Androgenic alopecia, commonly known as male or female pattern baldness, is a prevalent hair loss condition that affects a significant portion of the population. Understanding the available treatment methods is crucial for those seeking to address this issue and potentially slow down or reverse the hair loss process.
Topical Treatments
Topical medications are often the first line of defense against androgenic alopecia.
Minoxidil:
Application: Minoxidil is available in liquid or foam formulations. It is typically applied directly to the scalp twice a day.
For example, a person with androgenic alopecia would part their hair in sections and carefully apply the minoxidil to the affected areas, ensuring it reaches the scalp.
Mechanism of Action: It works by increasing blood flow to the hair follicles, which in turn may stimulate hair growth. It can also prolong the anagen (growth) phase of the hair cycle and prevent the follicles from shrinking.
Results: Initial results may be seen within a few months, with continued use potentially leading to thicker and more visible hair growth over time. However, it is important to note that minoxidil needs to be used continuously; if discontinued, the hair loss may resume.
Topical Finasteride:
Prescription Requirement: This is a prescription-only topical treatment. It is applied once a day to the scalp.
How It Works: Finasteride inhibits the enzyme 5-alpha reductase, which converts testosterone to dihydrotestosterone (DHT). DHT is a major contributor to androgenic alopecia as it binds to hair follicles and causes them to miniaturize. By reducing DHT levels, topical finasteride aims to slow down or stop the hair loss process.
Considerations: As with any prescription medication, it is essential to consult a doctor before use. Side effects may include scalp irritation or, in rare cases, more systemic effects like sexual dysfunction, although the latter is less common with topical application compared to oral finasteride.
Oral Medications
Oral medications can also play a significant role in treating androgenic alopecia.
Oral Finasteride:
Dosage and Administration: The typical dosage for treating androgenic alopecia is 1mg per day. It is taken orally with a glass of water.
Effects on Hair Growth: Similar to the topical form, it reduces DHT levels. This can lead to a reduction in hair loss and, in some cases, regrowth of hair. Studies have shown that over a period of a year or more, many patients experience an improvement in hair density and thickness.
Potential Side Effects: The most well-known side effect is sexual dysfunction, which includes decreased libido, erectile dysfunction, and ejaculation disorders. However, not all patients experience these side effects, and they may subside if the medication is discontinued. Regular monitoring by a doctor is recommended to assess both the effectiveness of the treatment and any potential side effects.
Anti-Androgens (Spironolactone):
Usage in Women: Spironolactone is an anti-androgen that is more commonly used in women with androgenic alopecia. It is usually prescribed in doses ranging from 50 to 200mg per day.
How It Helps: It blocks the binding of androgens to their receptors, thereby reducing the androgenic effects on the hair follicles. This can lead to a decrease in hair shedding and potentially stimulate hair regrowth.
Monitoring and Side Effects: Since it can affect potassium levels in the body, regular blood tests to monitor potassium are necessary. Side effects may include breast tenderness, menstrual irregularities, and in some cases, an increase in potassium levels, which can have implications for heart health.
Low-Level Laser Therapy (LLLT)
LLLT is a non-invasive treatment option that has gained popularity.
Treatment Procedure:
Devices: There are various LLLT devices available, including helmets, combs, and caps. These devices emit low-level laser light at specific wavelengths. For example, a person would wear the LLLT helmet for a prescribed amount of time, usually around 20 – 30 minutes per session.
Frequency: Treatment sessions are typically recommended 2 – 3 times a week. The light penetrates the scalp and is thought to stimulate the mitochondria in the hair follicle cells, increasing cell activity and promoting hair growth.
Evidence of Effectiveness:
Clinical Studies: Multiple clinical studies have shown that LLLT can increase hair density and thickness. It may also improve the quality of the hair shaft, making it stronger and less prone to breakage. However, the degree of improvement can vary from person to person, and it may take several months of consistent treatment to see significant results.
Platelet-Rich Plasma (PRP) Therapy
PRP therapy is an emerging treatment option for androgenic alopecia.
The Process:
Blood Draw and Preparation: A small amount of the patient’s blood is drawn, usually around 10 – 30ml. The blood is then placed in a centrifuge to separate the platelet-rich plasma from the other components. The PRP is then injected into the scalp in multiple sites, usually at the areas of thinning or balding.
How It Works: The platelets in the PRP contain growth factors that can stimulate the hair follicles. These growth factors can promote cell proliferation, angiogenesis (formation of new blood vessels), and extracellular matrix remodeling, all of which are beneficial for hair growth.
Efficacy and Considerations:
Results: Some patients report a reduction in hair loss and an increase in hair thickness and density after a series of PRP treatments. However, the results are not always consistent, and multiple sessions, usually spaced 4 – 6 weeks apart, are often required.
Safety: Since it uses the patient’s own blood, the risk of allergic reactions or transmission of diseases is minimal. However, like any injection-based procedure, there is a small risk of infection or bruising at the injection sites.
Hair Transplantation
Hair transplantation is a more invasive but potentially definitive solution for some cases of androgenic alopecia.
Surgical Procedure:
Harvesting Hair Follicles: There are two main methods: follicular unit transplantation (FUT) and follicular unit extraction (FUE). In FUT, a strip of skin containing hair follicles is surgically removed from the back or sides of the scalp (where hair is usually more resistant to loss) and then dissected into individual follicular units. In FUE, individual follicular units are directly extracted from the donor area using a small punch tool.
Implanting the Follicles: The harvested follicles are then carefully implanted into the bald or thinning areas of the scalp.
The surgeon makes small incisions or punches in the recipient area and places the follicles at the appropriate angle and depth to ensure natural-looking growth.
Recovery and Results:
Post-Operative Care: After the surgery, patients need to follow strict post-operative care instructions. This includes keeping the scalp clean, avoiding strenuous activities for a period of time, and taking prescribed medications to prevent infection and reduce swelling.
Growth Timeline: The newly transplanted hair follicles will typically shed within a few weeks after the surgery, which is a normal part of the process. New hair growth usually starts to become visible after 3 – 6 months, and the full results may not be apparent for 1 – 2 years. The transplanted hair is usually permanent and should grow like normal hair.
Conclusion
In conclusion, androgenic alopecia can be addressed through a variety of treatment methods, each with its own benefits, risks, and considerations. The choice of treatment depends on factors such as the severity of the hair loss, the patient’s gender, overall health, and personal preferences. It is often advisable to consult a hair loss specialist or a dermatologist who can assess the individual’s situation and recommend the most appropriate treatment plan. With the right approach and consistent treatment, many patients can achieve significant improvements in their hair loss condition and regain their confidence.