The Science Behind Hair Loss
Hair loss is rarely a single problem with a single solution. It’s often caused by a mix of factors, and understanding these mechanisms helps explain why personalised treatments are so valuable.
For many people, the issue begins with the hormone dihydrotestosterone (DHT). In conditions like androgenetic alopecia (commonly known as male or female pattern baldness), DHT causes hair follicles to shrink over time. This “miniaturisation” leads to thinner, weaker hair, and eventually, the follicles stop producing hair altogether.
But hormones aren’t the only culprit. Reduced blood flow to the scalp can deprive follicles of essential nutrients, while inflammation or conditions like eczema can create an unhealthy environment for growth. With so many contributing causes, it’s clear that effective hair loss compounding treatment needs to take a comprehensive approach, particularly one that considers a person’s unique circumstances and addresses multiple factors at once.
Before we go further, it’s worth discussing the two ingredients that are widely recognised as the cornerstones of hair loss treatment:
- Minoxidil: By increasing blood flow to the scalp, minoxidil stimulates hair follicles and extends the anagen phase, the active growth stage of hair. This improves the supply of nutrients and oxygen to the roots, encouraging thicker, stronger strands.
- Finasteride: Unlike minoxidil, which works locally, finasteride tackles hair loss at its hormonal root. It blocks the enzyme responsible for converting testosterone into DHT, slowing down follicle shrinkage and helping to preserve existing hair.
Much of the science behind hair loss treatment revolves around these two ingredients, which is why they’re central to so many over-the-counter and prescription options. However, they truly shine in the context of compounded formulations. Compounding allows pharmacists to combine these proven ingredients, adjust their strengths, and incorporate other supportive components to better match an individual’s specific needs.
How Compounding Enhances Hair Loss Treatment
One of the greatest strengths of compounding is its ability to combine multiple active ingredients into a single, tailored formula. This approach is commonly used for conditions that don’t respond amazingly to one-dimensional treatments, and hair loss is definitely an example of that. Compounding allows us to address multiple contributing factors simultaneously, offering a more comprehensive and targeted solution.
On their own, minoxidil and finasteride are proven to be effective, but when combined, they create a powerful synergy. Minoxidil works to stimulate growth, while finasteride ensures that the hormonal causes of hair loss are kept in check. This approach not only encourages thicker hair growth, but also creates healthier, more resilient hair over time.
At Zenith Pharmacy, the formula doesn’t stop there. We carefully consider additional ingredients that may further enhance the effectiveness of the treatment, taking into account each patient’s personal and medical needs, as well as the specific causes and challenges of their hair loss. Some examples include:
- Retinoic Acid: Known for its exfoliating properties, retinoic acid improves the scalp’s ability to absorb minoxidil, helping it penetrate deeply into hair follicles where it’s needed most.
- Caffeine: Emerging research suggests that caffeine promotes thicker, stronger hair while also reducing scalp dryness—an issue some people experience with topical treatments.
- Fluocinolone: This anti-inflammatory steroid helps reduce irritation and inflammation, creating a healthier environment for regrowth. It’s particularly beneficial for patients with scalp conditions like eczema.
Because every individual’s experience of hair loss is different, no two formulations are exactly alike. And this is the beauty of compounding. A tailored approach means that each compounded solution is designed to be as effective and well-suited to the patient as possible.
Why Tailoring Dosage, Strength, and Forms Matter
Sometimes how a medication is delivered, and in what strength, can be just as important as the medication itself. This is one area where standard over-the-counter and prescription treatments can fall short. Frankly, commercial options are limited, leaving some people searching for more flexible, tailored approaches. Compounding offers a solution by better matching treatments to an individual’s needs, improving both effectiveness and comfort.
Minoxidil is probably best known as a topical liquid, particularly because it is available over-the-counter when below prescription strength. Compounding not only allows for fine-tuning the strength of minoxidil (including prescription-strength versions) but also opens the door to more suitable forms. For instance, foam-based minoxidil is a popular alternative for those who experience irritation from the propylene glycol found in liquid solutions. A small adjustment like this can make treatments far more tolerable for sensitive scalps.
Then there’s oral minoxidil, a systemic option that bypasses the scalp entirely. While less common, oral minoxidil can be particularly valuable for patients who:
- Don’t respond to topical treatments (due to a lack of the sulfotransferase enzyme needed to activate minoxidil at the follicles).
- Struggle with side effects like dryness, tangling, or poor hair texture caused by topicals.
Many of our patients appreciate the convenience and consistency of oral minoxidil. And with some evidence suggesting that the oral form can help reduce shedding, it is becoming increasingly recognised as a viable and effective form of hair loss treatment.
The same principle applies to other hair loss treatments, like finasteride. While oral finasteride is effective at reducing DHT levels, it’s not without its drawbacks. For patients concerned about systemic side effects, a topical formulation can offer a more targeted approach. By applying finasteride directly to the scalp, its effects are concentrated where they’re needed most while minimising broader hormonal impact.
While some variations of strength and form are available commercially, compounding is the only way to ensure that treatments are precisely tailored. Everything from dosage adjustments to combined ingredients and custom delivery methods can be personalised to reduce side effects, increase tolerability, and ultimately remove barriers to treatment. The result is a hair loss treatment plan that is easier to stick to, which is essential for achieving better, long-term outcomes.
Addressing Sensitivities and Unique Patient Needs
Standard treatments can work well for many people. But for others, they introduce new issues, such as irritation, sensitivities, or conflicts with existing conditions. As compounding pharmacists, this is where we step in to shape the treatment around the individual, rather than force a standard treatment to fit.
Earlier, we touched on the challenges some patients face with topical minoxidil, particularly liquid versions containing propylene glycol. This additive is actually supposed to improve delivery, and for many people, it does. But for those with scalp sensitivities, having constant dryness, flaking, and itching can be enough to make someone stop using it altogether. A compounded, propylene glycol-free formulation resolves this problem, showing how a simple fix is sometimes a game-changer.
When you have underlying scalp conditions like eczema, seborrheic dermatitis, or inflammation, these issues go even deeper. A scalp that’s irritated or inflamed isn’t just uncomfortable; it’s not conducive to hair growth. These are situations where we can add supportive ingredients like fluocinolone, a mild anti-inflammatory steroid that reduces irritation and creates a healthier foundation for hair growth.
Sometimes, it’s not about irritation or scalp health but about how a person’s body processes a treatment. Earlier, we touched on how some people don’t respond to topical minoxidil because they lack the enzyme needed to activate it. In cases like this, a compounded oral formulation bypasses the problem entirely, offering an alternative that works systemically. On the other hand, when systemic side effects from oral finasteride is a risk, a topical version can provide targeted treatment while mitigating other concerns.
These are just a few examples, but they highlight the importance of personalisation if you want the best results. When dealing with standard medications, your sensitivities, scalp health, and personal medical needs become obstacles. But with compounding, these needs become opportunities to tailor smarter, more effective solutions.
Written By
Zen Xiao