The age of 10 million people with hair loss. [모락모락(毛樂毛樂)]is a special article for those who are losing precious hair. Together with plastic surgery specialist Park Soo-jin (Maxwell Dermatology), we provide clear answers to various hair loss information and questions.
The representative treatment method used in the treatment of hereditary hair loss is ‘taking drugs’. However, there are people who hesitate because of concerns about the possible side effects of taking hair loss pills, or the burden of taking them for the rest of their lives. Director Park Soo-jin explained in detail the principles and effects of typical hair loss pill treatment.
Hair LossㅣSource: Getty Image Bank
Q. What are some of the representative drugs to treat hereditary (androgenetic) hair loss?
Drug treatments for androgenetic alopecia play a role in slowing the process of hair loss. Representative drugs for male pattern baldness include ‘Finasteride’ and ‘Dutasteride’.
Finasteride is the first androgenetic hair loss treatment in the world and was approved by the US FDA in 1997. By blocking the action of type 2 5-alpha reductase (5-α Reductase), it stops the conversion of testosterone, a hormone male, into a hormone called DHT (dihydrotestosterone) which attacks the root of the hair follicle, reducing its concentration By doing so, it prevents the scalp hair follicle from shrinking and stops the increase in hair loss
The original Dutasteride drug was first marketed in the world in 2009 as a treatment for male pattern hair loss in Korea. By inhibiting enzymes type 1 and type 2 of 5-alpha reductase that convert testosterone to DHT, the reduction of DHT is higher.
Another hair loss treatment is Minoxidil. Minoxidil, used as a vasodilator for treating high blood pressure and used when hair grows out, was approved by the FDA as a hair loss treatment in 1988 after several clinical trials. Minoxidil acts on peripheral blood vessels to increase blood flow to the skin, activate hair follicle cells, and extend the hair growth cycle. In the case of cyclical hair loss, it has the effect of preventing hair loss by reducing the level of T lymphocytes, which is the main cause, to normalize the immune function, and by promoting the division of hair follicle cells, it acts directly on the proliferation of interstitial cells to promote hair growth.
When minoxidil is taken, the effect of the drug appears throughout the body, and when applied, the effect appears only on the area where it is applied. Recently, someone on YouTube said, “If you take minoxidil, hair loss treatment is over,” many female patients come to the hospital to get a prescription for minoxidil. Of course, it is true that you can see good effects by taking minoxidil. However, after taking minoxidil, many people experience thickening of body hair on the arms, legs and armpits.
Additionally, side effects of taking minoxidil can include swelling of the entire body, reflex tachycardia, and headaches. Animal studies have also reported necrosis of parts of the heart muscle and parts of the left ventricle. There was also an incident where a 7-year-old girl developed vomiting and persistent hypotension and tachycardia for 40 hours after accidentally taking minoxidil. The effect of taking minoxidil in this way is strong, but there are definitely parts to be careful about, so it is important to take it only when necessary after consulting a hair loss specialist.
Q. I’m curious about the difference in effect between finasteride and dutasteride.
Although the effects of the two drugs are similar, according to a recently published paper, dutasteride was found to be significantly more effective in preventing the progression of hair loss than finasteride in M-shaped and parietal hair loss. Considering the fact that finasteride reduces the conversion of testosterone to DHT by about 70%, but dutasteride, which inhibits type 1 and type 2 enzymes, reduces DHT by about 90%, this can be predicted as a natural result.
The adverse events of the drug that many patients are most curious about were similar for both drugs. Dutasteride is also much more effective than finasteride in treating benign prostatic hyperplasia. However, given these facts, discussions are still ongoing as to whether it is appropriate for young patients with normal prostate size and function to take dutasteride from the start. In addition, since finasteride was released 12 years earlier than dutasteride and has more data, it can be thought that safety has been established. Therefore, it is recommended to receive a correct diagnosis and a prescription from a specialist according to the progress of the individual patient.
C. If there is a family history of hair loss, more and more young people are taking hair loss medication as a preventative measure before symptoms appear. Is there really a deterrent effect?
Even if there is a family history, not everyone will experience hair loss. Even if you have the gene, you may not be able to express it, so you don’t need to take medicine as a preventative measure unnecessarily. In fact, there are many cases where patients who visit the hospital say that they have not lost hair yet, so do not take medicine and only after a year see the relative progress. However, if the thinning seems to be decreasing or the hairline is receding, visit the hospital to get a proper diagnosis and take the appropriate medication.
Many people feel burdened by hair lossㅣSource: Getty Image Bank
Q. Many people are burdened by the idea that they have to take hair loss medication for the rest of their lives. If a person who has been taking hair loss pills for a long time stops, will the hair loss continue immediately?
Androgenic alopecia is a lifelong progressive disease. If 5-alpha reductase is inhibited and the rate of conversion of testosterone to DHT is continuously reduced, the progression of androgenetic alopecia is greatly inhibited. When you stop taking the drug, DHT is produced again and hair loss resumes. There are many patients who feel burdened by the fact that they have to take medication ‘for life’ to gradually stop the production of DHT.
In order to prevent diseases while we live, there are steps that we are taught from a young age and take for granted ‘for life’. For example, brush your teeth three times a day, apply sunscreen every day, and diabetic patients take diabetes medications to keep blood sugar levels low. In addition, hypertensive patients take ‘lifelong’ medicines to keep their blood pressure at an appropriate level. Hair loss is also a disease, so it is natural to take ‘lifelong’ medication to stop the progress. If the correct education and understanding is ensured, the resistance to the word ‘life’ will decrease, and it will become a natural behaviour.
If you take hair loss pills for a long time and then stop, DHT is regenerated and hair loss starts again. Therefore, if hair loss is a concern, it is fine to continue taking the medication.
Q. What nutritional supplements are good to take along with the hair loss medication prescribed by the hospital?
In the 1960s, workers at the Carlsberg Brewery in Germany had full, shiny hair thanks to regular consumption of brewer’s yeast. Brewer’s yeast is an essential element for making beer and has a protein structure similar to hair. Medicinal yeast is a purified yeast used in beer, and a drug was released in Germany in 1978. In addition to medicinal yeast, there’ This product contains essential nutrients for hair growth, such as L-cysteine and keratin.
L-cysteine and keratin are also the main components of hair, and have antioxidant effects and help hair growth when taken. Thiamine increases the proliferative capacity of hair forming cells, and pantothenic acid helps metabolize energy for hair cell proliferation and stimulates tissue cell growth and regeneration. However, as it is difficult for the body to absorb these ingredients when taken as they are, it is recommended to take lactic acid bacteria at the same time. This is because lactic acid bacteria increase the absorption rate by helping the primary hydrolysis.
Recently, biotin, which has been prominent as a hair loss nutrient, is an essential ingredient for protein metabolism that composes the scalp and hair. By supplying nutrients to the scalp and keeping the scalp healthy, the health of the hair follicles also improves. It may be effective in hair loss caused by biotin metabolism disorder or biotin deficiency, but it is not guaranteed to be effective for all patients with hair loss. There are products on the market that contain as much as 10,000 mcg of biotin, but there is no evidence that the higher the biotin content, the better the hair loss treatment effect. I recommend taking it.
Director Park Soo-jinㅣSource: Maxwell Dermatology
Support = Haidaq Counseling Doctor Park Soo-jin (Maxwell Dermatology Plastic Surgery Specialist)
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