Androgenic alopecia more commonly
known as male pattern hair loss affects the top and front of the scalp of most
middle aged men. It is believed to be caused by genetics and a specific male
hormone called dihydrotestosterone. Major cause of androgenic alopecia is due
to dihydrotestosterone, premature androgenic alopecia is said to be caused by
low levels of sex-hormone binding globulin, follicle stimulating hormone,
testosterone and epitestosterone. Transgenic studies have found that men with
androgenic alopecia have higher 5-alpha-reductase, lower total testosterone, higher
unbound/free testosterone, and higher free androgens, including
dihydrotestosterone. dihydrotestosterone is produced by converting testosterone
using 5-alpha-reductace. (En.wikipedia.org, 2018)

      There are various treatments currently
available for androgenic alopecia such as, hair replacement or transplantation,
Cosmetics, Micropigmentation to resemble shaven scalp, hairpieces, minoxidil
solution, finasteride tablets (type II 5-alpha reductase inhibitor), dutasteride.
In this essay drug based treatments will be further explored such as the
minoxidil solution and finasteride tablets. Minoxidil and finasteride are the
only Food and Drug Administration (FDA) approved drugs and low-level laser
light therapy the only FDA-cleared device for the treatment of androgenetic
alopecia. Minoxidil, finasteride, and low-level laser light therapy are
effective for promoting hair growth in men with androgenetic alopecia. (Adil
and Godwin, 2017)

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    Minoxidil has been effective on 54% of
patients on first application. It was introduced clinically as an
anti-hypertension medication, but was found to have the side effect of
hypertrichosis, an abnormal amount of hair growth over the body. (Tricarico et
al., 2018). These observations led to the development of topical minoxidil as a
treatment for hair loss. It was approved by the FDA for the treatment of male
androgenetic alopecia in 1984. A common side effects of minoxidil are
hypertrichosis on the face and hands, itching of the scalp, increased dandruff
and erythema. Contact allergic dermatitis to minoxidil can occur.

    Finasteride is a synthetic azo-steroid. It is
a potent and highly selective antagonist of type II 5 alpha reductase. It binds
irreversibly to the enzyme and inhibits the conversion of testosterone to
dihydrotestosterone. Finasteride was initially approved by the FDA to be used
in benign prostate hyperplasia and was approved to treat male androgenic
alopecia in 1997. The main use of finasteride is to reduce dihydrotestosterone production
so that its action on scalp hair follicle is reduced. Long-term studies have
reported few adverse effects when using finasteride. In the finasteride group
loss of libido was reported in 1.9% and erectile dysfunction in 1.4% in the
first year. With regards to long-term safety, finasteride has now been in use
for over 10 years and many recipients are elderly men taking 5mg per day
however very few side-effects have been observed. There is no effect of long-term
use on bone mineral density. Reversible painful gynaecomastia has been reported
and the incidence is thought to be around 0.001%. (Sinclair, 2004)

   Androgen
alopecia is becoming increasingly common among men as they age. Many find it a
distressing and unwelcome event seek treatment to prevent further hair loss and
reverse the process. Moreover, androgen alopecia may be a marker of increased
risk of cardiovascular diseases. The hair follicle is a complex organ biologically.
The changes in the hair follicles that lead to baldness have caught the
interest of stem cell scientists, geneticists, developmental biologists and
immunologists and hair biology has become a fruitful scientific endeavour

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