Current treatment options available for the consumer

Topicals – there are innumerable topical treatments being offered online, in pharmacies; hair salons – even in supermarkets.

• Activance Rhodanide is a natural, nutrient topical therapy with Rhodanide being the active vitaminoid for cellular regeneration of the hair follicle and hair shaft integrity. Activance boosts the hair’s Rhodanide + moisture levels (by up to 50%) and revives hair follicle activity. University studies have shown Activance lengthens the hair ‘growth cycle’ (termed: ‘Anagen’) whilst protecting against hair shaft fracturing (split ends).

Activance’s appeal is there are no known side effects from its use; safe for all ages and both sexes – including during pregnancy and breast-feeding. Its solid anti-inflammatory effects allow it to be multi-purpose: acne, burns (including sun over-exposure) and stinging bites.

**Activance Clinician Formula (CF) is the most intense formulation for hair regrowth (only available through select Practitioners such as Anthony Pearce Trichology) **

• Minoxidil is a widely known topical lotion approved to stimulate follicle hair growth. Under various brand names, Minoxidil is available ‘over the counter’ (OTC) in 2% and 5% strengths. Most of these commercial preparations are still the rudimentary pre-1970 FDA-approved preparation known to be poorly absorbed, and the 30% propylene glycol additive is the most common cause of scalp irritation with OTC Minoxidil.

Additionally, Minoxidil is therapeutically effective in only 45% of users (Chan: 2019) as it needs to be converted to Minoxidil sulphate to be activated. According to Chan, 55% of the population lack the conversion enzyme or produce an incompetent enzyme to effect conversion.

‘Next generation’ Minoxidil are pre-converted ‘hybrid’ medication-nutrient-phyto (plant-based) combinations to enhance skin penetration, inhibit hormone-induced follicle regression, and be anti-inflammatory to the skin environment.

• **NEW + exclusive to AP Trichology** Equol with DMSO (Equol ‘Plus’) is an advanced topical therapy which directly inhibits the action of dihydrotestosterone (DHT) on androgen-sensitive hair follicles to aid in preventing dermal papilla changes, with resultant IL-6 (1) up-regulation and follicle miniaturisation – the cause of scalp hair thinning.

IL-6 is a key modulator of hair loss and inhibiting its over-expression in the hair follicle has been the subject of much research.  When the androgenic scalp hair thinning process is activated, IL-6 gene expression is up-regulated, so both IL-6 concentration and activity is increased. Equol ’Plus’ binds and inactivates DHT, which in turn blocks IL-6 formation. (1) Interleukin-6: an endogenous chemical active in inflammation.

 DMSO is a non-damaging skin absorption enhancer for topical medication (Equol) as well as scalp anti-inflammatory and analgesic agent. Unlike Retinoic acid or Cortisone, DMSO does NOT adversely alter skin (epidermis) structure. . DMSO is available in strengths of 0.1%, 0.3% and 1.0% – (available soon and exclusively from Anthony Pearce Trichology)

Medical/Surgical Procedures (performed by a registered and experienced Medical Practitioner)

• Protein-Rich Plasma procedure/s (PRP): PRP is an autologous ‘needling’ procedure where 10-20 ml of the person’s blood is drawn and then platelets and plasma are separated and re-injected into the scalp.  A summary of PRP use and efficacy from Dr. Sahar Nadimi MD – a US Plastic Surgeon http://www.chicagohairinstitute.com:

‘PRP therapy has been used in other specialties for years– including dermatology, orthopaedics, dentistry, cardiac and plastic surgery–to enhance tissue healing.

More recently, PRP has been postulated as a new therapy for female and male androgenic alopecia, and to aid in wound healing after hair transplant.

For hair loss, PRP is injected in the tissue where hair growth is desired and may require a series of treatments, depending on patient response.  Although some studies have shown hair growth after PRP therapy, other studies have not shown a significant improvement in hair loss.

Currently, there are no large studies regarding the optimal protocol for treating hair loss with PRP. Use of PRP to promote hair growth is currently not an FDA-approved indication and is prescribed off-label.  It is important to recognise that PRP for hair loss should be considered a complementary treatment, rather than a stand-alone replacement.

Studies have shown that patients tend to obtain better and longer-lasting results when using additional medical therapy (Minoxidil and/or oral 5-AR inhibitors in addition to PRP injection’.

