scholarly journals Expert opinion on current and emerging treatment options in androgenetic alopecia and telogen effluvium: an Indian perspective

Author(s):  
Bharat Lalwala ◽  
Siddhartha Das ◽  
Srinivasa Murthy ◽  
Abir Saraswat ◽  
U. R. Dhanalakshmi ◽  
...  

<p class="abstract">The diagnosis and management of hair loss needs an organized and systematic approach for recognizing pattern of hair loss and identification of hair loss etiology. Early and specific diagnosis is essential to initiate appropriate treatment in the early phases of hair loss. Topical minoxidil and oral finasteride are the only approved drugs for androgenetic alopecia (AGA). Various other treatment options are widely used but have limited clinical evidence. Similarly, there are no specific treatments recommended for telogen effluvium (TE). However, the treatment may become challenging with increasing availability of new formulations and drugs with no substantial evidence to support them. Multiple focused group discussions were conducted among Indian dermatologists to gain expert opinion on appropriate management of AGA and TE in the current scenario. This article summarizes the consensus clinical viewpoints for topical and oral medications, role of nutritional supplements, and other adjunctive therapies in managing AGA and TE. The panel highlighted that the choice of treatment for AGA and TE depends on the individual hair loss pattern and response to medications. A brief discussion on the use of shampoos and procedures has also been highlighted.  </p>

2020 ◽  
Vol 63 (5) ◽  
pp. 277-285
Author(s):  
Doyoung Kim ◽  
Sujin Park

Androgenetic alopecia (AGA) is the most common type of hair loss and affects both men and women. Male pattern hair loss shows characteristic frontal recession and vertex baldness, whereas female pattern hair loss produces diffuse alopecia over the mid-frontal scalp. AGA is mediated by increased androgen susceptibility in affected scalp hairs. 5α-Reductase converts testosterone into dihydrotestosterone, a potent androgen, in the scalp. Both androgen receptors and 5α-reductase have higher expression levels in the balding scalp than in non-affected regions. Increased androgen susceptibility induces hair follicle miniaturization, which leads to the progressive loss of thicker terminal hairs in the balding scalp. Currently, topical minoxidil and oral 5α-reductase inhibitors, such as finasteride and dutasteride, are approved options for the pharmacological treatment of AGA. Topical minoxidil remains the mainstay of therapy for mild to moderate AGA in both men and women. The daily intake of 1-mg finasteride or 0.5-mg dutasteride shows better efficacy than topical minoxidil in regard to hair regrowth in male AGA. Anti-androgens can be used in female AGA wit clinical and biochemical evidence of hyperandrogenism. Patients may be overwhelmed and confused by the variety of treatment options for AGA management, including over-the-count drugs with low evidence quality. Therefore, physicians must be aware of the current guidelines for the management of AGA based on evidence-based approaches to select better options for patients.


Medicina ◽  
2021 ◽  
Vol 57 (4) ◽  
pp. 311
Author(s):  
Santo Raffaele Mercuri ◽  
Giovanni Paolino ◽  
Matteo Riccardo Di Nicola ◽  
Laura Vollono

Background: female androgenetic alopecia (FAGA) is a common cause of non-scarring alopecia in women, affecting approximately 40% of women by age 50, bearing a significant psychosocial burden on affected patients. Platelet-rich plasma (PRP) has been widely investigated as a potential effective treatment for several dermatological conditions, including male androgenetic alopecia (MAGA). However, few studies have been conducted focusing on the use of PRP in FAGA. The aim of this review was to identify reports that investigated the use of PRP for the treatment of FAGA. Methods: Electronic databases of MEDLINE, EMBASE, and Cochrane Central Register of Controlled Trials (CENTRAL) from inception to September 2020 have been searched using different combinations of the following terms: “androgenetic alopecia,” “FAGA,” “female pattern hair loss,” “platelet-rich fibrin,” “platelet-rich plasma,” and “PRP”. Results and conclusions: Eight (n = 8) clinical studies consistent with our research were identified. A total of 197 subjects has been enrolled in the included studies. All of them were adult female patients (mean age: 38.9) affected by female pattern hair loss. PRP is a well-tolerated procedure which showed promising results in males-only and mixed populations of AGA patients. PRP showed to produce high levels of satisfaction and improvement in the quality of life in patients affected by FAGA. In the light of this evidence, PRP may be proposed in patients who did not respond or did not tolerate topical minoxidil, as well as in combination with topical and oral treatments.


2020 ◽  
Vol 54 (3) ◽  
Author(s):  
Blythe N. Ke ◽  
Juan Paolo David S. Villena ◽  
Ma. Lorna F. Frez

Background. Androgenetic alopecia (AGA), also known as pattern hair loss, is the most common type of hair loss in men and women. Due to very limited therapeutic options, search for other effective and safe drugs is necessary. Objectives. This review aims to evaluate the efficacy and safety of a potential treatment option, topical adenosine, for AGA in male and female adults. Methods. A search of databases (Cochrane Library, Pubmed Medline, and others) was performed with no time limitations placed. We included human interventional studies published in English involving the use of topical adenosine for AGA in healthy adult males and females. Risk bias assessment was performed using the Cochrane Collaboration criteria. Results. All four trials in this review, with a total of 260 participants, used 0.75% topical adenosine lotion twice a day for a period of 6-12 months. Comparators were placebo, topical niacinamide, and topical minoxidil. Evaluated parameters include improvement in baldness grading as assessed by dermatologists and investigators, improvement and satisfaction as assessed by participants, anagen growth, thick/thin/vellus hair ratio, and hair density. Two trials found significant improvement with thick hair ratio (>60 or >80 μm) with the use of topical adenosine while two trials showed higher overall participant satisfaction with topical adenosine. Few to no adverse effects were reported with its use. Conclusion. This is the first systematic review involving topical adenosine for AGA. Topical adenosine may be effective in increasing thick hair ratio and improving the self-perception of hair growth. With minimal to no adverse effects, it may serve as an adjunct or alternative to present treatment options. However, more studies are needed to strengthen these findings.


