Twenty years ago there was no specific medication for androgenetic alopecia (baldness). Lotions, potions, bottles, plants, home remedies and “miracle” products were used in an attempt to resolve hair loss cases. Sometimes the use of these products coincided with spontaneous cures or the problem was aggravated. Nowadays there are effective medicines to combat baldness.

Systemic (oral) treatment:

For thousands of years non-medical treatments through plants, home remedies and magic potions were sold by charlatans in an attempt to treat baldness. Currently, the pharmaceutical industry has discovered some substances that were initially indicated for other pathologies and were eventually adopted in the treatment of baldness. These products have beneficial effects against baldness.

Finasteride

How it works: Finasteride does not inhibit male hormones (androgens), but inhibits the enzyme 5-alpha reductase (5?) Type 2 that does not allow testosterone (T) to be converted to dihydrotestosterone (DHT) Of hair follicles promoting follicle atrophy and miniaturization of hair and definite loss of hair.

Indication: men with genetic predisposition to baldness or with fall in the initial and intermediate stages of hair.

Duration of treatment: It should be used indefinitely or according to medical criteria.

Results: It begins to act after two months of use and the results can be perceived with six months of treatment. As soon as the use is suspended, the hair falls again. It should not be used by women who are pregnant or who may become pregnant during their use.

Dutasteride

Although it is approved only to treat prostatic hyperplasia, many dermatologists have used ‘off label’ in the USA for being effective also in androgenetic alopecia. There are reports in urological scientific studies that show a lower incidence of libido side effects and greater efficacy against baldness.

How do you act? Similar to Finasteride with a differential inhibit 5-alpha reductase type I and type 2 enzymes that do not allow testosterone to be converted to dihydrotestosterone.

Indications: They are the same as those of Finasteride.

Flutamide

It is a potent anti-androgen.

Cimetidine

It acts with an antiandrogen, but with little effectiveness.

Spirolactone

Originally used to treat hypertension, it also has a mild antiandrogenic effect and is commonly indicated to treat acne, androgenetic alopecia and female hirsutism, because it reduces the production of androgenic hormones.

Cyproterone acetate

Found in some birth control pills, it acts as an antagonist of androgenic hormones and is also a potent progestagen to treat hirsutism (enlargement of the hairs). It is also used in female pattern baldness.

Nutrition Supplements

They are commonly associated with the base treatment to aid in the recovery of follicles.

Treatment Topic (non-surgical site)

Minoxidil

This substance is a vasodilator used orally in the treatment of hypertension and has the property of inducing hypertrichosis in certain patients. Since then it has been used topically in patients with androgenic alopecia, proving to be effective.
Imiquimod and Difenciprona (DPCP)

The first is a topical immunomodulator. On the other hand, Difenciprona (DPCP) acts as a topical sensitizer. They are indicated for the most advanced cases of alopecia areata and should be monitored by a dermatologist. On-site weekly applications are held. Skin irritation, redness, itching and the presence of lymph nodes may occur. It is an option when the conventional treatments (topical corticosteroids, injectables and oral, DNCB, Antralina, Minoxidil) have already been used without solution. Imiquimod, originally indicated for treating warts, has also been used to treat Alopecia Areata and also actinic keratoses and vitiligo.

Cyclosporine

Cyclosporin is a potent immunosuppressant. It can be used both topically and orally.

Topical immunotherapy

Topical immunotherapy promotes an accumulation of suppressor T cells around the hair follicles and, as nonspecific cells, end up producing a negative immunoregulation responsible for the normal development and growth of the follicle.

Dinitrochlorobenzene (DNCB)

First used contact with good results in 25 to 80% of cases. This efficacy, however, depends on factors such as duration of disease, speed and degree of patient sensitization, extent and severity of Alopecia Areata, association with atopy, family history of the disease and previous corticosteroid therapy.

Esquartic Diesteryl ester (SADBE)

It presents as an advantage the characteristic of not being mutagenic like the DNCB, however as a systemic effect it can promote the growth of hair in areas not treated topically.

Difenciprona

White crystalline powder more stable than SABDE and non-mutagenic like DNCB. In some patients, the dose usually employed has to be adjusted, so that it produces the desired effect.

Vitamin Complexes

The amino acids and vitamin complex (A, B1, B2, B6 and E) reinforce the hair from the root, helping in the process of keratinization and as an antioxidant, preventing cell aging.