Because there are so many causes of hair loss we are asked, “what is the best therapy to improve and restore my hair”? Most patients we see want to know, “why is my hair shedding”? Why is my hair thinning? What can I do?
It is therefore most important to:
- Diagnose the main cause or causes of an individual’s hair loss.
- Offer the most effective treatment with least amount of side effects for that cause or causes of that patient’s hair loss
- Proceed in a systematic treatment fashion
- Explain, in detail, all treatment options nutraceutical, medical, biologic and surgical options if needed
- Give realistic goals
In most cases, after determining the cause of hair thinning or shedding combinations of medicines like Low Dose Oral Minoxidil and DHT blockers like (Spironolactone, Finasteride, Dutasteride) can be given in combination. Additionally, these medications, depending on the age or cause of hair loss can also be used in combination with biologics like Cytokine Rich Plasma, and exosomes.
Fig 1, below is a patient on combination LDOM 5 mg and Dutasteride 0.5 mg at one year:
There is no one set combination, so treatment combinations all depend on the cause of hair loss, age and sex of a patient. Other factors such as prior side effects must be considered when planning a treatment protocol.
Fig 2, this is a combination Bio scalp CRP/Matrix and LDOM at 6 months, then 1 year.
Most of all it is important to explain all therapies and give honest realistic expectations regarding treatment options. If surgery is indicated, then combination therapy should also be utilized to improve and preserve all existing hair.
The old adage “if you have a hammer everything looks like a nail” is so appropriate with hair loss. Hair loss is multifactorial so the treatment options must also be multifactorial.