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-2015年台灣毛髮移植醫學會韓式美型植髮讀書會研究報告
發佈時間:2018-07-27 點擊率:1

主講者 發毛診所鍾文桂醫師   共同參與: 鄒積鎮醫師 林宜蓉醫師 黃挺達醫師




The androgen most closely implicated in the expression of male pattern hair loss in dihydrotestosterone(DHT).
 
Two isoenzymes of 5AR
Type I: pilosebaceous unit and sebaceousgland
Type II: outer root sheath of scalp hairfollicle, prostate, and dermal papilla
 
Key steps in androgen pathway:
1. Testosterone bound to circulatingbinding globulins
2. Testosterone enters target cell
3. Conversion of testosterone to DHT by5-alpha-reductase
4. DHT binds to cytosol androgenreceptor(AR)
5. DHT-AR complex enters cell nucleus
6. DHT-AR complex binds to DNA, producingcell-specific mRNA
7. Protein synthesis produces physiologic effect
Alternative pathway:
1. Direct binding of testosterone toalternate cytosol AR
2. T-AR complex enters cell nucleus
 
 
Therapeutic approach to female pattern hairloss
1. careful physical examination, includinghair pull and trichogram.
2. Laboratory evaluation to rule outendocrine disorders, iron deficiency, lupus, other systemic disorders.
3. Consider scalp biopsy to rule outalopecia areata, telogen effuvium, inflammatory or scarring hair lossprocesses.
4. Being topical minoxidil 2%solution
5. Consider hair transplantation, ifappropriate.
6. Consider antiandrogen therapy.
 
Hair growth medication and mechanism ofaction
1. Minoxidil: topical hypertrichotic agent.calcium channel opener, vasodilator.
2. Finasteride: type II 5AR blockade.
3. Fluridil: topical anti-androgen
4. Dutasteride: type I and type II 5ARblockade.
5. Flutamide: systemic nonsteroidal antiandrogen
6. Spironolactone: systemic weakantiandrogen
7. Cyproterone acetate: systemic potentantiandrogen
8. Inocoterone acetate: topicalantiandrogen
 
Tips on using minoxidil
1. men should use 5% solution
2. women should use 2% solution
3. use twice daily to maximize efficacy
4. apply to scalp, not hair
5. apply to all thinning areas, not just tothe crown
6. use dropper, not spray attachment
7. if scalp irritation develops, consultdermatologist
8. transient hair loss can occur 4-8 weeksafter initiation. reassure patient about this and continue medication
 
Tips on using finasteride
1. begin use at earliest signs of hair loss
2. Take baseline photos for futurecomparison
3. no change in hair density over time issuccess, not failure
4. discuss sexual concerns at each visit
5. if needed(rarely), prescribe sildenafil,tadalafil, or vardenafil to enhance sexual performance
6. women should not handle crushed orbroken tablets
7. women should not use finasteride

8. no risk of developing fetus exposed tosemen of men on finasteride


來源:台灣毛髮移植醫學會

上一篇:賀林宜蓉醫師榮任國立臺灣科技大學"運用金屬玻璃鍍層進行植髮針性能提升研究"計畫主持人下一篇:自製避孕藥洗髮精洗頭 真的會讓頭髮長的比較快嗎?



※ 本文公開說明:本文案例均已經過當事人同意刊登露出,並簽署同意公開授權書。本文術前術後案例照資訊,僅作為手術與醫療資訊之介紹分享,其治療效果因個人體質與術後保養而有異。提醒 您,任何手術與 醫療處置均有潛在風險,並非每個人都適合,本文內容僅供參考,實際須由醫師當面與您進行評估及溝通而定。

本站資訊無法取代醫師當面診斷,每個人體質不同,治療效果因人而異,建議您親自前來由醫師做進一步的評估

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