En la actualidad, minoxidil y finasteride son los únicos tratamientos aprobados por la FDA para la APM.
FINASTERIDE
¿Cómo funciona Finasteride?
Finasteride es un tipo 2 inhibidor de la enzina 5α-reductasa. Se reduce la conversión de testosterona a DHT.
¿Cuál es el beneficio de tomar finasteride?
En el 80% de los sometidos a tratamiento Finasteride, se observa un aumento significativo en la cantidad de cabello y tamaño de las fibras, junto con una prolongación de los períodos de crecimiento del cabello.
¿Cuánto tiempo pasará antes de que se noten las mejoras del uso de Finasteride?
Las mejoras se notan 6-12 meses después del inicio del tratamiento. Se requieren dos años de uso para lograr el máximo efecto, y se recomienda el uso continuo con el fin de mantener este beneficio. La interrupción del tratamiento suele causar resultados no deseados.
¿En qué zona del cuero cabelludo es Finasteride más eficaz?
Finasteride es más eficaz sobre las regiones superiores y frontales del cuero cabelludo. Sin embargo, es potencialmente eficaz donde el cabello miniaturizado está presente.
¿Cuál es la dosis recomendada?
La dosis media es de 1 mg / día, pero con una dosis de 0,2 mg se puede llegar a observar una mejora significativa.
¿Hay alguna posibilidad de reacción con otras drogas?
No existe ninguna interacción conocida.
¿Hay alguna enfermedad o condición que contraindica el uso de finasterida?
Finasteride no debe ser usado por mujeres que están embarazadas y pacientes con enfermedad hepática.
¿Cuáles son los efectos secundarios?
Los efectos adversos informados de Finasteride incluyen: disminución de la libido (1,9%), disfunción eréctil (1,3%), y la disfunción eyaculatoria (1%). En algunos pacientes, los efectos adversos de la medicación persistieron durante al menos 3 meses después de dejar su uso. Aunque la causa clara no ha sido determinada, la FDA ha advertido acerca de sus efectos sexuales adversos potencialmente persistentes, a pesar de la interrupción. Finasteride trabaja para reducir los niveles de antígeno (PSA) específico de la próstata y la ginecomastia se ha reportado en raras ocasiones. Un reciente estudio investigó la asociación entre el cáncer de mama masculino 5-ARI de y el resultado reveló una falta de asociación positiva.
MINOXIDIL
¿Cómo funciona el Minoxidil?
Todavía no está claro cómo funciona el Minoxidil. En teoría puede prevenir o retrasar la miniaturización folicular.
¿Cuál es la dosis recomendada de Minoxidil?
Con la APM, una solución al 5% es superior a una solución del 2%. Con la APF, tanto el 1% y 2% de soluciones de minoxidil aumentan la cantidad de cabello. La dosis recomendada es de 1 ml (25 gotas) tanto para la formulación de 2% y 5%, o la mitad dos veces al día.
¿Cuánto dura el tratamiento de Minoxidil?
El tratamiento de Minoxidil es a largo plazo. La interrupción del Minoxidil hará que aparezca el efecto"sheeding" en todo el cabello en que se utilizó.
¿Cuáles son los efectos adversos de Minoxidil?
Los efectos adversos de minoxidil incluyen irritación de la piel, hipertricosis en la cara y las manos, y taquicardia. Una preparación de espuma de propileno glicol-libre del 5% es potencialmente menos irritante y menos sucia. La hipertricosis es totalmente reversible.
¿Hay alguna enfermedad o condición que contraindica el uso de Minoxidil?
Minoxidil no debe utilizarse en mujeres embarazadas o en lactancia. Debe utilizarse con precaución en pacientes con enfermedades cardiovasculares también.
DUTASTERIDE
¿Cómo funciona Dutasteride?
La dutasterida inhibe las enzinas de tipo I y II , 5α-reductasa en consecuencia hace que aumente la cantidad de cabello y el grosor del cabello al mejorar la relación de pelo anágeno a pelo telógeno , y resultando una mejora en la cobertura del cuero cabelludo.
¿Cuál es la dosis recomendada?
La dosificación de dutasteride 0,5 mg / día se considera adecuada para mejorar o prevenir la progresión de la APM.
¿Cuáles son los efectos adversos de la dutasterida?
Los efectos adversos de dutasterida son impotencia, disminución de la libido, sensibilidad en los senos, aumento de las mamas, y trastornos de la eyaculación.
¿Hay alguna enfermedad o condición que contraindica el uso de dutasteride?
Los hombres que están siendo tratados con dutasteride no deben donar sangre. Dutasteride no debe utilizarse en mujeres en edad reproductiva sin el uso de un método anticonceptivo eficaz. Además, la función hepática debe ser monitoreada mientras toma este medicamento.
La vía PG está íntimamente relacionada con el crecimiento del cabello debido a que tanto PGE2 y PGF2 ayudan a promover el crecimiento del cabello, mientras que PGD2 inhibe el crecimiento del cabello. En los hombres con casos leves de AGA, el 0,1% de latanoprost, un análogo de PGF2, ha demostrado que aumenta significativamente la densidad del pelo y pigmentación.
Ketoconazol es un agente anti-fúngico efectivo en el tratamiento de la dermatitis y la caspa que puede estimular el crecimiento del cabello. Por lo general se utiliza como soporte a otros tratamientos AGA.
Plasma rico en plaquetas (PRP) es una solución de plasma con plaquetas. PRP se utiliza con frecuencia en la cirugía cosmética y aspectos relacionados con la cicatrización de heridas . Algunos cirujanos de trasplante capilar utilizan PRP, ya sea mediante el almacenamiento de los injertos en PRP o mediante la inyección de PRP en el cuero cabelludo antes de la colocación de injertos. Los datos para justificar su efecto directo en la estimulación del crecimiento del pelo es limitado.
Varios tipos de productos utilizando la TLBI están disponibles para el tratamiento adyuvante incluyendo el Peine Laser Max para pelo aprobado por la FDA para el tratamiento de la alopecia de patrón masculino y la APF. TLBI, en particular la longitud de onda de 650-900 nm a 5 mW, puede considerarse un tratamiento alternativo eficaz para cualquiera de estas condiciones de forma autónoma o como terapia.
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