Medical Treatment
At present, minoxidil is the only treatments approved by the FDA for MPHL.
Improvements are noticed 6-12 months from the commencement of treatment. Two years of use are required to achieve the maximum effect, and continuous use is recommended in order to maintain this benefit. The discontinuance of the treatment will cause undesirable results.
FINASTERIDE
What is the recommended dosage?
The average dosage is 1 mg/day, but with a dosage of 0.2 mg/day significant improvement is observed.
Is there a potential for reaction with other drugs?
No known drug interaction exists.
Is there any disease or condition that contraindicates the use of Finasteride?
Finasteride use should not be used by women who are pregnant and by patients with liver disease.
MINOXIDIL
How does Minoxidil work?
It is still unclear how Minoxidil works. It may prevent or delay follicular miniaturization.
What is the recommended dosage of Minoxidil?
With MPHL, a 5% solution is superior to a 2% solution. With FPHL, both 1% and 2% Minoxidil solutions increase hair count. The recommended dosage is 1 ml (25 drops) for both 2% and 5% formulation, or half a cap full of foam applied twice daily.
How long is the Minoxidil treatment?
Minoxidil treatment is long-term. The discontinuation of Minoxidil will cause the shedding of all Minoxidil-dependent hair within 4 to 6 months.
What are the adverse effects of Minoxidil?
The adverse effects of Minoxidil include skin irritation, hypertrichosis on the face and hands, and tachycardia. A propylene glycol–free foam preparation of 5% is potentially less irritating and less messy. Hypertrichosis is totally reversible. The adverse effects of Minoxidil include skin irritation, hypertrichosis on the face and hands, and tachycardia. A propylene glycol–free foam preparation of 5% is potentially less irritating and less messy. Hypertrichosis is totally reversible.
Is there any disease or condition that contraindicates the use of Minoxidil?
Minoxidil should not be used in pregnant or nursing women. It should be used with caution in patients with cardiovascular disease as well.
DUTASTERIDE
How does Dutasteride work?
Dutasteride inhibits both type I and II 5α-reductase consequently increasing hair count and hair weight by improving the ratio of anagen to telogen hairs, and resulting in improvement in scalp coverage.
What is the recommended dosage?
The Dutasteride dosage of 0.5 mg/day is considered adequate to improve or prevent the progression of MPHL.
What are the adverse effects of Dutasteride?
The adverse effects of Dutasteride are impotence, decreased libido, breast tenderness, breast enlargement, and ejaculatory disorders.
Is there any disease or condition that contraindicates the use of Dutasteride?
Because of its long half-life, men who are being treated with Dutasteride should not donate blood. Dutasteride should not be used in women of a reproductive age without the use of effective contraception. Additionally, liver function should be monitored while taking this drug.