Frontal baldness is an early stage of androgenetic alopecia (AGA), the most common form of hair loss affecting men and women. Also referred to as a receding hairline or pattern baldness, this condition is characterized by progressive hair loss, especially of scalp hair. Numerous treatments claim to treat frontal baldness, although there is no cure for this hereditary form of hair loss. However, for those who want to treat AGA, options include topical and oral medications, surgical hair restoration and light therapy.
A review of AGA therapeutic options, published in the July 2014 issue of "American Journal of Clinical Dermatology," concluded the most effective, evidence-based treatments are topical minoxidil -- for men and women, and oral finaseteride -- for men only. In some cases, other medications that regulate hormone levels, such as oral contraceptives or spironolactone, may be prescribed to counter female pattern baldness, although these are not FDA approved treatments for AGA. Other drugs, herbal therapies and nutrition supplements are proposed to help, although many of these require more studies to determine effectiveness and safety.
Minoxidil is a topical medication approved by the Food and Drug Administration (FDA) to treat AGA in both men and women. It works by prolonging the active growth phase of the hair follicle, slowing the rate of existing hair loss and allowing hair to appear thicker and become longer. Approximately 30 to 40 percent of users experience significant hair growth, although this may take several months to achieve. Minoxidil will not work if the hair loss is due to medications such as chemotherapy, or a consequence of thyroid conditions, nutritional disorders or scarring. An over-the-counter minoxidil solution is available, although your dermatologist may recommend a prescription-strength solution or minoxidil pills if indicated.
Finaseteride is an FDA-approved prescription medication which is indicated for treating AGA in men. This medication works by inhibiting the enzyme which converts testosterone to DHT, or dihydrotestosterone. DHT is a necessary sex hormone for men, but elevated levels can interfere with the growth cycle of scalp hair. As with minoxidil, it may take several months of finasteride therapy to determine its effectiveness, and treatment needs to continue as long as the positive results are desired.
When medication treatment of AGA fails, or when a more permanent solution is desired, hair transplantation is a treatment option. This procedure harvests hair follicles that are DHT resistant, usually from the back of the head, and transplants these follicles to the areas that are thinning or bald. This hair often sheds after surgery, but the transplanted hair regrows to full capacity within 1 to 3 months. Surgical results vary based on surgeon expertise, method and individual differences.
Low-level light therapy is a relatively new treatment that uses devices -- such as helmets, combs or hand-held devices -- to emit light which penetrates the scalp and stimulates hair growth. The precise mechanism of action is not clearly understood. While research has determined this therapy can be safe and effective, more data is needed to understand optimal treatment parameters, including duration and frequency of treatment, and to understand long-term safety.
Available AGA treatment options usually work best if started early, when hair is just beginning to thin, as therapy may be less effective in areas already devoid of hair. Anyone interested in treating frontal baldness would benefit from speaking to a doctor or dermatologist about hair loss treatments, in order to understand the risks, benefits and costs before choosing a treatment plan.
Reviewed by Kay Peck, MPH RD