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Current and Future Medical Treatment of Androgenetic Alopecia

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Practical Aspects of Hair Transplantation in Asians


The key change of androgenetic alopecia (AGA) is the thinning of hairs caused by miniaturization of hair follicles, not the shedding of hairs. As terminology implies, androgens (male sex hormones), especially dihydrotestosterone (DHT), play important roles in the pathogenesis of AGA, but no exact pathogenesis has been proven so far. However, several medications are successfully used for AGA through various mechanisms.

Many medical treatments for AGA have been introduced. Currently, oral 5AR inhibitors, including finasteride and dutasteride, and topical minoxidil are mainstream therapies. In addition, the topical 5AR inhibitor 17α-estradiol, mesotherapy, and LLLT can all be used as second-line treatments in some countries for both in men and women. Antiandrogens can be successfully used in females as well.

Cell-based treatment may be the future of medical treatment of hair loss, but more time is needed to establish effectiveness, cost, and technical details.

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  1. Kaufman KD, Rotonda J, Shah AK, Meehan AG. Long-term treatment with finasteride 1 mg decreases the likelihood of developing further visible hair loss in men with androgenetic alopecia (male pattern hair loss). Eur J Dermatol. 2008;18:400–6.

    CAS  PubMed  Google Scholar 

  2. Kaufman KD, Girman CJ, Round EM, Johnson-Levonas AO, Shah AK, Rotonda J. Progression of hair loss in men with androgenetic alopecia (male pattern hair loss): long-term (5-year) controlled observational data in placebo-treated patients. Eur J Dermatol. 2008;18:407–11.

    PubMed  Google Scholar 

  3. Drake L, Hordinsky M, Fiedler V, Swinehart J, Unger WP, Cotterill PC, Thiboutot DM, Lowe N, Jacobson C, Whiting D, Stieglitz S, Kraus SJ, Griffin EI, Weiss D, Carrington P, Gencheff C, Cole GW, Pariser DM, Epstein ES, Tanaka W, Dallob A, Vandormael K, Geissler L, Waldstreicher J. The effects of finasteride on scalp skin and serum androgen levels in men with androgenetic alopecia. J Am Acad Dermatol. 1999;41:550–4.

    CAS  PubMed  Google Scholar 

  4. Rossi A, Cantisani C, Scarnò M, Trucchia A, Fortuna MC, Calvieri S. Finasteride, 1 mg daily administration on male androgenetic alopecia in different age groups: 10-year follow-up. Dermatol Ther. 2011;24:455–61.

    Article  CAS  Google Scholar 

  5. Sato A, Takeda A. Evaluation of efficacy and safety of finasteride 1 mg in 3177 Japanese men with androgenetic alopecia. J Dermatol. 2012;39:27–32.

    Article  CAS  Google Scholar 

  6. Yeon JH, Jung JY, Choi JW, Kim BJ, Youn SW, Park KC, Huh CH. 5 mg/day finasteride treatment for normoandrogenic Asian women with female pattern hair loss. J Eur Acad Dermatol Venereol. 2011;25:211–4.

    Article  CAS  Google Scholar 

  7. Choi GS, Kim JH, Oh SY, Park JM, Hong JS, Lee YS, Lee WS. Safety and tolerability of the dual 5-alpha reductase inhibitor dutasteride in the treatment of androgenetic alopecia. Ann Dermatol. 2016;28:444–50.

    Article  CAS  Google Scholar 

  8. Jung JY, Yeon JH, Choi JW, Kwon SH, Kim BJ, Youn SW, Park KC, Huh CH. Effect of dutasteride 0.5 mg/d in men with androgenetic alopecia recalcitrant to finasteride. Int J Dermatol. 2014;53:1351–7.

    Article  CAS  Google Scholar 

  9. Gupta AK, Charrette A. Topical minoxidil: systematic review and meta-analysis of its efficacy in androgenetic alopecia. Skinmed. 2015;13:185–9.

