Alopecia is a condition wherein there is an abnormal loss of hair. In terms of timing, it can be acute or chronic. In terms of distribution, it can be localized, complete or partial. The most common known site of alopecia is the scalp, but other foci of hair on the body, such as eyebrows, eyelashes, beard and pubic hair, can also be affected. Patterned hair loss on the scalp (androgenetic alopecia), commonly known as balding, is usually genetic. This means that if your father or mother had androgenetic alopecia, you could eventually experience the same condition.
Other forms of hair loss may be side effects of some drugs, such as metoprolol, levodopa, colchicine, propylthiouracil and carbimazole, caused by infections, trauma, thyroid dysfunction and immune diseases such as systemic lupus erythematosus. When alopecia is secondary to drug use, spontaneous hair regrowth usually occurs once these drugs are discontinued. For the other causes, proper medical treatment combined with alopecia treatment is the best method of addressing alopecia. Treatment of hair loss depends on its cause, and it is always best to consult with your doctor regarding treatment options.
Pharmacological Treatment
There are two drugs available for the treatment of androgenetic alopecia: minoxidil and finasteride. Other drugs used for the treatment of other types of alopecia include antifungals and steroids.
Minoxidil is a known topical drug. It is administered by directly applying approximately 1 mL on the scalp. It seems to lengthen the period of growth phase of the hair follicles. Hair regrowth with this alopecia medication is usually noted within four months of use. It is found to work best at the vertex and can be used by both sexes. This drug should be used continuously because discontinuation results in reversion. The most common adverse side effects of this drug include skin irritation and allergic contact dermatitis.
Finasteride is a drug taken orally with a dose of 1 mg once a day. It is a 5-alpha reductase type 2 inhibitor, which means it inhibits the enzyme responsible for the conversion of testosterone to dihydrotestosterone (DHT). DHT is responsible for balding. Hair regrowth is noted within six to eight months of use and is found to work best at the vertex and frontal area. Unlike minoxidil, you cannot use finasteride if you are a woman; it can cause problems for women, especially fetal problems during pregnancy. It should also be used for the rest of life just like minoxidil, because discontinuation of use will also result in reversion. Some of its adverse side effects include sexual dysfunction, decreased libido and breast enlargement (gynecomastia).
Surgical Management
Hair loss can be surgically managed by either a hair transplant or scalp flaps. In a hair transplant, donor hairs are taken from areas of the scalp with thick hair density and implanted on bald areas and areas of the scalp with thin hair density. Scalp flaps involve rotating an area of your scalp with good hair density to a bald area and/or an area with thin hair density. However, this is effective only in children because their hair follicles are relatively more active.
