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Have you been using an over-the-counter hair loss treatment that “guarantees” to stop hair loss and stimulate growth of new hair? Has it performed as the label promises?


Is your hair loss continuing, without a sign of new hair growth?


If the answer is “yes” to all of the above, you have joined a very large club made up of people who elected to “do something” about hair loss by purchasing and using a direct-to-consumer medication you heard about from a friend, read about in advertisements, or came across on the World Wide Web. Perhaps you were also attracted by claims that the medication is “all natural”, “herbal”, “based on an ancient formula”, “discovered by a doctor”, etc.


One claim you probably did not find was that the medication is approved for use by the Food and Drug Administration (FDA).


Eventually, after learning that the “guaranteed” results of the direct-to-consumer product did not appear as promised, it may be time for you to consult a physician hair restoration specialist about (1) the cause of your hair loss, and (2) finding out if you are a candidate for medical or surgical hair restoration.


Here are some facts you should know about direct-to-consumer products that promise to stop hair loss and stimulate growth of new hair:


Very few, if any, have ever been rigorously tested for safety and efficacy in well-designed clinical trials. Claims or “guarantees” of efficacy are rarely based upon good science; claims are more likely to be so-called testimonials from presumably satisfied users of the product.


Only two hair restoration medications have been approved by the FDA after testing for safety and efficacy in clinical trials. These are the topical medication minoxidil (Rogaine®) and the orally administered prescription medication finasteride (Propecia®). Safety and efficacy information for these medications is clearly stated, as required by the FDA, in Product Information provided with the product. Neither product “guarantees” to stop hair loss or stimulate growth of new hair because hair loss can be due to many causes that may or may not be treatable by the medications. Finasteride (Propecia®) is available only by prescription from a physician. While minoxidil (Rogaine®) is available as an over-the-counter topical medication, both finasteride and minoxidil are most effective when used as recommended by a physician hair restoration specialist, after the cause of hair loss is correctly diagnosed.


While the chemistry and pharmacodynamics of minoxidil and finasteride are known and predictable on the basis of scientific studies and clinical trials, the same is not true of most direct-to-consumer products that promise hair restoration. There are few studies of the clinical effects of the “natural” or “herbal” ingredients in these products. There may or may not be adequate production line quality controls in place to assure that the product ingredients do not vary from batch to batch. Because the products are not approved by the FDA, their production is not subject to FDA supervision.


The potential interactions of direct-to-consumer products with other consumer products or prescription medications are generally not known. The physiologic effects of the products are not well described. Thus, you should inform your physician hair restoration specialist if you have used, or are using, such products. The physician needs to have this information prior to any recommendation for a hair restoration program.


While most of the direct-to-consumer products are probably benign, some can have a potential for physiologic effects that may complicate professional medical or surgical treatments for hair loss.


If you have a medical history of contact dermatitis or allergic reaction to skin-care or hair-care products, you should be cautious about using any direct-to-consumer hair restoration medication. Some skin-care and hair-care products can cause allergic reactions and irritations in people sensitive to certain chemicals. Some skin-care and hair-care products cause outbreaks of acne in people with a predisposition to acne. Product ingredients should be listed on the product label; you may recognize “problem” chemicals if you have a medical history of allergic or inflammatory skin reactions. “Herbal” or “natural” ingredients may be more difficult to recognize because some are known by several different names.


Fragrances may be added to some products to make their aroma attractive. Fragrance chemicals are common offenders in allergic skin reactions; allergic dermatitis typically appears on skin that comes into contact with fragrance chemicals. Skin of the face, neck and hands may exhibit allergic reaction to fragrance chemicals applied to the scalp if the hair restoration product is accidentally applied to those areas.


Products that contain “oily” chemicals may contribute to worsening of the skin condition called seborrheic dermatitis. This condition is often recognized in people who have oily, flaky “dandruff” in their hair and on clothing.


It is tempting to undertake a do-it-yourself program of hair restoration, using a non-FDA-approved direct-to-consumer product. The economics of a do-it-yourself program may be attractive. However, if a do-it-yourself program does not produce results—and if it results in some harmful or annoying skin effects—it may be more effective and cost-effective to consult a physician hair restoration specialist. Consultation with a physician hair restoration specialist can assure that (1) the cause of hair loss is correctly diagnosed, and (2) a hair restoration program can be developed to fit your budgetary and personal-appearance needs.




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