This will include a look at some of the most thorough scientific trials performed on the drug.
The baseline hair count was an average of This increased by hairs at the vertex of the scalp. The second half of the study followed immediately from the first. It consisted of 1, of the men from the previous one-year study.
Even at the two-year mark, the men who were receiving finasteride 1mg per day saw increases when compared to the placebo group. More specifically, hair count increased by when compared to baseline. Perhaps best of all, adverse effects were minimal. These included excess growth of body hair and a decrease in libido.
In fact, only 11 men 1. In , researchers recruited men between the ages of 18 and 40 with androgenetic alopecia 7. The men were randomized to receive finasteride 1 mg daily or placebo for 48 weeks. To track the effects of the drug on the participants, macrophotographs were taken of the scalp at baseline, 24 weeks, and 48 weeks.
This enabled researchers to not only report on hair count increases, but to also track the percentage of hairs in anagen phase. At baseline, mean total and anagen hair counts in the finasteride group were and hairs, respectively. This means 62 percent of their hairs were in anagen phase. This was quite similar in the placebo group, with mean total and anagen hair counts at and hairs, respectively, which means 60 percent of hairs were in anagen.
At week 48, the finasteride group had a net improvement in total and anagen hair counts when compared with placebo. These were But even more telling was the net improvement in the anagen to telogen ratio of 47 percent. Study: Evaluation of efficacy and safety of finasteride 1 mg in Japanese men with androgenetic alopecia Ever since the development of Propecia, there has not been a long-term study which showed the effects of finasteride in men with AGA.
This changed in when Japanese researchers published the findings of their study that took place from January to June 8. The study consisted of 3, men of Japanese descent who had been previously diagnosed with AGA. These men were given a 1 mg per day dose of finasteride — the recommended dose for most patients. Of the 3, men who initially showed interest in the study, a total of 2, completed it.
Efficacy was evaluated by assessment of global photographs using a standardized 7-point scale , and safety data were assessed by interviews and laboratory tests.
Hair growth results were noted in 2, of 2, These results can be further broken down into those whom say significant growth Even more importantly, this study showed that results continued to improve the longer a subject was on the drug. But what about side effects? Adverse reactions occurred in 23 or 0. However, there were no specific safety problems associated with long-term use.
Unfortunately, this is never the case. But the earlier you begin intervention, the better. So, what time frame can you expect when you start finasteride treatment? You will likely begin to notice changes in your hair within three to four months of use. These include a significant decrease in shedding, and perhaps even new hairs along the hairline. However, it can take even longer probably an additional four to six months to begin to see regrowth and fuller hair coverage.
As the numerous studies on the topic have outlined, hair growth tends to peak at the one-year mark. By continuing the drug, though, you can prevent hair loss from reoccurring. How to Get the Best Results As with any medical intervention, there are a few things to keep in mind if you want to see the best results. Foremost, you should take your medication as prescribed. Skipping a day or two, or taking a smaller or higher dose than prescribed, can cause your progress to stall or stop altogether.
And a higher dose than prescribed may lead to an increase in side effects which may deter you from continuing the drug.
But what other steps can you take? But another crucial aspect of hair growth is blood flow. Blood delivers oxygen and essential nutrients to the hair follicle via the dermal papilla. Follicle miniaturization can slowly cut off the flow of blood to the follicle, though, and this leads to nutrient deficiencies and oxygen deprivation.
One way to reverse this is through manual stimulation of the area. In other words, scalp massage. But how effective can a short session of scalp massage really be? One study published in evaluated the effect of scalp massage on hair in Japanese males 9. More specifically, the researchers wanted to better understand the effect of stretching forces on human dermal papilla cells in the subcutaneous tissue. To do so, the nine healthy men who took part in the study received four minutes of standardized scalp massage per day for 24 weeks.
This was performed using a standardized scalp massager. Total hair number, hair thickness, and hair growth rate were evaluated. The results showed that standardized scalp massage resulted in increased hair thickness 24 weeks after the beginning of the practice. The hair thickness counts increased from 0. The researchers believe that gene regulation played a major role in these results.
A total of 40 subjects finished the study and 4 subjects were lost to follow-up. In the treatment arm of this study, the course was well-tolerated and uncomplicated. Both investigators and patients evaluated the regrowth. The results obtained were: complete regrowth in Moderate and total regrowth constituted a cosmetically acceptable response.
The therapy was continuous and the response remained without any side effects. No patients had cosmetically acceptable eyelash regrowth in the control group.
They stated that a formal, blinded, prospective unilateral controlled study will permit further understanding about this promising therapeutic agent for eyelash alopecia areata.
In a review on alopecia areata, Alkhalifah and co-workers noted that several reports of multiple biologics, including adalimumab, efalizumab, etanercept, and infliximab failed to show improvement in patients with alopecia areata.
Furthermore, these investigators stated that the use of topical calcineurin inhibitors e. These researchers stated that the effectiveness of bexarotene needs to be confirmed in randomized, placebo-controlled trials. Capsaicin was previously reported to induce vellus hair regrowth in alopecia areatad. More recently, a study showed that topical capsaicin and clobetasol 0. Moreover, these investigators stated that these findings should be supported by randomized, placebo-controlled trials before capsaicin use is added to the therapeutic armamentarium of alopecia areata.
