Q Is there any effective, safe cure for alopecia androgenetica? I sailed through a symptom-free menopause, aged 56, but three years on, I notice that my hair has thinned considerably. I have also lost most of my body hair. Is Regaine (minoxidil) safe? Or do you know of any alternative treatments? I've heard of coconut oil, fenugreek seeds, etc. Do such things work? I already eat a very healthy diet and take all the vitamins and minerals recommended for improving the health of the hair.
I'm desperate, and I'm sure that other subscribers must share my problem. Since becoming aware of it, I've noticed it in so many other women - and those thinning patches at the crown of the head do look truly awful. - MC, London
A Yes, androgenetic alopecia (patchy balding) is a type of hair loss which can happen postmenopause (Dermatologica, 1946; 3: 213-8). One of the problems of menopause is a slowing down of oestrogen production, resulting in weak, dry hair which can fall out.
Don't worry. As much as two-thirds of men and two-fifths of women can expect some hair loss by their mid-40s to -50s. There are different types and different causes.
Some practitioners suggest psoralen plus ultraviolet A (PUVA) treatment, but there is no research to support this, it is not very effective and exposure to UVA radiation has potential long-term side-effects (Br J Dermatol, 1995; 133: 914-8).
Minoxidil (Rogaine in the US; Regaine in the UK) has a 26-30 per cent success rate, but there are problems. First, it is an antihypertensive. According to the Physicians' Desk Reference, its many side-effects include oedema, gastrointestinal upsets, breast tenderness, skin rashes and increased heart rate. It is contraindicated in pregnant and breastfeeding women.
Ironically, you should not use minoxidil for hair loss if you are hypertensive. The topically applied solution can cause rashes and allergic reactions. Also, women who use minoxidil are five times more likely to suffer other unpleasant side-effects, including breathing difficulties, diarrhoea, nausea, vomiting, dizziness and muscle aches and pains.
Once you start using minoxidil, you must keep on using it. When the treatment stops, the regrown hair falls out again.
A more promising, natural preparation for restoring hair loss is Thymu Skin [New Action Products, 147 Ontario Street, Buffalo, NY 14207, USA; tel: +(716) 873 3738; fax: +(716) 873 6621], derived from calf thymus extract combined with various botanicals such as aloe vera, nettle and birch, plus vitamins, fatty acids and other immune boosters. Its advantage is that while you are regrowing your hair, you are also boosting your immune system. Its success rate for men is around 60 per cent. For women it's a bit higher.
Another herbal preparation which has shown promise is HairPrime [Universal Biologics, 3920 Cypress Drive, Suite D, Petaluma, CA 94954, USA; tel: +(707) 765 3080; fax: +(707) 765 8355; www. unibio. com]. One study (J Dermatol Treat, 1996; 7: 159-62) showed that, after 40 weeks of treatment, the mean hair count increased by 77 per cent. Overall, 90 per cent of the patients showed increased hair growth vs 33 per cent in the placebo group. Another study showed similarly encouraging results (Townsend Lett Docs, 1996; Nov: 68-72).
Some of the success with these natural preparations may be due to the nutritional supplements that are part of the regime. So, you may wish to get yourself checked out for any mineral deficiencies. Low levels of vitamin B, zinc and iron can all cause hair loss.
Simple aromatherapy massage may be an effective treatment for hair loss (Arch Dermatol, 1998; 134: 1349-52). In a double-blind, controlled trial of 86 subjects with alopecia, half the patients massaged essential oils (thyme, rosemary, lavender and cedarwood) in a base of jojoba and grapeseed oils into their scalp each day. The controls used only the base oils for their daily massage. The trial lasted seven months. Computer analysis of the treated areas confirmed that 44 per cent of the treated patients had improved compared with only 15 per cent of the controls.
Oiling the scalp and massaging the hair roots gently are useful steps towards curtailing hair loss. Coconut oil provides good nourishment for hair, and coconut or mustard oil can be used at least three times a week. Certain medicated oils such as mahabhringraj oil, amla and arnica oils are also helpful.
Among herbs, those rich in phytoestrogens appear to be the most effective for menopausal symptoms. The proprietary product Phytosterol, made from rhubarb root extract, can improve hair and skin that are in poor condition (BMJ, 1990; 301: 905-6; Reprod Toxicol, 1989; 3: 81-9; Zschr Angw Phytother, 1981; 111: 1-8).
Hypnosis is another way to treat skin complaints. According to a review by a researcher at the University of South Florida, hypnosis can successfully treat an wide array of skin problems, including acne caused by picking and squeezing, alopecia, atopic dermatitis, herpes simplex, lichen planus, pruritus (itching), psoriasis rosacea, trichotillomania (compulsive pulling out of one's own hair), urticaria (hives) and vitiligo (a pigment disorder) (Arch Dermatol, 2000; 136: 393-9).