MALE AND FEMALE ANDROGENC ALOPECIA

Alopecia is diagnosed when new hairs are thinner than normal. The problem does not lie when the hair falls, but on the hair quality when it grows back. Do not confuse a “fine hair” with alopecia because there are many people who have always had thin or weak-looking hair. This does not necessarily mean alopecia.

In androgenetic alopecia, the enzyme 5-alpha-reductase and testosterone hormone are responsible for hair loss. The enzyme converts testosterone into dihydrotestosterone (DHT) who ultimately is responsible for reducing the follicles, causing the membrane pillars on the scalp to become rigid. The new hairs growing out are weaker and finer than normal until they disappear.

A clinical inspection is completed to diagnose distribution and quality of hair. We must also conduct a test with the help of our patient by asking him/her to wash hair for a total of four times, every two days. The hair that falls out must be picked up and brought to us in an envelope. We will evaluate the length and hair type (anageno- catagen-telogen). The number of hairs will be counted and a diagnosis will be provided.

The TrichoScan test is conducted before starting any treatment and 6 months after to assess response to treatment. It is a digital system that depending on the diameter of the hair emits different colors for immediate accountability.

Normal hairs are gradually being replaced by thinner and shorter hairs until they finally disappear completely. Often there is seborrheic dermatitis with itching and flaking of the scalp, but this is not the cause of hair loss, but the consequence of the action of androgens. Depending on sex, hair loss occurs in different ways:

• Men lose hair selectively in some areas, especially in the frontal and parietal region. Generally they begin to see a receding hairline. Thinning of bald areas on the crown is also affected. This is what is commonly known as entries. Thinning of bald areas on the crown is also affected. Previous analysis is required.
• Women: Hair loss is diffuse. In other words, the loss of hair is spread out throughout the scalp; however, the most affected regions are the temporal parietal and occipital area.

Androgenetic Alopecia can be treated with topical and oral treatments Androgenetic Alopecia can be treated with topical and oral treatments. Custom-made formulations containing minoxidil that are associated with anti androgens are available for topical treatments. Oral treatment will contain finasteride. This drug reduces levels of dihydrotestosterone which is responsible for hair loss. This way, the hair growth cycle is normalized and the loss of hair is stopped. At least 3 months of treatment are required to begin to see changes. Only one tablet a day is needed and it may be taken with or without food.

The treatment must take between 3-6 months to see results. If you stop taking it, you will probably lose the hair you have gained within 9-12 months after treatment discontinuation. It is important that you tell your urologist that you are taking this drug.

Minoxidil treatment can also be effective. It is preferred to administer this drug twice a day by applying 20 drops on the scalp and then performing a massage. Let your dermatologist know if you have a heart condition. Modifying the formula to your specific needs can solve possible problems like dryness, oily scalp or allergic itching.

Mesotherapy with platelet-rich plasma is still experimental.

Laser treatment gives good results as an adjunctive therapy as it stimulates hair growth.

In our institution we have performed hair transplants for many years. The area to be treated must be abundant in hair follicles for a successful outcome. The micro grafts transplanted into the donor area will last forever. Art in the implementation of micro grafts is crucial. In our institution, the specialist performing this procedure is not only a dermatologist, but also hair transplant facial artist who will guarantee a good aesthetic outcome as well. The operation is performed under local anesthesia with little pain. The patient may go back to work at 48h post intervention.