Can Hair Loss Medication Treat COVID-19?

DHT inhibitors like finasteride and dutasteride can help with hair loss prevention. Scientists have found a relationship between these drugs and COVID-19. DHT blocker medications are also known as 5-alpha reductase drugs. The medication may alter the pathway that the virus uses to enter the target cells or it may work through other mechanisms. We know that patients who have used these medications have done better after being diagnosed with COVID-19. Can it be considered or used as a treatment option for this disease? To answer to this question, we will go in-depth about our current status with the pandemic and what the study really means (for those of you who love details about scientific studies).

COVID-19 Update

COVID-19 updated information and studyThe ongoing COVID-19 pandemic is nearing what many hope will be a breakthrough in finding a cure for the disease. The possibility of a vaccine for COVID-19 has been discussed for months. A Centers for Disease Control and Prevention panel is scheduled to vote this week on who will be the first people eligible to get the coronavirus vaccine. In addition, Moderna has requested emergency clearance from the Food and Drug Administration for its COVID-19 vaccine. Moderna applied for their emergency clearance after Pfizer applied for authorization back in November.

While the first doses of one of these vaccines are expected to be distributed before the end of 2020, a recent study shows 5-alpha-reductase inhibitors work to reduce the remission time of COVID-19. The results come from a randomized, double blind, placebo controlled interventional trial conducted on 130 SARS-CoV-2 positive men.

The Background Behind the Study

The entry of SARS-CoV-2 into type II pneumocytes depends on the proteolytic enzyme known as TMPRSS2. The promoter of this enzyme in humans is an androgen response element which means androgen sensitivity could be a possible risk factor for COVID-19.

There was a previous report, about a retrospective cohort analysis, that showed the protective effects of 5-alpha-reductase inhibitors in COVID-19. It was also shown that men using 5-alpha-reductase inhibitors were less likely to have to be admitted to an intensive care unit than men not taking 5-alpha-reductase inhibitors. Plus, men that were shown to use 5-alpha-reductase inhibitors had a greatly reduced frequency of symptoms than men shown to not use 5-alpha-reductase inhibitors as outpatients.

Given the above information, the study was conducted to determine if 5-alpha-reductase inhibitors can be considered to be a beneficial treatment if they are given to a patient after a SARS-CoV-2 infection.

How the Study was Performed

The study was conducted as a double-blinded, prospective, investigative study of dutasteride, which was also randomized, for the treatment of COVID-19. The subjects in the study were people confirmed as being positive for SARS-CoV-2 and treated in an outpatient setting.

The study had a number of endpoints, revolving around the remission times, for a set of symptoms predetermined for the study. The predetermined set of symptoms included:

  • Hair loss medication can it cure COVIDHaving a fever or a feverish feeling
  • Sore throat
  • Cough
  • Body pain or muscle ache and pain
  • Shortness of breath
  • Headache
  • Nasal congestion
  • Fatigue
  • Runny nose or nasal discharge
  • Diarrhea
  • Vomiting or nausea
  • Loss of appetite
  • Loss of smell or taste

Study Results

A total number of 130 SARS-CoV-2 positive men were included by the research team in the study. There were 64 test subjects included in the dutasteride arm as well as 66 test subjects included in the placebo-controlled group.

The study results showed that the difference in the average remission times for fatigue or ageusia (which is the loss or impairment of the sense of taste) or anosmia (which is the loss or impairment of the sense of smell) was statistically different between the two groups. The results showed, for the dutasteride group and the placebo group respectively, 5.8 days vs. 10.1 days for fatigue and 7.3 days vs. 13.4 days for either ageusia or anosmia.

The study results also showed that the total amount of remission time was greatly reduced for the men in the study that were give dutasteride. Their remission time was 9.0 days as opposed to the 15.6 days of remission time seen in the placebo group. When the loss of smell and taste are excluded from the results, the average time for total remission was 7.3 days for the dutasteride group as opposed to the 11.7 days seen in the placebo group.

Overall, the study results showed that the total remission time for men that used 5-alpha-reductase inhibitors was greatly reduced compared to men that were not taking the 5-alpha-reductase inhibitors.

The Study and how it Relates to Hair Loss

Patients that are suffering from hair loss might be curious to learn how the above study relates to the loss of hair on the scalp.

Dutasteride and finasteride are the two most frequently used 5-alpha-reductase inhibitors. These medications are used to inhibit the conversion of testosterone into dihydrotestosterone which is the androgen that causes male pattern baldness. Finasteride has been FDA approved for treatment of male patterned baldness. Even though dutasteride is approved as a male pattern baldness treatment in some countries, it has not yet received the approval of the FDA for use as a hair loss drug in the United States. Instead, it is approved by the FDA as a drug to combat prostate enlargement. It can only be prescribed as an off-label treatment option for hair loss.

