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Medical Therapy

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Medical Therapy

There are only two FDA approved effective medical therapy for hairloss and they are minoxidil lotion and finasteride.

Minoxidil

It is an effective drug to be applied on scalp. The exact mechanism of action is not known but it is thought to increase blood supply to hair follicles. This potentiates hair growth and converts the thin miniaturised hair to become thicker.

Formulation

It is available in many formulations (lotion, foam) and concentrations(2%, 5% and 10%). The 5% lotion is the most commonly prescribed.

Application

It should be applied twice daily to get maximum benefits. But apllying it atleast once a daiy for atleast 3-4 days in a week is better than no therapy. We encourage patients to be as regular as possible with this therapy. Er washing the hair in the morning

1-3 pumps should be taken depending upon the area of baldness. It should be applied to the scalp and massaged lightly. It should be applied after.

Side effects

Some patients complain of irritation and itching after application. This occurs as a result of alcohol present in,otions. Such patients benefit with foam formulation as they are better tolerated.

Overall it is a well tolerated medication

Results

One must aplly it regularly for a period of 6 months to yield benefits. The results are visible after 3 months of continous use.


Finasteride

It is also an FDA approved medication for hair loss. It blocks 5 alpha reductase enzyme which converts Testosterone to Dihydrotestosterone (DHT). This DHT hormone is responsible for hair loss. Finasteride reduces the level of DHT in the body and thereby improves hair loss. It converts the thin miniaturized hair into thicker terminal hair. The effects last for as long as the treatment is taken

Dosage:

It is usually given as a 1 mg tablet to be taken at night daily or on alternate days.

Side effects

The side effect of sexual dysfunction is more hyped than reality. It is more psychological as a result of expecting the side effect to occur and anxiety toward it. Side effects such as decreased libido and ejaculation disorder have been reported. In our experience, is it a well tolerated drug when give as a dose of 1 mg at night. Dysfuction, if any, reverse on discontinuation of drug. It is contraindicated in women of child-bearing age.


Hormonal Therapy for Females

Hair loss in females can occur due to an underlying hormonal imbalance, when when corrected can cause hair regrowth nad improve the thickness of hair.
In females, hormonal imbalance presents in various ways such as resistant acne, hair loss on scalp, excessive facial hair, acanthosis nigricans (darkening and thickening of skin folds), seborrhoea (excessive oil production), obesity and thyroid disorder.
Hormonal therapy in the form of oral contraceptives is given in such patients.

Duration

It should be taken for a minimum period of 6 months.

Side effects

Headache, breast discomfort, abdominal discomfort, irregular menstrual cycle are reported.

Contraindication

history of heart disease, smoker, uncontrolled hypertension, history of migraine,diabetes and pregnancy.