Treatments for Hair Loss

Our second blog post on hair loss now focuses on the various treatments available for this condition. In medicine, it's essential to initially assess the potential causes of hair loss and prioritize addressing them. Hair loss often has multiple causes, so each factor must be taken into account.

As discussed in our previous post, nutrient deficiency plays a significant role in hair loss and skin aging.

Add a protein shake from a good source

A diet rich in protein is crucial, but consuming enough protein through food alone can be difficult. Adding a protein shake to your diet can be helpful. At VitaLifeMD, we recommend protein powders with minimal sugar content. When choosing a protein supplement, whether in powder or bar form, it's important to consider the ratio of protein to carbohydrates/sugar.

Dr. Fradin-Read often reviews protein bars brought in by patients during office visits and frequently finds that they contain nearly equal amounts (around 20 grams) of protein and carbohydrates, which are not always of the best quality. One recent patient was surprised to learn this and commented, "No wonder it tastes so good, and my kids love it!"

Consider some supplements for hair support

Many products are offered over the counter for patients suffering from hair loss. They include multiple ingredients that often overlap with other vitamins or natural supplements that the patient is already taking. Therefore, it is important to reconcile the list with your provider before adding a new hair loss product on your own. For example, Nutrafol, which has become very popular and seems to show results, contains Vitamin D and Iodine. Several patients bought a subscription for the products online encouraged by the strong advertising messages from the company, not realizing that they were also taking Vitamin D and Iodine elsewhere. As a result, their levels of both nutrients reached a toxic level and could have had serious side effects if taken long-term, one of them being the risk of hair loss!

Another warning pertains to a specific nutrient containing marine collagen extract from sharks. Strangely, a few patients who were taking this supplement had high levels of mercury in their blood (which incidentally can cause hair loss!) and we couldn't determine the cause of this elevated heavy metal level. They had taken every possible measure to reduce mercury intake: ceased eating fish, removed potential teeth fillers, and had no toxic exposure. Despite these precautions, their blood mercury levels remained high for months. Dr. Fradin-Read examined the ingredient list of the product and found that the marine collagen extract was sourced from sharks (a large fish known to be contaminated with mercury). She advised the patients to discontinue the supplement, and as expected, two months later, their blood mercury levels returned to normal. This was the only intervention made during that time, leaving no doubt that the product was the culprit.

These cases highlight the importance of carefully selecting supplements for hair loss and integrating them into general vitamin supplementation with caution.

At VitaLifeMD, we recommend Pure Encapsulations Hair Skin and Nail Ultra. This original formula offers numerous advantages and is easy to use. Compared to the four capsules of Nutrafol, it requires only two capsules daily, providing double the dose of Biotin (an essential vitamin for hair support).

It maintains a perfect Zinc/Copper ratio, as these minerals need to be balanced, while Nutrafol only contains Zinc and lacks Copper. The collagen extract is sourced from chicken instead of fish in other products, eliminating the risk of mercury contamination. It includes silica, a crucial element for the structure of hair strands not commonly found in other products, certainly not in Nutrafol. It excludes Vitamin D, Iodine, and Selenium, allowing your provider to recommend the right dose of these nutrients without adjusting to the content in hair products.

Finally, a personal note from Dr. Fradin-Read: Most hair loss products include what they term a "proprietary blend" of nutrients in their formula. These blends do not disclose their exact composition, and we are unaware of the quantity of each ingredient.

Topical Products

Numerous topical products are available and can be beneficial, often when used in conjunction with other treatments. We will discuss two formulas offered at VitaLifeMD. The Peptide Hair Trio combines three peptides (including Copper peptide) that promote hair growth by improving nourishment and stimulating the function of the hair follicle. Conveniently packaged in a set of three bottles, each product can be applied separately to the scalp at night.

The other formula we recommend is produced by a local compounding pharmacy. It combines minoxidil with vitamins, androgen blockers, and a mild steroid, offering good efficacy, especially when there is a component of inflammation of the scalp in addition to hair loss.

