Evidence-based treatments for androgenic alopecia, such as minoxidil, finasteride, low-level laser light therapy, dutasteride, platelet-rich plasma, and topical ketoconazole. It discusses the efficacy, safety, and mechanism of action of these treatments, as well as future developments in understanding this polygenic condition.
N-Acetyl-Cysteine (NAC) was found to improve hair parameters in men with early-onset androgenetic alopecia, showing increased terminal hair count and decreased vellus hair count, with good tolerability. NAC, used alone or with minoxidil, may help due to its antioxidant properties, though its effectiveness can vary among individuals.
Scalp biopsies are crucial for diagnosing hair loss conditions like Diffuse Unpatterned Alopecia (DUPA) and retrograde hair loss, as treatments like finasteride and dutasteride may not be effective if other conditions are present. Combining PPAR-GAMMA agonists with retinoids could improve treatments for conditions like Lichen Planopilaris.
A 25-year-old has used minoxidil for 7 years, finasteride for 2 years, oral minoxidil and dutasteride for 3 months, and also tried microneedling and nizoral. They are considering a hair transplant but are concerned about being a good candidate due to potential retrograde alopecia.