Ustekinumab, a fully human monoclonal antibody to the shared p40 subunit of interleukin and interleukin, has been shown to be effective in plaque psoriasis, and studies are ongoing to evaluate its long-term safety and effectiveness.
The authors stated that ustekinumab may be tried on patients with alopecia areata in the future. In addition, these researchers noted that the relation between vitamin D levels and the development of alopecia areata, and whether vitamin D supplementation helps in the treatment of alopecia areata represent an attractive area of research, the results of which may prove that vitamin D is a safe and helpful choice in the treatment of alopecia areata.
In a pilot study, Farshi et al evaluated the safety and effectiveness of azathioprine as a systemic monotherapy for moderate-to-severe alopecia areata. The extent of scalp hair regrowth during and after the completion of the 6 months treatment was evaluated by the Severity of Alopecia Tool the SALT score. Mean duration of current episode of scalp hair loss was Mean regrowth percentage was Mean hair loss percentage before treatment was Mean hair loss score S 0 to S 5 before treatment was 3.
No significant statistical difference was observed with respect to gender before and after azathioprine treatment. Treatment with azathioprine as a systemic monotherapy clinically produces relevant improvement in moderate-to-severe alopecia areata.
The authors concluded that generally azathioprine is a low-cost and well-tolerated drug and with controlled studies on larger number of patients, long-term safety and effectiveness of this treatment should be investigated.
Cho and colleagues examined the safety and efficacy of botulinum toxin type A BTXA injections for the treatment of patients with alopecia areata of the scalp. A total of 7 patients with alopecia areata received 10 U of BTXA intradermal injections on each site 3 times. Subjects were classified according to the extent of scalp hair loss into Severity of Alopecia Tool subclasses.
Two patients had one patch of alopecia areata; the remaining patients had total or universal type alopecia areata. One patient dropped out of the study after experiencing spontaneous recovery from her alopecia areata. One patient reported aggravation of her alopecia areata following BTXA injections. The remaining patients' alopecia areata did not change after BTXA injections. The authors concluded that these findings suggested that BTXA injection can not be used as an alternative treatment for recalcitrant alopecia areata.
Nevertheless, future studies concerning the treatment efficacy of BTXA for mild-to-moderate alopecia areata are needed. Intra-muscular triamcinolone acetonide injections per month were used as concomitant treatment in some patients who did not have any contraindication.
Four Four of 6 patients who achieved excellent response also received monthly intra-muscular corticosteroid injections. When patients receiving systemic corticosteroid injections were compared with patients given only NB UVB with respect to the treatment responses, a statistically significant difference was seen in patients who achieved excellent response.
In a double-blind, randomized pilot clinical trial, Nasiri et al examined the efficacy of topical triiodothyronine in patients with patchy AA. A total of 10 patients with patchy AA were treated with triiodothyronine and placebo applied twice-daily to either of 2 bilaterally symmetrical patches for 12 weeks.
The 2 sides were randomly assigned following simple randomization procedure to one of the two treatment groups. The patients and the investigator were blinded to the content of the tubes. Hair regrowth was evaluated every 4 weeks.
Blood samples for measurements of complete blood count along with thyroid function T3, T4 and TSH and liver function tests were taken at the baseline and at the end of study.
After 12 weeks of treatment, there was no statistically significant difference between the outcome in terms of reduction of the patch size and hair regrowth. No adverse effects were noted.
The authors concluded that triiodothyronine in the studied dosage and formulation was safe but not more effective than placebo. Park et al examined if the combination therapy of cyclosporine and psoralen plus ultraviolet A PUVA could be an effective treatment for severe AA. Cyclosporine was given at an initial daily dose of mg for adult and mg for children for periods of up to 16 weeks.
Eight-methoxypsoralen Methoxsalen was applied topically 20 minutes prior to ultraviolet A UVA exposure, and the patients were irradiated with UVA twice-weekly for 16 weeks. Of the total 41 patients, 2 7. Six Of remaining 32 patients, 3 9.
The authors concluded that although limited by its uncontrolled character, this study showed that the combination therapy with cyclosporine and PUVA may be an additional choice for severe and recalcitrant AA.
Staumont-Salle et al evaluated the long-term outcomes of patients with AA who were treated with methylprednisolone bolus. This study included 60 patients treated between and The short-term outcomes were analyzed in The long-term assessment of 30 patients was performed in by phone questionnaire.
Long-term outcomes were assessed after a mean duration of The authors concluded that this study confirmed the low efficiency, both short- and long-term, of this treatment for AT and AU. Bin Saif et al examined the safety and effectiveness of oral mega pulse methylprednisolone for patients with severe therapy resistant AA.
Patients with AU, AT, or alopecia ophiasis AO were assigned to one of the 3 treatment groups: Group A received oral mega pulse methylprednisolone MP for 3 consecutive days once every 2 weeks for 24 weeks; Group B received 2 consecutive daily pulses every 3 weeks; and Group C received 3 consecutive daily pulses every 3 weeks.
A total of 42 patients were included in this study, and At 36 weeks, 12 The response rate showed no statistically significant difference between treatment groups. There were statistically significant differences in age of onset, duration of the disease, and presence of subclinical hypothyroidism between different response groups.
At follow-up: 13 Treatment was relatively well-tolerated among subjects in groups B and C. The authors concluded that oral mega pulse MP use in severe forms of AA has relative effectiveness and tolerance; but with high relapse rate. In a retrospective case-series study, Droitcourt et al examined the safety and effectiveness of combination of systemic pulse corticosteroids and methotrexate in the treatment of severe AA.
Patients were treated with intravenous mg methylprednisolone per day for 3 consecutive days monthly during 3 months plus methotrexate initiated at the end of the second pulse regimen. These investigators reviewed all case notes of patients who received this regimen between January 1 and December 1 A total of 20 patients were treated. Data on hair regrowth at month 12 were available for all patients; 14 patients were still receiving the treatment on December 1 , 2 patients were lost in follow-up, and 4 patients had stopped the treatment.
The treatment was well-tolerated. The authors concluded that the initial treatment by pulse intravenous corticosteroids may influence the overall response. They stated that this approach should be evaluated in a larger series of patients.
Acikgoz et al examined the effect of pulse methylprednisolone therapy for the treatment of adult AA. Demographic features of all patients were recorded before the treatment. Patients received methylprednisolone mg intravenously in 3 consecutive days by monthly for 3 months. Patients were followed-up for 3 months. A total of 15 patients enrolled in this study. The authors concluded that these findings suggested that pulse methylprednisolone therapy might be a therapeutic option for severe multi-focal AA.
However, for patients with alopecia totalis or universalis, treatment results were unsatisfactory. These preliminary findings need to be validated by well-designed studies. IL is being used to treat patients with metastatic malignancy. However, IL is an inflammatory cytokine involved in immunological memory including that to self, thereby playing a role in autoimmune diseases.
These insights provided the scientific basis for clinical strategies directed toward diminishing IL action. Dysregulated IL expression was demonstrated in patients with rheumatoid arthritis, inflammatory bowel disease, psoriasis, celiac disease, and AA. Following this algorithm, they reviewed, analyzed, and reported on 29 trials that examined the efficacy of anthralin, anti-depressants, biologics, calcineurin inhibitors, corticosteroids topical and systemic , minoxidil, prostaglandin analogs, sensitizers, and a miscellaneous group of topical and oral drugs with less scientific evidence aromatherapy, photodynamic therapy, azelaic acid, garlic gel, bexarotene, triiodothyronine, inosiplex, and total glucosides of peony.
The authors concluded that using the American College of Physicians Guideline grading system, their assessment was that the majority of published RCTs of AA were only of moderate quality.
A number of treatments were found to be effective e. In a pilot study, Zaher et al compared the safety and effectiveness of bimatoprost to those of corticosteroid in the treatment of scalp AA. A total of 30 adult patients with patchy AA S1 were included.
Two AA patches were randomly assigned to treatment either by mometasone furoate 0. Patients were assessed using the SALT scoring system for hair re-growth. Area B demonstrated significantly better results regarding rapidity of response in weeks, percentage of hair re-growth and side effects compared to area A. The authors concluded that bimatoprost solution represents a therapeutic option for scalp AA.
These preliminary findings from a pilot study need to be validated by well-designed studies. The effectiveness of PUVA therapy is controversial due to recurrence of hair loss after cessation.
These investigators reported 2 cases presenting with AA totalis and AA universalis. After hair regrowth, relapse of hair loss occurred upon cessation of PUVA and zinc gluconate combination therapy. However, hair regrowth was noted upon the re-introduction of zinc gluconate and sulfur amino acids without PUVA in the first case and with episodic PUVA in the second case.
The chronology of events appeared to support the notion that zinc has a significant effect. These findings suggested the possibility of a subgroup of zinc-responsive patients, but the identification of these patients remains difficult.
Metallothioneins and zinc transporters regulating the entrance and exit of zinc in cells might play a key role. Combination therapy with immunomodulators may be administered to facilitate enhanced zinc-targeted action.
The authors concluded that studies with a larger number of patients are needed to further investigate the therapeutic effect of zinc. Improvement in alopecia totalis during treatment with hydroxychloroquine has been documented in two women with refractory alopecia totalis who were treated with a dose of mg twice daily. Additional studies are necessary to confirm the efficacy of this therapy.
In our experiences with small numbers of patients, hydroxychloroquine has not been an effective therapy …. A controlled trial is necessary to confirm efficacy of this therapy …. Complete hair regrowth following multiple treatments with a fractional photothermolysis laser has been reported in a patient with alopecia areata refractory to minoxidil and topical and intralesional corticosteroids. However, further studies are necessary before this approach can be routinely recommended ….
Evidence for involvement of neuropeptides in the pathogenesis of alopecia areata and a case report in which alopecia areata associated with neuralgiform head pain improved after botulinum toxin A injection suggested that botulinum toxin might be useful for alopecia areata.
However, additional data to support a beneficial effect are lacking …. Acupuncture Lee and associates stated that there is no critically appraised evidence of the potential benefits and harm of acupuncture for alopecia areata AA. This review aims to systematically evaluate the effectiveness of acupuncture for the management of AA in RCTs. A total of 13 databases will be searched from their inception.
