Topical and Oral Medication for Alopecia

Topical treatment for alopecia is available as a lotion or foam. It is usually included in compounded formulations with different concentrations, prescribed according to the clinical judgement of the dermatologists expert in hair disorders within our unit. A medical prescription is required to obtain this treatment.

Its effects generally begin to be noticeable around three to four months after starting therapy, with peak effectiveness occurring after approximately one year of continued use. During the first few weeks, it is common to experience increased hair shedding. This is a completely normal phenomenon known as the shedding effect.

The shedding effect is a transient and reversible telogen effluvium that we frequently observe at Grupo Pedro Jaén. It commonly occurs in patients who start pharmacological treatment for different types of alopecia.

This temporary increase in hair loss can cause concern and lead patients to believe that the prescribed medication is not working or may even be worsening their condition. However, it is a normal, temporary and reversible process as treatment progresses.

This treatment can be easily applied at home. The lotion or foam is applied directly to the scalp on dry hair using a dropper, spray or simply with the fingers, following the instructions provided by the dermatologist.

In most cases, topical treatment for alopecia is applied at night, allowing the hair to be washed normally the following day. It is a very safe active treatment, with potential side effects limited to mild scalp irritation or itching. In most cases, these symptoms are not caused by the active medication itself, but by excipients in the formulation, such as propylene glycol or alcohol. These discomforts usually resolve with the use of specific shampoos.

Many patients are reluctant to use topical treatment for convenience reasons, as they feel it makes their hair greasy or causes irritation or rashes on the scalp. For this reason, oral formulations of these active substances were developed.

The content of this page has been prepared by the Communication Department and the Medical Team of Grupo Pedro Jaén, in line with our editorial commitment to ensuring the accuracy and up-to-date nature of the information provided.

References on topical and oral medication for alopecia:

1. New Treatments for Hair Loss. Vañó-Galván S, Camacho F. Actas Dermosifiliogr. 2017 Apr; 108(3):221-228. doi: 10.1016/j.ad.2016.11.010.

2. Superiority of dutasteride over finasteride in hair regrowth and reversal of miniaturization in men with androgenetic alopecia: A randomized controlled open-label, evaluator-blinded study. Shanshanwal SJ, Dhurat RS. Indian J Dermatol Venereol Leprol. 2017 Jan-Feb;83(1):47-54.

3. Effectiveness and safety of oral dutasteride for male androgenetic alopecia in real clinical practice: A descriptive monocentric study. Vañó-Galván S, Saceda-Corralo D, Moreno-Arrones OM, Rodrigues-Barata R, Morales C, Gil-Redondo R, Bernárdez-Guerra C, Hermosa-Gelbard Á, Jaén-Olasolo P. Dermatol Ther. 2020 Jan;33(1):e13182. doi: 10.1111/dth.13182.

4. Long-term safety and efficacy of dutasteride in the treatment of male patients with androgenetic alopecia. Tsunemi Y, Irisawa R, Yoshiie H, Brotherton B, Ito H, Tsuboi R, Kawashima M, Manyak M; ARI114264 Study Group. J Dermatol. 2016 Sep;43(9):1051-8.

5. A randomized, active- and placebo-controlled study of the efficacy and safety of different doses of dutasteride versus placebo and finasteride in the treatment of male subjects with androgenetic alopecia. Gubelin Harcha W, Barboza Martínez J, Tsai TF, Katsuoka K, Kawashima M, Tsuboi R, Barnes A, Ferron-Brady G, Chetty D. J Am Acad Dermatol. 2014 Mar;70(3):489-498.e3.

6. Mesotherapy with dutasteride in the treatment of androgenetic alopecia. Saceda-Corralo D, Rodrigues-Barata AR, Vano-Galvan S, Jaen-Olasolo P. Int J Trichol 2017;9:143-5.

7. Effectiveness and safety of low-dose oral minoxidil in male androgenetic alopecia. Jimenez- Cauhe J, Saceda-Corralo D, Rodrigues-Barata R, Hermosa-Gelbard A, Moreno-Arrones OM, Fernandez-Nieto D, Vaño-Galvan S. J Am Acad Dermatol. 2019 Aug;81(2):648-649.

8. Safety of low-dose oral minoxidil treatment for hair loss. A systematic review and pooled-analysis of individual patient data. Jimenez-Cauhe J, Saceda-Corralo D, Rodrigues-Barata R, Moreno- Arrones OM, Ortega-Quijano D, Fernandez-Nieto D, Jaen-Olasolo P, Vaño-Galvan S. Dermatol Ther. 2020 Aug 5. doi: 10.1111/dth.14106.