AGA+Treatments

=Treating AGA =

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Originally intended for use in blood pressure regulation, minoxidil's observed side effect increases hair growth. The exact action that minoxidil takes to cause hair growth is unknown. Minoxidil is available in up to a 5% solution and a 5% foam. Efficacy should be judged after six months of treatment because early in treatment some patients will notice increased hair shedding due to follicle cells transitioning from telogen to anagen. An increased rate of hair shedding is also seen if therapy stops.(2) ======

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** Efficacy: ** All studies show an increased level of hair growth and a higher level of hair growth when applied twice daily. It needs to be noted that a high level of placebo growth is also associated with these studies.(2) ======

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 **Problem:** Minoxidil must be applied to the scalp (not the hair) twice daily and left in for at least four hours after use on both occasions. Compliance over a long period is important to achieve results. ======

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Propecia (Finasteride 1mg), and Proscar (Finasteride 5mg) are type II 5-alpha-reductase inhibitors but only Propecia is approved for use in AGA while Proscar is approved for benign prostate hyperplasia (BPH) only. Avodart (Duasteride 0.5 mg) is also a 5-alpha-reductase inhibitor but it is only approved for use in BPH. By inhibiting 5-alpha-reductase Finasteride prevents testosterone converting into Dihydrotestosterone. Finasteride has shown to decrease scalp DHT levels up to 70% which reduces DHT-Androgen receptor complex formation and slows AGA. Just like minoxidil, efficacy should also be gauged after six months of treatment.(2) ======

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** Problem: ** The side effects can be a major deterrent for any patient considering finasteride. Side effects include increased risk of high grade prostate cancer, erectile dysfunction and decreased libido along with others. ======



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Hair follicle transplant surgery can be useful for patients with a sufficient donor hair source (elsewhere on the head). Hair follicle transplant procedure is now microsurgical for less scarring when compared to the scalp reduction surgery which could leave considerable scarring. Hair follicle's that are resistant to androgen retain their resistance when transplanted. ======

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**Efficacy:** This varies highly depending on the skill of the surgeon and surgical team. ======

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**Problem:** Expensive, requires donor hair and a skilled team doing the procedure. (2) ======

=Difficulty in creating AGA treatments =

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The tree above compares androgen receptor mRNA of several different species to show how distant human AR mRNA is from mouse and rat AR mRNA. The distance represents how different the sequence alignment is. Normal mouse AR does not express AGA so researchers had to go to great lengths to create a mouse model. Recently, in 2010 a mouse model for AGA was developed by a team of researchers by causing the mouse to over express human AR. (3) ======

Next:

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(2)Bluemeyer, A., Tosti, A., Messenger, A., Reygagne, P., Del Marmol, V., Spuls, P., Trakatelli, M., & Finner, A. (2011). Evidence-based (s3) guideline for the treatment of androgenetic alopecia in women and in men. Journal of the German Society of Dermatology,9: S1–S57. doi: 10.1111/j.1610-0379.2011.07802.x ======

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(3)Crabtree JS, Kilbourne KJ, Peano BJ, Chippari S, Kenney T, McNally C, Wang W, Harris HA, Winneker RC, Nagpal S, Thompson CC 2010 A mouse model of androgenetic alopecia. Endocrinology 151:2373-2380 ======

<span style="display: block; height: 1px; left: -40px; overflow: hidden; position: absolute; top: -25px; width: 1px;"> http://www.genome.jp/kegg-bin/highlight_pathway?scale=1.0&map=map00140&keyword=Dihydrotestosterone