Management of hair loss

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The hair loss management , also known as alopecia or baldness, may include medications and surgery.

Video Management of hair loss

Drug

Treatments for various forms of hair loss only have moderate success. Three drugs have evidence to support their use in male hair loss patterns: finasteride, dutasteride, and minoxidil. They usually work better to prevent further hair loss than to regrow hair loss.

They can be used together when hair loss is progressive or further back growth is desired after 12 months. Other drugs include ketoconazole, and in women alopecia spironolactone androgenic and flutamide. The combination of finasteride, minoxidil and ketoconazole is more effective than individual use.

Minoxidil

Minoxidil, topically applied, is widely used for hair loss treatments. It may be effective in helping promote hair growth in men and women with androgenic alopecia. About 40% of men experience hair regrowth after 3-6 months. This is the only FDA-approved topical product in the United States for androgenic hair loss. However, increased hair loss has been reported.

Antiandrogen

Finasteride is used to treat hair loss in men. Treatment provides about 30% increase in hair loss after six months of treatment, and effectiveness only lasts as long as the drug is taken. There is no good evidence for its use in women. It can cause gynecomastia, erectile dysfunction and depression.

Dutasteride is used off label for male hair loss patterns.

There is a tentative support for spironolactone in women. Because of feminine side effects and infertility risk it is not often used by men. It can also cause low blood pressure, high blood potassium, and abnormal heart rhythms. Also, women who are pregnant or trying to conceive are generally unable to use drugs because they are teratogens, and can cause ambiguous genitals in newborn children.

There is temporary evidence for flutamide in women; However, it is associated with a relatively high level of liver problems. Like spironolactone, it is usually used only by women.

Ketoconazole

Ketoconazole can help women.

Maps Management of hair loss

Surgical treatment

Hair Transplant

Hair transplantation is a surgical technique that moves an individual hair follicle from a body part called a donor site to bald or bald body parts known as a receiving site. It is mainly used to treat male pattern baldness. In this condition, transplant containing hair follicles that are genetically resistant to balding is transplanted into a bald scalp. It is also used to restore eyelashes, eyebrows, beard hair, chest hair, and pubic hair and to fill scars caused by accidents or surgeries such as face-lift and previous hair transplants. Hair transplantation differs from skin grafts in grafts containing almost all epidermis and dermis around the hair follicles, and many small transplants are transplanted rather than one strip of skin.

Since hair grows naturally in follicles in groups of 1 to 4 hair, transplants take advantage of this natural follicular unit. This achieves a more natural appearance by matching hair to hair through Follicular unit transplant (FUT).

Donor hair can be harvested in two different ways. Small graft from naturally occurring units with one to four hairs, called follicular units, can be moved into the bald areas of hair restorations. These follicular units are planted on the scalp within a very close proximity to each other and in large quantities. Graft obtained in one or both of the two main methods of surgical extraction, follicle unit transplantation, colloquially referred to as "strip harvesting", or Follicular Unit Extraction (FUE), in which the follicles are transplanted individually.

In FUT, skin strips containing many follicular units are extracted from the patient and dissected under a stereoscopic microscope. The strip removal site is sewn closed. Once split into follicle follicle units, each unit is individually inserted into a small receiver site made by an incision in a bald scalp. In newer techniques, the roots are taken from the donor area and divided into strips for transplantation. Strips, two to three millimeters thick, are isolated and transplanted onto a bald scalp. After surgery, the bandages are worn for two days to protect the stitched strips during healing. A small strip scars remain after healing, which can be covered by the scalp of hair growing on top of the scar.

Scalp Reduction

Scalp reduction is a surgical procedure in which a hairless area on the scalp of a bald man is reduced. This procedure can reduce the area of ​​the scalp without hair.

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Radiation-induced hair loss

Radiation induces hair loss through follicle follicle follicle cell destruction and changes in keratin expression. Radiation therapy has been associated with increased production of mucin in hair follicles.

Studies have suggested electromagnetic radiation as a therapeutic growth stimulant in alopecia.

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Cosmeses

Certain shampoos and hair salts visually thicken the existing hair, without affecting the growth cycle. There are also developments in the fashion industry with wig designs. Fashion accessories have also proven to be a source of psychological support for women undergoing chemotherapy, with cancer sufferers in one study describing their wig as a "permanent companion". Other studies in women have demonstrated a more diverse psychosocial impact than the use of a sopak.

Special tattoos, commonly known as micropigmentation of the scalp, can mimic the appearance of a short haircut that is buzzed.

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Alternative medicine

Many people use unproven treatments, but there is little evidence of the effectiveness of vitamins, minerals, or other dietary supplements that regrow hair or maintain hair.

Laser therapy

Review 2008 and 2012 found little evidence to support the use of special lights or lasers to treat hair loss. In addition there is no FDA approved in America for this use. Both lasers and lights look safe.

Reviews 2014 and 2016 find tentative evidence about the benefits of lasers. While other reviews of 2014 conclude that the results are diverse, have a high risk of bias, and their effectiveness is unclear.

Dietary supplements

Food supplements are usually not recommended. Only one small trial saw palmetto showed temporary benefit in those with mild to moderate androgenetic alopecia. There is no evidence for biotin. Evidence for most other products is also insufficient. There is no good evidence for ginko, aloe vera, ginseng, bergamot, or hibiscus in 2011. Despite the lack of evidence and expert recommendations, there is a huge market for hair growth supplements, especially for products containing biotin.

