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Steroids & Hair Loss – Available Treatment Options


by Mike Arnold

When it comes to the subject of hair loss, you will find strong opinions on both sides of the fence. For some, it is simply a natural part of life; not something to be feared or despised. Being met with acceptance, these individuals fret little over the state of their hairline, opting to take a razor to their heads rather than invest in potentially costly treatments designed to spare this cranial covering. For others, hair loss can have a profound impact on the emotional well being of the individual, causing anxiety and negatively affecting one’s self-perception and quality of life.

While hair loss is genetically dependent, the use of AAS can dramatically accelerate the rate at which hair loss takes place, causing the user to begin the balding process 5, 10, or even 20 years sooner than would have occurred under natural circumstances.

A misconception exists that only certain steroids can exacerbate hair loss; particularly those with either a strong androgenic component or which convert to DHT. This is untrue. There is no doubt that certain steroids are more problematic than others, but the reality is that any steroid can hasten the rate at which hair is shed, even those with the best track records of success, such as Anavar or Turinabol. While personal response will play the largest role in determining how one responds to the various AAS, it should be understood up-front that all AAS share this potential trait.

Still, we are not completely at the mercy of these drugs. We have at our disposal a variety of treatments/procedures capable of stopping or even reversing this undesirable side effect. How one reacts to these can vary considerably, as results are dependent on drug/supplement type, personal response to the treatment employed, and whether or not the root cause is being properly addressed. However, prior to engaging in any hair loss program, one should first determine the exact cause(s), as this can eliminate wasted time and money. To this end, setting up an appointment with an endocrinologist who specializes in this area is a must, as bloodwork is necessary in order to verify the origin of hair loss, thereby pointing one in the correct direction.

Fortunately, there are several different types of products available which can potentially aide one in their hair loss prevention-restoration efforts. Although treating the primary cause is vital in mitigating further hair loss, attacking the problem from as many angles as possible typically produces the best results. There are 5 general categories of supplementation which have been shown to provide benefit for those suffering from this condition, with each category being separated according to its mechanism of action.

These include:
Vitamin and mineral based products: As one of the essential B vitamins, biotin plays an important role in the formation and maintenance of our hair, skin, and nails. In terms of effectiveness biotin is either hit or miss, with one’s current levels determining the degree of benefit obtained. In those who already consume adequate biotin, supplementing with additional amounts of this B vitamin is unlikely to provide substantial benefit, but for those with a nutritional deficiency, supplementation can supply startling results, occasionally causing a complete re-growth of lost hair within a short period of time.

Biotin deficiency is rarely the sole cause of hair loss in the United States. However, sub-optimal intake is common, with many taking in less than the RDA recommended minimum. More so, studies have shown that high levels of Biotin can increase the rate of hair growth beyond what RDA levels can achieve alone. For this reason, supplementing with biotin is a good idea for all those who suffer from hair loss.

Similar to Biotin, Zinc also plays an important role in the hair growth process. By restoring optimal levels of this essential mineral through supplementation, one can ensure that their hair loss efforts aren’t hampered by a simple nutritional deficiency.

Nitric oxide-based products:
As the 1st ever FDA approved drug for hair loss, Minoxidil (Rogaine) has been clinically proven to re-grow hair on the crown, back, and sides of the head. However, it is generally considered ineffective for treating frontal balding, which is generally associated with male pattern hair loss, otherwise known as androgenic alopecia. However, when used in combination with other treatment options, particularly anti-androgens, Minoxidil can be quite effective at initiating new hair growth over a significant portion of the scalp, filling in bald spots or patchy areas.

Rogaine works by increasing blood flow to the scalp, similar to the way ED drugs (such a Viagra) increase blood flow to the genitals. In fact, Minoxidil was originally created as a hopeful cure for ED, but scientists soon learned that it was more efficacious as a hair re-growth agent rather than an erectile dysfunction drug. With a high success rate in comparison to many other types of treatment, Minoxidil has become the leading product for those experiencing non-frontal balding and is considered basic stock for anyone fitting this criteria. Nitric Oxide stimulators are always applied topically when used for hair re-growth.

