- MINOXIDIL:
It is a potent peripheral vasodilator, administered orally, was used in the treatment of hypertension. In 1981 started its topical treatment of androgenetic alopecia. Its ultimate mechanism of action remains unknown (its vasodilator action does not fully justify its effectiveness), but it has shown a direct effect on the proliferation of follicular keratinocytes. Habitually used in alcoholic solution in concentrations ranging from 2-5% (in Spain only sold to 2% but is open for development at higher concentrations, with increased efficiency, which can be added to retinoic acid enhancing its effect) . It is useful to both men and women (the latter more effective, since there is a percentage of males in which the product is not effective). In your application you need to know that:

* Must remain in contact with the scalp at least 4 hours before retiring in the wash.
* The product should be applied twice daily (1 cc. Each time) accompanied by a gentle friction.
* The first results take two months to appear, so that its use must be consistent.
* Fundamentally recover hair that is “miniaturizing”, which again is as thick pigmented terminal hair, which means serving recovering the “fluff”. It will therefore be useful only to certain stages of alopecia (without exceeding the Grade III Ebling). There is therefore a “hair-restorer. Its primary use is the maintenance of hair once we reach the possible recovery of follicles.
* As described side effects: hair in the beard area (important appearance in women) is eliminated as the drug is stopped, headache in 10% of cases, and mild local irritation.
* By suspending the drug more than 4 months is a drop of hair with loss of all the profit.

Finasteride (Propecia):
Testosterone does not act directly on the follicle, but its active metabolite dihydrotestosterone (DHT), step regulated by an enzyme present in the follicles, 5-a-reductase type II. Finasteride works by inhibiting this enzyme, so that the transition to DHT is not produced and the process of “miniaturization” (follicle atrophy) stops, making some of these follicles, even in a time reversible process, recover its thickness and pigmentation, resulting in clinical improvement. This will result in a degree that depends on the number of follicles that are still in a time reversible. Patients who primarily benefit from the drug are men between 18 and 45 with mild to moderate alopecia (grades II-IV scale Ebling). The areas where improvement is mainly observed in the interparietal region and the “crown”, being less effective in “tickets.” In women, this treatment is now contraindicated. The first results can be seen in the first three months, being observed in many cases an improvement continued until about 18 months of treatment. The optimal treatment indication is to take a daily tablet of 1 mgr. for at least two years. Under these conditions the drug is effective in 86% of boys (much higher rate than that obtained with minoxidil). However, it is advisable to keep the daily intake of 1 mgr. continuously, since the discontinuation of more than 9-12 months represents a return to the previous situation. Furthermore higher doses pose no additional benefit and the possibility of side effects, which do not appear with the recommended dose. Among these side effects highlights the decreased libido, although it must be emphasized that they are described at the recommended dose of 1 mgr. At this dose are not necessary analytical checks or any kind of warning or limitation on the taking of other drugs.

It is important to emphasize that as of today, these are the only two effective treatments in male androgenetic alopecia (in postmenopausal women can use oral antiandrogens dermatologist guidelines and controls its management if necessary). All treatments are effective in their application or ingestion, and not solve the problem “forever” but require continuity.

Other “solutions”:
Before the appearance of the finasteride, a treatment for male androgenetic alopecia was disappointing. This led to the emergence of numerous “remedies” which usually owned by non-specialists in dermatology, promising results “miraculous.” Such is the case of ozone application, laser treatment or the insistent “on the root” follicle “weakened” and seborrhea. None of this is effective. The many lotions and blisters base their initial improvement in the placebo effect associated with the application of any substance “forward”, and the friction that accompanies their application which, by itself, produces a slight improvement in the first two months of use.

Some supplements such as cystine, soybeans and other minerals have their own space deficiency in certain situations: after childbirth or illness, crash dieting … where a supplement can help retrieve the follicle. This is the case of some types of diffuse alopecia by telogen effluvium, androgenetic alopecia is not where these products are meaningless. The use of vitamins has been popularized and justified without any rigorous or scientific study to support efficacy of their use. Therefore should not be recommended as naturally by other devices, since hypervitaminosis may lead to a dangerous situation to be avoided. It is true that a vitamin deficiency causes changes in the hair, but it would be a symptom of a consistent deficiency in extremely serious, fortunately difficult to see in our environment, except in cases of anorexia, alcoholism, or similar.

SHAMPOOS, DYES
The hair can be washed daily, even several times a day, if for example the practice of sports makes it necessary. It is better to use gentle shampoos often used, alternating with shampoos recommended treatment by a dermatologist if there is also seborrheic dermatitis. External products like hair gel, hair dyes, conditioners, etc. Not involved in the process of atrophy of the follicle, and how much can dry the terminal keratin that makes up the “stem” of hair, without that again, this is a situation that alters the course of a hormonally determined. The same recommendation applies with respect to wear their hair short or long, although involving traction hairstyles (braids, very marked and striped tie, etc.). Could irreversibly damage the hair follicles in involved.

A healthy person has between 100,000 and 150,000 folculos in the scalp, with a density that stick to over the years. When we are born we have 1,000 ms folculos per cm2 and, over the years, this density decreases progressively to about 250 per cm2 at 50 years of age.

Ms One of the problems common in trichological consultation is women between 25 and 50 years with diffuse hair prdida, sometimes greatly alarm the patient and / or their families. The cause frequent ms telognico effluvium, consisting of a hair prdida in the final phase of their growth cycle, which begins abruptly and may be triggered by thyroid problems, diet, childbirth, emotional estrs, frmacos, etc.. The hair recuperacin occurs within a few months away the cause and often requires no treatment-Specific.

Crnica telognico effluvium is the excessive and prdida diffuse telogen hair phase (phase of each) in women 30 to 60 years of age and whose cause is unknown. Dura ms of 6 months, sometimes up to 10 years, with occasional episodes of agudizacin of each. Fortunately, it tends to form espontnea resolved.

Of greater significance is the androgentic female alopecia (FAGA), then causes a slow and gradual disminucin hair density with miniaturized hairs (unlike telegnico effluvium) and therefore Dimetros differences in the stems of the hairs. This happens for both Gentic as hormonal factors that give rise to generate the fine hair folculo rather than terminal hair. FAGA The incidence is increasing, so that now affects up to 20% of women 30 years of age and 40% ms to ms the age of 65 years. The FAGA can take two patterns: the feminine, which is conserved implantacin Online surveys of frontal hair, and male, similar to male pattern baldness, with gradual decline of the aforementioned implantacin Online surveys. Before a FAGA always be ruled out hyperandrogenism and CFI to health surveillance and treatment, sometimes sistmico, valuing the patient’s age, degree of alopecia and the possible side effects of treatment.

Another rare form of alopecia, in comparison to the previous, is the scarring alopecia. Aqu early treatment is essential to prevent irreversible destruccin of folculo and sustitucin scar tissue.