Category Archives: Hair Loss Treatments

Hair Loss Treatment Guideline Update

Some countries release detailed official recommendations on hair loss treatments every few years. Usually, these are based upon guidelines from their national dermatological associations.

In virtually every country in the world, oral Finasteride and topical Minoxidil are typically the top two hair loss treatment recommendations. Those two are the only ever FDA approved medications to treat hair loss, so no surprise. However, thereafter you can find some unexpected treatment suggestions.

Hair Loss Treatments in Japan

In Japan, the 2018 Dermatological Association recommendations start with the following:

“Finasteride 1 mg daily, dutasteride 0.5 mg daily and topical 5% minoxidil twice daily for MPHL, and topical 1% minoxidil twice daily for FPHL, are recommended as the first-line treatments.”

The appearance of “Dutasteride” in the above is not as surprising as it would seem in most other countries. This is because Dutasteride has only been approved as a treatment for androgenetic alopecia (AGA) in South Korea and Japan. It seems like topical Finasteride is not popular in Japan (or for that matter, anywhere in the world). The oral version heavily dominates.

More surprisingly, topical Adenosine is listed as a second line of treatment to combat hair loss in Japan. Laser hair growth devices are also recommended as an option.

Finasteride is not recommended for female pattern hair loss (FPHL) sufferers in Japan. In many western countries, women are offered Finasteride for their hair loss as long as they are not planning to get pregnant in the future.

Strangely, oral Minoxidil is not recommended as a hair loss treatment in Japan. In contrast, oral Minoxidil for hair growth seems to be increasingly popular in nearby Asia/Pacific countries such as Thailand and Australia. And also increasingly popular in Spain (see next section). See this new study in support of the drug’s hair growth effects.

Prescribing Habits for Androgenic Alopecia in Spain

In September 2020, an updated survey of Spanish dermatologists showed interesting findings in regards to the prescribing habits for AGA.

Out of 243 dermatologists who responded, the most common treatments prescribed for male androgenetic alopecia were:

  1. Topical Minoxidil (100%).
  2. Oral Finasteride (92.6%).
  3. Oral Dutasteride (75.7%).
  4. Oral Minoxidil (50.6%).
Hair Loss Treatment Recommendations by % of Dermatologists in Spain, 2019-2020
Hair Loss Treatments
Hair Loss Treatment Recommendations.

Dutasteride and Oral Minoxidil Popular

It is extraordinary that Dutasteride and oral Minoxidil are so widely prescribed in Spain to treat male pattern baldness. In fact, the survey found oral Minoxidil to be prescribed even more widely for females (both premenopausal at 67.9% and postmenopasal 63%).

Oral Minoxidil is a blood pressure medication that can cause side effects such as faster heart rates, dizziness and increased body hair. I am amazed at how readily Spanish dermatologists are prescribing it to both men and women as a hair loss treatment.

In regards to Dutasteride for hair loss, Spain is a real trendsetter. This is surprising, since the drug has not been officially approved to treat hair loss in that country or in the EU. See my past posts with before and after photos of Dutasteride using hair loss patients in Spain:

Case Study

One of this blog’s avid readers is a person from Spain named “cuellar”. On our hair loss chat, he recently posted the below before and after photos of his hair. The “after” is 9 months into daily treatment with oral Minoxidil and oral Dutasteride. He said that the former has become extremely popular in Spain, confirming the findings of the above survey.

“Cuellar” thinks that he has lost ground recently per another newer photo, but hopefully it is just a temporary shed. He will keep us updated on his progress. He has seen no side effects other than a modest increase in body hair quantity. Maybe he can also try to get Dutasteride injections from Dr. Vañó since they live in the same country?!

Dutasteride and Oral Minoxidil Before After
Dutasteride and Oral Minoxidil: Before and After Hair Growth Photos (9 Months).