scholarly journals Pharmacological therapeutics in androgenetic alopecia

2020 ◽  
Vol 63 (5) ◽  
pp. 277-285
Author(s):  
Doyoung Kim ◽  
Sujin Park
Keyword(s):  
Hair Loss ◽  
Treatment Options ◽  
Daily Intake ◽  
Androgenetic Alopecia ◽  
Men And Women ◽  
Reductase Inhibitors ◽  
Female Pattern Hair Loss ◽  
Evidence Quality ◽  
Topical Minoxidil ◽  
Current Guidelines

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.

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

2021 ◽  
Vol 8 (1) ◽  
pp. 152
Author(s):  
Bharat Lalwala ◽  
Siddhartha Das ◽  
Srinivasa Murthy ◽  
Abir Saraswat ◽  
U. R. Dhanalakshmi ◽  
...  
Keyword(s):  
Expert Opinion ◽  
Hair Loss ◽  
Treatment Options ◽  
Androgenetic Alopecia ◽  
Oral Medications ◽  
Choice Of Treatment ◽  
Topical Minoxidil ◽  
Current Scenario ◽  
Approved Drugs ◽  
The Individual

<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>

scholarly journals Investigating the Safety and Efficacy of Platelet-Rich Plasma (PRP) Treatment for Female Androgenetic Alopecia: Review of the Literature

Medicina ◽  
2021 ◽  
Vol 57 (4) ◽  
pp. 311
Author(s):  
Santo Raffaele Mercuri ◽  
Giovanni Paolino ◽  
Matteo Riccardo Di Nicola ◽  
Laura Vollono
Keyword(s):  
Hair Loss ◽  
Platelet Rich Plasma ◽  
Androgenetic Alopecia ◽  
Cochrane Central Register ◽  
Review Of The Literature ◽  
Psychosocial Burden ◽  
Female Pattern Hair Loss ◽  
Central Register ◽  
Topical Minoxidil

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.

scholarly journals Managing patterned hair loss – a hair raising task!

2021 ◽  
Vol 1 ◽  
pp. 55
Author(s):  
Aseem Sharma ◽  
Manasi Shirolikar ◽  
Madhulika Mhatre
Keyword(s):  
Hair Loss ◽  
Clinical Presentation ◽  
Short Review ◽  
Population Based ◽  
Androgenetic Alopecia ◽  
Psychosocial Burden ◽  
Weighted Averages ◽  
Female Pattern Hair Loss ◽  
Topical Minoxidil

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.

Comparative study between the efficacy of topical sildenafil and topical minoxidil in the treatment of male androgenic alopecia

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Ali Abdulkareem Al-Shabkhon ◽  
Adel Ahmed Halim Emam ◽  
Ahmed Abd Elfattah Afify
Keyword(s):  
Hair Loss ◽  
Treated Group ◽  
Treatment Modalities ◽  
Androgenic Alopecia ◽  
Men And Women ◽  
Female Pattern Hair Loss ◽  
Topical Minoxidil ◽  
Temporal Side ◽  
Male Patients ◽  
Incidence Increase

Abstract Background Androgenic alopecia is the most common form of alopecia in men and women. Its incidence increase with age, many treatment modalities are available but results are variable. Androgenetic alopecia is a hereditary thinning of the hair induced by androgens in genetically susceptible men and women. Also known as male-pattern hair loss or common baldness in men and female-pattern hair loss in women. Thinning of hair usually begins between 12 and 40 years old in males and females. Inheritance is polygenic. Aim of the study To evaluate and compare the efficacy, safety and side effects of topical sildenafil and topical minoxidil in the treatment of androgenic alopecia Patients and methods This exploratory pilot study included 30 male patients suffering from androgenic alopecia. Included patients were divided into 2 equal groups based on treatment received; one group received 1% topical sildenafil and the other group received 55 topical minoxidil. Assessment of treatment response was done using trichoscopy. Results Sildenafil treated group showed statistically significant increase in VH and TH count at 18 cm point, 24 cm point after treatment compared to before treatment. While, temporal side showed statistically significant increase in VH only. minoxidil treated group showed statistically significant increase in TH count, T/V hair ratio and hair thickness at 18 cm point and temporal side after treatment compared to before treatment. VH count was significantly decreased after treatment compared to before treatment at 18 cm point. At 24 cm point, only TH was significantly increased after treatment compared to before treatment.