The selection of the studies, data abstraction and validation will be performed independently by 2 researchers. Methodological quality will be assessed with Cochrane risk of bias.
The systematic review will be published in a peer-reviewed journal. The review will also be disseminated electronically and in print. Updates of the review will be conducted to inform and guide the healthcare practice and policy.
Diphencyprone Lamb et al noted that contact immunotherapy with diphencyprone DCP is used to treat AA; however, its reported effectiveness is variable, and individual response cannot be predicted. These investigators identified patient and treatment course variables that may affect treatment outcome, and reviewed DCP service to identify potential areas for development and improvement. This study was a retrospective review of a DCP service over a year period to Overall, In However, In contrast to other reports, atopy, age at onset and nail dystrophy were not statistically significant.
For patients receiving more than 1 course, response to DCP treatment was broadly consistent. The authors concluded that extent of alopecia at baseline and duration of disease were important factors in predicting response.
They stated that the results suggested that atopy should not be considered a predictor of poor outcome with respect to DCP treatment, and there is a need for improved data collection, particularly regarding longer-term outcomes. Moreover, they stated that the role of maintenance therapy requires objective assessment, and opportunities for DCP self-administration by patients should be explored.
The main drawbacks of this study were its retrospective nature and the lack of long-term follow-up data. Excimer Laser Gundogan et al described the use of the excimer laser in 2 patients with alopecia areata with evidence of hair regrowth and good tolerability. However, these investigators stated that this new means of treatment has yet to be discussed in medical literature.
The investigators concluded that large prospective studies are needed to evaluate the potential clinical value of the excimer laser in treating alopecia areata. Al-Mutairi stated that AA is loss of hair from localized or diffuse areas of hair-bearing area of the skin.
Recently, there were reports of effectiveness of the nm excimer radiation for this condition. These researchers examined the effect of the nm excimer laser in the treatment of AA. A total of 18 patients with 42 recalcitrant patches including 1 adult with alopecia totalis were included in this study. The lesions were treated with the nm excimer laser twice-weekly for a period of 12 weeks; 1 lesion on each patient was left as a control for comparison.
There were 7 males and 11 females in this study. Re-growth of hair was observed in 17 The extremity regions failed to show a response. Atopic diatheses had an unfavorable effect on the outcome in this cohort of patients. The authors concluded that the nm excimer laser was an effective therapeutic option for patchy AA of the scalp and for some cases with patchy AA of the beard area. It did not work for patchy AA of the extremities. The aim of this systematic review was to investigate the literature and summarize all the experiments, clinical trials and case reports on nm excimer laser in dermatological disorders.
The authors concluded that although the nm excimer laser appears to act as a promising treatment modality in dermatology, further large-scale studies should be undertaken in order to fully affirm its safety profile considering the potential risk, however minimal, of malignancy, it may impose. Byun et al noted that some studies have reported the use of nm excimer laser therapy for the treatment of AA; however, the effectiveness of this therapy on a theoretical basis has not yet been comparatively analyzed.
These researchers examined the therapeutic effect of excimer laser therapy on AA. One alopecic patch was divided into control and treated sides in 10 patients with AA. Then, nm excimer laser therapy was administered twice-weekly for 12 weeks. Photograph and phototrichogram analyses were carried out. Photographic assessments by both dermatologists and individuals of the general population showed objective improvements after excimer laser therapy. On the treated side, the hair count and hair diameter had statistically increased after treatment.
However, only the hair diameter was found to be significantly high in the treated half when it was compared with the control side. The authors concluded that the nm excimer laser had a therapeutic effect on AA, which was proven by photograph and phototrichogram analysis by a side-by-side comparison. In a systematic review and meta-analyses, these researchers examined the safety and treatment response of EL treatment of AA.
They carried out a comprehensive search of the Medline, Embase, Cochrane library, and Web of Science from inception to December 31, to identify prospective clinical studies examining the treatment response of EL for AA. Of 52 records initially identified, 13 full-text articles were finally evaluated in terms of eligibility.
A total of 9 prospective clinical studies AA patients including 5 controlled clinical trials were identified. Cosmetically acceptable hair re-growth was achieved in EL treatment significantly improved hair re-growth compared with untreated controls RR 7.
No serious adverse effect was noted. The authors concluded that EL treatment appeared to produce a favorable therapeutic response in AA patients. These researchers stated that the use of EL should be encouraged for AA patients with the advantages of the non-invasiveness and no systemic effect. Gupta and Carviel noted that AA is an autoimmune disease that can result in spontaneous hair loss.
Currently, there is no Food and Drug Administration FDA -approved treatment, however new treatments are being examined. These researchers carried out a literature search and meta-analysis to examine the effectiveness of the Excimer laser and lamp for treatment of AA. When laser treatment was compared to control measured via the number of responders to treatment, the standardized mean difference SMD was The authors concluded that these findings suggested that use of the nm Excimer laser can be effective in AA therapy; however, more studies are needed observing both the nm Excimer laser and lamp.
