Male-Type Baldness or Hair Loss
(Androgenetic Alopecia in Men)
Billions of lirasare spent around the world on hair loss, which has become the most importantcosmetic problem for both women and men nowadays. Especially male-type hair loss, termed as androgenetic alopecia(AGA), has not been resolved for many years.
Hair loss that was initially defined as androgenic alopecia is named as androgenetic alopecia, meaning hair loss due to hormonal imbalance and with a geneticpredisposition.
Nowadays, the most commonly used synonym of AGA, named as male-type baldness or manly hair loss is “ordinary baldness.”Androgenetic alopecia involves hair loss progressing in a specific pattern on the hairy skin of the head. It constitutes a medical problem that annoys people when it is subjectively excessive or begins at an earlyage. Sufficient amounts of circulating androgens and genetic predisposition are requiredfor the development of AGA. In cases with no androgen in the body such as castrated men, AGA does not occur despite genetic predisposition.
Of men, 30% had AGA at the age of 30 years,and this rate was determined to be 50% in their 50s. The incidenceof AGA in white women in their 50s was 50%. Beck reported this rate as 27% and 64% in women aged 35–40 and 40–70 years, respectively.
In both sexes, androgens and their different levels regulate hair loss and growth in specific parts of the body. Pubicand armpit hair growth depends on testosterones. On the contrary, beard growth and scalp hair loss depend on dihydrotestosterone. The enzyme 5-a-reductase type2 is necessary to convert testosterone into dihydrotestosterone. Some findings indicate that 5a-reductase type 2plays an important role inAGA.Males with 5-a-reductase type 2deficiency do not experience baldness.
Aromatase in the outer root sheath of hair follicles is another enzyme having an important role inAGA. This enzyme converts testosterone and dihydrotestosterone into estrogen. The enzyme aromatase levels in the frontal area in women were found to be six times more than the levels in men. AGA in women progresses slowly compared with men,and the maintained frontal hairline in women can be explainedby the presence of this enzyme.
Similar to AGA, which is a physiological state, hair loss prompts people to look for a remedy. Therefore, studies on agents that increase hair growth have been conductedfor many years. Treatment options for AGA can be exploredunder two titles: surgical therapy and medical interventions. The method that has been triedin recent years is hair follicle transplantation. This methodhas led to a marked improvementin AGA. The cosmeticresponse is related to the experience of the surgeon as well as the density and thickness of occipital hair.
Agents used in AGA treatment can be categorizedinto three groups:
Minoxidil is a well-knowndrug in this category. It has been foundthat this oral drug used for hypertension treatment leads to an increase in hair. However, its underlying mechanism is still unknown. In AGA, the blood flow in the hairyskin decreases. Minoxidil ensures hair growth by enhancing this blood flow. Also, studies have shown that minoxidil has a direct effect on follicularmatrix and dermal papilla. In both women and men, a solution of minoxidil 2% applied topically was found to be effective. It requires continuity in the application. This drug is the first one whose use has been approvedby Food Drug Administration (FDA). Studies have found that the use of a solution of minoxidil 5% in men was more effective.It should be applied twice per day. It shows its effect within 6 months, and the maximum response is obtainedwithin 1 year.
The hair growth feature of Hair360containing a new active substance called PROCAREis important.A study compared the use of PROCARE active ingredient and minoxidil5% in 120 patients and showed that after 24-week implementation, the effectiveness of PROCARE active ingredient was much better than that of minoxidil 5%. Also, a patient satisfaction survey found that PROCARE active ingredient provided more significant recovery.After 24-week study, the researcher assessment determined that Hair360 spray was 2.48 times more effective than minoxidil 5%.
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The use of these drugs islimited to women because systemic antiandrogens have reducing effect on testosterone in circulation that is necessary for normal male sexual functions.
Finasteride is a type 2 5-α-reductase inhibitor and the first drug used in men. The key reaction in androgenic activity is that testosterone is convertedinto dihydrotestosterone. The enzyme 5-α-reductase is responsible for this reaction. Finasteride selectively prevents this reaction in prostate gland and skin. It was developed considering that it could be effective in the treatment of male-type hair loss, acne, and hirsutism. Finasteride has no effect on androgenic or estrogenic activities. Because finasteride does not cause an apparent decrease in testosterone levels, it is not considered an antiandrogen and hence safely used in men. It is an oral drug, and its half-life is 6–8 h. Its side effects are a decrease in sexual interest and ejaculation dysfunction. This isthe second drug whose use for AGA treatment has been approved by FDA for AGA treatment.
Some important active substances in Hair360 containing an active substance named PROCARE were used strong levelsnot to produce side effect by pressuring the enzyme 5-α-reductase type II.
AGA creates stress in most men. Of patients who were not bald, only 8% reported that they were concerned about the chances of being bald. However, 50% with slight hair loss and 75% with moderate and excessive hair loss stated that baldness was worrying for them, as they would look older and be physically and sexually less attractive compared with men who were not bald.
In conclusion, treatments with minoxidil and finasteride are still commonly used with rapid improvements in AGA treatment. The present study showed that Hair360 could be an alternative to minoxidil and finasteride and the combined use of these might enhance the success rate of AGA treatment.