Alopecia medical therapy
Alopecia medical therapy On the Web
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Currently in the USA, there are two drug-based treatments that are FDA-approved and one product that has been cleared by the FDA for the treatment of androgenetic alopecia. These are finasteride (marketed for hair loss as Propecia) and minoxidil.
- Androgenetic alopecia
- Tinea capitus/kerion
- Oral antifungals
- Alopecia areata
- Topical minoxidil (Rogaine, generic):
- Currently the treatment approved for both women and men
- Increases duration of anagen and enlarges miniaturized follicles
- Mechanism unclear
- Hair counts ~5x higher when compared to a 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 of treatment (men). Hence, treatment must continue indefinitely or regrown hair will be lost
- Women: increased hair growth in 60% vs 40% with use of 2% solution vs. placebo
- Decreased loss is usually seen within 2 months, growth w/in 4-8 months; stable at 1-1.5 yrs
- Cosmetically notable growth occurs in only 30-40%
- Best results if baldness present at vertex less than 5 years and less than 10 cm in diameter
- Rarely, contact or irritant dermatitis may be seen as a side effect
Finasteride showed improvement in males with hair loss at a dose of 1mg. Over 83% of the 1,553 men experiencing male hair loss had actually maintained or increased their hair count from baseline. Also, based on visual assessments, it was concluded that more than 80% had improved appearances.
Minoxidil was first used in tablet form as a medicine to treat high blood pressure, but after some patients experienced the side effect of excessive hair growth, further research was carried out into its use for the treatment of hair loss. FDA clinical trials showed that 65% of men with androgenetic alopecia maintained or increased their hair count by using 5% topical liquid minoxidil. 54% of these men experienced moderate to dense regrowth and 46% experienced hair loss stabilization and mild regrowth. When studied in women between the ages of 18-45 using controlled clinical studies, about 66% of the women with moderate degrees of hereditary hair loss reported hair re-growth after using 2% topical liquid minoxidil. Initial results occur at 4 months with maximum results occurring at 8 months.
placebo treatments have shown in studies to frequently have reasonable success rates and even similar side effects as other tested products, although both efficacy and side effects are lesser when compared to the products being tested. 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.
Regular aerobic exercise may keep androgen levels, especially free testosterone levels naturally lower while maintaining overall health, lowering stress and increasing SHBG.  Weight training without incorporation of aerobic exercise into the trainin regimen may lead to an increase in testosterone levels.    One study suggests that both a combination of heavy exercise and increased fat intake are required to produce an increase in free testosterone in strength trainers. While increased total or free testosterone would aid in the building and repair of muscle, it may also lead to hair loss in susceptible individuals.  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 has fewer side effects than finasteride and dutasteride. Unlike other 5-alpha-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.
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 hair loss 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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