Aujourd’hui, le minoxidile et finastéride sont des seuls traitements pour MPHL approuvé par FDA.
FINASTERIDE
Comment fonctionne-t-il le Finastéride?
Finastéride est un inhibiteur de réductase 5a type 2. Il réduit la conversion de testostérone en DHT.
Quel est l’avantage de prendre le Finastéride ?
Dans 80% des traitements par le Finastéride, la croissance importante de nombre de cheveux et de taille des fibres sont observés par des périodes prolongés de repousse des cheveux.
Combien de temps faudra-t-il avant de remarquer le progrès grâce à l’utilisation de Finastéride?
Le progrès est remarqué dans 6 à 12 mois à partir du début de traitement. L’utilisation pendant 2 ans est exigée pour atteindre à l’effet maximal et l’utilisation permanente est recommandée afin de maintenir cet avantage. L’interruption de traitement causera des résultats indésirables.
Dans quelle partie du cuir chevelu le Finastéride fonctionne plus efficace?
Le Finastéride est plus efficace sur le vertex et des parties supérieures- frontales de cuir chevelu. Cependant, il est éventuellement efficace où que les cheveux miniaturisés sont présents.
Quel est le dosage recommandé?
Le dosage moyenne est 1mg/ jour, mais le progrès important est observé avec le dosage de 0.2 mg/jour.
Est-ce qu’il y a une réaction possible avec des autres médicaments?
Aucune réaction médicamenteuse n’est connue.
Est-ce qu’il y a des maladies ou des problèmes qui contre-indiquent l’utilisation de Finastéride?
Le Finastéride ne doit pas être utilisés par des femmes enceintes et des patients ayant la maladie de foie.
Quels sont les effets adverses?
Les effets adverses rapportés de l'utilisation de Finastéride incluent: la baisse de libido (1.9%), la dysfonction érectile (1.3 %) et la dysfonction éjaculatoire (1%). Chez quelques patients, les effets adverses des médicaments persistent après l’utilisation interrompue après au moins 3 mois. Cependant, la cause évidente n’est pas encore déterminée, la FDA a averti des effets sexuels adverses possibles, sauf l’interruption. Le Finastéride fonctionne pour réduire l’antigène prostatique spécifique (PSA) et la gynécomastie qui ont été rarement reportés. Une étude récente examine la liaison entre 5-ARI et le cancer de sain chez l’homme. Le résultat a révélé qu’il n’y a pas une liaison entre eux.
MINOXIDIL
Comment fonctionne-t-il le Minoxidil?
Le fonctionnement de Minoxidil est toujours incertain. Il peut prévenir ou reporter la miniaturisation folliculaire.
Quel est le dosage recommandé pour le Minoxidil?
Pour MPHL, une solution de 5% est supérieure d'une solution de 2%. Pour FPHL (Perte de Cheveux chez les femmes), une solution de Minoxidil de 1% et 2%, tous les deux augmentent le nombre des cheveux. Le dosage recommandé est 1 ml (25 gouttes) pour toutes les deux formules donc le 2% et le 5%, ou l’application de la mousse pleine de demi- bouchon 2 fois par semaine.
Combien de temps dure le traitement de Minoxidil?
C’est un traitement de long-terme. L’utilisation interrompue de Minoxidil causera dans 4 à 6 mois la chute des cheveux qui dépendent de Minoxidil.
Quel sont les effets adverses de Minoxidil?
Les effets adverses incluent l’irritation de la peau, l’hypertrichose sur le visage et les mains, et la tachycardie. Une préparation de 5% de la mousse sans propylène glycol est potentiellement moins irritante et moins sale. L’hypertrichose est complètement réversible.
Est-ce qu’il y a des maladies ou des problèmes qui contre-indiquent l’utilisation de Minoxidil?
Les femmes enceinte et allaitante ne doivent pas l'utiliser. Il doit être utilisé prudemment pour des patients souffrant des maladies cardiovasculaires.
DUTASTERIDE
Comment fonctionne-t-il le Dutastéride?
Le dutastéride est un inhibiteur de réductase 5a type I et type II qui empêche la croissance de nombre de cheveux et du volume de cheveux en améliorant le ratio des cheveux anagènes aux ceux de telogènes et ayant un résultat amélioré sur la couverture du cuir chevelu.
Quel est le dosage recommandé?
Le dosage de 0.5 mg/j de Dutastéride est considéré adéquat pour améliorer ou prévenir la progression de MPHL.
Quels sont les effets adverses de Dutastéride?
Les effets adverses de Dutastéride sont l’impuissance, la baisse de libido, la sensibilité des sains et les dysfonctions éjaculatoires.
Est-ce qu’il y a des maladies ou des problèmes qui contre-indiquent l’utilisation de Dutastéride ?
À cause de sa longue demi-vie, l’homme soigné avec le Dutastéride ne doit pas faire don du sang. Les femmes à l‘âge de procréer qui n’utilise pas de contraception ne doivent pas utiliser le Dutastéride. En plus, la fonction de foie doit être contrôlée pendant la prise de ce médicament.
Le PG est étroitement lié à la repousse de cheveux car PGE2 et PGF2a la favorisent alors que PGD2 empêche la repousse de cheveux. Dans des cas moins sérieux de l’alopécie chez les hommes, 0.1% de latanoprost, un analogue de PGF2 ont démontré qu’ils diminuent la densité et la pigmentation des cheveux de manière significative.
Le kétoconazole est un antimycosique efficace pour le traitement de la dermite séborrhéique et des pellicules qui stimule la repousse de cheveux. Il est généralement utilisé avec les autres traitements de l'alopécie.
PRP est une préparation autologue de plasmas avec des plaquettes. PRP est fréquemment utilisé dans les opérations et les aspects liés à la guérison de cicatrice. Certains chirurgiens de greffe de cheveux utilisent PRP soit pour le stockage de greffons en PRP soit pour l'injection de PRP dans le cuir chevelu avant d’implanter les greffons. Les données pour confirmer l’effet direct sur la stimulation de repousse des cheveux sont limitées.
Plusieurs types de produits utilisant LLLT sont disponibles pour le traitement adjuvant y compris Hair Max Laser Comb approuvé par le FDA pour le traitement de MPHL et FPHL. LLLT pourrait être considère comme un traitement alternatif soit tout seul soit comme la thérapie adjuvant particulièrement pour le 650–900 nm longueur d’onde à 5mW.
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