February 2, 2022
Relative Efficacy of Minoxidil and the 5-? Reductase Inhibitors in Androgenetic Alopecia Treatment of Male PatientsA Network Meta-analysis
Aditya K. Gupta, MD, PhD1,2; Maanasa Venkataraman, MSc1; Mesbah Talukder, PhD1; et alMary A. Bamimore, PhD1
JAMA Dermatol. Published online February 2, 2022. doi:10.1001/jamadermatol.2021.5743
Key PointsQuestion For male androgenetic alopecia, what is the relative efficacy of monotherapy with orally and topically administered minoxidil, dutasteride, and finasteride?
Findings In this network meta-analysis of 23 trials, the rank of efficacy across treatments and the relative efficacy for every possible pairwise comparison of treatments were determined for 4 end points (ie, change in total and terminal hair count after 24 and 48 weeks). The results of this meta-analysis indicate that 0.5 mg/d of oral dutasteride has the highest probability of being the most efficacious treatment, followed by these agents in decreasing order of efficacy: 5 mg/d of oral finasteride, 5 mg/d of oral minoxidil, 1 mg/d of oral finasteride, 5% topical minoxidil, 2% topical minoxidil, and 0.25 mg/d of oral minoxidil.
Meaning The findings of this meta-analysis contribute to the comparative effectiveness literature for AGA therapies with regard to the compared interventions.
Dr. Rassman’s Concern: Dutasteride has a half life of 5-6 weeks so daily dosing at 0.5mgs make little sense to me. Blood levels and other organ impact at this dose building up over time, have not been analyzed or published.
Dermatology News Wrote: Here are comments and an analysis of this article which our readers may find significant: https://www.mdedge.com/dermatology/article/251693/hair-nails/male-alopecia-agents-ranked-efficacy-meta-analysis
Yes, dot scars are a consequence of FUE. ALL cuts into the human body produces scars. If your surgeon used a small punch of .95mm or less, the scars are barely visible. Larger punches create larger white dots. Sometimes the scars just stretch and become larger. Fixing it can be effectively treated with Scalp Micropigmentation
I’m in a bit of a predicament now. I can feel my hair getting thinner over the past year, but visually, my hair density still looks somewhat the same as before. If I were to take a picture right now, no one would even suspect I’m thinning because I still have a full head of hair. In fact the dermatologist I visited just took a look without using a trichoscan thought I was crazy and just prescribed me Minox unwillingly.
From what I have seen here, almost everyone hopped on Fin only when they start to see visible thinning. I haven’t come across anyone who has a head of hair on Fin. Despite people saying that prevention is the best, it seems that people only start medication once thinning becomes noticeable?
Finasteride has been shown to slow hair loss significantly when compared with men who didn’t take it. The spread between the two groups last years, showing that people who lose hair on finasteride lose it slower than they would have had they not taken in. Another way to look at it is that men on finasteride kept their hair longer over more than a decade than men who didn’t take it. Here is the graph that shows this: https://baldingblog.com/5-year-growth-plotted-with-propecia-compared-to-control-group/
I met with one of my patients this week who completed the entire hair transplant restoration. He is a successful businessman and told me that the impact on his life was enormous. He had spent too much time trying to hide his balding, using Toppik and combovers which never were good enough to hide it. Since his two hair transplant procedures were complete, he never had to think about his hair and his life returned as he had hoped. He said he never realized how much time and emotion went into his hair loss and now the nightmare is over. His business focus caused his business to significantly uptick.
So do I buy hair transplant or college intuition I’m 18 and have male pattern baldness
So do I buy hair transplant or college intuition I’m 18 and have male pattern baldness. There are a lot of approaches to hold on to your hair at 1 years of age and these work well. A transplant is a hopeless last resort after the age of 26
Some providers believe that large dots make for good SMP, so terribly wrong. