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Bernstein Medical Page Chapter 6 – Hair Loss Medications

The FDA approval of oral finasteride, in the form of Propecia, has been a major breakthrough in the medical management of male pattern baldness. Before Propecia, the only medically proven treatment was topical minoxidil (Rogaine) and this medication was only minimally effective and, for many, a nuisance to apply. Propecia, on the other hand, is a once-a-day pill that can significantly alter the progression of genetic balding, particularly if started when the hair loss is still in its early stages. The recent availability of finasteride in a generic, 5mg tablet, has decreased the cost of the drug – for those who don't mind cutting up pills. Avodart (dutasteride), a more potent medication that is related to finasteride, has been approved for the treatment of prostate enlargement, but not hair loss. Because of its affect on the balding process we will discuss this medication as well.

Hair Restoration Research Future in Hair Transplantation

itive inhibitors that chemically resemble the substrate, testosterone, and bind to the active site of the enzyme so that DHT is not formed. Propecia (finasteride) has recently been FDA approved in the USA for men with AGA. Propecia is a specific 5a-reductase type II enzyme inhibitor, and does not bind to the AR, and is therefore not called an "anti-androgen", but an androgen inhibitor. The pharmokinetics of finasteride reveal that after a 1 mg dose serum concentration of DHT decreases by 65% in 24 hours. Serum concentrations of testosterone and estradiol increase about 15% but remain within normal limits. Prostate concentrations of testosterone increase about sixfold2. Finasteride is well absorbed in the GI tract, metabolized in the liver and excreted in urine and feces, with a half-life of 5 to 6 hours. Small nanogram levels of the drug are detectable in human semen, but are not thought to have any consequence in women who are exposed by sexual contact. Three double-blind multi-center trials were conducted in men ages 18 to 41 years and the results of these trials have been presented as abstracts3,4. In combined results from two of the trials, 1553 men with mild to moderate male AGA of…

Bernstein Medical Page Dutasteride Info Sheet

largement and for male pattern baldness. It does this by inhibiting the action of both types (Type I and II) 5-alpha reductase enzyme. In contrast, finasteride, the FDA approved medication for hair loss, inhibits only the Type II enzyme, the enzyme that is present in highest concentrations in and around the hair follicles. Both dutasteride and finasteride produce a rapid decrease in serum DHT concentration. Lowering DHT appears to inhibit the miniaturization (shrinking) of affected hair follicles and helps restore miniaturized hair follicles to regrow visible hair. Dutasteride (Avodart) inhibits both type I and type II, 5a-reductase. At the 0.5-mg dose, it is about 3 times as potent as finasteride at inhibiting type II, 5?-reductase enzyme and more than 100 times as potent at inhibiting the type I 5?-reductase enzyme. Type I receptors inhibited by dutasteride are present in other organs of the body besides the skin, including the liver and kidneys.

Hair Restoration Research Follicular Unit Hair Transplantation

PUBLISHERS NOTE: Single copies of this article can be downloaded and printed only for the reader’s personal research and study. Synopsis: “Surgery of the Skin: Procedural Dermatology,” covers the entire range of dermatologic surgical procedures. It was conceived to be used as the core surgical textbook for dermatologic training programs. Dr. Bernstein’s chapter on follicular unit hair transplantation covers a wide range of subjects including the history of follicular unit hair transplantation, evaluating the patient, planning the surgery, setting-up the operating room, and maximizing the cosmetic outcome of the hair restoration. Specific topics include the techniques of Follicular Unit Transplantation including density assessment, single-strip harvesting, follicular unit extraction, anesthetic use, aesthetic design and many other important topics.

Hair Restoration Research New Analysis of Scientific Studies Questions Connection Between Propecia Use and Persistent Sexual Side Effects

ersistent sexual side effects have caused growing concern about this popular hair loss treatment. An increasing number of men now fear that Propecia (finasteride 1mg) will cause permanent sexual dysfunction. Merck’s and the FDA’s warning, however, was based on a small number of random self-reports, not on empirical studies that showed a cause and effect relationship between finasteride and sexual dysfunction. There are two possible reasons that existing studies have not found a significant relationship between finasteride use and persistent sexual dysfunction: 1) the effect of finasteride on sexual function is too small to significantly measure in any one study, or 2) finasteride has no significant negative effect on sexual function. To address the first possibility, Aditya K Gupta and Andrew Charrette ((Gupta AK, Charrette A. The efficacy and safety of 5α-reductase inhibitors in androgenetic alopecia: a network meta-analysis and benefit-risk assessment of finasteride and dutasteride. J Dermatolog Treat. 2014;25(2):156-61.)) at the University of Toronto recently conducted a large scale meta-analysis across 16 controlled studies, studies designed to test the efficacy of finasteride, to see if a significant number of patients in those studies reported persistent sexual side effects. The rationale of a meta-analysis is that if there is an…

Bernstein Medical Page Hair Restoration Papers

tics and medical treatment of patterned hair loss. J of Drugs in Dermat 2010; 9(11): 1-8. Boychenko O, Bernstein RM, Schweiger E. Finasteride in the treatment of female androgenetic alopecia: An interesting case and review of the literature. (Cutis, submitted for publication) Rassman WR,

Bernstein Medical News Exploring Hair Loss Treatments: Understanding the Side Effects of Rogaine and Propecia

her-densely/">thinning hair or balding. Two popular medications commonly prescribed for hair loss treatment are Rogaine (minoxidil) and Propecia (finasteride). Both are successful products for millions of men and women around the world to help maintain your hair with minimal to no side effects. While these medications can be effective in slowing down hair loss and promoting some hair regrowth, as with most medications, they also come with potential side effects and limitations for some people. In this comprehensive guide, we'll delve into the side effects of Rogaine and Propecia and explore why hair transplantation could offer a viable alternative for those seeking a permanent solution to hair loss.

Showing results 31 - 40 of 197 for the search term: finasteride.


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Address

110 E. 55th Street, 11th Floor
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New York, NY 10022

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