Hair loss has huge psychological effects, as its results focus on the scalp, an area which is a reference point of ourselves and of modern aesthetic perception of our image in general.
Apart from the normal hair loss in which hair are lost daily because of the natural regeneration, in abnormal level, hair loss is characterized by an increased number of hair that fall every day and not be replaced by new ones. In this way gradually created thinning hair, that called alopecia.
The number and the diversity of factors which cause the disease, make the diagnosis and the appropriate treatment a challenge, which without proper staging and monitoring during the treatment, can't give correct and scientifically proven results.
The early detection of the causes of hair loss is determinant to select the appropriate treatment regimen and to directly begin the treatment of the problem, but also to protect the existing hair follicles from further and possibly irreversible impairment.
The existing treatments, which most times act synergistically (i.e. a treatment regimen that combines them is selected) have the following targets:
- To stop the hair loss
- The stabilization of the thinning hair
- The strengthening of the hair follicles
- The reinforcement of the local microcirculation
- The stimulation of hair growth
- To cover the thinning area
Medication is the first line treatment for both male and female hair loss.
The aim is to slow the rate of hair loss or / and reverse the miniaturization process of the hair follicles.
So far, two drugs have been approved by the US Food and Drug Administration (FDA) for these purposes: minoxidil topical (a biological response modifier) and oral finasteride (a hormone modifier).
The minoxidil, which has vasodilating activity and is available at a concentration of 2% and 5%, increases the duration of the anagen stage of the hair growth cycle (during which hair grow and are rich in melanin) and magnifies and strengthens the miniature follicles, thereby reducing the further hair loss. The application of 1ml on scalp twice a day brings the best results after 26-52 weeks, with the top of the head to exhibit greater improvement and the frontal line the lower improvement. Besides the local application, if it's necessary, can also be used minoxidil injections in the thinning area.
Adverse dermatologic side effects, such as irritation of the scalp and unwanted hair growth in surrounding areas of the skin of the forehead or face, rarely observed. It is worth noting that the treatment interruption leads gradually (within 4-6 months) to the previous state. So, the scalp must be regularly monitored with trichoscopy in order to maintain the result on objective measurements basis and to increase or decrease the dosage or to sustain the result with lower doses.
Similar action has also the finasteride, the first approved oral treatment in pill form. It is basically a competitive inhibitor of the type II of 5α-reductase, the enzyme that involved in the conversion of testosterone to dihydrotestosterone (DHT) and is responsible for hair loss. The best response to treatment is observed again at the top of the head, while the lower in the frontal line.
However, it's worth noting that finasteride is teratogen and for this reason it shouldn't be taken by women who want to have a child, and has also be proven that it's ineffective in postmenopausal women. The side effects in men are unusual (decrease in sexual desire and capacity) and presented in less than 2% of patients. It is completely reversible after the treatment interruption and also, often resolved during a continuing treatment.
Mesotherapy and Hair Loss
In cases of hair loss and alopecia, we use mesotherapy to introduce in the skin of the scalp, ie inside the hair follicles, the appropriate pharmaceutical and multivitamin preparations for strengthening and regrowth of hair. Taking of medical history, clinical examination and digital dermoscopy have been preceded to diagnose the type of alopecia (androgenetica, telogen effluvium, cicatricial, areata, etc.), in order to determine the drug "cocktail" which will be used. Between the substances which are used, are included multivitamins, minerals, micronutrients, antioxidants in combination with pharmaceuticals, such as minoxidil, finasteride, dutasteride, steroids, etc. The treatments are made once a month for six to eight months, depending on the type of alopecia. From the very first treatments we observe reduction of hair loss, and then stabilization and strengthening.