In this part medicines clinically tested and effective in the treatment of hair loss will be presented. These medicines must be used with a doctor’s prescription.
Its effect is based on preventing the conversion of testosterone to its more potent form – dihydrotestosterone. This transformation is done by 5 alpha reductase enzyme. Finasteride blocks the activity of this enzyme. Preventing these irreversible transformations reduces the debilitating effects of androgens on scalp and protects from hair loss. While in some neurological diseases 5 mg daily usage is prescribed in hair loss 1 mg is sufficient. Effectiveness of Finasteride is proven in male type hair loss but it can be used also by women patients. Finasteride is contraindicated in pregnancy. Even mostly used as tablets in recent years it has been developed in topical form. Finasteride has synergistic effect with Minoxidil, when used in combination they increase their mutual effect. Male pattern hair loss or androgenetic alopecia (male pattern hair loss is genetic) is due to the effects of dihydrotestosterone (DHT) on hair follicles located in front and top of the head. DHT slows down hair growth and hair cycle and causes miniaturization of hair follicles.
These hairs begin slowly to shorten and thin, in the end they completely fall. DHT is formed from testosterone by the the enzyme of 5-alpha reductase. Finasteride prevents the formation of 5-alpha reductase enzyme.
Finasteride reduces the level of DHT in the scalp, its effect is apparently felt. Finasteride, reduces the level of DHT with %70. Serum increases testosterone with %9 and it is a normal rate. Finasteride is used to treat prostate at first, but it was fortunately found as effective in hair loss too. This truth was searched on boys in Salinas-Dominican Republic in 1974. These children have small amount of 5-alpha reductase. Also their DHT levels were very low and they had never been with prostate problems during their lifetime, they also had not experienced hair loss problems. Researchers were forced to find a medicine that prevents the formation of 5-alpha reductase enzyme. Later they used this medication to prevent the progression of the prostate and to prevent hair loss. This medicine stops progression of prostate in men over the age of 50. It is Finasteride 5-mg with label – name Proscar and is approved by FDA. Five years later Finasteride 1-mg was approved for hair loss treatment by FDA . Studies conducted that Finasteride stops hair loss and protect the existing hair among 90% of persons . Increase in amount of hairs was observed in 48% of men treated with Finasteride in a period of 5 years. In %42 of men hair loss increased and in %10 there was no difference according to their previous conditions. By comparison %6 of patients received Placebo treatment had prolonged hairs, no difference in %19 and hair loss was observed in %75 .
Effect of Finasteride on front side of head
Finasteride is used in treatment of hair loss in front and top parts of head. There are proves that Finasteride treats the hair loss in front side.
Finasteride must be taken one time per a day before or after meals.
Finasteride must be used during one year and in the end of this period hair loss stops and new hairs start grow. The effect of Finasteride is visible after one year. During first six months you can observe that existing hairs thin. The reason is that untill Finasteride shows its effect hairs continue to fall. It is very important to be patient in this period. To see the effect of this medicine you have to use it in a period of at least one year.
Side Effects of Finasteride
There is no side effect of Finasteride- 1 mg. After regular usage during 1 year in %3,8 of parients decrease in sexual desire was observed. The decrease in sexual desire was observed in %2,1 of the patients treated by Placebo treatment. After 5 year studies side effects observed were such: decrease in sexual desire (%0,3), impotence (0.3%), decrease in sperm count (0.0%).
Once you start using this medicine during time a decrease in sexual desire was determined. This condition finished in all patients who stop the therapy, and in %58 of patient who continue treatment. After stopping usage of this medicine side effects disappear in the period of couple of weeks. After stopping usage of Finasteride only hairs that grow as a result of this medicine will fall.
For many years, Minoxidil was used as antihypertensive (blood pressure lowering). Its side effects of strengthening hairs were determined and it started to be produced also as 2% and 5% lotion formula. The formula of %5 is is more effective with %50 according to the formula of %2. This medicine gives expansionary effect on blood vessels and lowers blood pressure, probably it causes the same effect when used topically and this increase feeding of follicles. There are not known significant side effects except itching, burning, forming of acne and contact dermatitis. After stopping using it these side effects disappear. One side effect, very rarely observed, is that it also causes hypotension (low blood pressure). To be more effective usage of %5 formula is recommended for men and usage of %2 formula is recommended for women. It must be used as cures for 6-9 months in the mornings and in the evenings. When used in excess, flowing to front side may cause thickening in hairs on the forehead area. Patients should be warned about it.
Minoxidil is the first medicine which treats hair loss and is approved by FDA. Minoxidil is a lotion and is applied directly to head. Nowadays it can be purchased from pharmacies without prescription. Minoxidil is a developed version of the antihypertensive medicine – Minoxidil. Minoxidil is taken orally but because it has side effects on heart and blood circulation it is being prescribed to be used when the effects of the other medicines pass. Virilisation on bodies of the patients who used Minoxidil was observed and it was thought that its directly applying on head will increase hair growing. Minoxidil was applied directly to tops of heads and it was wrongly thought that it was effective only to this area. Minoxidil is effective as on top of head as on other areas too. But Minoxidil is not effective to totally bald areas. The best results are visible since 5 months till 2 years period of time. Patients who use Minoxidil continue to lose their hairs even in a very small amount. The principle of working of Minoxidil is not clear yet but it is known that this medicine increases the period of follicle growing circle. This condition effects as enlarging the diameter and length of miniature hairs.
Minoxidil is used two times per a day. The treatment is directly applying to head and its effect is visible only there. That’s why if there is hair loss Minoxidil must be applied to the front part of the head. The formula of %5 is double effective in comparison with the formula of %2 solution, but because of the content of propylene glycol it may cause stiffness and dificulty in combing. This problem can be solved as using the solution of %5 in the nights before sleeping and %2 solution during days. When you start to use Minoxidil you will see its effect in the period of 6-12 months. Also, Minoxidil provides thickenning of your hairs. It can not make new hairs to grow on the areas where are not existing hair roots. In these situation the single solution is hair transplantation.
Usage by Women
Women must use only the solution of %2. Because women are more sensitive to side effects and it can cause hypotension. Also Minoxidil can cause allergy to women more often than to men. The side effect will be increased with the products of %5, and that’s why FDA don’t approve this doze for women. Besides, Minoxidil can cause virilisation on women faces. Eventough some bristles spills after treatment, some women may need laser hair removal. Care must be taken not to use Minoxidil on temples and forehead. Side effects are more common in using of %5 formula solution.
There are some important medicines that are being still experimented and not approved by FDA and WHO. Inosetero acetate, flupamid, spirinolacton, hyaluronic acid, topical applications of estrogen, aromatase cytochrome P-450 enzymes, ketoconazole can be mentioned among them.
Fue Hair Transplant
Fue Hair Transplant
The method that is named as FUE, in other words follicular unit extraction, is a method for hair transplant defined in 2004. First time it was defined, it was performed with a special.
In hair loss cases doctor’s first concern is to provide medical shampoo to patients. A shampoo chosen properly according to the hair structure of the patients will protect them.