What are the effective treatments for hair fall?

Effective Treatments for Hair Fall

For hair fall treatment, topical 5% minoxidil applied once daily for at least 6 months is the first-line recommendation, with oral finasteride (1mg daily) for men and combination therapies for more severe cases. 1

Diagnosis and Initial Evaluation

• Establish correct diagnosis through clinical examination
• Rule out underlying conditions through laboratory testing:
  • Thyroid function (TSH and free T4)
  • Iron stores (ferritin)
  • Vitamin D levels
  • Zinc levels 1

Treatment Algorithm Based on Hair Loss Type

For Androgenetic Alopecia (Pattern Hair Loss)

1. First-line treatment:

   • Topical 5% minoxidil foam once daily 1, 2
   • Apply directly to scalp in affected areas
   • Allow to dry for 4 hours before washing 2
   • Continue for at least 6 months to properly evaluate response 1

2. For men only:

   • Oral finasteride 1mg daily 1
   • Warning: May cause sexual dysfunction and gynecomastia
   • Pregnant women should not handle tablets 1

3. Alternative/adjunctive options:

   • Low-dose oral minoxidil (0.25mg) + spironolactone (25mg) for women 1
   • Platelet-rich plasma (PRP) therapy: Initial 3 sessions at 4-6 week intervals, then maintenance every 6 months 1
   • Low-level laser therapy: 3 times weekly 1

For Alopecia Areata

1. Limited patchy alopecia (fewer than five patches <3cm diameter):

   • Intralesional corticosteroids (triamcinolone acetonide 5-10 mg/mL) 1
   • Observation is also legitimate (80% spontaneous remission if <1 year duration) 1

2. Extensive alopecia areata:

   • Contact immunotherapy with diphenylcyclopropenone (DPCP) 1
   • Methotrexate or sulfasalazine for severe cases 1

Proper Application of Topical Minoxidil

1. Part hair in thinning area
2. Apply 1mL directly to scalp using dropper
3. Spread evenly over affected area
4. Allow to stay on scalp for about 4 hours before washing
5. Wash hands immediately after application 2

Treatment Monitoring Schedule

• 3-month mark: Initial assessment (early signs of improvement may be visible)
• 6-month mark: Critical evaluation point (significant improvements should be noticeable)
• 12-month mark: Comprehensive evaluation of treatment efficacy 1

Important Considerations

• Treatment duration: Continue indefinitely to maintain results 1
• Combination approaches: May provide maximum efficacy (e.g., PRP + minoxidil) 1
• Hair styling products: Can be used after minoxidil has dried 2
• Hair coloring/perming: Avoid using minoxidil on the same day as chemical treatments 2

Common Pitfalls to Avoid

• Premature discontinuation: Results take 4-6 months to become noticeable 1, 3
• Inconsistent application: Reduces effectiveness 1
• Unrealistic expectations: Hair regrowth varies between individuals 2, 4
• Ignoring underlying conditions: Medical issues can impair treatment response 1

Side Effects to Monitor

• Scalp irritation or dryness (most common)
• Allergic contact dermatitis (rare)
• Unwanted facial hair growth (rare and reversible)
• Cardiovascular effects (rare with topical use, more common with oral) 2, 5

Recent evidence suggests that low-dose oral minoxidil (1mg daily) may be as effective and safe as standard topical minoxidil for pattern hair loss, offering an alternative for patients who struggle with topical application 6, 3. However, the British Journal of Dermatology and American Academy of Dermatology guidelines still recommend topical formulations as first-line therapy 1.