Contact a Family and Dr A Messenger, Consultant Dermatologist, Royal Hallamshire Hospital, Sheffield, UK.

 

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