There are a number of hair loss treatments for women available in the marketplace, below we will discuss three of the most popular options: Ketoconazole (Nizoral), Finasteride (Propecia, Proscar) and Cyproterone Acetate with Ethinyloestradiol (Diane 35, Diane 50) and outline some of the plus and minuses related to each.
Ketoconazole known by the brand name Nizoral is a topical treatment that is available only by prescription. This medication is used to treat fungal infections, and is effective for hair loss treatment due to its having the side effect of curbing testosterone production. Overproduction of testosterone and other androgens in the adrenal glands and reproductive organs of the body is a leading cause of hair loss in women.
Nizoral used as a shampoo contains 2% ketoconazole and is effective not only for the treatment of scalp conditions which may lead to loss of hair, but also for androgenetic alopecia. Nizoral is often prescribed as part of a treatment regimen for this genetic condition. Nizoral is currently available over the counter in a 1% strength, which obviously may not be as effective as the stronger prescription strength. No significant side effects are associated with its use.
Finasteride (Propecia, Proscar)
Finasteride works by inhibiting the enzyme 5-alpha reductase which is associated with the production of dihydrotestosterone (DHT). DHT production acts to shrink hair follicles and makes it difficult for healthy hair to grow.
Finasteride was first introduced as a treatment for prostate gland enlargement under the brand name of Proscar and was originally available as a 5 mg pill. Due to its inhibitive effect on the production of androgens, it was found to be effective in the treatment of men’s hair loss and a 1mg pill was approved by the FDA in 1998 for this purpose.
Men taking Finasteride have reported a reduced incidence of hair loss and the medication has been known to trigger regrowth in most male patients. While not widely prescribed for women, it is likely to work for at least some women. However, women who are pregnant or nursing should not take the drug, nor should women planning on becoming pregnant due to the reported increased occurrence of birth defects in male infants whose mothers took the drug while pregnant. Additional side effects in men include erectile dysfunction and libido suppression; these do not occur in women.
Cyproterone Acetate with Ethinyloestradiol (Diane 35, Diane 50)
First introduced as a contraceptive under the brand names Diane 35 and Diane 50; cyproterone acetate has been prescribed in Europe for several years as a treatment for women’s androgenetic alopecia. This drug is not available in the United States for use as either a contraceptive or a hair loss treatment for women at the current time.
The drug is a compound of cyproterone and estradiol which is an estrogen hormone. Both versions of the drug contain 2 mg of cyproterone; Diane 35 contains 0.035 mg of estradiol, and Diane 50 contains 0.50 mg.
Both Diane 35 and Diane 50 work to block the effects of male hormones—which are in fact present in all women, but which in some females are responsible for women’s hair loss. Both versions of the drug have proven effective in both preventing initial hair loss and triggering regrowth, but must be taken on an ongoing basis with no break to maintain this result.
Common side effects reported by women taking these drugs include breast tenderness, headaches and decreased libido. Sometimes the best treatment is to start with hair loss vitamins for women and see if this helps first.