List the treatments that you currently recommend for hair concerns. Please include over-the-counter (OTC), prescription,
and other treatments.
Dr. Bucay: I recommend Viviscal, topical minoxidil, bimatoprost
off-label mixed in with minoxidil solution, Ducray Neoptide® Spray (Ducray Laboratoires Dermatologiques, Boulogne, France) if appropriate, oral spironolactone, which acts as a 5-α reductase inhibitor, oral finasteride, and oral dutasteride.
Dr. Roberts: I recommend finasteride, minoxidil, spironolactone,
tretinoin, vitamins, supplements, laser, platelet-rich plasma, and hair transplantation.
Dr. Waldorf: I recommend OTC conditioners/prewashes to protect/
improve the condition of the hair, Latisse® (Allergan, Inc., Irvine, CA), RevitaLash® (Athena Cosmetics, Inc., Ventura, CA) for hair and brows, minoxidil, and, for men only, Propecia® (Merck & Co., Inc., Kenilworth, NJ).
Do you believe there is a need for an effective oral hair supplement?
Dr. Bucay: Absolutely!
Dr. Roberts: Absolutely, yes.
Dr. Waldorf: For an effective hair and nail supplement. Many patients are on “hair/nail” supplements.
Several reports describe the use of combination therapy for the treatment of hair loss, such as topical minoxidil with finasteride for male pattern hair loss,23 or topical minoxidil with spironolactone
for female pattern hair loss.24 Others describe the use of topical minoxidil with herbal products such as red ginseng25 or nutritional supplements containing antioxidants, vitamins, iron, folic acid, biotin, calcium, minerals, and amino acids.26
How about combining supplement use with topical minoxidil?
Dr. Waldorf: Minoxidil doesn’t compete with supplementation. They would use them at the same time.
Dr. Roberts: Yes, they do 2 different things. That’s synergy…it’s a different approach.
Dr. Waldorf: Who do you have use it?
Dr. Bucay: For every patient who comes in complaining of hair loss or thinning hair, they realize they don't have as much hair as they used to. I don't see anything clinically wrong, but I think as we get older a lot of people do notice their hair.
Review of Viviscal Clinical Results
After reviewing the data, how do you see Viviscal fitting into a treatment regimen for your patients?
Dr. Bucay: I think that Viviscal is an excellent option either as a stand alone supplement or as part of a comprehensive hair restoration
plan. This may include prescription medications or even the recommendation for hair transplantation, which I do not do.
Dr. Roberts: Viviscal should be used by hair loss patients who do not have shellfish allergies or contraindications.
Dr. Waldorf: The data were persuasive. I am currently doing
an anecdotal “trial” on myself and a patient to see if we notice the difference.
Dr. Dayan: All of the patients from my study are on Viviscal. Every single one of them continued on, and they’re thrilled.
The opinions expressed in this supplement are solely those of the authors. Carl S. Hornfeldt PhD RPh has received honoraria
fees as a consultant for Lifes2good. Mark Holland is an employee of Lifes2good. Steven H. Dayan MD was an advisor to Viviscal and an investigator in the clinical studies. Heidi A. Waldorf MD, Vivian W. Bucay MD, Wendy E. Roberts MD, and Steven H. Dayan MD all received an honorarium for their participation
in the roundtable discussion.
- Rogers NE, Avram MR. Medical treatments for male and female pattern hair loss. J Am Acad Dermatol. 2008;59(4):547-566.
- Gan DC, Sinclair RD. Prevalence of male and female pattern hair loss in Maryborough. J Investig Dermatol Symp Proc. 2005;10(3):184-189.
- Stough D, Stenn K, Haber R, et al. Psychological effect, pathophysiology,
and management of androgenetic alopecia in men. Mayo Clin Proc. 2005;80(10):1316-1322.
- Jain VK, Kataria U, Dayal S. Study of diffuse alopecia in females. Indian J Dermatol Venereol Leprol. 2000;66(2):65-68.
- Thiedke CC. Alopecia in women. Am Fam Physician. 2003;67(5):1007-1014.
- Harrison S, Bergfeld W. Diffuse hair loss: its triggers and management. Cleve Clin J Med. 2009;76(6):361-367.
- Tosti A, Piraccini BM, Sisti A, Duque-Estrada B. Hair loss in women. Minerva Ginecol. 2009;61(5):445-452.
- Trueb RM. Diffuse hair loss. In: Blume-Peytavi U TA, Whiting DA, Treub R, eds. Hair Growth and Disorders. Springer; 2008.
- Le Floc’h C, Cheniti A, Connétable S, Piccardi N, Vincenzi C, Tosti A. Effect of a nutritional supplement on hair loss in women. J Cosmet Dermatol. 2015;14(1):76-82.
- Lengg N, Heidecker B, Seifert B, Trüeb RM. Dietary supplement increases anagen hair rate in women with telogen effluvium: results of a double-blind, placebo-controlled trial. Therapy. 2007;4(1):59-65.
- Glynis A. A double-blind, placebo-controlled study evaluating the efficacy of an oral supplement in women with self-perceived thinning hair. J Clin Aesthet
- Di Cerbo A, Laurino C, Palmieri B, Iannitti T. A dietary supplement improves facial photoaging and skin sebum, hydration and tonicity modulating serum fibronectin, neutrophil elastase 2, hyaluronic acid and carbonylated proteins. J Photochem Photobiol B. 2015;144:94-103.
- van der Donk J, Passchier J, Knegt-Junk C, et al. Psychological characteristics
of women with androgenetic alopecia: a controlled study. Br J Dermatol. 1991;125(3):248-252.