Medical Treatments for Female... Video Transcript

Participants

David R. Marks MD, Michael L. Reed MD, Neil Sadick MD

Summary

In a world where female hair loss is almost taboo, finding the right treatment can be confusing. Do the products that work for men work for women, too? Join our panel of specialists as they discuss the treatment options for women.

Webcast Transcript

DAVID R. MARKS, MD:  Hi, and welcome to our webcast.  I'm Dr. David Marks.  People don't like to talk about it, but women can lose hair, just like men.  For these women, finding the right treatment can be confusing.  Do the products that work for men work for women, too?  What products work best?  What lifestyle changes do women need to make?

Here to talk about the treatment options for women are two experts.  First is Dr. Neil Sadick.  He's a dermatologist and a cosmetic surgeon at the Weill Cornell Medical College.  Welcome.

NEIL SADICK, MD:  Hi, David.

DAVID R. MARKS, MD:  Next to him is Dr. Michael Reed.  He's also a dermatologist and a hair transplant surgeon at NYU in New York City.  Welcome.

MICHAEL REED, MD:  Thank you.

DAVID R. MARKS, MD:  The treatment options are a little bit different for women in some cases.  What are they, in general?

MICHAEL REED, MD:  Well, there's topical treatment and there's oral treatment for women, theoretically.  I assume that we're talking about the typical female pattern hair loss patients.  Probably the first thing a woman can do if she sees that she is starting to see scalp and not hair without any other unusual findings is she can go to the local pharmacy and she can buy and treat herself with 2% minoxidil, which is available as Rogaine and also available generically, and try that for a period of six or 12 months and see if that has an effect.

DAVID R. MARKS, MD:  What is it?  A shampoo?

MICHAEL REED, MD:  It's a topical solution.  It's clear, it's colorless.  It can be put on with a medicine dropper or spray bottle, but usually the medicine dropper is better.  It's put on twice a day and it takes a while to work.  Use it at least six to 12 months before deciding that it's not effective and going on to something else.  That's what I recommend.

DAVID R. MARKS, MD:  And the something else is what?

NEIL SADICK, MD:  If women are not responsive to this more conservative regimen using 2% minoxidil, I usually recommend that they use an agent called spironolactone, which is an androgen blocker that is prescribed by dermatologists and endocrinologists.

DAVID R. MARKS, MD:  What's an androgen?

NEIL SADICK, MD:  An androgen is a hormone, usually a masculinizing type of hormone, that is most commonly elevated in men compared to women, but is also present in women, and it's felt to play a role in terms of hair loss.  An increased amount of androgen or an increased sensitivity of receptors where androgens act are felt to play a major role in androgenetic hair loss, both in men and women, and there is a class of drugs that tends to inhibit these hormones and their receptors.  I've found this to be the most successful second option if a conservative route such as 2% minoxidil is not effective in women with diffuse hair loss.

DAVID R. MARKS, MD:  And spironolactone is a pill?

NEIL SADICK, MD:  Spironolactone is a pill.  It's actually a water pill or diuretic, but another major action of spironolactone is, again, to block these androgen receptors that decrease the amount of hormone activity in women.

DAVID R. MARKS, MD:  How long does it take to see an effect on hair?

NEIL SADICK, MD:  We usually see an effect when it's positive within a period of three to six months.