Hair Loss Treatment:
Male Pattern Hair loss treatment
A) Pharmacologic (over the counter VS prescriptive)
Treatment of Androgenic alopecia progresses over time and although the current available medical treatments like finasteride (Propecia), Spironolactone (Aldactone) and minoxidil (Rogaine) in the form of foam or shampoo etc. Though they could be effective in arresting the progression of hair falling & restart hair re- growth, but they allow only partial regrowth of hair at its best. It also could take few months to see an improvement, let alone bearing up with some inconvenient side effects, for example, Propecia uncommonly may cause Erectile Dysfunction in men.
Others prescriptive medications include anxiolytics (Amitriptyline for stress) dihydrotestosterone, 5-alpha-reductase, topical application of VEGF: vascular endothelial growth factor & prostaglandins (PG’s). others specific treatments like anti- infections or for SD e.g antidandruff shampoo, antifungal, Nizoral & Salicylic Acid etc.1-3
B) Non-Surgical Hair growth Treatments
There are Non- Surgical procedures that help in preventing and reversing hair loss by promoting hair regrowth. These procedures are becoming more popular nowadays because they can be done as an office procedures, with no analgesia required (well tolerated with no or minimal discomfort), no down time, in addition to proven effective results in restoring the hair thickness and resuming hair growth.4,5
1- Botulinum A- Neurotoxin (BTX) injection in the scalp
In a study 63 patients with AGA were treated with BTA injection in the scalp, 30 sites were injected with 100 U of BTA in each site and repeated every 3 months for a total of 4 times. Hair counts, head photographs, evaluation scores, and self-assessment were assessed in patients with AGA.
Hair growth and density were significantly augmented, and the area of hair loss was attenuated after each treatment as revealed by head photographs. The effective rate of BTA was 73.3% following 4 times treatment. The study concluded that BTA is a safe and effective therapeutic strategy for the treatment of AGA without adverse effects, and BTA combined with FNS exhibited a superior therapeutic effect than BTA alone.6
2- Steroid injection in the scalp (may help Autoimmune Alopecia Areata) or topical Metformin may be useful in Cicatrical Alopecia.
3- Growth factor either topical application or through intradermal injections of a hair formulation into the scalp skin in single-arm interventional pilot study in which 1000 patients (of both genders) had intradermal injection of a formulation containing vascular endothelial growth factor, basic fibroblast growth factor, insulin-like growth factor & keratinocyte growth factor, all suspended in a sterile injectable vehicle.
These Intradermal injections of such hair formulation were injected into the scalp once every 3 weeks for a total of eight sessions. Hair pull test was performed before every session. Two months after the completion of the eight sessions. Relevant safety assessments through physical examination, questionnaires, and appropriate laboratory examination were conducted throughout the study. Significant reduction in hair fall was seen in 83% of the patients on hair pull test.7,8
4-Vampire Hair Treatment/ PRP Hair therapy
Platelet Rich Plasma (PRP) could work as prevention & as a treatment of hair loss. A sample of your own blood is taken to extract plasma which contains a range of growth factors and proteins that speed tissue repair when injected into patient scalp help to promote hair growth. Treatment would require 3 sessions with 4 weeks apart for hair follicle to respond.9-11
5- Autologous Cell therapy for hair loss & in Hair cloning: are still under study. Autologous cell grafting with Hair specific Growth factors (Rigenera cones) showed encouraging. 12
6- Stem Cell Based Therapy for Hair Loss is still advancing.20-22
7- Hair Mesotherapy with special nutrients, HA & other peptides that are supported by both experts’ opinion & practice evidenced results.
8- Other Non-Surgical procedures include Carboxythera-y in Hair Loss Treatment, LED therapy, Low Level Laser therapy-LLLT (approved by The Food & Drug Administration as a treatment for hereditary hair loss in men & women).23-29
All these kinds of procedures are performed by Dr. Nadia Yousri herself with excellent results recorded.
C) Surgical : Hypoderm Hair Transplantation (Replacement) which is beyond the scope of this blog.
D) Life style:
A healthy lifestyle of low stress, proper diet, and gentle hair care should help promote healthy hair growth for a long time.
Dr. Nadia YOUSRI is highly experienced in all the Non-Surgical procedures for Hair treatment with excellent results.
Dr. Nadia Yousri, OB&GY, Sexual Wellness & Regenerative Aesthetic Gynaecology Consultant™, FRCOG, PhD, MSc, DFFP, Published 19/05/2021, copyrights reserved to drnadiayousri.com©®
YouTube: Dr. Nadia Yousri: https://youtu.be/PdTObUhTnyo
Links to the press:-
1- Controversies in the treatment of androgenetic alopecia: The history of finasteride.
Andy G, John M, Mirna S, Rachita D, Michael K, Maja K, Aseem S, Zeljana B. Dermatol Ther. 2019 Mar;32(2): e12647.
2-A randomized, double-blind controlled study of the efficacy and safety of topical solution of 0.25% finasteride admixed with 3% minoxidil vs. 3% minoxidil solution in the treatment of male androgenetic alopecia. Suchonwanit P, Srisuwanwattana P, Chalermroj N, Khunkhet S. J Eur Acad Dermatol Venereol. 2018 Dec;32(12):2257-2263
3-The effectiveness of treatments for androgenetic alopecia: A systematic review and meta-analysis. Adil A, Godwin M. J Am Acad Dermatol. 2017 Jul;77(1):136-141.e5.
4-Efficacy of non-surgical treatments for androgenetic alopecia: a systematic review and network meta-analysis. Gupta AK, Mays RR, Dotzert MS, Versteeg SG, Shear NH, Piguet V. J Eur Acad Dermatol Venereol. 2018 Dec;32(12):2112-2125.
