the cme on treatment of androgenetic alopecia in ludhiana

www.akclinics.com

Evidence Based Treatment Update in Androgenetic Alopecia

for Men

www.akclinics.comHair Follicle Growth Cycle

Anagen/Active Growth Phase : 2-6 years

Catagen/Transition Phase : 1-2 weeks

Telogen/Resting Phase : 1-2 months

www.akclinics.comHair Types

Terminal hairs are thick, long, and dark, as compared with vellus hairs which are short, fine and light-colored

Vellus hairs develop into terminal hairs during and after puberty

www.akclinics.comAndrogenetic Alopecia (AGA) Loss of hair with increasing age in genetically predisposed

individuals Decreased anagen and increased telogen Affects both males & females Characterized by

Miniaturization of the hair follicle Reduction in thickness of hair shaft Decrease in hair density Reduced hair growth rate

www.akclinics.comAndrogenetic Alopecia

Androgenetic alopecia is characterized by the gradual conversion of terminal hairs into indeterminate and finally into vellus hairs

www.akclinics.comAndrogenetic Alopecia: Male Men experience receding of frontal hairline and/or vertex

baldingHamilton-Norwood classification

www.akclinics.comAndrogenetic Alopecia: Female Women experience diffuse thinning over the entire top of the

head i.e. vertex

Ludwig classification

www.akclinics.comAndrogenetic Alopecia: Pathophysiology

Role of Dihydrotestosterone (DHT)

Testosterone Dihydrotestosterone5-α Reductase

Androgenetic Alopecia

Shortens Anagen

www.akclinics.comAndrogenetic Alopecia: Pathophysiology

Role of Dihydrotestosterone (DHT)

www.akclinics.comTreatment of Androgenetic Alopecia: Evidence Based

www.akclinics.comTreatment Options

Medical Miscellaneous Surgical Light Therapy

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1. Am J Clin Dermatol. 2014; 15: 217-230. 2. J Dtsch Dermatol Ges. 2011; 9 Suppl 6: S1-57.

www.akclinics.comLevel of Evidence

J Dtsch Dermatol Ges. 2011; 9 Suppl 6: S1-57.

www.akclinics.comMinoxidil

Am J Clin Dermatol. 2014; 15: 217-230.

www.akclinics.comMinoxidil

J Dtsch Dermatol Ges. 2011; 9 Suppl 6: S1-57.

www.akclinics.com5-Alpha Reductase Inhibitors

Am J Clin Dermatol. 2014; 15: 217-230.

www.akclinics.com5-Alpha Reductase Inhibitors

J Dtsch Dermatol Ges. 2011; 9 Suppl 6: S1-57.

www.akclinics.com5-Alpha Reductase Inhibitors

J Dtsch Dermatol Ges. 2011; 9 Suppl 6: S1-57.

www.akclinics.comHormonal treatment

Am J Clin Dermatol. 2014; 15: 217-230.

www.akclinics.comHormonal treatment

J Dtsch Dermatol Ges. 2011; 9 Suppl 6: S1-57.

www.akclinics.comHormonal treatment

J Dtsch Dermatol Ges. 2011; 9 Suppl 6: S1-57.

www.akclinics.comCombination treatment

Am J Clin Dermatol. 2014; 15: 217-230.

www.akclinics.comMiscellaneous

Am J Clin Dermatol. 2014; 15: 217-230.

www.akclinics.comMiscellaneous

Am J Clin Dermatol. 2014; 15: 217-230.

www.akclinics.comSurgery

Important role in AGA patients who do not have success with medical therapies

Include hair transplantation and scalp reduction or a combination of both

Considered to have insufficient evidence in both sexes

Limitation of not having efficacy in preventing the progression of AGA

Long-term combination therapy of hair transplantation and oral finasteride 1 mg daily in male patients has been suggested

Am J Clin Dermatol. 2014; 15: 217-230.

www.akclinics.comSurgery

J Dtsch Dermatol Ges. 2011; 9 Suppl 6: S1-57.

www.akclinics.comLow-level light therapy (LLLT) Various products using LLLT, including comb, hood, and

helmet are available LLLT, particularly 650–900 nm wavelength at 5 mW, may be

an effective alternative treatment for AGA patients either as a stand-alone or adjunctive therapy

Am J Clin Dermatol. 2014; 15: 217-230.

www.akclinics.comConclusion Medical treatment in terms of efficacy and safety with the best level

of evidence include topical minoxidil and oral finasteride

Topical minoxidil appears to be the most effective and safe treatment in females

There is limited evidence to conclude the efficacy of hormonal treatment

Various miscellaneous agents are claimed to have some role

Follicular unit hair transplantation is a good option when medical treatment is not effective

Light therapy may be an alternative treatment option

Am J Clin Dermatol. 2014; 15: 217-230.

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