Custom Compounding to Treat Hair Loss in Women
Hair loss is a common side effect of chemotherapy but some women shop for wigs because of another medical condition entirely. The condition, alopecia, occurs when the body attacks the hair follicles, stopping hair growth before it can even happen. Alopecia can affect anyone—men, women, and children. But while we talk about male pattern baldness and pediatric concerns quite a bit, baldness in women comes with a lot more stigma. Imbalances in testosterone, estrogen, and even thyroid hormones can cause alopecia. Luckily custom compounding can rebalance these hormones and keep women from having to resort to wigs.
Losing Hair Doesn’t Have to Be a Part of Life
In my practice, I’ve seen a lot of women who mourn the loss of their once-thick healthy hair. ‘It’s just a part of life,’ they say with a small laugh. The truth is, everyone loses hair, but most are able to regrow it. Hair growth has a four-part life cycle:
- Anagen (Growing Phase);
- Catagen (Transition Phase);
- Telogen (Resting/Shedding Phase); and
- Exogen (New Hair Phase).
As we grow older, hormonal changes in our bodies cause this cycle to change and hair follicles to get smaller. But for some people, hair loss doesn’t just stop there. The natural testosterone in their bodies converts to dihydrotesterone (DHT) with the help of an enzyme in the oil glands of a hair follicle. DHT binds with receptors in the hair and shrink the diameter of new strands, thinning out the hair. Because men have a high level of testosterone, their hair thinning is easily obvious. But women also carry low levels of testosterone, called androgenic hormone, and changes in this hormone level can be a trigger for alopecia.1 Hair thinning in women is different from that in men because the loss is diffuse occurs across the whole scalp rather than from a receding hairline. Also, the alopecia may be accompanied by other conditions, such as hirsutism or infertility.2 Diagnosis of specific symptoms is crucial for developing an effective treatment.
Women typically have one of two types of hair loss:
- Androgenic alopecia, caused by the presence of androgen hormones, is tied to any number of sources, including high-androgen birth control pills, pregnancy, and even menopause.
- Telogen Effluvium, caused by an estrogen imbalance that further triggers an extended shedding phase of the hair cycle, is often brought on by childbirth, severe infection or surgery, and even extreme stress.
Thyroid imbalance and insulin resistance can further increase hair thinning in these women.
Custom Compounding for Thicker, Fuller Hair
Combination therapy offers the best chance to slow or stop hair loss3, and can be addressed through custom compounding. A topical cream applied to the scalp is the simplest, most accessible option and typically contains patient-dependent amounts of:
- Minoxidil, vasodilator that promote hair follicle growth
- Finasteride, type P-selective 5a-reductase inhibitor that decreases DHT
There are other options that patients should consider as well, including4:
- Ketoconazole, a topical anti-fungal medication that stimulates new hair growth;
- Spironolactone, which lowers testosterone and androgen levels;
- Azelaic Acid, a naturally occurring substance that reduces the amount DHT;
- Corticosteroids applied to the scalp promote hair growth, with injections having a higher efficacy than topical treatments; and
- Nutritional supplements that also promote hair growth include zinc, Vitamin A, iron, vitamin B complex, Vitamin E, calcium, magnesium, choline and inositol;
Combinations of these drugs and supplements in different amounts and in different methods of delivery, such as creams, gels, and even injections, can be developed uniquely to the patient. Between hormonal imbalances and side effects from necessary medications, it can be difficult to isolate and treat alopecia in women but these conditions deserve as much consideration as male pattern baldness. Steps you can take include:
- Keeping your dispensary stocked with a variety of drugs and herbal supplements targeted against alopecia. Patients are often reluctant to talk about severe hair loss and appreciate options for mild topicals as well as more rigorous therapies.
- Consulting with your patient and her physician about other symptoms that accompany hair loss. She might be suffering from other hormone-based conditions the patient should also be aware of and treated for.
- Staying aware of nutritional deficiencies that can cause hair loss and those that are caused by treatment for alopecia. Supplementing for those deficiencies is a hot area of discussion right now and can improve patient outcome significantly. She’ll thank you for it.
Alopecia doesn’t need to be hidden under hats and wigs—with the right treatment regimen through custom compounding, you’ll be able to compliment your patient on her hair style the next time she stops by.
Custom compounding for women’s concerns is an area of healthcare that is rapidly growing in both attention and in drug development. Pharmaceutica North America wants to be your partner in treating women with the most recent, frontline therapies. PNA offers a range of high-quality, effective medications that you can provide to your patients with confidence. Please contact us today to learn more about the latest in women’s medicine and what we can do for you.
- “Causes of Hair Loss,” http://www.americanhairloss.org/women_hair_loss/causes_of_hair_loss.asp ↩
- “Alopecia: Hormonal and Hereditary Factors,” September 3, 2014, http://www.pharmacytimes.com/publications/issue/2014/sept2014/alopecia-hormonal-and-hereditary-factors/P-1 ↩
- “Alopecia in Women,” March 2003, http://www.aafp.org/afp/2003/0301/p1007.html ↩
- “Hair Loss: Treatments and drugs, April 25, 2015, http://www.mayoclinic.org/diseases-conditions/hair-loss/basics/treatment/con-20027666 ↩