An Update on the Treatment of Female Alopecia and the Introduction of a Potential Novel Therapy

In 2015, the authors reviewed treatment options for female hair loss, basing their suggestions on a thorough literature search and their own experience. They found that if increased androgens were identified, the source (ovary and/or adrenal) could be suppressed with drugs like oral contraceptives or glucocorticoids. If serum androgens were normal, agents blocking dihydrotestosterone at the hair shaft level, such as spironolactone or 5α reductase inhibitors, seemed effective. However, a Cochrane systematic review concluded that the only drug proven to improve alopecia by randomized controlled studies using rigorous criteria was minoxidil. Based on this, the authors decided to add minoxidil to their treatment paradigm. They also suggested a potential novel therapy for inflammation-related alopecia - dextroamphetamine sulfate.