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Mechanism

Some lines of evidence support the dermal papilla of hair follicles as an androgenic target for the prevention and reversal of hair loss. Type 1 and 2 5? the enzyme reductase is present in the pilosebaceous unit in the papillae of each hair follicle. They catalyze the formation of testosterone androgens and DHT, which in turn regulates hair growth. Androgens have different effects on different follicles: they stimulate IGF-1 in facial hair, causing hair regrowth, but stimulate TGF? 1, TGF? 2, dickkopf1 and IL-6 on the scalp, causing miniaturization of hair follicles.

Female androgenic alopecia is characterized by thinning of diffuse crowns without hair recession, and such male counterparts rarely cause total hair loss. Finasteride and minoxidil are usually first-line therapy for treatment. Other options include topical or systemic spironolactone, or flutamide, although they have high feminizing side effects and are better tolerated in women's androgenic hair loss.

More advanced cases may be resistant or unresponsive to medical therapy, and require hair transplantation. Natural units consisting of one to four hairs, called follicular units, are removed and transferred to the hair restoration area. This follicular unit is grown on the scalp at close range and in large quantities. Graft obtained either from Follicular Unit Transplantation (FUT) or colloquially referred to as "strip harvesting" - or Follicular Unit Extraction (FUE). In the first, the skin strips with the follicular units are extracted and dissected into graft of individual follicular units. The surgeon then instills a slice into a small incision, called the receiving site. A special scalp tattoo can also mimic the appearance of a short haircut that is buzzed. Androgenic alopecia also occurs in women, and more often appears as diffuse thinning without hair recession. Like male colleagues, conditions rarely cause total hair loss. Treatment options are similar to men, although topical or systemic estrogens are more commonly used.

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Research

Bimatoprost and latanoprost

Latanoprost and bimatoprost are specific PGF2a analogues topically applied, and have been found to lengthen the eyelashes, darken the hair pigmentation and lengthen the hair. Bimatoprost is available as a treatment for eyelash growth. Latanoprost has demonstrated the ability to increase hair density and scalp pigmentation, and theorize to function on dermal papilla. A study found latanoprost was not effective in eyelashes in patients with alopecia areata. It has also been found to be ineffective in the treatment of eyebrow hair loss.

Hormones

Estrogen is an anti-androgen indirect and can be used to treat androgenetic hair loss in women with oral contraceptives. Systemic estrogen increases SHBG, which binds to androgens, including testosterone and DHT, which in turn reduces their bioavailability. Topical formulations are available in Europe. Hair follicles have estrogen receptors and are theorized that topical compounds act directly against them to promote hair growth and counteract androgen action. Large clinical studies that show no effectiveness. Topical treatments are also usually not available in North America.

There is tentative evidence for cyproterone acetate in women.

IGF-1

In December 2012, the topical application of IGF-1 in liposome vehicles led to thicker and faster hair growth in transgenic mice with androgenic alopecia. The study did not show measurable systemic levels or hematopoietic side-effects, suggesting potential for use in humans. Radiofrequency of low energy irradiation induces IGF-1 in cultured human papillary cells. Adenosine stimulates dermal papilla in vitro to induce IGF-1, along with FGF7, FGF-2 and VEGF fibroblas growth factors. ? increased transcriptional cataline, which promotes dermal papilla as well. The isoflavone diet increases the production of IGF in the papilla dermal scalp in transgenic mice. Topical capsaicin also stimulates IGF in hair follicles through the release of vaniloid-1 receptors, which in turn causes more CGRP. Ascorbic acid has led to increased expression of IGF in vitro .

Plasma rich platelets

Reviews in 2013 and 2017 on the use of platelet-rich plasma (PRP) to regrow hair find insufficient evidence to draw clear conclusions.

Stem cell therapy

Although previous follicles are thought to be lost in areas of baldness, they are more likely to be inactive, as recent studies show that the scalp contains the stem cells from which the follicles appear. Research on these follicle stem cells can lead to success in treating baldness through hair (HM), also known as hair cloning .

As per May 2015 review, no successful strategy to produce human hair follicles, for hair regrowth, from adult stem cells has not been reported. However, in April 2016, scientists from Japan published the results of their work in which they created human skin from pluripotent stem cells; planted into laboratory mice, cells produced by the skin with hair and glands.

Genetics

From 2005 to 2007 Curis and Procter & amp; Gamble collaborated in developing topical hedgehog agonists for hair loss; the agent did not meet the safety standards, and the program was stopped. In 2008, researchers at the University of Bonn announced that they had discovered the genetic basis of two different hair loss forms. They found that the P2RY5 gene causes a rare and inherited form of hair loss, called simplex hypotrichosis. This is the first receptor in humans known to play a role in hair growth. The researchers found that the SOX21 gene disorder in mice caused hair loss that doubled. Research has suggested SOX21 as a master regulator of hair cuticle differentiation, with disorders that cause alopecia cycles in mouse models. The removal of SOX21 dramatically affects the hair lipids.

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References

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External links

• "Medical Treatment for Balding in Men", April 1999, American Family Doctor (medical journal)

Source of the article : Wikipedia