Medical Treatment

Medical treatment has been found to reverse the thinning process when taken for adequate periods.

Finasteride

Only FDA approved (Year 1997) oral medicine for male pattern baldness.

Mechanism of action

Finasteride works by blocking an enzyme (5-alpha reductase) that converts testosterone to DHT (Dihydrotesteterone - the active form of testesterone). This causes DHT levels to drop by almost 70%, although the serum testesterone levels remains within nor-mal limits.

Duration:

Finasteride should be taken for atleast 6 months to 1 year before its relevant benefit on clin-ical picture can be assessed.

Use:

It is used in men and females (after the child bearing age)

Benefit

• 1) It halts the progression of hair loss
• 2) It causes hair thickening
• 3) It improves the density

Minoxidil

It is the first FDA approved topical medicine being used for hair loss both in men and wom-en. Initially minoxidil was used as a blood pressure lowering medicine, where it was observed that it caused significant hair growth on the body. Then it was thought that minoxidil if applied directly on scalp topically might lead to localised hair growth. From then onwards various studies were done and its efficacy has been assessed multiple times over years.

Mechanism of action:

Minoxidil increase the duration of hair follicle growth cycle (anagen phase). This improves the quality of hair by increasing the thickness and length of the miniaturised hair. It is a direct stimulator of follicular growth (via Vascular endothelial growth factor and prostaglandin synthesise and also stimulates dermal papilla cells) How long to apply? It needs to be applied for 6 months to 1year to see visible change in growth patterns.

Side effects?

• 1) Increased hair growth on other sites if applied incorrectly
• 2) Hypotension (very few patients)
• 3) Light headedeness
• 4) Contact dermatitis
• 5) Flakiness on scalp
• 6) Irritation on scalp
• 7) Dryness on scalp

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