Treating hair loss – where many get it wrong (and why we are different)

Sudden and obvious or slow imperceptible loss of scalp hair density is one way your body is communicating things have changed.

These changes can be:

1. Insufficient nutrient reserves to support hair growth activity.
2. Internal metabolic-hormonal disturbance compromising the hair follicle process (ie: maintaining a normal growing phase).
3. Onset of disease or chronic illness.
4. The natural changes from biological ageing: hormonal re-balancing, decreased nutrient absorption and deterioration of the skin structures.

BECAUSE changing scalp hair density, quality or texture is a reflecting barometer of internal changes, your treating practitioner MUST assess the above 4 points plus any other issue that is individual for you.

When underlying deficiency or disturbance is corrected or stabilised, improvement in the hair will usually follow in time. IF the focus is totally on the hair to the exclusion of what’s happening within the body then poor outcomes for the patient is likely whatever the treatment being offered.

There has also been a proliferation of online products delivered to your door like ‘Uber Eats’. Some are allegedly ‘special’ wet products (1) formulated for hair loss, others are herbal supplements and some are prescription medication.

Sales are usually preceded by a concentrated social media blitz to gain a profile and often headed up by some ‘celebrity’ allied health person, social influencer or medical endorser.

Whilst that’s the way modern treatments are offered today, they carry potential assumptions and concerning issues with them:

• They are usually very generic treatments and ASSUMES the consumer has either androgenic scalp hair thinning or some stress-related hair loss.
• IF there is any online consultation offered, again it’s very basic and does not consider the many variables which might influence a treatment regime.
• Rarely if ever is the client’s medical history assessed nor pre-treatment pathology tested undertaken.
• Cost to the consumer is often far higher than what it ordinarily should be, and often you are contracted to a specific purchase period or numbers of products to purchase.

The (supposedly) ‘prescription-only’ medications: oral Minoxidil alone or in combination with oral finasteride or spironolactone, are NOT currently approved by the Australian Therapeutic Goods Administration (TGA) (2) as treatment for androgenic scalp hair loss – but are still offered by some online operators to consumers as if they were lollies.

They appear to be provided to consumers with only the most basic health check – if at all – sometimes not even by a doctor as legally required, but by untrained hair loss salespeople paid on commission with one of the multi-national hair loss companies.

One would have serious doubts if these unqualified consultants would possess the medical knowledge to know if these medications were appropriate for an individual consumer, or what are the potential side effects.

When taken orally, Minoxidil and Spironolactone are anti-hypertensive (blood pressure) medications. If topical Minoxidil is also being used, this combination may adversely affect the heart and blood pressure in a pre-disposed person.

I personally know of one older woman who had to be admitted to an intensive care unit of a Sydney hospital when she was over-prescribed a dosage of oral Minoxidil; two others required emergency care for respiratory-circulatory collapse from Minoxidil excessively prescribed.

Potential adverse risks of Finasteride are loss of sexual libido, decreased sperm count with long-term use and mood disturbance. Finasteride is also believed to conceal underlying prostate disease in older males.

An overview of the main points of the TGA’ s position on the use of these drugs:

1. There is only ONE oral form of Minoxidil (trade name: Loniten) available for use in Australia. Approved indications are as follows: indicated as adjunct therapy in adults with severe hypertension (ie: high blood pressure) which has failed to respond to multiple anti hypertensive therapy.
2. Use of medicines (such as Spironolactone and oral Minoxidil) outside the specified indication/s or intended purpose is termed ‘Off Label’

‘Off-label’ is used at the discretion of the medical prescriber who is solely responsible for obtaining informed consent from the patient. ‘Informed consent’ means the patient MUST BE notified of all risks or benefits of the ‘off label’ treatment vs other available treatments OR no treatment at all based on individual circumstances.

Medical practitioners are required to prescribe in accordance with Good Medical Practice, the code of conduct published by the Medical Board of Australia – this code highlights the importance of informed consent, but the TGA does not regulate health professionals or clinical practice.

If you are considering taking one of these drug-combinations whether it be from an online source, sales ‘consultant’ from some commercial studio or hair loss centre – or even from your GP, please appreciate you be being asked to take blood pressure and other medication NOT intended or approved as a hair loss treatment.

I believe fatal consequences for a patient will inevitably result from this current cavalier behavior by groups seeking to make easy $$. If it hasn’t already happened someone will die either by drug reaction or deliberate overdose taken by an emotionally unstable individual (3).

Is a head of hair really worth putting your health at risk for??

Copyright Anthony Pearce 2021

1. Shampoos, conditioners and hair serums.
2. Full TGA response is available on legitimate request (anonymous requests will be ignored)
3. In the early 2000’s I assisted two clients and the NSW Dept. of Fair Trading in actions against a notorious, unqualified hair loss charlatan in Sydney. His actions resulted in these two clients suffering near fatal respiratory arrests and permanent skin damage from the inappropriate use of Minoxidil as directed by him.