5-Androgenetic alopecia: an evidence-based treatment update.
Varothai S, Bergfeld WF. Am J Clin Dermatol. 2014 Jul;15(3):217-30.
6-Effectiveness and Safety of Botulinum Toxin Type A in the Treatment of Androgenetic Alopecia. Zhou Y, Yu S, Zhao J, Feng X, Zhang M, Zhao Z. Biomed Res Int. 2020 Aug 4;2020:1501893
7-Effects of topical application of growth factors followed by microneedle therapy in women with female pattern hair loss: a pilot study. Lee YB, Eun YS, Lee JH, Cheon MS, Park YG, Cho BK, Park HJ. J Dermatol. 2013 Jan;40(1):81-3.
8-Intradermal injections of a hair growth factor formulation for enhancement of human hair regrowth – safety and efficacy evaluation in a first-in-man pilot clinical study.
Kapoor R, Shome D. J Cosmet Laser Ther. 2018 Oct;20(6):369-379.
9-Comparison between single- versus double-spin prepared platelet-rich plasma injection in treatment of female pattern hair loss: clinical effect and relation to vascular endothelial growth factor. El-Husseiny RM, Saleh HM, Moustafa AA, Salem SA. Arch Dermatol Res. 2020 Sep 5.
11-Treatment of male pattern alopecia with platelet-rich plasma: A double-blind controlled study with analysis of platelet number and growth factor levels.Rodrigues BL, Montalvão SAL, Cancela RBB, Silva FAR, Urban A, Huber SC, Júnior JLRC, Lana JFSD, Annichinno-Bizzacchi JM. J Am Acad Dermatol. 2019 Mar;80(3):694-700.
18-Platelet-rich plasma for androgenetic alopecia: A review of the literature and proposed treatment protocol.Stevens J, Khetarpal S. Int J Womens Dermatol. 2018 Sep 21;5(1):46-51
19- Autologous cell-based therapy for male and female pattern hair loss using dermal sheath cup cells: A randomized placebo-controlled double-blinded dose-finding clinical study.Tsuboi R, Niiyama S, Irisawa R, Harada K, Nakazawa Y, Kishimoto J. J Am Acad Dermatol. 2020 Jul;83(1):109-116.
20-Establishment of an Efficient Primary Culture System for Human Hair Follicle Stem Cells Using the Rho-Associated Protein Kinase Inhibitor Y-27632. Wen L, Miao Y, Fan Z, Zhang J, Guo Y, Dai D, Huang J, Liu Z, Chen R, Hu Z. Front Cell Dev Biol. 2021 Mar 5;9:632882
21- Advances in Stem Cell-Based Therapy for Hair Loss.Egger A, Tomic-Canic M, Tosti A. CellR4 Repair Replace Regen Reprogram. 2020;8:e2894. Epub 2020 Sep 2.PMID: 3296869
22- Up-to-date Clinical Trials of Hair Regeneration Using Conditioned Media of Adipose-Derived Stem Cells in Male and Female Pattern Hair Loss. Shin H, Won CH, Chung WK, Park BS. Curr Stem Cell Res Ther. 2017;12(7):524-530. doi: 10.2174/1574888X12666170504120244.PMID: 28474542
23-Low level laser therapy and hair regrowth: an evidence-based review.
Zarei M, Wikramanayake TC, Falto-Aizpurua L, Schachner LA, Jimenez JJ. Lasers Med Sci. 2016 Feb;31(2):363-71.
24- Examining the Safety and Efficacy of Low-Level Laser Therapy for Male and Female Pattern Hair Loss: A Review of the Literature.
Egger A, Resnik SR, Aickara D, Maranda E, Kaiser M, Wikramanayake TC, Jimenez JJ .Skin Appendage Disord. 2020 Sep;6(5):259-267
25-Efficacy and safety of a low-level laser device in the treatment of male and female pattern hair loss: a multicenter, randomized, sham device-controlled, double-blind study.Jimenez JJ, Wikramanayake TC, Bergfeld W, Hordinsky M, Hickman JG, Hamblin MR, Schachner LA. Am J Clin Dermatol. 2014 Apr;15(2):115-27.
26-The growth of human scalp hair in females using visible red light laser and LED sources.
Lanzafame RJ, Blanche RR, Chiacchierini RP, Kazmirek ER, Sklar JA. Lasers Surg Med. 2014 Oct;46(8):601-7.
27- Low-level laser (light) therapy (LLLT) for treatment of hair loss.
Avci P, Gupta GK, Clark J, Wikonkal N, Hamblin MR. Lasers Surg Med. 2014 Feb;46(2):144-51.
28- Novel Approach to Treating Androgenetic Alopecia in Females With Photobiomodulation (Low-Level Laser Therapy). Friedman S, Schnoor P. Dermatol Surg. 2017 Jun;43(6):856-867.
29- The growth of human scalp hair mediated by visible red light laser and LED sources in males. Lanzafame RJ, Blanche RR, Bodian AB, Chiacchierini RP, Fernandez-Obregon A, Kazmirek ER. Lasers Surg Med. 2013 Oct;45(8):487-95
1-Cold caps and scalp cooling systems. https://www.breastcancer.org/tips/hair_skin_nails/cold-caps. Accessed Jan. 31, 2020.
2-Chemotherapy and you: Support for people with cancer. National Cancer Institute. https://www.cancer.gov/publications/patient-education/chemotherapy-and-you.pdf. Accessed Feb. 3, 2020.