Medication

Medication can stop and stabilize hair loss
Hardly impulse hair regrowth, side effects to watch

Drug treatment for androgenetic alopecia (AGA)


Androgenetic alopecia (gradual loss of hair due to the influence of male hormones - androgens, DHT) is the most common to explain hair loss in men, less common in women.

For other types of alopecia, read here.

 

Why drugs are very important in the treatment of AAG hair loss, especially before a transplant ?

A first reason is the effectiveness of these drugs (Finasteride, Minoxidil), which really make it possible to slow the process of hair loss, even to stop it, and in certain cases to obtain a regrowth of the follicular units affected by alopecia. .

This is particularly the case for thinning hair, which can perfectly regain a good density simply with a drug treatment.

They are more effective in young patients (20 to 30 years) and for relatively moderate hair loss, and they are of no interest for patients who have very advanced stable baldness.

The other reason is that they make it possible to prepare for the success of a later transplant, because the implanted grafts grow much more surely, so the success rate of the transplant can approach 100%.

The best known surgeons generally only accept patients who are undergoing medical treatment for a year or 6 months before the transplant. Otherwise, they may consider that they are not good candidates for a hair transplant.


What are the disadvantages of the most prescribed drugs (Finasteride, Minoxidil)?

The main disadvantage of the androgen-inhibiting drug is that stopping treatment causes the effects to stop. So you really have to take it continuously.

If Finasteride fails to slow down hair loss, you can try Dutasteride.

The potential side effects of Finasteride are well known (loss of libido, reduced sexual function in men, in 1 to 10% of cases).

This is why a number of patients are looking for alternatives to Finasteride tablets:

  • they can opt for Topical Finasteride (0.25%), applied to areas of hair loss, it diffuses locally and therefore it does not have the dreaded side effects ; however its results are not still scientifically proven and therefore its marketing is still restricted
  • or for food supplements, such as Saw Palmetto, or AlphaRegul from ARLOR laboratories (available in tablets, lotions, shampoos)

In all cases, it is recommended to consult a doctor before opting for a drug treatment.


What are the main indications, in men and in women?

Men :

  • Minoxidil: topical solution at 2 or 5% concentration for men
  • Finasteride (Propecia, Proscar): in 1mg tablets over a long period (watch out for side effects), or in lotion (Topical Finasteride)
  • Dutasteride: if Finasteride fails
  • Flutamide: anti-androgen tablets
  • Spironolactone: in applications, also produces anti-androgenic effects

Women :

  • Minoxidil: generally more effective in women than in men, concentration 2, 3-5% in women
  • Finasteride: contraindicated, because risk of malformation of the fetus in case of pregnancy
  • Other anti androgens: Cyproterone acetate, Spironolactone, Cimetidine, Ketoconazole (shampoo)
  • Low-dose oral contraceptives (Ethinyloestradiol): they can block the action of male hormones, especially in combination with cyproterone acetate.
  • Oestro Progestogens: In menopausal women, estrogens and progesterone (pills, creams) are commonly prescribed as a treatment for androgenetic alopecia.

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