生髮林宜蓉醫師-生髮研究所│台北掉髮健髮門診│專治雄性禿│落髮治療專家

掉髮治療專家林宜蓉醫師現職為高地植髮家診所最高顧問,專治雄性禿、女性禿女性掉髮、產後掉髮、圓形禿、少年禿、疤痕修護、異常性掉髮、頭皮等問題。
-2015年台灣毛髮移植醫學會韓式美型植髮讀書會研究報告
發佈時間:2015-05-07   點擊率:1790
主講者 發毛診所鍾文桂醫師   共同參與: 鄒積鎮醫師 林宜蓉醫師 黃挺達醫師




The androgen most closely implicated in the expression of male pattern hair loss in dihydrotestosterone(DHT).
 
Two isoenzymes of 5AR
Type I: pilosebaceous unit and sebaceousgland
Type II: outer root sheath of scalp hairfollicle, prostate, and dermal papilla
 
Key steps in androgen pathway:
1. Testosterone bound to circulatingbinding globulins
2. Testosterone enters target cell
3. Conversion of testosterone to DHT by5-alpha-reductase
4. DHT binds to cytosol androgenreceptor(AR)
5. DHT-AR complex enters cell nucleus
6. DHT-AR complex binds to DNA, producingcell-specific mRNA
7. Protein synthesis produces physiologic effect
Alternative pathway:
1. Direct binding of testosterone toalternate cytosol AR
2. T-AR complex enters cell nucleus
 
 
Therapeutic approach to female pattern hairloss
1. careful physical examination, includinghair pull and trichogram.
2. Laboratory evaluation to rule outendocrine disorders, iron deficiency, lupus, other systemic disorders.
3. Consider scalp biopsy to rule outalopecia areata, telogen effuvium, inflammatory or scarring hair lossprocesses.
4. Being topical minoxidil 2%solution
5. Consider hair transplantation, ifappropriate.
6. Consider antiandrogen therapy.
 
Hair growth medication and mechanism ofaction
1. Minoxidil: topical hypertrichotic agent.calcium channel opener, vasodilator.
2. Finasteride: type II 5AR blockade.
3. Fluridil: topical anti-androgen
4. Dutasteride: type I and type II 5ARblockade.
5. Flutamide: systemic nonsteroidal antiandrogen
6. Spironolactone: systemic weakantiandrogen
7. Cyproterone acetate: systemic potentantiandrogen
8. Inocoterone acetate: topicalantiandrogen
 
Tips on using minoxidil
1. men should use 5% solution
2. women should use 2% solution
3. use twice daily to maximize efficacy
4. apply to scalp, not hair
5. apply to all thinning areas, not just tothe crown
6. use dropper, not spray attachment
7. if scalp irritation develops, consultdermatologist
8. transient hair loss can occur 4-8 weeksafter initiation. reassure patient about this and continue medication
 
Tips on using finasteride
1. begin use at earliest signs of hair loss
2. Take baseline photos for futurecomparison
3. no change in hair density over time issuccess, not failure
4. discuss sexual concerns at each visit
5. if needed(rarely), prescribe sildenafil,tadalafil, or vardenafil to enhance sexual performance
6. women should not handle crushed orbroken tablets
7. women should not use finasteride

8. no risk of developing fetus exposed tosemen of men on finasteride


來源:台灣毛髮移植醫學會

上一篇:賀林宜蓉醫師榮任國立臺灣科技大學"運用金屬玻璃鍍層進行植髮針性能提升研究"計畫主持人 下一篇:自製避孕藥洗髮精洗頭 真的會讓頭髮長的比較快嗎?



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