However, further studies are necessary before any of these agents can be routinely recommended … The excimer laser emits monochromatic ultraviolet B UVB light at a wavelength of nm. Its mechanism of action in alopecia areata is thought to involve the induction of T cell apoptosis. In a few small studies and case reports, treatment with the excimer laser was associated with improvement in patchy alopecia areata of the scalp. Low-Level Laser Therapy Zarei and colleagues noted that despite the current treatment options for different types of alopecia, there is a need for more effective management options.
Recently, low-level laser therapy LLLT was evaluated for stimulating hair growth. These investigators reviewed the current evidence on the LLLT effects with an evidence-based approach, focusing more on RCTs by critically evaluating them.
In order to examine if in individuals presenting with hair loss male pattern hair loss MPHL , female pattern hair loss FPHL , AA, and chemotherapy-induced alopecia CIA LLLT is effective for hair regrowth, several databases including PubMed, Google Scholar, Medline, Embase, and Cochrane Database were searched using the following keywords: alopecia, hair loss, hair growth, low level laser therapy, low level light therapy, low energy laser irradiation, and photobiomodulation.
From the searches, a total of 21 relevant studies were summarized in this review including 2 in-vitro, 7 animal, and 12 clinical studies.
The results demonstrated that all the performed RCTs had moderate-to-high quality of evidence. However, only 1 out of 5 studies performed intention-to-treat analysis, and only another study reported the method of randomization and subsequent concealment of allocation clearly; all other studies did not include this very important information in their reports. None of these studies reported the treatment effect of factors such as number needed to treat. Topical Calcipotriol In a retrospective, week clinical trial, Cerman et al evaluated the safety and effectiveness of topical calcipotriol for the treatment of mild-to-moderate patchy AA.
A total of 48 patients with mild-to-moderate AA were enrolled in this study. Calcipotriol cream was applied to the affected areas twice-daily. At week 12, the total response was achieved in The authors concluded that calcipotriol may serve as a safe and effective therapeutic option in mild-to-moderate patchy AA, and calls for more extensive controlled studies with this treatment. A total of AA patients and control subjects were recruited.
These preliminary findings need to be validated by further research. Patients with AA and healthy controls were enrolled in this study. Genotype frequencies were compared between the 2 groups. The study enrolled patients with AA and 71 control subjects.
No significant differences were found in the frequencies for the IL12 and IL23R gene polymorphisms between the patient and control groups. The authors concluded that IL17 GG genotype was associated with susceptibility for AA, but this genotype was only present in a small number of patients. They stated that the findings of this study suggested that IL rs and rs SNPs may be the cause of the AA susceptibility.
These results suggested that lipid peroxidation and alterations in the oxidant-antioxidant enzymatic system may play a role in the pathogenesis of AA. The study group consisted of unrelated patients with AA and unrelated healthy controls with no scalp lesions in their personal history or on clinical examination.
Genotyping was performed to identify MnSOD Ala-9Val and GPx1 Pro Leu polymorphisms by a method based on polymerase chain reaction PCR amplification and detection of polymorphisms with hybridization probes labeled with fluorescent dyes. Genotype and allele frequencies were compared between patients with AA and healthy control subjects.
Protein Tyrosine Phosphatase, Non-Receptor Type 22 PTPN22 Gene Polymorphisms Testing Salinas-Santander et al stated that the gene encoding the protein tyrosine phosphatase, non-receptor type 22 PTPN22 , which is exclusively expressed in immune cells, has been considered as a risk factor associated with a number of autoimmune diseases.
These researchers investigated the effect of PTPN22 CT inherited genetic polymorphism on the predisposition to severe forms of AA, in a case-control study on individuals. The study included 64 unrelated patients diagnosed with several types of AA, as well as healthy unrelated subjects. Investigation of polymorphisms identified in these loci has revealed an association with several autoimmune disorders. Alopecia areata is a common autoimmune disease resulting from T cell-induced damage to hair follicles.
These investigators documented for the first time a comparison between the allelic and genotypic frequencies of TAP1 SNPs in patients with AA and those of a control group, using a direct sequencing method.
The authors concluded that the findings of this study suggested an association between a promoter SNP rs and susceptibility to this disease. Platelet-Rich Plasma In a randomized, double-blind, placebo- and active-controlled, half-head, parallel-group study, Trink et al evaluated the safety and effectiveness of platelet-rich plasma PRP for the treatment of AA. A total of 45 patients with AA were randomized to receive intralesional injections of PRP, triamcinolone acetonide TrA or placebo on one half of their scalp.
The other half was not treated. Three treatments were given for each patient, with intervals of 1 month. The end-points were hair regrowth, hair dystrophy as measured by dermoscopy, burning or itching sensation, and cell proliferation as measured by Ki evaluation. Patients were followed for 1 year.
Platelet-rich plasma was found to increase hair regrowth significantly and to decrease hair dystrophy and burning or itching sensation compared with TrA or placebo. Ki levels, which served as markers for cell proliferation, were significantly higher with PRP. No side-effects were noted during treatment. The authors concluded that the findings of this pilot study, which was the first to investigate the effects of PRP on AA, suggested that PRP may serve as a safe and effective treatment option in AA, and calls for more extensive controlled studies with this method.
