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Treatment of female pattern hair loss with combination therapy
Abstract
Female pattern hair loss (FPHL) is a common nonscarring alopecia characterized by progressive loss of terminal hairs. FPHL is a major concern for women and has a high impact on quality of life. Therapeutic regimen is often challenging and requires multiple combinations of topical, systemic, and interventional therapies to control hair loss and produce satisfactory hair regrowth. This article reviews common treatments of FPHL and their efficacy.
... Mild-to-moderate FPHL can be treated with oral antiandrogen therapies and/or topical minoxidil with good results in many cases. 1 Anti-androgen therapy is used in FPHL if hyperandrogenism is present or if there is a poor response to minoxidil. 33 However, information on their efficacy is limited and they have not been approved by FDA. 33,34 The commonly used antiandrogenic drugs in combination with minoxidil include 5-alpha reductase inhibitors (finasteride, dutasteride), spironolactone, flutamide, and cyproterone acetate. ...
... 33 However, information on their efficacy is limited and they have not been approved by FDA. 33,34 The commonly used antiandrogenic drugs in combination with minoxidil include 5-alpha reductase inhibitors (finasteride, dutasteride), spironolactone, flutamide, and cyproterone acetate. 33 The summary of clinical trials of topical minoxidil combined with oral anti-androgens is given in Table 3. [35][36][37] ...
... 33,34 The commonly used antiandrogenic drugs in combination with minoxidil include 5-alpha reductase inhibitors (finasteride, dutasteride), spironolactone, flutamide, and cyproterone acetate. 33 The summary of clinical trials of topical minoxidil combined with oral anti-androgens is given in Table 3. [35][36][37] ...
p>Female pattern hair loss (FPHL) is a common cause of hair loss and is associated with a reduction in quality of life and psychological morbidity. It is characterised by nonscarring progressive thinning of hair with gradual reduction in the number of hairs, with prevalence increasing with advancing age. A differential diagnosis of FPHL includes conditions like chronic telogen effluvium, diffuse alopecia areata, and some cases of scarring alopecia such as frontal fibrosing alopecia. A comprehensive history and thorough clinical examination are essential in establishing the diagnosis of FPHL. Additionally, dermoscopy is a valuable tool for appropriate diagnosis, specifically in early stages of the disease. Due to the chronic course and progressive nature of FPHL, long-term management is essential for sustained effects. Medical treatment with minoxidil remains the mainstay treatment for FPHL. Other therapeutic modalities include topical therapies like biomimetic peptides, systemic therapies like oral anti-androgen drugs such as finasteride and spironolactone as well as oral minoxidil in selected cases. Dermatosurgical procedures like platelet rich plasma, microneedling, low level laser and hair transplantation have been used. The role of diet has also been debated. The current article provides an overview on the optimal use of topical minoxidil for management of FPHL in Indian clinical practice.</p
... Combination therapy is commonly used in the treatment of hair disorders to achieve better results, as supported by both literature and clinical practice. 8,9 The participants specifically selected hair injectables (82%) as the most commonly combined therapy with LDOM, followed by finasteride (74%). These findings are expected, as hair disorders in Saudi Arabia are frequently treated in private sectors where injectables are commonly used. ...
Background
The utilization of low-dose oral minoxidil (LDOM) has emerged as a relatively new treatment option for hair loss, gaining recognition among dermatologists worldwide.
Objective
To assess the knowledge, attitude, and practice patterns among dermatologists in Saudi Arabia regarding the use of LDOM in the management of hair loss.
Methods
An online survey, which was distributed to dermatologists practicing in Saudi Arabia through email and mobile messages. Both univariate and bivariate analyses were performed to investigate the factors that may be associated with enhanced knowledge and practice patterns concerning the utilization of LDOM for the management of hair loss.
Results
A total of 84 dermatologists was included in this study, with 50 (60%) being male. It was found that 83 (99%) of the participants identified patterned hair loss as the most common indication for LDOM usage. Additionally, 77 (92%) recognized hypertrichosis as a well-known side effect. 48 (82%) of the dermatologists had never prescribed LDOM due to its unavailability in local pharmacies.
Conclusion
The usage of LDOM for hair disorders is increasing. Nonetheless, many dermatologists abstain from prescribing this medication due to its limited availability in local pharmacies.
Androgenetic alopecia (AGA) is the most common form of hair loss characterized by progressive reduction and miniaturization of terminal hair follicles on the scalp. While this condition is benign in nature and often considered part of the normal aging process, it is a familiar cosmetic concern encountered by dermatologists as it negatively impacts patient’s quality of life. Developing a therapeutic regimen for patients is often challenging as treatment options are limited, not well tolerated by all patients and may result in sub-optimal treatment outcomes. In this chapter, we discuss the use of PRP as an adjuvant therapy for treatment of AGA.
The first FDA-cleared platelet-rich plasma (PRP) collection devices were developed for use in orthopedic surgery in the 1990s, but recently there has been an explosion in off-label use of newer devices for aesthetic indications. The protocol for PRP preparation involves blood collection, platelet isolation via centrifugation, platelet activation, and administration into target tissues. Each of these steps introduces a source of variation that affects the composition and efficacy of the final PRP product, and this explains the significant heterogeneity seen among the preparation systems currently on the market. A number of classification systems have been proposed to help systematize the reporting of PRP outcomes, but they can also be used to compare devices. Aesthetic clinicians must understand the components of a PRP preparation system in order to critically evaluate the scientific literature on this topic and to offer the most effective treatment regimen to patients. The nuances pertaining to each of the preparatory factors discussed in this chapter are sources of great debate and require further study.
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