Management of androgenetic alopecia: a review
Keywords:Androgenetic alopecia, Hair loss, Finasteride, Minoxidil, Alternative therapies
Androgenetic alopecia is a patterned hair loss disorder affecting approximately 73% of men and 57% of women in their lifetime, this affection can cause psychological effects like low self-stem and depression diminishing the quality of life. Currently, finasteride and minoxidil are the only two drugs approved by the food and drug administration (FDA), and devices of low-level laser therapy are FDA cleared. Alternative therapies for androgenetic alopecia treatment include a drug like dutasteride, botulinum toxin A, cell-based therapies like adipose-derived stem cell-conditioned medium and platelet-rich plasma protocols. A combination of two or more therapies can be found in the literature, the general consent indicates that any combination has higher efficiency than a single therapy. Finasteride is in less use due to the related sexual side effects, some adjuvant techniques have emerged to improve the delivery and effectiveness of minoxidil, i.e. micro needling. The surgical approach is mainly focused on hair transplant surgery, which offers relatively less invasive procedures and is a more suitable option for long time results, however, it is expensive. Recently, drug-assisted delivery techniques have emerged to improve the efficiency of conventional drugs; transdermal drug delivery through ultrasound pressure waves means creating diffusion channels, increasing skin permeability and stimulating cell differentiation and growth factor utilization along with minoxidil absorption. Another approach for drug-assisted delivery is the embodiment of finasteride in polymer-based microspheres aiming for a sustained and controlled delivery, which can be beneficial to reduce the regular doses decreasing adverse effects.
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