Female hormones support and medications targeting male hormones 

As a simple rule, keep in mind that female hormones (estrogen and progesterone) are “good for hair” and androgens (Testosterone, Dihydrotestosterone -DHT, and DHEA) in excess cause hair loss. Estrogen prolongs the anagen phase of hair growth, positively impacting the growth of existing hair and increasing hair density. Progesterone blocks the production of DHT, the male hormone primarily responsible for hair loss.

Around menopause, female hormones decline while male hormones increase, making it easy to understand why many women start experiencing hair loss or thinning when their hormones shift. This can actually be one of the first signs of perimenopause, alongside irregular cycles.

If this occurs, it's important to act quickly as some hair loss may become irreversible. Bioidentical hormone replacement therapy, administered safely and tailored to each patient's needs, can provide the necessary support to slow down or even halt the process. For women who cannot or choose not to take hormones, other treatments can be suggested, including natural phytoestrogens and supplements.

In cases of excess androgen, products targeting DHT production may offer some help. These products act as inhibitors of the enzyme 5α-Reductase, reducing DHT production from adrenal and gonadal sources. Saw palmetto, a natural supplement, has a minor effect on this enzyme and may be considered. The FDA currently approves two indications for 5-alpha-reductase inhibitors: benign prostate hyperplasia (BPH) and androgenic alopecia (male pattern hair loss). Although not FDA-approved, clinicians have used 5-alpha-reductase inhibitors to manage hirsutism (excessive body hair). While relatively effective in slowing male pattern baldness, these medications have side effects that should be considered before prescribing to a patient. Traditionally recommended for men, some women are now using them to counter excess DHT.

Spironolactone, a synthetic aldosterone receptor antagonist, reduces total testosterone levels and blocks androgen receptors in target tissues. It is often used with good efficacy to mitigate the effects of testosterone on skin (acne) and hair in female patients with male pattern hair loss.

Thymosin Beta4 peptide

Thymosin beta 4 is a small peptide that accelerates hair growth. It acts during the active phase of the hair follicle cycle by promoting the differentiation and migration of stem cells. This increases the growth of existing follicles and the development of new ones. Thymosin beta is administered at home by the patient daily through a small subcutaneous injection. This peptide is extremely safe and there is almost no side-effect except rare bruising at the injection site.

Minoxidil oral 

Minoxidil is a potassium channel opener, which can stimulate the proliferation of hair follicle epithelial cells and promote hair growth. It has long been utilized as a topical treatment under the brand name Rogaine, available over the counter, or prescribed as a lotion at a higher concentration by physicians. It is also available in pill form for both men and women, and typically yields positive results after several months of daily use. One of the side effects in women can be facial hair growth, especially for those with darker hair. It might slightly reduce blood pressure levels and therefore is best taken at bedtime. Starting at a low dose is essential, and side effects should be carefully monitored. Besides these usually minor precautions, it remains one of the most potent hair loss treatments.

In office treatments 

PRP

Platelet-rich plasma (PRP) is a technique that involves injecting platelets from the plasma collected in the patient’s blood into the affected areas of the scalp. These platelets contain cytokines, growth factors, and proteins that promote hair follicle regeneration and hair growth by enhancing the anagen phase of the hair cycle. Not only do hair follicles live longer, but there is also an increase in density due to the proliferation of follicles. The treatment is offered in our office under the care of our nurse practitioner, Carley Cassity, who has extensive experience in this technique. It involves mini-injections administered underneath the skin of the scalp in the affected areas.

Exosomes

Exosomes are small vesicles extracted from stem cells and are extremely rich in natural growth factors and proteins. The products used at VitaLifeMD originate from a world-class laboratory operating within FDA guidelines. These products consist of exosomes derived from highly purified extracts of placental mesenchymal stem cells (MSCs) and are enriched in amino acids, enzymes, and antioxidants. The regenerative effects on the hair follicle are clear, and clinical trials are already showing the benefits on hair growth with a significant increase in hair density and thickness. The treatment can be combined with the PRP technique and is administered by our nurse practitioner, Carley, as well. Several patients have already experienced the benefits of this treatment, which can ultimately provide the best support for hair growth for everyone.