What treatments are available for frontal hair loss (alopecia)?

From the Guidelines

To improve hair loss at the front of your scalp, start with FDA-approved medications like minoxidil (Rogaine) applied twice daily to the affected area and finasteride (Propecia) 1mg taken orally once daily for men only, as these treatments have shown to be effective in improving hair growth and reducing further hair loss 1. These treatments work best when started early, with minoxidil improving blood flow to hair follicles and finasteride blocking DHT, the hormone responsible for male pattern baldness.

• Consider adding a ketoconazole shampoo like Nizoral used 2-3 times weekly to reduce scalp inflammation.
• Nutritional support through biotin supplements (2,500-5,000 mcg daily) may help strengthen existing hair. For more advanced cases, consider platelet-rich plasma (PRP) injections, which have shown promise in treating androgenetic alopecia, with a recommended dose of 5-7 mL PRP, using 0.05 to 0.1 mL/cm2, and a minimum of 3-5 sessions with a 1-month interval between sessions 1. Alternatively, platelet-rich fibrin (PRF) may be a safe and effective treatment option, with some studies suggesting it has theoretical advantages over PRP 1. Hair transplantation provides a permanent solution for significant frontal hair loss. Frontal hair loss often results from androgenetic alopecia (pattern baldness), which is influenced by genetics and hormones, so addressing these underlying factors is crucial for successful treatment. Consistency is key, as most treatments require 3-6 months before visible improvements appear.

From the Research

Treatment Options for Hair Loss at the Front

• Androgenetic alopecia is a common cause of hair loss in men and women, and various treatment options are available, including minoxidil, finasteride, and platelet-rich plasma (PRP) therapy 2, 3, 4.
• Combination therapy with PRP and minoxidil has been shown to be more effective than monotherapy with either treatment alone, with significant increases in hair density, diameter, and terminal hair rate 2, 5.
• Low-Level Laser Therapy (LLLT), microneedling, and other treatments have also been studied for the treatment of androgenetic alopecia, with varying degrees of efficacy 3, 5.
• Topical finasteride has been shown to be a potential alternative to oral finasteride, with similar efficacy and fewer systemic side effects, and combining it with minoxidil may be an effective treatment option for male androgenetic alopecia 6.

Efficacy of Combination Therapies

• Studies have demonstrated that combination therapies, such as PRP and minoxidil, can lead to better clinical results than monotherapy with either treatment alone 2, 5.
• The combination of topical finasteride and minoxidil has been shown to be safe and effective for increasing hair density and diameter in male androgenetic alopecia patients, with similar efficacy to topical minoxidil alone 6.
• However, more research is needed to fully understand the efficacy and safety of combination therapies for the treatment of androgenetic alopecia, and to determine the optimal treatment protocols 3, 5.

Considerations for Treatment

• Patients with androgenetic alopecia should be evaluated by a healthcare professional to determine the best course of treatment, taking into account the severity of hair loss, medical history, and other factors 4.
• Treatment options should be individualized, and patients should be informed of the potential benefits and risks of each treatment, as well as the likelihood of success 3, 6.