Alopecia medical therapy
Alopecia medical therapy On the Web
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In the USA, there are only 2 drug-based treatments that have been approved by the FDA (Food and Drug Administration) and one product that has been cleared by the FDA for the treatment of androgenetic alopecia, otherwise known as male or female pattern hair loss. The two FDA approved treatments are finasteride (marketed for hair loss as Propecia) and minoxidil.
- Androgenetic alopecia
- Tinea capitus/kerion
- Oral antifungals
- Alopecia areata
- Topical minoxidil (Rogaine, generic):
- Hair counts ~5x higher than placebo with use of 5% solution (men)
- Hair counts 45% higher with use of 5% solution compared with use of 2% solution (men)
- Hair counts returned to those of placebo group within 24 weeks after discontinuation Rx (men)
- Women: increased hair growth in 60% vs. 40% with use of 2% soln vs. placebo
- Advice for patients:
- 1 mL bid applied to dry scalp with spray or dropper; spread lightly w/finger
- Expect decreased loss w/in 2 mos, growth w/in 4-8 mos; stable at 1-1.5 yrs
- Best results if baldness present at vertex less than 5 years and less than 10 cm in diameter
- Cosmetically notable growth occurs in only 30-40%
- Rx must continue indefinitely or regrown hair will be lost
- Side effects = rare contact or irritant dermatitis; no change blood pressure, heart rate or weight
A pharmaceutical company reportedly sought to find the smallest effective quantity of finasteride and test its long-term effects on 1,553 men between ages 18 and 41 with mild to moderate thinning hair. Based on their research, 1 mg daily was selected, and after 2 years of daily treatment, over 83% of the 1,553 men experiencing male hair loss had actually maintained or increased their hair count from baseline. Visual assessments concluded that over 80% had improved appearances.
Minoxidil was first used in tablet form as a medicine to treat high blood pressure, but it was noticed that some patients being treated with Minoxidil experienced excessive hair growth (hypertrichosis) as a side-effect. Further research showed that by applying topical Minoxidil solution directly to the scalp, it could prove to be beneficial to those experiencing hair loss.
FDA clinical trials showed that 65% of men with androgenetic alopecia maintained or increased their hair count from the use of minoxidil 5% in liquid form. 54% of these men experienced moderate to dense regrowth and 46% experienced hair loss stabilisation and mild regrowth.
In controlled clinical studies of women aged 18-45, 2 out of 3 women with moderate degrees of hereditary hair loss reported re-growth after using 2% minoxidil. Initial results occur at 4 months with maximum results occurring at 8 months.
Interestingly, placebo treatments in studies often have reasonable success rates, though not as high as the products being tested, and even similar side-effects as the products. For example, in Finasteride (Propecia) studies, the percent of patients with any drug-related sexual adverse experience was 3.8% compared with 2.0% in the placebo group.
Weight training without aerobic exercise may increase testosterone.    One study suggests that both heavy exercise and increased fat intake, in combination, are required for increased free testosterone in strength trainers. Increased total or free testosterone would help them build and repair muscle, but may cause susceptible individuals to lose hair. 
However, there is at least one study that indicates a decline in free testosterone combined with an increase in strength due to an (unspecified) strength training regime.
Saw Palmetto (Serenoa repens) is an herbal DHT inhibitor often claimed to be cheaper and have fewer side effects than finasteride and dutasteride. Unlike other 5alpha-reductase inhibitors, Serenoa repens induces its effects without interfering with the cellular capacity to secrete PSA. Saw palmetto extract has been demonstrated to inhibit both isoforms of 5-alpha-reductase unlike finasteride which only inhibits the (predominant) type 2 isoenzyme of 5-alpha-reductase.
Beta sitosterol, which is a constituent in many seed oils, can help to treat BHP by lowering cholesterol. If used for this purpose, an extract is best. Consuming large amounts of oil to get at small quantities of beta sitosterol is likely to exacerbate male pattern baldness.
While drastic, broad spectrum anti-androgens such as flutamide are sometimes used topically. Flutamide is potent enough to have a feminizing effect in men, including growth of the breasts.
Through 2006, a drug development company spent $1,000,000 on a hair growth program focused on the potential development of a topical hedgehog agonist for hair growth disorders, such as male pattern baldness and female hair loss. The hairloss research program was shut down in May 2007 because the process did not meet the proper safety standards.
WNT Gene Related
In May 2007, US company Follica Inc, announced they have licensed technology from the University of Pennsylvania which can regenerate hair follicles by reawakening genes which were once active only in the embryo stage of human development.
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