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QUESTION OF THE WEEK


Do I have to use my hair loss treatment "forever"?

Forever

The word ‘forever’ has a fairly clear meaning and isn’t really open to much in the way of interpretation.  Forever means continually. Forever means for always. Forever means forever.

For those with genetic hair loss, treatments must be used forever. If treatments are stopped, any benefits that a patient achieved will be lost. Surprisingly, when you pick up a bottle of a typical medication or treatment for genetic hair loss, the word forever is nowhere to be found.


Use daily.

Take 1 pill per day.

Do not use if pregnant or breastfeeding

Use three times per week

Check with your doctor before using.


Nowhere will you see forever.


I’m all for clarity and directness. I’m all for labels saying it as it is. Use daily – forever. Use three times per week - forever. Check with your doctor before deciding to use - forever. It might not sound so swell in terms of marketing glamour but it sure would ease a lot of confusion. For example, every week, I meet with a patient with genetic hair loss who has now has developed hair loss after stopping a medication that was originally prescribed to them for their hair loss.

You mean I was supposed to use this forever?”

 

Some hair loss treatments are forever

If the hair loss is due to "genetic" hair loss (sometimes called androgenetic hair loss), then the treatment needs to be used forever (provided it shows evidence of helping). One of the most common criticisms I hear regarding the use of the FDA approved treatment minoxidil is that patients dislike the fact that it needs to be used ‘forever.’ If the treatment is stopped, hair loss resumes. It is true that this medication needs to be used forever. However, the same rules apply for all the treatments for genetic hair loss. Anything that works, needs to be used continuously. Hormone blocking pills, lasers, PRP - they need to be used forever.


Some hair loss treatments are not forever

For other hair loss conditions, the rules are different. For alopecia areata, treatment is administered until hair grows back and then it is stopped. For scarring hair loss conditions, treatment is given until the disease becomes quiet, then treatments are slowly reduced. In some patients, medicines can be stopped without the disease "reactivating." For telogen effluvium (hair shedding problems), treatment is given until the shedding pattern returns to normal.


Conclusion

In the field of hair loss, it is important to understand the meaning of "forever". For some types of hair loss, medications must be used forever to maintain their beneficial effects. 



This article was written by Dr. Jeff Donovan, a Canadian and US board certified dermatologist specializing exclusively in hair loss.



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