scholarly journals A randomised trial of 5% minoxidil versus combination of 5% minoxidil and oral spironolactone in treatment of female pattern hair loss

2019 ◽  
Vol 5 (4) ◽  
pp. 668
Author(s):  
Nachiket Madhukarrao Palaskar ◽  
Nitin Dinkar Chaudhari ◽  
Garima Laxminarayan Balpande ◽  
Swapna Subhash Khatu
Keyword(s):  
Combination Therapy ◽  
Hair Loss ◽  
Tertiary Care ◽  
Randomised Trial ◽  
Life Questionnaire ◽  
Care Hospital ◽  
Female Pattern Hair Loss ◽  
Group I ◽  
Topical Minoxidil ◽  
Group Ii

<p class="abstract"><strong>Background:</strong> Female pattern hair loss (FPHL) is a common form of nonscarring hair loss. We compared the usefulness and safety of topical minoxidil alone with combination of oral spironolactone and topical minoxidil in the treatment of FPHL.</p><p class="abstract"><strong>Methods:</strong> This prospective, single-centre, randomised open label study over 100 patients attending tertiary care hospital in Mumbai during period December 2011 to June 2012. The data were entered into SPSS version 21 for analysis. Data collected were coded and described as frequency and percentage for qualitative data and means and standard deviation for quantitative data. Statistical analysis was done using chi-square and student t test. Statistical significance was considered if p value was less than 0.05.<strong></strong></p><p class="abstract"><strong>Results:</strong> There were 48 patients in Group I and 46 patients in Group II. At 6 months, significantly higher mean Sinclair grade was observed among Group I patients as compared to Group II patients (2.85±0.68 vs 2.56±0.50, p=0.02). We observed a significant improvement in women’s androgenetic alopecia quality of life questionnaire in Group I patients at 12 months after treatment (26.93±2.25 vs 23.47±2.95, p&lt;0.001). Minoxidil and spironolactone were tolerated well by the patients.</p><p class="abstract"><strong>Conclusions:</strong> Combination therapy of topical minoxidil and oral spironolactone has an additive effect. However, plateau of effectiveness of the combination therapy in normoandrogenic patients at 6 months of therapy was observed. We recommend the combination for 6 months and continuation of therapy with minoxidil only.</p>

scholarly journals Androgenetic alopecia: pathogenesis and potential for therapy

2002 ◽  
Vol 4 (22) ◽  
pp. 1-11 ◽  
Author(s):  
Justine A. Ellis ◽  
Rodney Sinclair ◽  
Stephen B. Harrap
Keyword(s):  
Androgen Receptor ◽  
Hair Loss ◽  
Genetic Predisposition ◽  
Scalp Hair ◽  
Androgenetic Alopecia ◽  
Growth Cycles ◽  
Men And Women ◽  
White Males ◽  
Determining Factors ◽  
The Many

Androgenetic alopecia occurs in men and women, and is characterised by the loss of hair from the scalp in a defined pattern. Determining factors appear to be genetic predisposition coupled with the presence of sufficient circulating androgens. The prevalence of this condition is high (up to 50% of white males are affected by 50 years of age) and, although there are no serious direct health consequences, the loss of scalp hair can be distressing. Knowledge of the pathogenesis of androgenetic alopecia has increased markedly in recent years. Pre-programmed follicles on the scalp undergo a transformation from long growth (anagen) and short rest (telogen) cycles, to long rest and short growth cycles. This process is coupled with progressive miniaturisation of the follicle. These changes are androgen dependent, and require the inheritance of several genes. To date, only one of these genes, which encodes the androgen receptor (AR), has been identified. Of the many treatments available for androgenetic alopecia, only two (finasteride and minoxidil) have been scientifically shown to be useful in the treatment of hair loss. However, these therapies are variable in their effectiveness. Discovery of the involvement of the AR gene, and the identification of other genes contributing to the condition, might lead to the development of new and more effective therapies that target the condition at a more fundamental level.

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