Hair Replacement Guide

Finasteride and Other Medications

Finasteride, a prescription drug marketed in a 1-mg tablet as Propecia (Merck Pharmaceutical), was approved by the FDA in 1998 for the treatment of androgenetic alopecia. (Finasteride, in a 5-mg tablet, was manufactured and marketed earlier as Proscar, which is still used to treat prostrate abnormalities.)

Propecia works by decreasing the concentration of the male hormone DHT (see previous page) by about 60 percent in people taking one tablet per day. Since finasteride inhibits this hormone, which is a key factor in the miniaturization of scalp hair follicles, this allows for a reversal of the balding process. Results are usually seen in about three months, and this drug is also dose-dependent. Generally, finasteride is not beneficial in the treatment of female pattern baldness.

Some researchers say that a combination of minoxidil and finasteride provides hair growth that is superior to that resulting from the use of either single drug. Talk to your doctor about this. Side effects that have been attributed to finasteride include decreased libido and groin aches.

Other Medications

Other less familiar options include using Retin-A (brand name, Ortho Pharmaceutical) alone and in combination with minoxidil to treat male pattern baldness. It is thought that the combination works because the increased absorption caused by Retin-A increases the amount of minoxidil reaching the hair follicle cells. (Since Retin-A is degraded by strong light, you should only use it at night. If you're using a combination formula, wear a hat or stay in the shade.)

Xandrox solutions, which are alternatives to Rogaine, come in formulas with varying amounts of minoxidil, Retin-A and azelaic acids. Ask your doctor or pharmacist to help you choose the right formula.

Over-the-Counter Products

If the shampoo bottles marked "for thicker hair" grab your attention in the store, you might want to think again before tossing one into your cart. According to the FDA, none of the shampoos or hair products that claim to give you thicker, fuller hair can actually do that. What these products do, instead, is to create the appearance of greater fullness by plumping up hair follicles.

There's another interesting product on the market -- make-up that colors your scalp the same color as your hair. It's cheap, it's fast and it's safe. (Manufacturers say it won't run when wet but easily washes off with normal shampooing.) You can't create a frontal hair line with this product, but if you can't afford surgery or a new wig, why not check it out?