‘Stopping hair loss is not enough’: How to treat, restore hair loss from start to finish
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Key takeaways:
- Begin by evaluating patient history to rule out and focus on certain hair loss causes.
- Start treatment with supplementation and topical therapies, later transitioning to oral options.
MIAMI BEACH, Fla. — Speakers at South Beach Symposium walked practitioners through the hair loss treatment journey from start to finish.
As part of the new South Beach Symposium track, “Derm Conditions from Start to Finish: Medical and Cosmetic Derms Working Together,” Maryanne Makredes Senna, MD, assistant professor of dermatology at Harvard Medical School and director of Lahey Hair Loss Center of Excellence and Research Unit, and Glynis Ablon, MD, FAAD, associate clinical professor at UCLA and owner of Ablon Skin Institute & Research Center, walked practitioners through how to treat hair loss — not only stopping disease progression but also restoring patients’ baseline.
“Stopping hair loss is not enough because we know that hair thinning is progressive and often by the time patients reach a dermatologist’s office, they have experienced significant loss and no longer feel like themselves,” Senna told Healio. “As hair is so important to our identity, it is important to help patients increase their hair density and try to get them back as close to their baseline as possible.”
According to Senna, practitioners should first require extensive intake forms that comb through patients’ history. By going through their history, practitioners can rule out telogen effluvium or other inflammatory causes that are resulting in hair loss and instead focus on hormonal, genetic or lifestyle issues.
The next course of action, depending on the etiology, can be attempting to use supplements such as Serenoa repens or plant-based oils. According to Ablon, patients often look for natural remedies before trying a medication, so it is worth attempting this avenue first.
Next, patients can use topical treatments, such as topical finasteride and minoxidil, or low-level light laser therapy. However, if this doesn’t work, the next course of action can be oral medication or platelet rich plasma injections.
The oral options for men include low dose oral minoxidil 2.5 mg to 10 mg once daily, finasteride 1 mg daily or dutasteride 0.5 mg three times a week or daily. For women, options include spironolactone 12.5 mg to 200 mg daily, low dose oral minoxidil 1.25 mg to 5 mg daily or bicalutamide 25 mg daily.
Finally, photo documentation throughout the process is crucial to evaluating progress, not only for the sake of the clinician, but for the sake of the patients as well.
“I cannot stress this enough,” Senna said during her presentation. “If you don’t have the photos, you are dead in the water. ... Nothing you say to a patient is going to make them feel like they’re better unless you have photos.”
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Senna MM, et al. Hair loss and restoration. Presented at: South Beach Symposium; Feb. 8-11, 2024; Miami Beach, Florida.
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