Patients interested in learning more about dutasteride, as well as other hair loss prevention methods, are invited to contact our office to schedule a consultation appointment with one of our experienced and board-certified doctors.

MA

Do Some Hair Loss Drugs Increase Suicide Risks?

A recent study shows that drugs used to treat male pattern baldness, as well as an enlarged prostate, might increase the chances of depression and self-harm on the part of patients. However, the drugs that were part of the study do not increase the risks of suicide.

The study, conducted by a research team led by Dr. Blayne Welk of Western University in Ontario, focused on 5a-reductase inhibitors. This class of medications includes drugs used to combat male pattern baldness, which are also used to treat the medical condition known as an enlarged prostate gland.

Who Was the Study Conducted On?

The research team studied 93,197 men in Canada, age 66 or older, that started to use new 5ARI medications between the years of 2003 and 2013. They also studied an additional 93.197 men who never had to use 5ARI.

What Were the Results of the Study?

Suicide Risk Due to Hair Loss Medication - True or FalseAs reported in JAMA Internal Medicine, the overall results showed that 5ARIs did not have a link to any increased suicide risks. The first 18 months of the study did show that the men using the medication had a risk of self-harm that was 88% higher than the men not using the 5ARIs. However, the risk did not extend any further than that 18 month period. The men in the 5ARI study group did show a high risk of depression (94%) during the first 18 months of the study. Once the first 18 months of the study passed, the depression risk fell all the way to 22%. Overall, the type of 5ARI used by the patients did not alter the results in any major way.

When writing the conclusion of their study, the research team said that any risks of psychiatric effects on patients stayed low. The conclusion of the study also determined that “the potential benefits of 5ARIs in this population likely outweigh these risks for most patients.”

As a reminder to anyone considering a hair transplant, one of the first steps in the hair restoration process is a consultation appointment with a board-certified doctor. An experienced and trained doctor can examine a patient and determine if he or she is physically and mentally fit to undergo a hair transplant.

Hair Loss Product: Viviscal

Hair Loss medicationViviscal is a hair loss product that comes in the shape of tablets and is made of AminoMar and a mixture of other nutrients.  AminoMar is a fish protein that is claimed to help hair grow better.  Malnutrition can affect human hair and some microelements like Zinc and other vitamins that are essential to the growth of hair.  However, despite of the extensive advertisement, there is no evidence that healthy people not suffering from any malnutrition of these elements can be helped with their hair growth.

The science behind AminoMar, which is promoted by Viviscal as its hair growing ingredient, is very limited and certainly questionable. In addition to the active ingredient AminoMar, there is no evidence that the other ingredients can help grow hair in people who are not malnourished.

If you are suffering from malnutrition and are concerned that your hair loss is associated with lack of certain nutrients, you need to be examined by a doctor who can order some lab work to easily determine the level of those elements which can be treated if it is found to be necessary.

Do the Effects of Propecia Level Off After Three Years?

Q:

Good day Dr. Mohebi,

I hope everything is fine with you. I have a question about Propecia.  I have been taking it for few years now. I remember you mentioning in the past that Propecia effects level off after 3 years.

If this is the case, should I continue taking it ?

I look forward to your answer.

 

A:

It is good to hear from you.

The effects don’t level off but, it’s important to note, you won’t continue seeing the initial effects that had been noticeable due to the initial enlargement of some of the miniaturized hairs. You have been making DHT all along but at a lower level as time passes.

At this point, it is still slowing down your hair loss. If you stop taking it, you will see a more aggressive loss of your native hair that is prone to balding.

Does PRP Really Work for Hair Loss Treatment

Q:

Hi, Doctor.

PRP-for-Hair-Loss-TreatmentI had a quick question. Recently, I tried to grow my hair long and realized after my locks had reached the length that I like them at, my hair is noticeably thinning around my crown area. It’s been happening since I was about 18 years old, but none of my barbers had informed me that it was thinning, repeatedly telling me that it was just my cowlick, until now. I’d like to combat this hair loss, but it is my understanding that any medications you start becomes a lifelong commitment. Also, I am afraid the common side effects associated with Propecia, but I do want to know if it can help. I’ve also done some research on PRP, and it seems I would have to maintain the regimen throughout the year, how many times would I need treatment to maintain results?

 

A:

I would recommend that you seek an evaluation from a hair specialist or a hair surgeon. Make sure the initial evaluation specifically includes a microscopic evaluation, which will give you an indication of what your future pattern of hair loss may be. Only after this initial meeting and evaluation could it be determined what treatment options are best for you.

