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There are now more topical and oral medications than ever. Determining the right medication or combination of medicines for you depends on your age,sex and cause of hairloss degree of hair loss and budget.
Only two hair restoration medications have been approved by FDA: Topical medication Minoxidil and orally administered Finasteride.
Neither guarantees to stop hair loss or the regrowth of new hair, for hair loss can be due to many causes that may or may not be treatable by these two.
Finastride is only available by prescription from a physician.Minoxidil is available as an over-the counter topical medication.Both of these drugs are most effective when recommended and prescribed by a hair specialist physician who has made the diagnosis.

Finasteride:

It selectively inhibits the activity of 5-alpha reductase type 2, an enzyme essential to the activity of certain androgenic hormones. Testosterone is the most potent of the androgenic hormones. Whithin the cells sensitive to testosterone ( prostate,skin and hair follicles ),it is converted to dihydrotestosterone (DHT) by 5 alpha reductase.It has been investigated that men with normal or high levels of 5-alpha reductase are more likely to develop male pattern hair loss (MPHL) and benign enlargement of the prostate gland. Finasteride,which inhibits the activity of this enzyme was first developed to treat benign prostatic enlargement. Then it was studied in treating MPHL and was proved to be effective.  

Finasteride: in women

Many women experience a form of androgenetic alopecia known as female-pattern hair loss

The only medical therapy available for women is topical minoxidil (Rogaine® ). Finasteride can have under-masculinizing effects on a male fetus; therefore, finasteride should not be taken by a woman who is pregnant or who may become pregnant during the course of treatment. A woman who is experiencing hair loss should consult a physician hair restoration specialist for examination, diagnosis and recommendation for treatment based on diagnosis.

What About Minoxidil (Rogaine® )?

Minoxidil (Rogaine® ), a treatment applied topically to the scalp in 2% or 5% solution. Minoxidil is available over-the-counter but is best used under the supervision of a Dermatologyist.

Minoxidil (Rogaine® ) tends to be more effective in women than in men. The reason for this is not well understood. Only the 2% solution of Rogaine® is approved by the FDA for marketing to women, but there is substantial evidence from hair counts and photographic before-and-after evaluation that the 5% solution has additional benefit for women just as it has for men

Minoxidil is a drug that was developed for one medical use (to lower blood pressure), but turned out to have another unexpected but valuable application (to stimulate growth of hair in people with MPHL). The effect of minoxidil on hair growth was not predictable on the basis of its vasodilating action (relaxing blood vessels to lower blood pressure). Neither is minoxidil known to have any effects on androgens, the male hormones associated with androgenetic alopecia.

The topical solution has been shown over a period of 15 years of clinical trials and patient care to be a safe and effective treatment for hair loss due to MPHL. It is effective in about 30% of persons who receive the treatment. For reasons not yet understood, women have a higher response rate than men to topical minoxidil.

Topical minoxidil is generally more effective in improving hair growth in central areas of the scalp than in frontal areas. Minoxidil has been shown to be effective in increasing the amount of time that hairs stay in the anagen (growth) phase versus telogen (resting) phase. It has been shown effective in initiating growth of vellus (soft, fine) as well as terminal (long, coarser) hairs.

When topical minoxidil is first applied, shedding of telogen-phase hairs may be increased for a short time. This loss of telogen-phase hairs is temporary, and the lost telogen hairs will be replaced by new hair over the next weeks and months of minoxidil therapy.

Once started, topical minoxidil treatment for androgenetic alopecia is a lifetime commitment if the treatment proves effective. If regular application of topical minoxidil is halted, all hair grown in response to the therapy will be rapidly lost over the next 3 to 6 months.

Minoxidil can complement and supplement other hair restoration treatments. For example, in a planned approach to hair restoration agreed to by a patient and physician hair restoration specialist, minoxidil may be used to complement hair transplantation or other surgical methods such as scalp reduction [Roenigk HH, Jr. Scalp reduction. In: Roenigk & Roenigk’s Dermatologic Surgery, 2nd ed. New York: Marcel Dekker, Inc., 1996:1213-1226]. Minoxidil may be applied to stimulate hair growth inside and/or outside areas of surgical hair restoration, contributing to improved "fullness" of scalp hair.

Side effects of topical minoxidil are few and generally minor (transient skin irritation or itching). The vasodilating (blood-pressure lowering) effect of oral minoxidil does not occur with the topical formulation. There is a small risk for facial hair growth associated with use of minoxidil—a finding that may be a side effect of the drug or may be due to accidental application of the topical solution to the face.

Nonsurgical Hair Additions and Replacements

Some people want "a little extra" to enhance medical or surgical hair restoration. Other people are temporarily or permanently unable to grow hair and are therefore not candidates for transplantation. And some may want to avoid any type of surgical procedure or may be attracted to the promise of unlimited density and fullness.

For those with a genetic condition that can not grow hair or those with temporary hair loss (chemotherapy) wigs are a good solution.

Hair addition is good for those with thin hair. It need regular long – term care to prevent dandruff. Synthetic hair has been implanted into the human scalp for more than 20 years. It has been banned by ISHRS because of it is side effects although it is still practiced in some countries.

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