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Q. What are treatment options for androgenetic alopecia?

Answered by
Dr. Sandhya Narayanan Kutty
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Nov 28, 2022

Hello doctor,

I am suffering from androgenetic alopecia and also have a family history of male pattern baldness. I am currently using Minoxidil 5 %. Can I take Finasteride 1 mg?

Thank you.

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Hello,

Welcome to icliniq.com

MPHL or male pattern hair loss may occur due to multiple reasons, including genetic susceptibility, where hair loss may be transmitted genetically from the family, especially from the maternal end of your family, due to hormonal imbalances due to an increase in the level of androgen hormone, which leads to hair loss in the form of androgenetic alopecia, due to seborrheic Dermatitis or dandruff, climate changes in case of extremely hot or extremely cold climates, dietary changes and vitamin and mineral deficiencies especially vitamin D3 deficiency, frequent usage of hair creams, gels and treatments including smoothening, straightening and coloring of hair and may also occur due to stress following any viral infections or surgeries.

Genetically transmitted MPHL usually requires topical and oral medication treatment, and severe cases of balding may also require hair transplant procedures as the chances of hair loss may persist throughout life. My advice:

1. Since you are already using Minoxidil 5 % solution, I would like to advise you to add Finasteride along with the same. You can use a combination of Minoxidil with Finasteride. The above solution may be applied on the front and the crown area in case of hair loss in that area. The quantity that needs to be applied is 1 ml via the spray or the dropper applicator, which is available along with these solutions. It is advised to use the solution for years and continue using the medication for at least one year. This is because they act by increasing the blood supply on the hair follicles, which results in the growth of hair, and abrupt stopping of the medication would result in a sudden cutoff of the blood supply to the high follicles, which may result in loss of hair. Therefore, it is advised to be used consistently for one year and maybe eventually tapered down. For example, initially using them once daily for seven days per week for the first year, followed by once daily for six days per week for the second year, and later reduced to 5 days per week in the third year, and so on.

2. Finasteride tablets are not mandatory and are not usually advised to be taken, especially since you are young. Finasteride tablets have side effects, and their constant intake may result in complications due to which they are not much encouraged. Since topical finasteride solution is already available, they may be used instead of oral medication intake.

3. Take a multivitamin supplement tablet once daily after dinner for two months. They help in hair growth. They may be continued after a one-month break of 1 month following the two months of continuous intake and used continuously with frequent breaks of at least one month in between.

4. For hair stimulation, multiple procedures are available that yield good results for hair growth stimulation. Platelet-rich plasma or PRP, along with mesotherapy or GFC (growth factor concentrate), are treatments where superficial injections using an insulin syringe are done at periodic intervals of 4 weeks and are continued for at least six sessions or more for better results. In PRP and GFC treatments, one's blood is drawn in a 10 to 12 ml quantity and centrifuged in a machine to separate the plasma containing platelets or growth factors which are then taken in a small insulin syringe to inject superficially into the areas of hair loss over the scalp. The growth factors would help stimulate the hair follicles, restoring hair growth. Mesotherapy, on the other hand, is a similar treatment wherein vitamins consisting of biotin and other hair growth vitamins in the form of serum are injected similarly and may be done coupled with PRP or GFC every 15 days for better results. These procedures do not have side effects and help with hair growth stimuli. Other treatments, including laser techniques, are also available for hair growth stimulation and are done in sessions of at least six every four weeks. The procedures mentioned above are usually done at a dermatologist's clinic, so I would like to advise you to consult a dermatologist in person to undergo the procedures.

Apart from the above, having a balanced diet in the form of fruits, vegetables, fiber, and proteins, along with the consumption of at least 12 glasses of water in a 250 ml glass size daily, is advised. On the other hand, an imbalanced diet with red meat, milk and dairy products, sweets, and fried and oily food may trigger hormonal fluctuations, thereby leading to hair loss. Therefore, I suggest you do the following blood tests.

1. Complete blood count (CBC).

2. Serrum ferritin and iron levels.

3. Vitamin D3 levels.

4. Thyroid function test (TFT).

Kindly follow up with the blood reports for further management in case of variations in the same parameters.

Thank you.


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