Author: Kathy Jones

Medical hair restoration in the literal sense includes the hair
loss treatment which depends upon the use of medicines. Unusual
hair loss both in men and women is caused by the alterations in
the androgen metabolism. Androgen is a male hormone which has a
major role to play in regulation of hair growth or hair loss.
The dermal papilla is the most important structure in a hair
follicle which is responsible for hair-growth. It is the dermal
papilla, the cell of which divides and differentiates to give
rise to a new hair follicle. The dermal papilla is in direct
contact with blood capillaries in the skin to derive the
nutrients for the growing hair follicle. Research has shown that
dermal papilla got many receptors for androgens and there are
studies which have confirmed that males have more androgenic
receptors in dermal papilla of their follicles as compared to
females. The metabolism of androgen involves an enzyme called 5
alpha reductase which combines with the hormone
androgen(testosterone) to form the DHT (Dihydro-testosterone).
DHT is a natural metabolite of our body which is the root cause
of hair loss. Proper nutrition is critical for the maintenance
of the hair. When DHT gets into the hair follicles and roots
(dermal papilla), it prevents necessary proteins, vitamins and
minerals from providing nourishment needed to sustain life in
the hairs of those follicles. Consequently, hair follicles are
reproduced at a much slower rate. This shortens their growing
stage (anagen phase) and or lengthens their resting stage
(telogen phase) of the follicle. DHT also causes hair follicle
to shrink and get progressively smaller and finer. This process
is known as miniaturization and causes the hair to ultimately
fall. DHT is responsible for 95% of hair loss. Some individuals
both men and women are genetically pre-disposed to produce more
DHT than the normal individuals. DHT also creates a wax-like
substance around the hair roots. It is this accumulation of DHT
inside the hair follicles and roots which is one of the primary
causes of male and female pattern hair loss. Blocking the
synthesis of DHT at molecular level forms the basis for the
treatment of MPHL ( male pattern hair loss) and FPHL ( female
pattern hair loss). There are many natural DHT blockers and a
number of drugs which are used for medical hair restoration. Let
us see the main drugs which are available for medical hair
restoration in men and women. Minoxidil Minoxidil has the
distinction of the first drug being used for promoting the hair
restoration. This medical hair restoration treatment drug was
used earlier as an oral antihypertensive drug, but after its
hypertrichosis (excessive body hair) effects were noticed, a
topical solution of the drug was tested for its hair growing
potential. Minoxidil was then approved as medical hair
restoration treatment drug for men by the US Food and Drug
Administration (FDA) in 1988 as a 2% solution, followed by 5%
solution in 1997. For women, the 2% solution was approved in
1991. Though 5% solution is not approved for women, it is used
as a medical hair restoration treatment by many dermatologists
worldwide. Both solutions are available without a prescription
in the US. Mechanism of action Minoxidil is thought to have a
direct mitogenic effect on epidermal cells, as has been observed
both in vitro in vivo. Though the mechanism of its action for
causing cell proliferation is not very clear, minoxidil is
thought to prevent intracellular calcium entry. Calcium normally
enhances epidermal growth factors to inhibit hair growth, and
Minoxidil by getting converted to minoxidil sulfate acts as a
potassium channel agonist and enhances potassium ion
permeability to prevent calcium ions from entering into cells.
Thought the exact action of minoxidil preventing the formation
of DHT has not been shown but the drug has been shown to have a
stabilizing effect on the hair loss. The result of the drug
takes about few months time to be evident since it is the time
which is necessary for restoring the normal growth cycle of hair
fibers. Use of Minoxidil has approved by FDA for men (Norwood
II-V) and women (Ludwig I-II ) older than 18 years. It is used
as a medical hair restoration treatment either for frontal or
vertex scalp thinning. It brings about an increase in density
which is mostly caused by conversion of miniaturized hairs into
terminal hairs rather than a stimulated de novo re-growth. The
hair loss becomes stabilized after continued use of drug, which
takes about a year‚s time for the medical hair restoration
treatment to show its complete results. Hair loss restoration
treatment with 0.05% betamethasone dipropionate and 5% topical
minoxidil are found to be superior to minoxidil alone. Topical
minoxidil is very well tolerated and adverse effects are mainly
dermatologic. The most frequent adverse effect is an irritant
contact dermatitis. Though minnoxidil does not have any effect
on blood pressure, it should be used with caution in patient
with cardiovascular diseases. It is also contraindicated in
pregnant and nursing mothers. Finasteride The drug finasteride
was earlier used as treatment for prostate enlargement, under
the medical name Proscar. But in 1998, it was approved by FDA
for the Medical hair loss restoration in MPHL. Mechanism of
Action Medical hair restoration treatments with Finasteride
depends upon its specific action as an inhibitor of type II
5α-reductase, the intracellular enzyme that converts male
hormone androgen into DHT (Dihydro Testosterone). Its action
results in significant decrease in serum and tissue DHT levels
in even in concentration as low as 0.2mg. Finnasteride is able
to stabilize hair loss in 80% of patient with Vertex hair loss
and in 70% of patients with frontal hair loss. Most of these
patients are able to grow more hair or retain the ones they
have. The peculiar thing about Propecia is that its effect is
more pronounced in crown area than in the front. The hair that
grow after the medical hair restoration treatments are better in
texture and are thicker, more like the terminal hair. The best
thing about medical hair restoration treatment with the
finnasteride is that it is well tolerated and has minimal side
effects. Sexual dysfunction (decreased sex drive, erectile
dysfunction, and decreased semen volume) are observed in about
3.8% of cases. But these side-effects subside within few months
of Medical hair restoration treatments or disappear within a
week‚s time as soon as the treatment is stopped. It generally
requires about 6 to 12 months for the m edical hair restoration
treatment to be apparent but the side effects appear earlier. So
even after the medicine is stopped, there is no possibility of
loosing the hair that has been gained, but the side effects are
sure to disappear. Many hair restoration surgeons find Propecia
(finasteride) to act as an excellent adjunct to the surgical
hair restoration. There are several benefits of this kind of
combination therapy. As the Medical hair restoration with
Propecia brings about a hair re-growth in the crown area, it has
a complementary action; it allows the surgeon to have more donor
hair to be available for frontal hair transplant and design the
hairline at his own will. Since finasteride has no effect in the
frontal area of the scalp, it does not have any interference
with the surgical hair restoration.

Combination Therapy There are reports which say that use of
finasteride and topical minoxidil combination therapy as a
Medical hair restoration treatment is of more advantage in cases
of mild to moderate MPHL. Further studies are in progress. Many
hair restoration doctors have already started the use of
combination therapy in order to obtain better hair growth. Anti
Androgen Therapy For women with hyperandrogonism( with increased
levels of androgen) who do not respond well to minoxidil,
antiandrogen therapy is another option of Medical hair
restoration. In UK the most commonly used anti-androgen for
women is CPA (cyproterone acetate), which is used in combination
with ethinyl-estradiol. However, in United States, where CPA is
not available, the aldosterone antagonist spironolactone is the
alternative choice of hair restoration doctors. Flutamide
Medical hair restoration with flutamide has shown improvement as
hair loss restoration treatment in women with hirsutism. For
hyperandrogenic premenopausal women, flutamide is a better
medical hair restoration agent than both the CPA or finestride.
Hair loss restoration management is a structured process which
depends upon many factors along with the medical hair
restoration. For more details on the topic you can refer to
section medical hair restoration or article on male pattern hair
loss or female pattern hair loss at our site
hairtransplantadvice.com.