2021 ◽  
Vol 1 ◽  
pp. 55
Author(s):  
Aseem Sharma ◽  
Manasi Shirolikar ◽  
Madhulika Mhatre

Diffuse alopecia wields a significant psychosocial burden by virtue of its clinical presentation and visibility. Patterned alopecia is an umbrella term with the focus point being androgen-mediated alopecias - androgenetic alopecia/male pattern baldness/male androgenetic alopecia and female pattern hair loss/female androgenetic alopecia, both of which have a genetic susceptibility that alters the follicular sensitivity to circulating androgens. Diffuse alopecia affects nearly half the population based on weighted averages. It may present with hair shedding and hair thinning (miniaturization) or a combination. With the female variant, the role of androgens is not fully delineated; hence, the term female pattern hair loss which has replaced prior nomenclature. Managing patterned hair loss has seen a sea change in the last decade, moving well beyond the FDA-approved modalities - topical minoxidil and oral finasteride. Through this short review, the authors have attempted to condense existing information into a ready reference.


2021 ◽  
Vol 33 (1) ◽  
pp. 63
Author(s):  
Damai Trilisnawati ◽  
Sarah Diba ◽  
Yuli Kurniawati ◽  
Suroso Adi Nugroho ◽  
Rusmawardiana Rusmawardiana ◽  
...  

Background: Male androgenetic alopecia (MAGA), also known as androgenetic alopecia, is the most common hair loss in males who have a genetic predisposition. The pattern of baldness in MAGA starts from the frontal area in a triangular pattern, followed by progressive thinning of the vertex until baldness occurs. Generally, the diagnosis of MAGA is established by clinical examination. FDA has approved a combination of topical minoxidil and oral finasteride for MAGA treatment. Currently, there is another treatment option like dutasteride, a prostaglandin analog, ketoconazole, and co-adjuvant therapy like laser therapy, hair transplantation, and so on. Purpose: To provide an updated treatment for MAGA. Review: Etiopathogenesis of MAGA is influenced by genetic susceptibility and hormonal factors. The European Consensus Group set the evaluation diagnosis of MAGA to include a historyof hair fall, physical examination, hair examination, supporting examination, and clinical documentation. There are therapeutic options for MAGA, including antiandrogen therapies, androgen-independent therapies, and co-adjuvant therapies. The FDA has approved a combination of topical minoxidil and oral finasteride for MAGA treatment. MAGA may affect patients’ quality of life and self-esteem. In general, patients expect higher. Conclusion: MAGA is the most common progressive hair loss in males. The MAGA therapy is expected to achieve cosmetically significant regrowth and to slow additional hair loss.


2020 ◽  
Vol 27 ◽  
Author(s):  
Firoz Anwar ◽  
Salma Naqvi ◽  
Fahad A. Al-Abbasi ◽  
Nauroz Neelofar ◽  
Vikas Kumar ◽  
...  

: The last couple of months have witnessed the world in a state of virtual standstill. The SARS-CoV-2 virus has overtaken globe to economic and social lockdown. Many patients with COVID-19 have compromised immunity, especially in an aged population suffering from Parkinson disease (PD). Alteration in dopaminergic neurons or deficiency of dopamine in PD patients is the most common symptoms affecting 1% population above the age of 60 years. The compromised immune system and inflammatory manifestation in PD patients make them an easy target. The most common under trial drugs for COVID-19 are Remdesivir, Favipiravir, Chloroquine and Hydroxychloroquine, Azithromycin along with adjunct drugs like Amantadine with some monoclonal antibodies. : Presently, clinically US FDA approved drugs in PD includes Levodopa, catechol-O-methyl transferase (COMT) inhibitors, (Entacapone and Tolcapone), Dopamine agonists (Bromocriptine, Ropinirole, Pramipexole, and Rotigotine), Monoamine oxidase B (MAO-B) inhibitors (Selegiline and Rasagiline), Amantadine and Antimuscarinic drugs. The drugs have established mechanism of action on PD patients with known pharmacodynamics and pharmacokinetic properties along with dose and adverse effects. : Conclusion and relevance of this review focus on the drugs that can be tried for the PD patients with SAR CoV-2 infection, in particular, Amantadine approved by all developed countries a common drug possessing both antiviral properties by downregulation of CTSL, lysosomal pathway disturbance and change in pH necessary to uncoat the viral proteins and antiParkinson properties. The significant prognostic adverse effect of SARS-CoV-2 on PD and the present-day treatment options, clinical presentation and various mechanism is warrant need of the hour.


Sign in / Sign up

Export Citation Format

Share Document