Treatment of androgenetic alopecia / male and female pattern hair loss - new developments and recommendations

[madman]

Six patients with hair loss

 

[madman]

Hair follicle miniaturization in androgenetic alopecia

Hair thickness heteregeneity

Decreased number of hairs per follicular unit

Perifollicular hyperpigmentation (peripilar sign)

4 trichoscopy features of androgenetic alopecia

 

[madman]

Pathogenetic factors in androgenetic alopecia

DHT/Inflammation/Blood Vessels

 

[madman]

Avoid vasoconstriction

Men who smoke

Twin study: nonsmokers vs smokers

 

[madman]

Minoxidil

Topical/Oral

Minoxidil overdose

48 mg - >1000 mg/d

 

[madman]

5-alpha reductase inhibitors

Reduction of serum DHT level by:

Herbal 5-alpha reductase inhibitors:

 

[madman]

Finasteride

Oral/Topical

Dutasteride

Oral/Intralesional

Efficacy and safety of twice- or thrice-weekly dutasteride versus daily finasteride in men with androgenetic alopecia: A randomized, investigator-blinded, active-controlled, parallel-group pilot study - PMC

Dutasteride is sometimes used in treating male androgenetic alopecia; however, published data on intermittent regimens are scant. To evaluate efficacy and safety of twice-weekly and thrice-weekly regimens of dutasteride, and to compare with ...

pmc.ncbi.nlm.nih.gov

 

[madman]

5-alpha reductase inhibitors

Finasteride and dutasteride in women of childbearing potential

High dose Finasteride/Dutatsteride may cause:

13853 women

Treated with finasteride or dutasteride

 

[madman]

Measures to minimize risk of suicidal thoughts with finasteride and dutasteride

Most cases were reported in people using 1 mg finasteride tablets (not 5 mg and not dutasteride)

no evidence linking suicidal ideation to finasteride spray

 

[madman]

spironolactone

25mg-200 mg daily

Combination therapy (spironolactone + minoxidil) for androgenetic alopecia in adolescent girls

 

[madman]

A Canadian Consensus on Androgenetic Alopecia 2025

https://journals.sagepub.com/doi/10.1177/12034754251368849?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed