Q: I am a 41 year old female suffering from androgenetic alopecia [female pattern baldness]. I want to know what line of treatment I should follow. I have heard about a liquid topical solution named CRINAGEN which is available abroad. Do you know where I can get it in Mumbai?

A:We presume the diagnosis of androgenetic alopecia in your case has been made by an appropriate specialist. The reason, I am making this observation is due to the fact that androgenetic alopecia, apart from hair loss, has at least in some cases other signs of virilization such as deepened voice and enlarged clitoris.

In andregenetic alopecia in women there is an increase in the blood levels of androgens (male sex hormones). If there is evidence of hyper-androgen state (i.e. overactivity of male sex hormones) then one needs to use an oral anti-androgen agent: cyprotereone or spironolactone. If there is no evidence of hyperandrogen state, then one uses topical minoxidil with or without tretinoin or topical finasteride; failing which hair transplant is the only option. However your doctor is the best person to give you proper advice.
The topical application of progesterone (female sex hormone), spironolactone and cyproterone has not given good results. Crinagen is not the name of the medicine but a trade name. It is a non-prescription (no need for doctors prescription), over-the-counter therapy. It means that it has not been tested or certified by drug regulatory authorities. The manufacturers claim that this natural product contains water, polysorbate 20, azelaic acid, zinc acetate hydrate, niacin (vitamin B-3), vitamin B-6, saw palmetto extract and ginko biloba. It is claimed that this product decreases the production of a male hormone associated with hair loss. It is important to remember that the manufacturers themselves advise that Crinagen should be used concurrently with an immunosuppressant agent, available on doctors prescription only. No scientific trials have been conducted to test these claims. The product is not available in India but can be bought in the United States.