    PubMed  Google Scholar 

  10. Choi JW, Na SY, Park KC, Youn SW, Huh CH. Relation between treatment efficacy and cumulative dose of 3% topical minoxidil in male pattern baldness. J Am Acad Dermatol. 2012;66:e10–2.

    Article  Google Scholar 

  11. Lucky AW, Piacquadio DJ, Ditre CM, Dunlap F, Kantor I, Pandya AG, Savin RC, Tharp MD. A randomized, placebo-controlled trial of 5% and 2% topical minoxidil solutions in the treatment of female pattern hair loss. J Am Acad Dermatol. 2004;50:541–53.

    Article  Google Scholar 

  12. Orfanos CE, Vogels L. Local therapy of androgenetic alopecia with 17 alpha-estradiol. A controlled, randomized double-blind study. Dermatologica. 1980;161:124–32.

    Article  CAS  Google Scholar 

  13. Kim JH, Lee SY, Lee HJ, Lee WS. The efficacy and safety of 17α-estradiol(Ell-Cranell alpha 0.025%) solution on female pattern hair loss: single center, open-label, non-comparative, phase IV study. Ann Dermatol. 2012;24:295–305.

    Article  CAS  Google Scholar 

  14. Sinclair R, Wewerinke M, Jolley D. Treatment of female pattern hair loss with oral antiandrogens. Br J Dermatol. 2005;152:466–73.

    Article  CAS  Google Scholar 

  15. Burke BM, Cunliffe WJ. Oral spironolactone therapy for female patients with acne, hirsutism or androgenic alopecia. Br J Dermatol. 1985;112:124–5.

    Article  CAS  Google Scholar 

  16. Peereboom-Wynia JD, van der Willigen AH, van Joost T, Stolz E. The effect of cyproterone acetate on hair roots and hair shaft diameter in androgenetic alopecia in females. Acta Derm Venereol. 1989;69:395–8.

    CAS  PubMed  Google Scholar 

  17. Budde J, Tronnier H, Rahlfs VW, Frei-Kleiner S. Systemic therapy of diffuse effluvium and hair structure damage. Hautarzt. 1993;44:380–4.

    CAS  PubMed  Google Scholar 

  18. Park SY, Na SY, Kim JH, Cho S, Lee JH. Iron plays a certain role in patterned hair loss. J Korean Med Sci. 2013;28:934–8.

    Article  CAS  Google Scholar 

  19. Moftah N, Moftah N, Abd-Elaziz G, et al. Mesotherapy using dutasteride-containing preparation in treatment of female pattern hair loss: photographic, morphometric and ultrastructural evaluation. J Eur Acad Dermatol Venereol. 2013;27:686–93.

    Article  CAS  Google Scholar 

  20. Kim H, Choi JW, Kim JY, Shin JW, Lee SJ, Huh CH. Low-level light therapy for androgenetic alopecia: a 24-week, randomized, double-blind, sham device-controlled multicenter trial. Dermatol Surg. 2013;39:1177–83.

    Article  CAS  Google Scholar 

  21. Lee SH, Zheng Z, Kang JS, Kim DY, Oh SH, Cho SB. Therapeutic efficacy of autologous platelet-rich plasma and polydeoxyribonucleotide on female pattern hair loss. Wound Repair Regen. 2015;23:30–6.

    Article  Google Scholar 

  22. Shin H, Ryu HH, Kwon O, Park BS, Jo SJ. Clinical use of conditioned media of adipose tissue-derived stem cells in female pattern hair loss: a retrospective case series study. Int J Dermatol. 2015;54:730–5.

    Article  Google Scholar 

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Correspondence to Chang-Hun Huh M.D., Ph.D. .

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Huh, CH. (2018). Current and Future Medical Treatment of Androgenetic Alopecia. In: Pathomvanich, D., Imagawa, K. (eds) Practical Aspects of Hair Transplantation in Asians. Springer, Tokyo.

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