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男性型脱发的治疗综述。

A review of the treatment of male pattern hair loss.

机构信息

Sinclair Dermatology, East Melbourne, VIC, Australia.

出版信息

Expert Opin Pharmacother. 2020 Apr;21(5):603-612. doi: 10.1080/14656566.2020.1721463. Epub 2020 Feb 17.

Abstract

: Androgenetic alopecia is a common hair loss disorder affecting up to 80% of males by the age of 80. It is characterized by androgen related progressive thinning of hair in a defined pattern. It results in diminished self-esteem, reduced confidence and distress in affected men, irrespective of age or stage of baldness. An effective treatment for hair baldness is needed.: In androgenetic alopecia, hair follicles undergo progressive miniaturization. Genetic factors and androgens are key role-players in disease pathogenesis. Herein the authors review the pharmacologic treatment of androgenetic alopecia, which involves 5 alpha reductase inhibitors, minoxidil and prostaglandins. Non-pharmacologic approaches are also explored.: Androgenetic alopecia progresses over time and although the current available medical treatments like finasteride and minoxidil are effective in arresting the progression of the disease, they allow only partial regrowth of hair at its best. Early treatment achieves a more optimal outcome. Non-pharmacologic treatments like PRP can be considered in patients refractory to medical treatment. MPHL: male pattern hair loss; AGA: androgenetic alopecia; DHT: dihydrotestosterone; 5AR: 5-alpha-reductase; VEGF: vascular endothelial growth factor; PG's: prostaglandins (PG's); PGD2R: prostaglandin D2 receptor; VPA: valproic aid; SR: Serenoa Repens; PRP: platelet-rich plasma; PDGF: platelet derived growth factor; TGF: transforming growth factor; ERK: extracellular signal-regulated kinase; PKB: protein kinase B; LLLT: low-level laser therapy; ROS: reactive oxygen species; RCT: randomized control trial; SFRP1: secreted frizzled related protein 1; DP: dermal papilla; PDE5: phosphodiesterase 5.

摘要

男性型脱发是一种常见的脱发疾病,80 岁时多达 80%的男性受其影响。其特征是雄激素相关的毛发进行性变薄,呈特定模式。这会导致受影响的男性自尊心下降、自信心降低和痛苦,无论年龄或脱发阶段如何。需要一种有效的治疗脱发的方法。

在男性型脱发中,毛囊逐渐发生微小化。遗传因素和雄激素是疾病发病机制中的关键因素。本文作者综述了雄激素性脱发的药物治疗,包括 5α 还原酶抑制剂、米诺地尔和前列腺素。还探讨了非药物治疗方法。

雄激素性脱发会随着时间的推移而进展,尽管目前可用的药物治疗方法,如非那雄胺和米诺地尔,可有效阻止疾病的进展,但它们只能使头发在最佳状态下部分再生。早期治疗可获得更理想的效果。对于药物治疗抵抗的患者,可以考虑非药物治疗方法,如 PRP。MPHL:男性型脱发;AGA:雄激素性脱发;DHT:二氢睾酮;5AR:5α-还原酶;VEGF:血管内皮生长因子;PG's:前列腺素(PG's);PGD2R:前列腺素 D2 受体;VPA:丙戊酸;SR:锯棕榈;PRP:富血小板血浆;PDGF:血小板衍生生长因子;TGF:转化生长因子;ERK:细胞外信号调节激酶;PKB:蛋白激酶 B;LLLT:低水平激光治疗;ROS:活性氧;RCT:随机对照试验;SFRP1:分泌卷曲相关蛋白 1;DP:真皮乳头;PDE5:磷酸二酯酶 5。

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