Progesterone, Finasteride and Minoxidil to Treat Female Hair Loss?

Q:

Dear Dr. Mohebi –

There is an article in the LA times about a doctor practicing in LA who treats women’s pattern hair loss by injection of progesterone into the scalp, as well as prescribing Finasteride and applying minoxidil-plus solution onto the scalp.

As an expert in the field, I appreciate your opinion about this hormonal method of hair loss treatment.

Thank you.

____________________

A:

Thank you for your question and your kind words. Although there are many practices regarding the treatment of female pattern hair loss, we try to remain evidence based in our recommendations. This means that we only use treatments and methods that are proven to work through scientific studies or peer reviewed publications.

There is no proof that the injection of progesterone to the scalp can treat typical female pattern hair loss. Minoxidil is a known hair loss medication that can help women who have significant miniaturization (thinning of hair shafts) experience some increased density (thickening of hair shafts). Candidacy of the patients needs to be determined by a doctor after microscopic evaluation of the scalp before starting on minoxidil.

Finasteride should only be prescribed to women who are not pregnant or planning on becoming pregnant, and are losing their hair in a “male pattern” due to increased levels of testosterone, due to a variety of potential factors. This needs to be tested and documented before starting a woman on finasteride. I should mention that finasteride is FDA approved under the name Propecia as a potential treatment for certain types of hair loss in men, not women.

Some doctors may use different methods of hair loss treatment. They may also promote themselves and their “innovative methods” in the media and on the internet. That does not make their case any stronger or provide a shred of evidence that their treatment methods will work. We are in an era of evidence based medicine, and the research, history, safety and potential treatment benefits are readily avilable to everyone.

I strongly encourage everyone to agree to treatment recommendations accepted and practiced by the medical society through scientific research or those through published peer reviewed journals.