Pharmacist's Antidote | Your hair is "suddenly gone"? How to save your hairline~

The hair that was thick and dense before has now become thin and soft, and several strands will fall out with a light grab; the hair will be greasy if it is not washed for a day, but when it is washed, a basin of fallen hair is heartbreaking... This is all because of seborrheic alopecia.

Seborrheic alopecia, also known as androgenic alopecia, often occurs in adolescence, most commonly between the ages of 20 and 40, and can be divided into male and female types.

The male type begins with hair loss from the temples or hairline, with the hairline moving backwards. In the most severe cases, the entire head loses hair, exposing the shiny scalp, which is usually accompanied by increased oil secretion on the scalp.

The female type has milder symptoms, mainly manifested as diffuse and uniform hair loss on the forehead, with the hair on the top of the head gradually becoming sparse and the braids becoming noticeably thinner.

Androgenic alopecia is a common and frequently occurring disease in dermatology, and it is also one of the difficult diseases to treat. Because this disease affects the appearance and beauty, it often brings great mental stress and psychological burden to patients. Many people cannot understand why they are losing their hair: they are in good health and have no problems, so why are they losing their hair? How can we save the receding hairline?

Who stole your hair?

Androgenic alopecia is an androgen-dependent hereditary hair loss disease, the onset of which may be related to factors such as endocrine dysfunction, genetics, fungal infection and inflammation. In addition, many young people's casual lifestyle habits may also increase the risk of androgenic alopecia.

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Poor mental state: such as excessive stress, tension or anxiety, may cause hair loss and aggravate its symptoms;

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Poor eating habits: Long-term low-protein diets or severely calorie-restricted diets may also aggravate androgenic alopecia;

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Bad work and rest habits: such as staying up late for a long time and irregular life, are important factors that induce or aggravate androgenic alopecia.

The key points of the hairline protection campaign

At present, the efficacy and mechanism of action of Western medicine for androgenic alopecia are clear, and the main therapeutic drugs include the following categories:

Oral medications

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Finasteride

Finasteride is only suitable for male patients. Because it can increase the estrogen level in women, theoretically increasing the risk of breast cancer, and taking finasteride can cause the feminization of male fetuses, it is contraindicated in women who want to have children.

The drug inhibits 5α-reductase, reducing the production of dihydrotestosterone and the damage to hair follicles. The recommended dose is 1 mg, taken once a day. It should be noted that the drug takes a long time to take effect, and continuous use is required to observe obvious effects. Generally, hair loss decreases after taking the drug for 3 months, and continuous use for 1 to 2 years can achieve better results. However, if the effect is still poor after 12 months of use, it is recommended to stop the drug.

The drug is well tolerated, with a low incidence of adverse reactions and is relatively mild. Some patients may experience decreased libido, impotence, and decreased ejaculation, but these symptoms usually disappear gradually during medication, and adverse reactions can subside within a few days after discontinuation of medication.

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Spironolactone

Spironolactone is suitable for female patients. It can reduce the production of testosterone by the adrenal glands and has a slight competitive effect on the binding of dihydrotestosterone to androgen receptors. The daily dose is 40-200 mg, and the course of treatment is at least 1 year. The main adverse reactions are menstrual disorders, decreased libido, breast pain, etc. During treatment, it is necessary to pay attention to check the blood potassium concentration. It should be noted that the current clinical use of spironolactone to treat androgenic alopecia is an off-label use of the drug, so it must be used under the guidance of a doctor or pharmacist.

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Ethinylestradiol Cyproterone

This drug is a competitive antagonist of androgen, which can reduce the content of free androgen in the circulation. It is used for female patients and taken on the 1st to 5th day of menstruation, 1 tablet per day, for 21 consecutive days, and then stopped for 7 days before starting the next course of treatment. Generally, symptoms can be improved after taking it for 3 to 6 months.

Topical medications

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Minoxidil

Minoxidil is an effective topical hair growth promoting drug that can stimulate the vascular endothelial growth factor in dermal papilla cells, improve microcirculation, and promote hair growth. It is more effective for those with mild to moderate hair loss. Clinically, there are two concentrations available: 2% and 5%.

Currently, there are 5% concentration of minoxidil liniment, tincture and spray, 2% concentration of liniment and spray in China for male hair loss patients. The recommended dosage is 1mL (about 7 sprays of spray) applied to the affected area of ​​the head each time, starting from the center of the affected area, and massage with hands for 3 to 5 minutes. Regardless of the size of the affected area, the daily dose should not exceed 2mL.

For female patients, currently only 2% concentration of minoxidil gel is recommended in China. The recommended dosage is 1g twice a day, applied to the affected area of ​​the head. Excessive use does not increase the efficacy, and it is not recommended for pregnant women.

The average effective time of the drug is 6 to 9 months. Common adverse reactions include hirsutism, local irritant dermatitis and allergic dermatitis, which will disappear after stopping the drug. If allergic symptoms such as local itching and skin redness occur, you can try to switch to minoxidil foam preparations that do not contain propylene glycol.

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Other lotions

Since androgenic alopecia patients are often accompanied by scalp inflammation, selenium disulfide lotion, compound sulfur lotion, ketoconazole lotion, etc. can also be used on weekdays to inhibit oil secretion and eliminate scalp inflammation. These lotions are suitable for patients with oily scalp, dandruff and itchy scalp.

Androgenic alopecia is difficult to control and requires long-term treatment. Do not give up halfway. In addition to the rational use of medication, patients should also pay attention to diet conditioning. They can eat more foods rich in protein and B vitamins to regulate oil secretion and benefit health. In addition, regular work and rest, adequate sleep, and relief of mental stress can all help reduce the degree of hair loss.