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Cookie DeclarationAl momento, Minoxidil e Finasteride sono gli unici prodotti approvati dalla FDA per MPHL.
FINASTERIDE
Come funziona la Finasteride?
La Finasteride è un inibitore della 5α-reduttasi di tipo 2. Diminuisce la conversione del testosterone in DHT.
Quali sono i benefici della Finasteride?
L’80% dei pazienti in trattamento con Finasteride riscontra un netto incremento nella conta dei capelli e nella dimensione delle fibre, oltre a periodi prolungati di crescita del capello.
Quanto tempo occorre prima di notare gli effetti della Finasteride?
I primi risultati saranno visibili entro 6-12 mesi dall’inizio del trattamento. Per ottenere i massimi risultati sono necessari due anni di utilizzo, ed è consigliato l’uso costante per mantenere i benefici ottenuti. L’interruzione del trattamento causa effetti indesiderati.
In quali zone dello scalpo è più efficace?
La Finasteride ha maggior effetto sulla zona mediana e del vertice dello scalpo. Tuttavia, è potenzialmente efficace su tutte le aree miniaturizzate.
Qual è la dose consigliata?
In media, la dose giornaliera consigliata è di 1mg/die, ma con dosi di 2 mg/die è possibile produrre miglioramenti rilevanti.
La Finasteride può causare reazioni con altri medicinali?
Non esistono evidenze d’interazioni con altri farmaci.
Vi sono malattie o condizioni mediche che precludono l’utilizzo della Finasteride?
La Finasteride non è adatta all’uso da parte di donne in gravidanza o pazienti con malattie del fegato.
Quali sono gli effetti collaterali?
Gli effetti collaterali della Finasteride includono: diminuzione della libido (1.9%), disfunzione erettile (1.3%) e disfunzione eiaculatoria (1%). In alcuni pazienti gli effetti collaterali si sono protratti fino ad almeno tre mesi dalla fine dell’assunzione. Sebbene non siano state stabilite relazioni di causalità, la FDA ha segnalato la potenziale persistenza degli effetti collaterali di natura sessuale anche dopo cessazione del trattamento. La Finasteride riduce i livelli dell’antigene prostatico specifico (PSA); sono stati segnalati alcuni rari casi di ginecomastia. Uno studio recente ha esaminato la correlazione fra i farmaci 5-ARI e il cancro al seno maschile: i risultati hanno dimostrato una mancanza di correlazione.
MINOXIDIL
Come funziona il Minoxidil?
Il funzionamento del Minoxidil non è ancora chiaro. E’ possibile che rallenti o eviti il processo di miniaturizzazione dei follicoli.
Qual è la dose consigliata?
In caso di MPHL, l’utilizzo della soluzione con il Minoxidil al 5% è più efficace rispetto a quella al 2%, mentre in caso di FPHL, le soluzioni all’1% e al 2% incrementano entrambi la conta dei capelli. La dose consigliata è di 1 ml (25 gocce) di formulazione 2% e 5%, oppure mezzo tappo di schiuma da applicare quotidianamente.
Quanto dura il trattamento?
Il trattamento con Minoxidil è a lungo termine. Interromperlo causerà la perdita entro i 4-6 mesi dei miglioramenti ottenuti.
Quali sono gli effetti collaterali?
Gli effetti collaterali del Minoxidil includono irritazione cutanea, ipertricosi delle mani e del viso, e tachicardia A propylene glycol–free foam preparation of 5% is potentially less irritating and less messy. Hypertrichosis is totally reversible. Una spuma del 5% non contenente glicole propilenico è potenzialmente meno irritante. L’ipertricosi è del tutto reversibile.
Vi sono malattie o condizioni mediche che precludono l’utilizzo del Minoxidil?
Il Minoxidil non è adatto all’uso da parte di donne in gravidanza o allattamento. Deve essere usato con cautela in pazienti con malattie cardiovascolari.
DUTASTERIDE
Come funziona il Dutasteride?
Il Dustasteride inibisce entrambi gli isoenzimi di tipo 1 e 2 della 5α-reduttasi, incrementando la conta e il peso dei capelli attraverso il miglioramento del rapporto fra capelli anagen e telogen, ottenendo così una maggiore copertura.
Qual è la dose consigliata?
Con il Dutasteride, una dose di 0.5 mg/die è sufficiente a migliorare o prevenire l’aggravarsi dell’alopecia maschile.
Quali sono gli effetti collaterali?
Gli effetti collaterali del Dutasteride sono impotenza, diminuzione della libido, tenerezza e ingrandimento del seno, e disturbi dell’eiaculazione.
Vi sono malattie o condizioni mediche che precludono l’utilizzo del Dutasteride?
Data la sua lunga emivita, i pazienti trattati con Dutasteride devono evitare le donazioni di sangue. Il Dutasteride non deve essere utilizzato in donne in età riproduttiva che non adottano metodi contraccettivi efficaci. Inoltre, le funzionalità del fegato devono essere monitorate durante il trattamento.
La prostaglandina ha un ruolo fondamentale nella crescita dei capelli, perché la PGE2 e l’alfa-PGF2 favoriscono la crescita dei capelli, mentre la PGD2 la inibisce. In uomini con una leggera AGA, lo 0.1% di latanoprost, un anologo della PGF2, aumenta notevolmente la densità e la pigmentazione dei capelli.
Il Ketoconazole è un agente antifungino, efficace nel trattamento della dermatite e della forfora, che può stimolare la crescita dei capelli. Generalmente, è utilizzato in congiunzione con altri trattamenti per l’AGA.
Il plasma ricco di piastrine (PRP) è un gel autologo di plasma e piastrine. Il PRP è spesso utilizzato in chirurgia estetica e per velocizzare la guarigione dei tessuti. Alcuni chirurghi della calvizie utilizzano il PRP, scegliendo di conservarvi gli innesti o di iniettarlo nello scalpo prima dell’inserimento degli innesti.
Sono disponibili una varietà di prodotti per eventuali terapie aggiuntive dell’AGA, incluso il Lasercomb HairMax approvato dalla FDA per il trattamento dell’alopecia a pattern maschile e femminile. La terapia laser, in particolare con lunghezza d’onda 650-900 nm e potenza di 5mW, può dimostrarsi un trattamento alternativo valido per entrambe le tipologie, sia come terapia primaria che aggiuntiva. Non esistono dati consistenti a sostegno di un effetto diretto di stimolazione della crescita dei capelli.
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