There are a few FDA medications and methods that have proven to slow down hair loss such as Propecia and Rogaine.  However, hair transplant is the only viable, permanent solution at this point to restore ones hair. PRP (Platelet Rich Plasma) and mesotherapy are among the treatments that do not have significant scientific data to support their claims of treating hair loss.

Latisse and Alternatives for Eyebrow Hair Growth

Q:How to get Longer Eyelashes

Hello Dr. Mohebi!

I would like to have thicker eyebrows and have looked online for options to help me achieve this goal.  I heard Latisse could help so I bought it and have been trying it.

I know that I have to use it for a little while before I see results but I am getting kind of impatient. I am curious if there is a cheaper option since Latisse is rather expensive.  Careprost, Lumigan, Travoprost and Bimatoprost are all alternatives that I see people write about online as cheaper alternatives and they seem to have some success.

Do you have a recommendation? I would appreciate any insights you have to offer me.

A:

Bimatoprost is the scientific name of a synthetic prostamide anolog and it used for the treatment of glaucoma (an ocular disorder that results in optic nerve damage through an increased amount of fluid pressure inside the eyes).  This medication, as well as other prostamides, can also increase the growth phase of hair follicles.  In turn, this will lead to longer and fuller eyelashes.  Prostamides, such as Bimatoprost, were successfully tested for the treatment of eyebrow hair as well.

There are many different types of prostamides and they include:

  • Bimatoprost (with brand names such as Latisse, Careprost and Lumigan)
  • Travoprost (Brand name: Travatan)
  • Latanoprost (Brand name: Xalatan)

All of these prostaglandins are available in different concentrations and available at different prices. According to the American Academy of Optometry, all three ophthalmic drugs (bimatoprost, latanoprost, and travoprost) are effective treatments for the goal of increasing eyelash growth.

References

  1. Topical Bimatoprost for the Treatment of Eyebrow Hypotrichosis
  2. The Cosmetic Effects of Bimatoprost vs. Latanoprost vs. Travoprost vs. Placebo on Eyelash Growth

 

 

Shock Loss: Losing Hair after a Hair Transplant

Q:

Hello Dr. Mohebi,

My hair is slowly getting back to normal after my hair transplant but I am afraid I have lost most of the grafts. In addition, I think I am suffering from some real shock loss. My hair is not looking too good, it seems like I have less hair in the crown and temple area than I did before the hair restoration surgery. I really liked my new look after the 2nd day of the surgery when I had hair in the temples and frontal hairline. I understand that it is now a waiting game after the surgery but I am not seeing little dots where the implants were made on my scalp. I am looking for the dots in order to to give me hope that the hair will grow out. I would really appreciate hearing your thoughts and letting me know if I am worrying about hair loss for no reason.

A:

The loss of hair after a hair transplant is quite common and it is referred to as “Shock Loss”. In general, we can see two types of shock loss after a hair transplant:

  1. Shock-Loss after transplantThe transplanted hair will normally fall out in over 90% of patients after a hair transplant surgery. Hair fall occurs because the transplanted hair follicles go into a resting phase until they start growing new hair within a few months.  This is the most common type of shock loss that people experience after hair transplantation. Of course, this type of shock loss is temporary and a complete recovery is expected.
  2. Patients who receive a hair transplant before completing their hair loss may experience an accelerated loss of their native hair. Native hairs, which are generally prone to shock loss, are the hairs on the scalp that are supposed to fall out within the next few months to years.  Any physical or mental stress can accelerate the rate of this hair loss.  For example, a hair transplant as well as the inflammation from the healing of the skin can trigger this type of shock loss. A good portion of these follicles will start to grow hair again after their resting phase (which may last a few months). This type of shock loss may also be reversible to some degree and an experienced doctor can give you more information.

– MA

Vitamins for Hair Loss Treatment – Fact or Myth

I just read the result of a meta-analysis on CNN that indicates the inefficiency of multivitamins despite their wide use by most Americans in different age groups.

Losing hair? Do Vitamins work?This is also the question that I always get in my radio or TV talk shows on hair loss and hair restoration. Many people believe multivitamins could help stop their patterned hair loss. Even some doctors include Biotin (vitamin B1) or Zinc as one of their treatment options for patterned hair loss.

The fact about multivitamins is that none of those claims are documented by scientific studies. We know the causes of patterned baldness in men and women (androgenetic alopecia) and that is not due to vitamin insufficiency. I know it might be confusing when you see different types of vitamins that are made for nails and hair in the market. However, that still does not change the fact that patterned hair loss may require vitamins. If you are not suffering from malnutrition or malabsorption, you should have enough vitamins for your hair. Taking extra vitamins does not help your patterned baldness.

If you are not sure what is causing your hair loss, you can see a good hair specialist for a personal one on one consultation to evaluate your hair loss.