Note of Caution: I would NOT recommend consumers sign contracts with any commercial hair loss clinics acting as go-between agents for PRP procedures. Qualifications of ‘consultants’ are dubious; duty-of-care (according to contract) is on the consumer – and you will pay 5-10 times more than if you went to a medical practice specialising in PRP therapy. PRP is NOT Stem Cell Therapy (despite the marketing claims of one commercial hair loss clinic and it’s ex-cricketer’s endorsements)

• Hair transplantation: Follicular Unit Extraction (FUE) – a ‘scar-free’ micro-grafting procedure is the modern option. A skilled surgeon will typically provide an aesthetically pleasing outcome, but prospective clients should be aware of the following:

1. Total cost of the procedure/s (which may need to be undertaken in stages)
2. Pharmaceutical hair loss treatments such as Minoxidil or Propecia/Avodart may still be required to maintain existing ‘androgen-sensitive’ scalp hair. The Activance Professional range (particularly Practitioner Formula) is an excellent post-surgery leave-in treatment to decrease inflammation, encourage skin repair and transplanted follicle health for (eventual) optimal hair growth.
3. Ensure baseline pathology testing is assessed – as well as any current health conditions. Underlying deficiencies or health conditions will significantly influence hair transplantation success or failure.
4. Autologous hair transplant procedures are not usually appropriate as a 1^st treatment measure for women because nutrient deficiency or internal metabolic-hormonal disturbance is frequently the cause of female hair loss.

Oral natural and nutrient treatments –

• 1. EQUOL is a product (from Europe) which shows real promise as a non-drug alternative to stabilise androgenic thinning in adult men and women. Additionally:
     • Equol aids in diminishing the menopausal symptoms of ‘hot flashing’ and night sweats in women.
     • Equol can be used in the treatment of benign prostatic hypertrophy in older men.

   

• Equol is a compounded isoflavanoid capsule derived from Soy, requiring gender-titrated co-factors (Zinc + Selenium) to be scalp hair follicle-specific (Equol ‘O’)

  Equol ‘O’ (oral capsule) binds with free DHT, thereby inhibiting DHT-induced follicle miniaturisation and ‘pattern’ hair loss. Equol has a non-steroidal oestrogenic action; there are NO known adverse side effects with Equol ‘O’ as there are with the oral prescription drugs (Finasteride or Spironolactone et al).

  For more information search the word: daidzen. **Exclusive to Anthony Pearce Trichology**

• High quality Nutrient therapy (Molecular nutrition) is an essential foundation to support the continuously active hair follicle process. Optimal bio-available nutrients such as Vitamin D, zinc, iron and metabolic stability are vital to follicle activity.
• Saw palmetto at 160mg twice daily may assist in altering Testosterone (TT) pathways and decrease the levels of ‘free’ circulating hormone.

• Tribulus: a herbal supplement commonly used by body builders to enhance Testosterone levels – but can lower endogenous TT and alter androgen pathways in women.

• Zinc supplementation will almost always improve the androgenic thinning process due to its powerful 5-alpha reductase (5-AR) inhibiting properties. Long-term hi-dose supplementing is NOT recommended without reviewing pathology levels as Zinc antagonises the absorption of – and its own absorption antagonised by Copper and Iron. 

• Despite its current ‘vogue’ in orthodox Dermatology I personally do NOT advocate the prescribing of Spironolactone, oral Minoxidil, Finasteride, contraceptive or other hormonal therapy for pattern hair thinning in women.

I have yet to see any of these drugs (which were ALL initially used to treat other health problems) stimulate noticeable scalp hair regrowth; they have many potential side effects and often mask the true cause of the thinning scalp hair event.

Laser Light Therapy:

Photo-biotherapy such as ‘soft/cold’ low level laser light (LLLT) is a strong vasodilator which moderates the skin’s immune response. To be therapeutically effective these laser appliances should be classified ‘3A’; be in the red-light spectrum + wavelength vicinity of 660-780nm. Bio-available power output should be 60-100mW.

Note: some commercially sold handheld lasers have a power output of 1.5-5mW, which is the power output of a TV remote control.  These ‘lasers’ offer little more than placebo effect.

LLLT as a SINGLE ‘stand-alone’ therapy will usually not regrow hair to any aesthetically satisfying degree in my experience. This was confirmed by the unpublished research study of Dermatologist Dr. Anthony White (Low energy laser treatment for androgenetic alopecia: 1994).

As a combination therapy however, LLLT can enhance the scalp environment due to its anti-inflammatory & blood perfusion properties – so hair growth potential is maximised.

LLLT is consistently effective (in a combined therapy approach) for inflammatory scalp conditions or stablisation of telogen effluvium hair shed. LLLT is a non-UV light source, and a versatile, safe treatment modality when used appropriately.

Note of Caution: I would NOT recommend consumers sign contracts with any commercial hair loss clinics offering laser therapy programs. Qualifications of ‘consultants’ are dubious; they appear to have little or no understanding to the contra-indications of LLLT, duty-of-care (according to contract) is on the consumer – and you will pay many $thousands more than if you went to a reputable trichology practice offering LLLT.  

Before commencing ANY hair loss treatment program, consumers would be wise to have their scalp hair concerns assessed by an experienced, qualified practitioner who will identify the type of hair loss they are experiencing, as well as any internal imbalance which may be the cause. Only then should a treatment plan be suggested which is appropriate to the condition; medical history, affordability – and what the Client is comfortable undertaking.

Anthony Pearce: 2020