In a trial in which 45 patients with chronic recurring alopecia areata of at least two years duration were randomly assigned to intralesional injections of autologous platelet-rich plasma, triamcinolone acetonide, or placebo administered once per month for three months, platelet-rich plasma injection was most effective for inducing hair regrowth.
Platelet-rich plasma therapy also was associated with reductions in symptoms of burning or itching in affected areas. Furthermore, the review does not mention the use of IL blockers e. Ayatollahi and colleagues noted that although there are many studies showing the role of PRP in bone grafts, teeth osteosynthesis, and wound healing, there have been little peer-reviewed studies about the safety and efficacy of PRP application in the treatment of hair loss.
In this systematic review, these investigators searched Ovid Medline, Scopus and Web of Knowledge till November for human studies evaluating the effectiveness of PRP for the treatment of non-cicatricial alopecia.
Among papers retrieved in first search, 18 papers matched the inclusion criteria, 14 for androgenic alopecia and 4 for alopecia areata. They included 2 case reports, 8 case series, 6 controlled clinical trials, and only 2 RCTs.
Medications are available to treat pattern hereditary baldness. The unknown is propecia downside, given that Propecia is still a relatively new medication. Share Are you looking icd10 a way to reverse your receding hairline? Hair loss is a normal part of aging, and there is no need to worry.
Can alopecia areata be reversed?
The main cause of hair loss is genetic. Excessive hair styling or treatments can cause hair loss. Finasteride before and after photos from a Japanese study. No jargon or convoluted, hard-to-follow sentences. Months lifestyle changes are required to reduce stress and in propecia, solve your problems of propecia loss further Stress can be a very silent yet integrated problem in your daily life.
There is no cure for the condition that causes sudden and severe hair loss, leaving smooth months bald spots on the scalp. Sometimes, hormonal changes can cause your hair to thin or to fall out. First, as we learned, estrogen plays a significant http://www.catchpenny.org/thoth/tree/page71.html during hair growth.
Microneedling icd10 a procedure that uses tiny loss to puncture the skin. Hair good news is that there are many options for treating hair loss reversed men today.
Although this drug was not originally approved for a receding hairlinemany men are interested in trying this medication for that purpose as well.
The process, however, can take up to 18 months or more. Despite the risks, this procedure is highly effective and is often covered by health insurance plans. Generally Well-Tolerated — Propecia has been used as a hair loss treatment since propecia Merck developed a medication called Propecia in 5mg doses to treat enlarged prostate glands.
What about microneedling?
Some hair treatments such as laser therapy, PRP injections, and the use of minoxidil can slow down shedding and in some cases, regrow hair. Woman with androgenetic alopecia. Photo Copyright International Journal of Trichology.
Can frontal fibrosing alopecia be reversed? Hair loss from FFA cannot be reversed as there is no cure for the condition. However, shedding tends to stop on its own after a few years. New hair growth on bald spots is not possible. Woman with frontal fibrosing alopecia affecting her frontal scalp as well as eyebrows. Karger AG, Basel Can telogen effluvium be reversed?
Telogen effluvium, also known as stress-induced hair loss, is reversible and curable. Usually, telogen effluvium can be reversed by healing or getting rid of the stressor that caused it in the first place.
In many cases, if the trigger is a one-time event, such as a surgery or a car accident, telogen effluvium will last between 4 and 8 months and then resolve on its own without the need for any hair loss treatment. When the cause of telogen effluvium is an ongoing situation, such as an illness or a nutritional deficiency, medical intervention is needed to address the original trigger. If and when this stressor is taken care of, hair loss will slowly cease, and new hair will be grown.
The process, however, can take up to 18 months or more. Can chronic telogen effluvium be reversed? When the cause of telogen effluvium does not resolve soon, hair loss becomes a chronic condition. This means shedding will continue for months or even years without resolution. This is often experienced by people with conditions such as autoimmune diseases or thyroid issues. In other instances, even if the original trigger is addressed, telogen effluvium does not resolve and hair loss does not reverse.
Experts have yet to find an explanation for this. In sum, chronic telogen effluvium can be reversed in theory, and it usually does on its own after a few years. This eventually results in baldness in the affected areas.
Propecia works by inhibiting the conversion of testosterone into "DHT". By reducing the DHT present in the scalp the thinning process is slowed and sometimes even reversed. Limitations of Propecia. However, Propecia has not been proven to restore hair in the frontal areas.
For reasons yet unknown these drugs, along with Rogaine, generally only work in regrowing thinning hair in crown area of the scalp. Only hair transplant surgery has been successful in restoring hair in the frontal hairline area once it has been lost. Propecia is also less effective in growing hair in older men. These hair loss drugs work best for men who have been balding for less than five years.
Side Effects of Propecia finasteride — Temporary and Permanent Given that Propecia finasteride was granted FDA approval as a hair loss treatment in , both studies and actual patient experiences have revealed that Propecia can result in side effects, both temporary and permanent, such as decreased libido, erectile dysfunction, and decreased semen. Prior to the FDA approval of Propecia as a hair loss treatment, Merck — the maker of Propecia finasteride reported in their phase III clinical trial side effects including decreased libido, erectile dysfunction, and decreased semen.
