Medical hair restoration in the literal sense includes the hair loss treatment which depends upon the use of medicines. Unusual hair loss both in men and women is caused by the alterations in the androgen metabolism. The metabolism of androgen involves an enzyme called 5 alpha reductase which combines with the hormone androgen (testosterone) to form the DHT (Dihydro-testosterone). DHT is a natural metabolite of our body which is the root cause of hair loss.
DHT gets into the hair follicles and roots (dermal papilla), it prevents necessary proteins, vitamins and minerals from providing nourishment for hair follicles. This shortens their growing stage (anagen phase) and lengthens their resting stage (telogen phase) of the follicle. DHT is responsible for 95% of hair loss.
Some individuals both men and women are genetically pre-disposed to produce more DHT than the normal individuals. DHT also creates a wax-like substance around the hair roots. DHT accumulation inside the hair follicles and roots is one of the primary causes of male and female pattern hair loss.
Blocking the synthesis of DHT at molecular level forms the basis for the treatment of MPHL (male pattern hair loss) and FPHL (female pattern hair loss). There are many natural DHT blockers and a number of drugs which are used for medical hair restoration. Let’s see.
Minoxidil has the distinction of the first drug being used for promoting the hair restoration. Minoxidil was then approved as medical hair restoration treatment drug for men by the FDA, USA in 1988 as a 2% solution, followed by 5% solution in 1997. For women, the 2% solution was approved in 1991. Though 5% solution is not approved for women, it is used as a medical hair restoration treatment by many dermatologists worldwide.
Mechanism of action
Minoxidil is thought to have a direct mitogenic effect on epidermal cells. Calcium normally enhances epidermal growth factors to inhibit hair growth. Minoxidil by getting converted to minoxidil sulfate enhances potassium ion permeability to prevent calcium ions from entering into cells. It takes about few months time for the results to be evident since it is the time which is necessary for restoring the normal growth cycle of hair fibers.
Though minoxidil does not have any effect on blood pressure, it should be used with caution in patient with cardiovascular diseases. It is also contraindicated in pregnant and nursing mothers.
The drug finasteride was earlier used as treatment for prostate enlargement, under the medical name Proscar. But in 1998, it was approved by FDA for the Medical hair loss restoration in MPHL.
Mechanism of Action
Medical hair restoration treatments with Finasteride depends upon its specific action as an inhibitor of type II 5α-reductase, the intracellular enzyme that converts male hormone androgen into DHT (Dihydro Testosterone). Its action results in significant decrease in serum and tissue DHT levels in even in concentration as low as 0.2mg. Finasteride stabilizes hair loss in 80% of patient with Vertex hair loss and in 70% of patients with frontal hair loss. The peculiar thing about Propecia is that its effect is more pronounced in crown area than in the front.
Many hair restoration surgeons find Propecia (finasteride) to act as an excellent adjunct to the surgical hair restoration.
There are reports which say that use of finasteride and topical minoxidil combination therapy as a Medical hair restoration treatment is of more advantage in cases of mild to moderate MPHL. Many hair restoration doctors have already started the use of combination therapy in order to obtain better hair growth.
Anti Androgen Therapy
For women with hyperandrogonism(with increased levels of androgen) who do not respond well to minoxidil, antiandrogen therapy is another option of medical hair restoration. In UK the most commonly used anti-androgen for women is CPA (cyproterone acetate), which is used in combination with ethinyl-estradiol.
In United States CPA is not available, the aldosterone antagonist spironolactone is the alternative choice of hair restoration doctors.
Medical hair restoration with flutamide has shown improvement as hair loss restoration treatment in women with hirsutism. For hyperandrogenic premenopausal women, flutamide is a better medical hair restoration agent than both the CPA or finestride.
Hair loss restoration management is a structured process. For more details on the topic you can refer to section medical hair restoration or article on male pattern hair loss or female pattern hair loss at our site hairtransplantadvice.com.