Treatment of Hair Loss

    September 1999 in “ The New England Journal of Medicine
    Vera H. Price
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    TLDR Finasteride and minoxidil are effective for hair loss, but continued research is needed for better treatments.
    The 1999 document reviewed treatments for hair loss, particularly androgenetic alopecia and alopecia areata. It explained the hair growth cycle and the impact of androgens. Finasteride and minoxidil were emphasized as effective treatments. Finasteride, tested in 1,879 men, improved hair counts and scalp coverage by reducing dihydrotestosterone levels. Minoxidil, available in 2% and 5% solutions, increased hair count duration of the anagen phase. A study with 393 men showed 5% minoxidil was more effective than 2%, and another study confirmed its efficacy over placebo, with rapid hair loss post-treatment cessation. Minoxidil's side effects included scalp irritation, while finasteride was well-tolerated but not for use in women who may become pregnant. In women, 2% minoxidil was effective, but 5% showed no significant improvement. Treatments for alopecia areata varied by patient age and severity, with options like topical minoxidil, glucocorticoids, anthralin, and immunotherapy. The document concluded that while finasteride and minoxidil have advanced hair loss treatment, ongoing research is essential for future success.
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