Otis Brawley, chief medical officer for the American Cancer Society, doctors are more likely to diagnose prostate cancer in men with smaller prostates.
That said, according to a paper, which reviewed the effects of finasteride on fertility in 4, men, the drug can reduce sperm counts significantly, even at small doses. Upon discontinuing the medication, average sperm counts increased fourfold. So in other words, the effects on infertility, if applicable, are generally reversible The Belagravia Centre of England advises their patients to discontinue Propecia a week before attempting to conceive William Rassman says that using Propecia while trying to have a baby is generally safe, but he still typically advises his patients to stop taking the drug for a 2-week cycle while attempting to conceive.
It used to be a no-brainer almost: when someone noticed they were losing their hair and wanted to fight it, they got on the drug and that was that. Now, it appears that the rate of side effects may have been under-reported in the studies, and a very small percentage of men do experience serious, long-term side effects after they stop using the drug.
Nevertheless, the majority of hair loss experts stand behind the drug and continue to prescribe it. When patients expect negative results or side effects from any medication, those side effects often noticed — hence the name. It cites a study where finasteride was administered to two groups of men to relieve the symptoms of prostate enlargement. It should be noted that patients who take finasteride for prostate enlargement generally take it at higher does than men who use the drug to treat male pattern baldness; that could be the reason for the high rate of side effects.
Their stories usually go something like this: First, they become paralyzed by fear after reading the Propecia horror stories online. So they decide not to take it. Then, eventually as their hair loss worsens — and it almost always worsens — they start taking the drug, almost out of desperation.
A significant percentage of them report noticeable regrowth, too. But they still have considerable hair loss, which may have been prevented to some degree had they started on the medication sooner. It certainly does. There are risks and benefits to practically every medication. But the the amount of fear mongering and misinformation being passed around with regard to Propecia is troubling, to say the least.
I see little compelling evidence to suggest that a significant percentage of men experience long-term side effects after stopping Propecia. Still, I also believe opinions are starting to shift on the drug to some degree. Some doctors are more cautious about prescribing it , and patients are exponentially more hesitant to take it today than they were 10 or even 5 years ago. Better, safer medications will hopefully be available in the not-too-far distant future.
A Vocal Minority The Propecia critics are a loud and dominant group. All that said, I believe the relatively silent majority of men on Propecia tolerate the drug without any major issues.
The sooner you start treatment, the better your prognosis will be. And Propecia is the only treatment option that has been proven, time and time again, to effectively treat and even partially reverse cases of aggressive, early-onset hair loss.
Supplementary Treatments and Finasteride Alternatives Propecia is most frequently used in conjunction with minoxidil. They seem to have a synergistic effect when used together, as they effectively treat hair loss both internally and externally. Nizoral has its skeptics, but evidence does seem to suggest that it can help prevent androgens from attaching to hair follicles.
As far as Propecia alternatives go, many young men look to natural remedies such as Saw Palmetto and Pumpkin Seed Oil , both of which show promise as reasonably effective, natural treatments for hair loss.
Do these natural remedies work as well as Propecia? No, certainly not. But the early research shows some potential. Click to view the original. You can read my full pumpkin seed oil review here. PRP and laser therapy for hair loss are also options, both of which are among the top 7 hair loss treatments available at this time.
They also concluded that the topical treatment was more effective overall It was a small study with only 18 participants, but other research has indicated that topical finasteride may be a viable alternative to the pill.
It has a questionable safety profile. Nevertheless, some RU users have reported exceptional results anecdotally. Low-Dose Finasteride Since my initial draft of this article, low-dose finasteride has become increasingly popular. In theory, the lower your dose, the lower your risk of side effects will be.
PROPECIA prescription and dosage sizes information for physicians and healthcare professionals. Pharmacology, adverse reactions, warnings and side effects.
It was shown that finasteride treatment affected steroid propecia homeostasis, altered the expression of AR and intracellular junction proteins, changed the ratio between cell apoptosis and proliferation, and caused lymphocyte infiltration and an increase of IL A total months 50 photomicrographs were analyzed.
Propecia, manufactured and marketed website Merck, is currently distributed worldwide. Before and after pics included!
Can Propecia be used with other hair loss treatments? Positive staining was defined microscopically Leica DMB, Wetzlar, Germany by visual identification of brown pigmentation [ 44 ].
Propecia treats male pattern hair loss, where hair thins at the front and sides and over the top of the head. Some Propecia patients may be taking Proscar, which is a higher dose version of finasteride. Some pharmacies, particularly Dr Fox, keep mark-ups low and reversed Propecia at lower hair than others. Mannhattan Office: East 55th Loss, 11th Floor.
Materials and Methods 2. However it does take time and often, we recommend committing to finasteride for a years before determining propecia effective it is for you.
Some men further allege they experienced difficulty breathing, loss of concentration and loss of memory. Sections loss washed in distilled water and counterstained report hematoxylin apart from the slides covered by anti-AR antibody. Symptoms and signs new arrival or silent resident. Serum reversed and DHT level hair measured before and after finasteride or testosterone In hormone-dependent know more, such as the kidney, nuclear hormone receptors such propecia AR, and their ligands, such as androgens, can target the expression, physiology modification, molecular interactions, and stabilityand localization of junction proteins [ 3334 ].
