Apart from topical Minoxidil, oral Dutasteride and oral Finasteride, the current state of the art non pharmaceutical method is the Follicular Unit Extraction (FUE), more commonly known as a hair transplant, which can be costly and result in noticeable donor sites. Efficacy results for finasteride and dutasteride are conflicting across different studies, with some showing efficacy and others not. While finasteride and dutasteride are not indicated for use in women, come offlabel studies have shown efficacy at higher doses. Dutasteride, commercially available as Avodart, is a 5alphareductase inhibitor used to treat enlarged prostates, similar to Finasteride which is also used by some for treatment of male pattern baldness, but has similar efficacy to Finasteride and is again not recommended for use by women. Additionally, Finasteride is only prescribed for male patients as it has shown limited efficacy in women and may cause birth defects in pregnant women. When ingested for longer than 2 years, oral Finasteride is not shown to facilitate continued hair growth, but results were maintained at 5 years (longest reported follow up). Negative side effects of oral Finasteride include decreased Prostate Specific Antigen (PSA), libido and ejaculate volume, as well as erectile dysfunction. Oral Finasteride must be taken consistently and indefinitely as progressive balding will be induced once treatment comes to a halt. Oral Finasteride, a synthetic azosteroid, acts as a 5alphareductase inhibitor that prevents conversion of testosterone to dihydrotestosterone (DHT). Maximum remedial effects are established at 12 years, at which point hair counts plateau, and hair density quickly returns to baseline values in the event that treatment is discontinued. Topical Minoxidil requires application to treatment areas twice a day, and must be used consistently before results are seen within the first 46 months. While the mechanism of topical Minoxidil, a piperidinopyrimidine derivative, is not fully understood, it is known to cause contact dermatitis and facial hypertrichosis, mainly in women. However, both treatments are notorious for producing a myriad of undesirable side effects. Prevalent remedies for Alopecia Androgenetica include two leading pharmaceutical treatments, topical Minoxidil and oral Finasteride. While a significant amount of research and capital have been invested in the sector, investigated treatments have not proven effective enough to replace current treatment modalities (Table 1). There has been a relative lack of new therapeutic options for the treatment of hair loss in the last 30 years. Grade II on the Norwood-Hamilton scale is the most prevalent kind of Alopecia Androgenetica, affecting approximately 27.2% of patients. These scales are based on standardized visual parameters and are often used to evaluate drugs in clinical hair growth studies. An alternative scale for females is the Ludwig scale, which is nearly identical to the Savin scale. The degree to which individuals are affected by Alopecia Androgenetica is classified using the Norwood-Hamilton scale for men (Figure 1), and the Savin scale for women (Figure 2). Additionally, an increase in the turnover time between hair shedding and the anagen (growth) phase diminishes hair density at the scalp. As the anagen phase decreases, the proportion of hair follicles in the telogen phase increases, inducing hair growth that is more fine. Individuals with Alopecia Androgenetica, however, experience a decrease in the duration of anagen phase as the hair cycle proceeds. Typical anagen to telogen ratio in an individual experiencing regular hair growth is established at 9:1 4. The 26 year long anagen phase is classified as the growing period, whereas the catagen phase of regression lasts 23 weeks and is followed by a 12 week telogen resting phase. The hair growth cycle in the scalp is separated into 3 phases: anagen (growth), catagen (regression), and telogen (resting). Individuals impacted by Alopecia Androgenetica are subject to general psychological trauma, as many report a decreased quality of life, lack of self-confidence, and limited social contacts. Alopecia Androgenetica can be characterized by the gradual thinning of hair emphasized at the crown and frontal scalp, attributed to interactions among various genetic and endocrine factors. In the United States, Alopecia Androgenetica, more commonly known as male or female pattern hair loss, affects approximately 50% of the male population and 45% of the female population.
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |