Treatment of androgenic baldness

  Early detection, early treatment and persistence are important.  In fact, there is no need to feel overly frustrated with hair loss, as a significant portion of patients can be improved if they are diagnosed early and treated appropriately.  In the treatment of androgenetic alopecia, it is very important to focus on early treatment, because the disease has the characteristic of progressive aggravation with age; in addition, hair regeneration is a very slow process, so long-term persistent treatment is needed. Commonly used treatment methods include oral medications, topical medications and hair transplantation, etc. The effect of combined treatment is generally better, the following is a brief introduction to several of the most commonly used treatment methods.  The most safe and effective drug for androgenic alopecia is finasteride, which can inhibit the production of dihydrotestosterone in the scalp and reverse the process of hair loss. It is very simple to use, only 1 mg orally daily. Generally, hair loss starts to decrease after 3 months of taking the drug, and hair starts to grow after 6 to 9 months; if you need to maintain the efficacy, a longer period of maintenance treatment is required. At least 1 year of treatment is recommended. If there is no significant effect after 1 year, it is recommended to discontinue the drug only if it is considered insensitive to the drug. The incidence of adverse reactions is low, a very small number of patients may experience loss of libido and reduced ejaculation, etc., most of which gradually disappear during the course of taking the drug, and the above side effects may improve after a few days or weeks if treatment is discontinued.  2. Spironolactone: It is mainly used for female patients with androgenic baldness. Spironolactone has a counteracting effect on androgens, thus reducing hair loss. The main adverse effects include decreased libido, increased urination and elevated blood potassium.  3.Cycloprogesterone: The main component is progestin, which has a strong anti-androgen effect and is mostly used to treat female patients with androgenic baldness with acne and hirsutism. The main adverse effects are reduced libido, weight gain, etc.  Topical drugs: Minoxidil solution: Minoxidil can dilate blood vessels to provide more blood supply to hair follicles and stimulate the growth of hair follicles. Topical minoxidil solution treatment generally takes more than 3 months to be effective, if you need to maintain the efficacy, you need a long period of maintenance treatment. Common adverse effects include contact dermatitis and hypertrichosis.  It is generally believed that oral finasteride combined with topical minoxidil solution can obtain better efficacy and is the most commonly used combination therapy in clinical practice.  Physical therapy: The FDA has approved three treatment modalities for the treatment of androgenic baldness, in addition to oral finasteride tablets and topical minoxidil solution, there is also low-energy laser laser treatment. It was found that low-energy laser irradiation with a wavelength of 655 nm has a stimulating effect on the growth of hairs in patients with androgenic baldness.  Hair transplantation: Hair transplantation is the surgical separation of hair follicles (usually from the occipital area) from areas with a strong congenital resistance to androgens and “planting” them into the balding area. Generally the hair starts to grow after 2 to 3 months of transplantation and the transplanted hair follicles will remain viable for a long time. The results of the surgery are more obvious for patients with mild cases, but there are limitations: (1) severe patients have limited access to autologous hair follicles and are not suitable for the surgery; (2) the surgery is time-consuming and expensive; (3) the surgery is not permanent, and oral or topical medication is still needed to maintain the results after the transplant.