Free Paper on Androgenetic Alopecia Treatment

Minoxidil

Minoxidil is available in the form of over the counter where it is sold as without a prescription from a medical practitioner. It is also availed in the form of a generic medication whereby the drugs are presented with chemical substances similar to the original drug which was developed and patented. In broader terms, minoxidil is used to offer support to the present hair follicles and to initiate hair regrowth (Dinh & Sinclair, 2007). In this case, minoxidil acts as a potassium channel opener by facilitating the transmission of ions by the use of potassium channels, an action which leads to hyperpolarization in cell membranes. The process of hyperpolarization involves alteration of the potential of the cell membrane rendering it harmful. Besides, it prevents action potentials through increasing the required stimulus needed to initiate the motion of membrane potential to assume the appropriate threshold. This process of hyperpolarization is initiated by potassium cation through potassium channels or by the influx of chlorine anion through chlorine channels. Theoretically, the action of widening and opening blood vessels and potassium channels introduces more nutrients, blood, and oxygen to reach the follicles. Such an action causes follicle hosted by the telogen phase to fall and are then replaced by the new thicker hairs that develop in the anagen phase. Minoxidil is termed as a prodrug which undergoes converted by the action of sulfation to minoxidil sulfate, a scheme made possible by sulfotransferase enzyme SULT 1A1. Although minoxidil has proved to assume great effectiveness in younger individuals experiencing hair loss for a shorter period, it shows minimal success in scenarios where a significant hair loss has been witnessed. Minoxidil regulates the vascular endothelial growth factor which maintains hair growth and dermal papilla vasculature.

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Finasteride

Finasteride is another medication used in the treatment of androgenetic alopecia, a treatment option which slows down the process of hair loss (Tanaka, Aso, Ono, Hosoi, & Kaneko, 2018). It is termed as an inhibitor as it prevents the testosterone conversion to DHT through blocking 5AR of type II. Finasteride has been associated with decreasing a large percentage of the levels of DHT by sixty-five to seventy percent range by taking a 5mg oral dosage daily. It also shows an improvement of thirty percent after treatment of six months. DHT hormone leads to hair follicle miniaturization and stops hair growth (Dinh & Sinclair, 2007). Finasteride reduces the serum DHT and scalp levels which leads to an increase or maintenance of the terminal hairs at the anagen phase by reversing and inhibiting hair follicle miniaturization. It shows a high level of efficiency at the vertex but also initiates the reduction of hair loss in the scalp. Finasteride also supports a partial regrowth which counteracts the expression of androgenetic alopecia as it increases both anagen and total hair counts Finasteride as an average half-life of between six to eight hours contributing to low effects compared with other medications. However, the failure to maintain a constant medication through an abrupt stoppage leads to the continuation of the balding process where the hair which had grown falls. Besides, it does not suppress the production of DHT completely as it lacks inhibitory effects of suppressing the isoenzyme 5 alpha-reductase type I. Another disadvantage is that it has a low affinity for AKR1D1 which reduces its efficiency. Its side effects include sexual dysfunction but for a short term. Such as a case is due to the activation of GABA A receptor which is caused by the activation of 3 alpha androstanediol. Although the dysfunction is said to stop after the patients cease using the drugs, persistent erectile dysfunction and diminished libido have been witnessed after abandoning the drugs.

Additional Treatment Options

Dutasteride

Dutasteride has also been termed as a perfect treatment for androgenetic alopecia and is applied by taking a daily dose of 0.5 mg or 2.5 mg (Choi, Kim, Oh, Park, Hong, Lee, & Lee, 2016). Dutasteride administered in 2.5 g is more efficient as it has a greater inhibitory effect to type one five alpha reductase which controls the DHT concentrations in the scalp. It functions by inhibiting 5-alpha-reductase enzyme, an action which presents the testosterone conversion to dihydrotestosterone. Also, it inhibits both 5-alpha-reductase of type I and type II and reduces the serum levels in the DHT by ninety percent making it more efficient than finasteride. Constant use of dutasteride in the treatment of androgenetic alopecia is safe and leads to increased vellus, total hair count and terminal in male patients. Studies conducted among the aged between eighteen and forty years found that dutasteride administered in 0.5 mg had a higher efficiency surpassing that of finasteride administered in 1 mg. It is also about three times as efficient as finasteride at suppressing the production of type 2 5-alpha-reductase and a hundred times as efficient as suppressing type one 5-alpha-reductase. However, many individuals have failed to use dutasteride as it has bears similar side effects to finasteride which include alterations on fertility, ejaculatory and erectile functions. These increased potency risks are associated with its high efficiency of inhibiting both types of 5 alpha-reductase. Also, it has an extended half-life of more than two hundred and forty hours, a factor which contributes to its adverse effects to the patients' body.

Hair Transplantation

Another method of treating androgenetic alopecia is through undergoing hair transplantation, a scheme which involves hair removal at the occipital scalp followed by reimplantation actions in the frontal scalp and bald vertex. One of the ways of carrying hair transplantation is by using the follicular unit transplantation involving natural hair transplanting in a unit of one to four hairs (Dua & Dua, 2010). In this scenario, the donor's hair is harvested using strip harvesting where a scalp strip of between eight to fourteen millimeters or between twenty to thirty centimeters is extracted underwound sutured and local anesthesia to eliminate discomfort. The extracted air is separated into units of follicular nature and then transplanted in the affected area. However, this method is not well accepted as it leaves the donor with a linear scar at the occipital area. An alternative method for the extraction of the donor's hair is the follicular unit extraction harvesting which involves the removal of individual follicles from the occipital hair, an action performed with the help of local anesthesia in conjunction with one-millimeter punch biopsies. The units produced are then introduced in the bald areas present in the scalp with the use of a microblade. This method is preferred as it does not result in scars as it only removes follicular units instead of vast tissues. Besides, less time is taken to heal as compared to strip harvesting. Follicular unit transplant is also used and incorporates the extraction of a linear strip from the side or back of the donor's scalp. The extracted strip undergoes dissection to individual grafts.

References

Choi, G. S., Kim, J. H., Oh, S. Y., Park, J. M., Hong, J. S., Lee, Y. S., & Lee, W. S. (2016). Safety and Tolerability of the Dual 5-Alpha Reductase Inhibitor Dutasteride in the Treatment of Androgenetic Alopecia. Annals of dermatology, 28(4), 444-50. doi: 10.5021/ad.2016.28.4.44.

Dinh, Q. Q., & Sinclair, R. (2007). Female pattern hair loss: current treatment concepts. Clinical interventions in aging, 2(2), 189-99. Retrieved from https://www.ncbi.nlm.nih.

Dua, A., & Dua, K. (2010). Follicular unit extraction hair transplant. Journal of cutaneous and aesthetic surgery, 3(2), 76-81. doi: 10.4103/0974-2077.69015.

Tanaka, Y., Aso, T., Ono, J., Hosoi, R., & Kaneko, T. (2018). Androgenetic Alopecia Treatment in Asian Men. The Journal of clinical and aesthetic dermatology, 11(7), 32-35. Retrieved from https://www.ncbi.nlm.nih.