Drug Therapy in Hair Loss

Hair shedding due to poor nutrition, skin condition, infections, emotional turmoil, medication, systemic diseases, toxic agents, smoking can cause temporary diffuse hair thinning. Familial balding is very common but the above factors must be looked into and treatment should be started accordingly. Male pattern baldness is characterized by receding hair line on temples forming a characteristic ‘M’ Shape, however, in female pattern blindness the hair fall is in the central portion of the scalp near the parting forming a Christmas tree like pattern. The hair follicles are miniaturized within the follicular unit i.e. hair shaft is gradually reduced in diameter, pigmentation and length during the process of baldness. The terminal hair are gradually transformed into indeterminate hair and finally convert into vellus hair.

Treatment for Hair Loss by Drug Therapy

If hair loss is genetic then it will not grow back naturally however the loss due to stress, side effect of drugs, any underlying disorder etc, the treatment is provided for eliminating the cause of the fall and activate the regrowth of hair.
Nutritional supplements in the form of amino acids, vitamins, fatty acids, antioxidants, iron, calcium,zinc are essential in hair growth and they are often used in combination to the currently available drugs for hair regrowth or hair loss treatment.
Currently two drugs are commonly used for treating MPB one is finasteride and the other is minoxidil. Both are FDA approved drugs.

Drug therapy for hair loss

Finasteride

Oral Formulation

Finasteride is marketed by the popular brand names ‘Propecia’, ‘Proscar’, Finax’ for preventing hair loss and promoting the growth of new hair in men only and not recommended for using in females and pediatric population.Finasteride is a 5-AR- II inhibitor and inhibits the conversion of testosterone into DHT. The effect of its treatment is seen in about three months or may be more. The treatment should be continued for sustained hair growth or else the reversal of hair growth occurs within a year.
Dose: Its recommended dose is 1mg per day and should be taken at the same time each day either before or after meals.
Precautions: Finasteride is absorbed through skin hence the tablets are coated so that the contact with skin is avoided, If the tablets are broken accidentally then the exposed area should be washed immediately with soap and water. If a dose is missed do not try to make up the missed dose by doubling the dose. Never take an extra dose as it will not have any extra effect. Pregnant women should keep away from the tablets as its exposure may lead to serious birth defects.
Inform your doctor about the drugs you are taking to know about any drug-drug interaction.
Side Effects: The drug has several side effects such as impotence, libido disorders, ejaculation, enlargement of breasts and hypersensitivity reactions such as rashes, urticaria etc.The incidence of these side effects is very low. The sexual side effects is temporary but uncommonly may persist even after discontinuation of treatment. The warning labels of the drug has been expanded by FDA in 2012.

Tropical Formulation

Currently Finasteride topical solutions in the dose range of 0.1% to 0.25% are being used alone or in combination for hair loss treatment. The topical Finasteride also helps in preventing the side effects occurring due to systemic exposure of Finasteride.

Minoxidil

Minoxidil is the FDA-approved drug to treat baldness. It helps in regrowth of gradually thinning hair. Minoxidil prolongs the growth phase of hair follicle. It is a vasodilator and probably improves the circulation in scalp by dilating the scalp blood vessels. This might improves the hair follicle function and stimulates the scalp hair growth.
Dose: Recommended dose of Minoxidil for females is 2% and for men 5%.
Precautions: Do not use if you have any allergy with the ingredients of Minoxidil solution. Inform your doctor if you are pregnant or planning pregnancy, taking any medicine, herbal preparations or dietary supplements, or have cardiac or blood pressure problems as minoxidil solution may interact with some medicines. It may cause dizziness, and hence avoid driving. Do not use the solution on irritated or sunburned scalp; and with other medicines/ointments. Protect your eyes, nose and mouth from minoxidil solution. In case of contact wash them immediately with cool tap water.
How to use: Use the solution as per the manufacturer’s instructions on the label. Wash your scalp using a mild shampoo. Dry your hair and scalp thoroughly before the application of minoxidil solution. Do not wash your hair or go for swimming for 4hours after application. DO not use any other hair products until the solution is completely dry.
Side Effects: Some of the common side effects of the drug include burning or irritation of the eye, itching, redness/irritation at the treated area; unwanted hair growth elsewhere on the body and severe side effects include allergic reactions, fainting, dizziness swollen hand and feet etc.

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