Most
people when deciding to treat themselves with a topical drug for conditions of
skin and hair (or on the recommendation of their physician), do not realize
that use of many of these drugs also can
cause internal side effects from their use.
Many drugs used topically are also absorbed into the blood stream from
the skin. As an example, corticosteroids
taken internally for a vast number of medical conditions, can cause adrenal
suppression. These drugs are also formulated
in topical form and are widely used for treating all sorts of skin conditions
such as eczema, seborrheic dermatitis, inflammation, etc. However, in some
cases these drugs are absorbed from the skin and can also result in adrenal
suppression. Some other drugs known as retinoids have been associated with
causing birth defects in animals and therefore when used systemically are not
indicated for use in women of childbearing potential. A few drugs in this class are also available
in topical formulations, but because of the risk of systemic absorption they
are not recommended for use in women of childbearing potential. Finally, many topical antibiotics such as clindamycin
are used to treat acne, but have also been known to be absorbed from the skin and
cause major gastrointestinal problems, just as they do when ingested.
When
doctors prescribe topical drugs to treat medical conditions, they assess the
benefit of the use of the drug vs. the potential to cause systemic side
effects. Depending on the seriousness of
the medical condition being treated, the risk of certain side effects occurring
is worth the benefit derived from use of the drugs in treatment. If they feel that the benefit outweighs the
risk of side effects, they prescribe or recommend the drug.
An
excellent example of applying this benefit to risk assessment is with the drug minoxidil. This drug was originally developed to treat
severe heart conditions, and there were numerous serious side effects
associated with it. However, doctors
determined that the benefit in using this drug far outweighs any risk of side
effects if the patient is carefully monitored.
Minoxidil was also formulated as Rogaine® for topical use to grow hair
in men and women with hereditary hair loss.
From 1/1/2004 to
03/31/2012, there have been 876 reports
of a serious adverse event where Rogaine was identified as the primary suspect
drug¹. While use of the drug
topically has produced a low number of serious systemic side effects, many of
those that have occurred are related to cardiac side effects such as dizziness,
and increased heart rate.
What
all of this means, is that when you treat yourself with topical drugs you can’t
just assume that they are benign, so you must weigh the benefit of using the
drug compared to its potential for occurrence of systemic side effects. This is
particularly true when you are treating yourself for aesthetic conditions such
as aging skin and hair loss.
In
recent years, the advent of lasers has revolutionized the treatment of many
aesthetic conditions, eliminating the concern of side effects occurring from
use of using topical drugs. One
outstanding example of a non-drug alternative is the HairMax LaserComb® which
is also indicated to treat hereditary hair loss.
Prior
to the introduction of the HairMax there was only one drug that was approved by
the FDA to treat hair loss in both men and women - Rogaine. The non-drug HairMax on the other hand, uses
laser phototherapy to effectively treat hair loss and promote hair loss in men
and women and has FDA Clearance. Best of
all, there have never been any reports of serious side effects occurring from
use of the HairMax LaserComb. This is in
contrast to Rogaine, where there
have been a number of reports of serious systemic side effects occurring. This perfectly illustrates that need to
assess the benefit of using a drug to treat aesthetic conditions vs. the
potential risk that can occur from use and to seek alternatives that have a
greater benefit to risk ratio.
The use of topical drugs can be a ‘double-edged
sword’ which while giving good treatment results, can also cause unforeseen
internal side effects from their use.
When treating aesthetic conditions in particular such as hair loss,
assessing the benefit to the risk entailed in use is an important
consideration. Seeking non-drug
alternatives such as the HairMax LaserComb is an ideal way of gaining effective
treatment, but with little if any risk from use.
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