Treatment Options for Alopecia

Hair loss, also called alopecia, affects millions of people in the United States. There are many ways to manage and treat alopecia. The treatment that works best for you will depend on many factors. This includes the type of alopecia you have.¹

Treatment depends on the type of alopecia

The 3 most common types of hair loss have different causes:^1,2

Androgenetic alopecia

This is often called male-pattern or female-pattern baldness. It is the most common type of hair loss. It is linked to genes and hormones. Treatment for this type focuses on slowing down the hair loss. It also aims to regrow hair.¹

Alopecia areata

This is an autoimmune disease. This means the body's immune system mistakenly attacks its own hair follicles. This causes hair to fall out, often in small, round patches. In severe cases, it can cause total hair loss on the scalp (alopecia totalis) or the entire body (alopecia universalis). Treatments for alopecia areata focus on calming the immune system.^1,2

Telogen effluvium

With telogen effluvium, a shock causes many hairs to stop growing. They all enter the resting (telogen) phase at once. About 2 to 4 months after the stressful event, these hairs begin to shed.¹

Common triggers for telogen effluvium include a severe infection, major illness or surgery, extreme emotional stress, or a new medication. The best treatment for telogen effluvium is to find and fix the cause. In most cases, this type of hair loss is temporary. Once the trigger is gone, your hair shedding will slow down and your hair will start to grow back.¹

Commonly used medicines for hair loss

Your doctor may suggest a drug to treat your hair loss. These drugs work in different ways. They can be a pill, a cream, or an injection.^1-3

Minoxidil

Minoxidil (Rogaine®) is a drug you can buy over the counter. It comes as a liquid or foam that you rub onto your scalp. This drug helps by making the hair's growing phase last longer.^1,2

Finasteride

Finasteride (Proscar®, Propecia®) is a prescription pill. It is approved only for men with androgenetic alopecia. It works by blocking a hormone that shrinks hair follicles. Finasteride is not safe for women who are pregnant or may become pregnant. This is because it can cause birth defects.^1,3

Corticosteroids

These drugs help reduce inflammation. They are a very common treatment for alopecia areata. A doctor can inject the drug directly into the bald patches on the scalp. This is called an intralesional injection. These injections are often the first choice for mild, patchy alopecia areata. Corticosteroids also come as creams or foams. These may be used for children or with other treatments.^1,2

JAK inhibitors

This is a newer class of drugs used to treat severe alopecia areata. These are pills you take by mouth. They work by blocking the immune system's signals that tell it to attack hair follicles. The US Food and Drug Administration (FDA) has approved 3 JAK inhibitors to treat alopecia areata:²

• Baricitinib (Olumiant®)
• Deuruxolitinib (Leqselvi®)
• Ritlecitinib (Litfulo®)

Complementary and alternative treatment options

Some people look for other ways to manage hair loss. These are often called complementary or alternative treatments. There is less scientific proof for these options.^4,5

• Essential oils – Some studies suggest that rubbing essential oils into the scalp might help. This included oils like lavender, rosemary, thyme, and cedarwood.
• Supplements – Many products claim to help hair growth. These often contain biotin and zinc. However, there is little proof that these help unless you are truly low in that nutrient.
• Platelet-rich plasma – This involves drawing your own blood. The blood is spun in a machine to separate the plasma. The plasma is then injected into your scalp. Some studies show it may help, but more research is needed.
• Stress reduction – Stress does not cause alopecia areata. But living with hair loss can be very stressful. Finding ways to manage stress, like yoga or meditation, can help you cope.

Supplements are not regulated by the US Food and Drug Administration (FDA) the same way other drugs are. This means that no outside agency confirms the ingredients or suggested dose.⁶

For example, a fish oil supplement may have more or less fish oil than listed on the label. A supplement may also contain ingredients that are not labeled correctly or at all. This can be dangerous. It can lead to taking too much or taking unwanted ingredients.⁶

The FDA created good manufacturing practices (GMPs) to help this situation. GMPs are guidelines for companies to follow when making supplements. But the FDA rarely inspects facilities making supplements in the United States. Companies outside the United States do not have these inspections at all.⁶

Many more supplements are sold than are tested. Your doctor can help you decide if a supplement is safe.⁶

Other ways to manage hair loss

Medical treatments are not the only choice. Many people find comfort and confidence in other ways.²

• Wigs and hairpieces – Modern wigs look very natural. They are made from human hair or synthetic fibers. They come in all colors and styles.
• Scalp prosthesis – This is a custom-made wig. It is designed to fit your head exactly. It can be held on with special tape or adhesive. A doctor may be able to write a prescription for a scalp prosthesis.
• Cosmetics – If you have lost eyebrows, you can use makeup pencils. Or you can try microblading, which is a type of semi-permanent tattoo. False eyelashes can be used for missing lashes.
• Hats and scarves – Many people use hats, scarves, or bandanas. These are a simple and stylish way to cover your head.
• Scalp protection – If your scalp is exposed, it needs sun protection. Your head can get sunburned easily. Always use a broad-spectrum sunscreen with at least SPF 30. Or, wear a hat when you are outside.

Talk with your doctor

Finding the right approach for your alopecia is a personal journey. There are many options, from medical drugs to wigs and scarves. You do not have to choose just one.

The best plan starts with a clear diagnosis from your doctor. Talk openly with them about your goals and concerns. They can help you find a treatment plan that is right for you.