Anti-androgen products: This category of supplementation includes a wide variety of products using several different delivery methods. Although Minoxidil is generally regarded as being more effective for hair re-growth, anti-androgens are considered the most effective option for stopping hair loss in those suffering from male pattern baldness.

The most commonly used products in this category are Finasteride and Dutasteride, both of which belong to the category of drugs known as 5-AR inhibitors. By directly decreasing the conversion of testosterone to DHT, these products reduce the amount of DHT available to androgen receptors in the scalp, thereby slowing or even halting DHT-induced hair loss. For those steroid users who rely on testosterone to increase muscle mass, 5-AR inhibitors are the most effective form of hair loss prevention available.

However, one should be aware that these drugs have side effects when consumed orally. Orally ingested 5-AR’s are systematic in nature, affecting DHT production throughout the entire body. This can have multiple unwanted side effects, such as a decrease in libido, reduced strength, and a weakened alpha-male mind-set. For this reason topical preparations are gaining in popularity, as their subdermal delivery systems allow the drug to bypass the circulatory system and directly enter the hair follicle where they are wanted.

As effective as these drugs can be for preventing DHT-induced hair loss, they offer no protection from the hair-shedding effects of other AAS. In order to prevent/reduce hair loss from other steroids, one must turn to anti-androgenic preparations which prevent AAS from binding to the AR, such as spirinolactone. Most BB’rs will recognize spirinolactone as a potassium-sparring diuretic most commonly used to dry-out before going onstage, but of particular relevance to this discussion is its ability to bind to the AR, effectively preventing other androgens from attaching to the androgen receptor and exerting their deleterious effects on the hairline. It should also be mentioned that Spirinolactone possesses mild 5-AR inhibiting effects of its own, although certainly not as potent as Finasteride or Dutasteride. Available in both oral and topical form, most choose to use the topical version due to its diminished propensity to cause systematic side effects.

Other drugs/supplements which fall into this same category of anti-androgens include metformin, various types of DHT inhibiting shampoos (ex. Nizoral), and herbs such as saw palmetto and Stinging Nettle Leaf. While the active ingredients and delivery methods of these products may vary, their mechanisms of action are identical, in that they either reduce DHT conversion or prevent DHT/steroids from attaching to the receptor site.

Products which speed the rate of hair growth: These products do not reverse or even stop hair loss. Rather, they supply ingredients which help your currently existing hair grow more quickly. Usually amino acid and vitamin-based, these products are most often formulated as shampoos. Higher quality versions utilize delivery systems similar to the topical anti-androgens, allowing them to penetrate the scalp and reach target tissues in concentrated form. While tablet/capsule varieties exist, orally consuming these products often prevents the active ingredients from reaching the hair follicle at sufficient dosages.

Hair fortifying/volumizing products: This category has no effect on hair loss prevention, re-growth, or the rate of hair growth. The sole purpose of these products is to strengthen the individual hair strands, while making them look thicker and healthier. This adds to the overall body, or volume of one’s hair. Basically, it “dresses up” what you already have, making it look better. There are numerous different products that fit this description, which again, are mostly in the form of shampoos.

With plenty of options available for treating hair loss, there is no need to sit back and let nature take its course. With a little bit of forethought and planning, anyone should be able to slow, stop, or even reverse this process. In almost all cases a holistic approach is best, as many of these products work synergistically to produce results superior to single product programs.

Although no one program can claim to be the most effective, certain protocols appear to provide above average results in the general population. These programs typically include an anti-androgen, a nitric oxide stimulator, anti-androgenic shampoos, and vitamin & mineral supplementation. A lay-out like this might include topical spirinolactone, 5% Minoxidil solution, Nizoral shampoo, biotin, and iron.

Keep in mind that these products take several weeks—and usually several months—just to begin working, so a long-term commitment (at least 6-12 months) is required in order to reap the desired benefits. Lastly, this is not a one and done cure. These products must be used indefinitely in order to continue experiencing these benefits. Otherwise, the hair loss process will resume all over again. While a permanent solution would be ideal, at least we have clinically and anecdotally proven products at our disposal, which will continue providing results so long as one is willing to use them over the long-haul.

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