• Treatment of AGA is either medical or surgical. The medical management focuses on decreasing androgen activity. Only two medications with proven efficacy are indicated for AGA: oral finasteride and topical minoxidil.⁴
• Minoxidil, a potassium channel agonist and potent peripheral arteriolar vasodilator, was originally used in the management of hypertension. Although its mechanism of action is unclear, minodixil has been observed to retard hair loss and reverse the balding process in some patients. It is approved for use as a 2% or 5% topical solution. However, the therapeutic effect is usually only temporary. Following discontinuation of the drug, the hair slowly falls out again. In addition, irritative dermatitis or contact allergic dermatitis are mentioned as adverse reactions.
• Finasteride, a selective inhibitor of 5-alpha reductase originally approved for use in the treatment of benign prostatic hypertrophy, is increasingly used in the management of alopecia. A significant number of patients have demonstrated retarded hair loss and renewed hair growth with this medication.²
• The majority of the antiandrogens are limited to use due to their potential for feminization, decreased libido,e rectile dysfunction and impotence in men.
• Drugs containing vitamins, aminoacids and trace elements may be used as supportive therapy.
• Gene therapy may become in the future another possibility for patients with AGA.

• Treatment is based on identifying and treating or correcting the underlying cause of telogen effluvium.
• Following the resolution of the triggering factors, complete recovery occurs over 4 to 6 months in most cases.

• Immunomodulating agents used in the treatment of alopecia areata include corticosteroids, minoxidil and anthralin cream.
• For small patchy disease, intralesional corticosteroid is the treatment of choice. Triamcinolone acetonide suspension recommended up to 3 mL of a 5 mg per mL solution is injected into the mid-dermis in multiple sites 1 cm apart.¹ Hair growth usually becomes apparent in four weeks. Injections are repeated every 4 to 6 weeks. 
• Oral corticosteroid therapy which is seldom used because of potential adverse effects is indicated in progressive alopecia areata. The recommended treatment in adults is 40 mg prednisone per day for seven days; then gradually tapered down for six weeks.
• In addition to continuous or pulsed systemic corticosteroids, psoralen plus ultraviolet A (PUVA) have also been used to treat longstanding and widespread alopecia areata.
• Potent topical corticosteroids, anthralin and minoxidil lotion are widely prescribed for limited patchy alopecia areata.

• In view of its psychologic nature, the mainstays of treatment for trichotillomania are focused on counseling and behavior modification therapy.
• Selective serotonin reuptake inhibitors and other medications for depression or obsessive-compulsive disorder may be used in some cases, although no medications are FDA-approved for treatment of trichotillomania.

• Oral antifungal agents such as griseofulvin, itraconazole, terbinafine and fluconazole are all effective in the treatment of tinea capitis.
• Shampoos, such as a 2% ketoconazole, 1% to 2.5% selenium sulfide, 1% to 2% zinc pyrithione, and povidone-iodine are also used as adjuncts, along with an oral antifungal. These shampoos may decrease scaling and itching substantially.

Written by: Healthplus24 team
Date last updated: March 24, 2009

• Evolutionary trend of Alopecia
• Normal hair growth
• Types of Alopecia
• Androgenetic Alopecia
• Telogen Effluvium
• Alopecia Areata
• Tinea Capitis
• Traumatic Alopecia
• Anagen Effluvium
• Evaluation and diagnosis of Alopecia
• Hair transplantation
• Bald scalp reduction
• Impact of moder life on Alopecia