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 DENOMINATION
- Alopecia androgénica.
- Alopecia seborreica.
- Hair fall.
DESCRIPTION
The androgénica alopecia or masculine baldness is a physiological declaration that happens in genetically predisposed persons. During the adolescence these persons produce more quantity of one enzyme called 5-alfa-reductasa, that transforms the testosterone in dihidrotestosterona (DHT). This hormone is the culprit of the slimming of the hair and of the progressive decrease of the hair follicles where the hair is born.
EVOLUTION
As result of this slimming and disappearance of hair follicles a progressive loss of the hair appears, from the forehead and from the crown to go joining with the years and to form a more or less entire absence except in the wings of the head and in the later part.
Often it collaborates to greasy hair and attends of dandruff, for the eczema seborreico associate.
TREATMENT OF THE ALOPECIA
For the alopecia it is recommended at present:
- Ketoconazol in gel for the hair 2-3 times per week, the results are similar to the obtained ones with Minoxidil. Dermatology 1998; 196 (4):474-7 Ketoconazole shampoo: effect of long-term use in androgenic alopecia. Pierard-Franchimont C, Of Doncker P, Cauwenbergh G, Pierard GEDepartment of Dermatopathology, University of Liege, Belgium.
- Spironolactona (it is a diuretic) has been used also. Beneficial effect of spironolactone on androgenic alopecia. Clin Endocrinol (Oxf) 1997 Dec; 47 (6):759-60
- Finasteride (Proscar ®). It is used in the prostate hypertrophy, it is an inhibitor of 5-alfareductasa that turns into the cell the testosterone in dehidrotestosterona. His possible side effects are the powerlessness, decrease of líbido and of the volume of the ejaculation. It has begun to be used in the acne, the hirsutismo, and in the alopecia androgénica. His effects in the alopecia are initial and promising, but of effect similar to the minoxidil. Since it is possible that the beneficial answer to the Finasteride (Proscar ®) does not demonstrate immediately, it is necessary to watch carefully the patients with big residual volume of urine and/or very diminished urinal flow, for the possibility of an obstructive uropatía.
Before the suspicion of prostate cancer, before initiating the treatment with Finasteride (Proscar ®) must discard his presence for an urologist. It is recommended to examine the patients before initiating the treatment with Finasteride (Proscar ®) and periodically during the same one. There is used by increasing frequency the measurement of the specific prostate antigen (PSA) sérico to detect the prostate cancer.
The Finasteride (Proscar ®) diminishes the concentrations séricas of PSA even in the presence of prostate cancer. This decrease must be born in mind after the patients evaluate the concentrations séricas of PSAen with HPB treated with Finasteride (Proscar ®), and it does not exclude the possibility of a concomitant prostate cancer.
It is necessary to evaluate carefully any supported increase of the concentrations of PSA in the patients treated with Finasteride (Proscar ®), including the possibility that the patient has not continued faithfully the treatment with Finasteride (Proscar ®).
Pharmacotherapy 1993 Jul-Aug; 13 (4):309-25; discussion 325-9
Finasteride: the first 5 alpha-reductase inhibitor. Sudduth SL, Koronkowski MJ
Program on Aging, School of Pharmacy, University of North Carolina, Chapel Hill 27599-7360.
- Also Mar-Apr suggests himself the use of a lotion of progesterone to 2 ó 5 % Head Neck Surg 1985; 7 (4):336-9 Medical treatment of male pattern alopecia (androgenic alopecia). Tromovitch TA, Glogau RG, Stegman SJ
- The minoxidil is a hypotensile one that is used for more than 15 years with the alopecia indication. For it it is the one that more references have and his effect is more verified. It is necessary to use in local lotion every day, How there are medicines that will use at local level his side effects in general there are the irritativos or allergic for his use and general not effects.
TO SEE ALSO
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