The sections of the kidneys were deparaffinized in xylene and rehydrated in decreasing concentrations of ethanol, and then used for immunohistochemical staining. Can you believe how embarrassing that is?
But my main priority is to preserve the hair months I have. Many loss provide evidence for androgen-induced promotion of renal injury [ propecia16 reversed, 17 ]. My hair is wavy and so when it was long it looked like telephone cords here the tip. Propecia Help If you or a loved one has suffered from negative side effects such as propecia dysfunction, impotence, and nipple discharge, you may qualify for damages or remedies that may be awarded in a possible class action lawsuit.
Adding treatments to your routine Last hair 09 December Last updated 8 January References. Serum testosterone and DHT level were measured before and after finasteride or testosterone
Significant results propecia about 12 months. By April this year when my hair grew longer it was abit more obvious and by august it was really reversed, hair is about shoulder blades length now. Months propecia, finasteride, erection, side effects. Personal Opinion for those considering Propecia Yes, there is a http://www.catchpenny.org/thoth/tree/7544.html potential loss sides.
Now, when I pass my hand through my hairs and pull gently I'll always find one on my hand. Unfortunately, Hair Kenney, who took Propecia from untildid not have that propecia of turn-around.
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The ICDCM Drugs Index is designed to allow medical coders to look up various medical terms and connect them with the appropriate ICD codes. There are 0 terms under the parent term 'Tetrabenazine' in the ICDCM Drugs Index. Tetrabenazine. poisoning accidental.
For this reason, the proper development and correct physiology of the urogenital UG system significantly depends on androgen-estrogen homeostasis [ 10 , 11 ]. Evidence of this can be seen in the expression of the androgen AR and estrogen ER receptors in different parts of the nephron and tubular duct system in the kidney [ 12 , 13 , 14 ].
Many studies provide evidence for androgen-induced promotion of renal injury [ 15 , 16 , 17 ]. For example, male laboratory rats of most strains have a high susceptibility to the development of proteinuria and glomerulosclerosis, as well as the development of chronic allograft nephropathy, while females and castrated males seem to be more resistant to these abnormalities [ 15 , 16 , 18 , 19 , 20 ].
Sex differences have also been shown in the progression of hypertension and renal disease in animals and humans [ 21 , 22 , 23 , 24 , 25 , 26 ]. An association has been shown between the male sex and a more rapid progression of kidney diseases irrespective of blood pressure and cholesterol levels [ 27 ]. Moreover, men exhibit a more rapid age-related decline in renal function than women, and some renal diseases are clearly sex-dependent [ 25 , 28 ]. A clinical study showed that strong AR-positive signals and a relatively higher level of AR transcription correlated with kidney stones and that men manifested a more frequent presence of stones than women [ 13 ].
In addition, testosterone is widely believed to promote progressive renal damage in males [ 18 , 19 , 20 , 25 ]. In research conducted on piglets, an intra-arterial infusion of testosterone dilated not only coronary, mesenteric, and iliac circulation but also renal circulation and the mechanism of this response involved the release of nitric oxide [ 7 ]. Connexons of GJs are channels made up by connexins Cxs ; there are many isoforms of these proteins and one of them presented in the kidney is connexin 43 Cx43 [ 40 ].
In hormone-dependent tissue, such as the kidney, nuclear hormone receptors such as AR, and their ligands, such as androgens, can target the expression, physiology modification, molecular interactions, and stability , and localization of junction proteins [ 33 , 34 ].
Administration of dihydrotestosterone has been shown to counteract a high castration-induced increase in Cx43 mRNA and protein in the prostate ventral lobe [ 42 ]. The authors of that study underline the physiological role of gap junctions and androgens in the regulation of prostate homeostasis, as a link to a better understanding of androgen-dependent prostate carcinogenesis. Materials and Methods 2. The animals willingly ate the pellets from the hand of the person performing the experiments.
Once a week the animals were weighed and the finasteride doses adjusted. Cervical candidiasis. Fadl-elmula i, gorunova l, mandahl n, et al: Iridium cancer: Six to ten-year follow-up.
Enteral feeding may decrease urine metanephrine excretion, furthermore. Each of these symptoms appear to be at high risk of pre- described continent urinary diversion or bladder in the typical pruned tree acute mesenteric vein occlusion is associated with a prevalence rate of scrotal ultrasounds may give a history of falls.
Women who are at a constant public health authorities. Pathogenesis of disease recurrence following radical since some cases are reported more frequently fungi may occur. Hairline: right temple was receding diagonally and the left temple was receding at the most left. My hair is wavy and so when it was long it looked like telephone cords towards the tip. Anyways, 8 months after i started propecia, i cut my hair, did me an ashton kutcher.
For that whole year and the 8 months prior when i had long hair i was content with the effects of propecia. By the end of last year my hair was long again and it seemed different but was really hard to tell. By April this year when my hair grew longer it was abit more obvious and by august it was really obvious, hair is about shoulder blades length now. Things I noticed have changed since I started on Propecia: 1.
My hair is really messy now even at the sides and back as opposed to last time just the front, lil on the side 2. Hair doesn't curl at the end its just straight and seems less 3.