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Abstract: Androgenetic alopecia is hair loss caused by elevated levels of androgens in the body, which often has a greater psychological impact on the human body. This patient, Mr. Zhang, had a 3-year history of hair loss and an oily scalp with itching, so he came to our hospital for consultation. After examination, the patient had typical androgenetic alopecia combined with seborrheic dermatitis of the scalp. After the application of oral and topical medications and psychological counseling, the patient’s hair loss symptoms were significantly relieved and new hair grew on the scalp.
Basic information】Male, 32 years old
Disease Type】Androgenetic alopecia combined with seborrheic dermatitis of the scalp
Hospital】Maanshan Seventeenye Hospital
Date of consultation】July 2021
Treatment plan】Oral medication (finasteride tablets) + topical medication (minoxidil tincture, ketoconazole lotion) + psychological guidance
Treatment Period】Outpatient treatment for six months
Effectiveness】Significant relief of hair loss symptoms, new hair on the scalp
I. Initial consultation
Mr. Zhang, a 32-year-old patient, came to our hospital because of serious hair loss recently. The patient reported that he started to lose hair 3 years ago and his hairline moved upward, and then hair loss also started to appear on the top of his head, with thinning hairs and an oily scalp, and his scalp would be itchy and oily if he did not wash his hair for only 2 days, and a lot of fallen hair existed on his pillow every morning, so the patient was very depressed.
After examining the patient, it was found that the patient had a receding hairline, sparse hair on the top of the head, and M+O-type alopecia. Dermoscopic examination suggested that the patient had diffuse erythema on the scalp, a brown ring at the hair root, and reduced hair density, which were consistent with the characteristics of androgenetic alopecia combined with seborrheic dermatitis of the scalp, so the patient was diagnosed with androgenetic alopecia combined with seborrheic dermatitis of the scalp.
Male androgenetic alopecia is related to the level of hormones in the body. It is necessary to take oral finasteride tablets to reduce the level of androgens in the body and apply topical minoxidil tincture to help hair growth.
Second, the treatment process
In this patient’s case, after comprehensive discussion, the patient was given finasteride tablets orally, which can reduce the level of androgens in the body and is the main drug for the treatment of male androgenetic alopecia. At the same time, it was decided to give the patient topical application of minoxidil tincture to promote hair growth on the scalp. Because of the patient’s comorbid seborrheic dermatitis, the patient was given ketoconazole lotion to treat the inflammatory scalp reaction.
After being informed of the treatment plan, the patient was concerned that finasteride tablets would affect his male function and was also more worried because he heard that a period of wild hair loss often occurs after the application of minoxidil tincture treatment. The patient was then reassured about his worries and the side effects of the above mentioned drug were explained to him, informing him that finasteride tablets for androgenetic alopecia are taken orally in very small doses and therefore the probability of hypogonadism is low, and even if it does occur, it can usually be recovered after stopping the drug. In addition, Minoxidil tincture caused by the wild hair loss period, the general loss of hair for the regressive phase of hair loss, so the so-called wild hair loss period for the treatment of hair loss does not affect, and the drug for about 1 month, the wild hair loss period will stop, after which there will be new hair growth. After hearing the above explanation, the patient was relieved of his worries and accepted the treatment plan with pleasure.
III. Treatment effect
After 2 months of medication, the patient came back to the clinic for a follow-up consultation and reported that her hair loss was significantly reduced and her symptoms of oily hair and itchy scalp were significantly relieved. After 3 months of medication, the patient came back to the clinic for follicular microscopy and found that many new hairs had appeared, the hair density was significantly higher than before, and the symptoms of seborrheic dermatitis such as scalp flushing were relieved and subsided. At the same time, the patient did not experience any significant adverse drug reactions such as loss of libido during the overall treatment. After communicating with the patient, it was found that the patient had greater confidence in the treatment, so the patient was instructed to continue to adhere to the medication for at least six months before gradually stopping it.
IV. Precautions
I am glad that after a series of treatments, the patient’s hair loss was significantly reduced and there was new hair growth, and the symptoms of seborrheic dermatitis were also relieved and subsided. However, since the treatment of androgenetic alopecia is a long process, patients still need to pay attention to the following points in daily life.
1, daily life need to adjust the mindset, learn to release stress, avoid anxiety and depression, while establishing confidence in treatment.
2, to develop better habits, try to avoid staying up late, strive to go to bed before 11 pm, and pay attention to the prohibition of alcohol consumption during the medication.
3, daily shampooing should pay attention to gentle movements, do not over-scratch the scalp, so as not to cause damage to the scalp follicles, and pay attention to not use too hot water when washing hair, should control the water temperature at the appropriate temperature.
4, daily diet should pay attention to eat less greasy, high sugar diet, eat more fresh fruits, vegetables, appropriate supplementation of trace elements.
V. Personal insight
At present, most middle-aged men in the clinic belong to androgenetic alopecia. This type of alopecia is treated with drugs that most people worry about because of their side effects, which is undesirable. In this case, the patient was worried about the medication and was resistant to the treatment, but after active science, the patient’s worries were dispelled and the treatment was carried out smoothly. This shows that when facing the side effects of drugs, it is necessary to have correct knowledge, and at the same time, patients should be guided positively and their concerns should be actively addressed so that they do not miss the right time for treatment.