From the Guidelines
Treatment options for androgenic alopecia should prioritize a combination of FDA-approved medications, such as minoxidil and finasteride, alongside procedural options like platelet-rich plasma injections and hair transplantation surgery, to maximize outcomes in terms of morbidity, mortality, and quality of life. When considering treatment for androgenic alopecia, it's essential to evaluate the effectiveness of various options based on the most recent and highest quality studies. According to 1, the evidence supporting the clinical efficacy of platelet-rich plasma (PRP) in androgenetic alopecia (AGA) is controversial, highlighting the need for improved and standardized study designs. However, 1 suggests that PRP can be an effective treatment modality, especially when combined with topical minoxidil, and that it may be more effective than minoxidil monotherapy in some cases.
Key considerations for treatment include:
- The use of minoxidil (2% solution for women, 5% solution or foam for men) applied twice daily to the scalp, as it increases blood flow to hair follicles.
- Finasteride (1mg daily oral tablet) for men, which blocks DHT and thereby reduces follicle shrinkage.
- Low-level laser therapy devices used 3 times weekly for 15-30 minutes to stimulate follicles.
- Platelet-rich plasma injections administered every 3-6 months, which have shown promise in promoting hair growth, particularly when used in conjunction with other treatments.
- Hair transplantation surgery for permanent results, which can be highly effective but should be considered after other options have been explored.
It's also important to note that newer treatments, such as oral minoxidil (0.25-5mg daily) and dutasteride (0.5mg daily), are used off-label and may offer additional benefits, although their use should be carefully considered based on individual patient needs and responses to established treatments. Assessing the response to treatment can be done through various methods, including photography, trichoscopy, hair counts, hair diameter measurement, pull test, patient self-assessment questionnaire, trichogram, and in some cases, scalp biopsy, as outlined in 1.
Ultimately, the most effective approach will likely involve a combination of these treatments, tailored to the individual patient's condition, response, and preferences, with the goal of maximizing outcomes in terms of reducing morbidity, minimizing mortality risks associated with treatment, and improving quality of life.
From the FDA Drug Label
Minoxidil topical solution 5% is a clear, light amber liquid medication containing 5% minoxidil for use only on the scalp to help regrow hair in men. Minoxidil topical solution 5% is for use only by men Minoxidil topical solution 5% is more likely to regrow hair in men with hair loss in the range shown. Results may be seen as early as 2 months with twice daily use. For some men, it may take at least 4 months for results to be seen
The treatment option for androgenic alopecia is minoxidil topical solution 5% for men, which can help regrow hair on the scalp. It is recommended to apply the solution twice a day, every day, and results may be seen as early as 2 months. However, it may take at least 4 months for results to be seen in some men 2.
- Key points:
- Minoxidil topical solution 5% is for use only by men
- It is more likely to regrow hair in men with hair loss on the vertex of the scalp
- Results may be seen as early as 2 months with twice daily use
- It may take at least 4 months for results to be seen in some men
- The solution should be applied twice a day, every day, directly to the scalp 2.
From the Research
Treatment Options for Androgenic Alopecia
- Androgenic alopecia, also known as male or female pattern baldness, can be treated with various medications and therapies.
- Two common treatments for androgenic alopecia are finasteride and minoxidil 3, 4, 5, 6, 7.
Medications for Androgenic Alopecia
- Finasteride is an oral medication that has been shown to be effective in treating male androgenetic alopecia, with a clinical cure rate of 80% in one study 3.
- Minoxidil is a topical solution that can be used to treat both male and female pattern hair loss, with significant improvement in hair diameter and density observed in several studies 4, 6, 7.
- Low-dose oral minoxidil has also been used off-label to treat androgenetic alopecia, with good clinical efficacy and safety 4.
Efficacy and Safety of Treatments
- Both finasteride and minoxidil have been shown to be safe and effective in treating androgenic alopecia, with minimal side effects reported 3, 4, 6, 7.
- The mechanism of action of minoxidil is thought to be mediated by mitochondrial adenosine triphosphate synthase-induced stem cell differentiation, which promotes hair growth 5.
- Long-term use of minoxidil has been shown to maintain nonvellus hair growth in men with androgenetic alopecia, with a slow decline in regrowth over time 6.
Treatment Outcomes
- Treatment outcomes for androgenic alopecia can vary depending on the individual and the severity of the condition.
- In general, treatment with finasteride or minoxidil can lead to significant improvement in hair growth and density, with many patients experiencing minimal to moderate hair growth 3, 4, 6, 7.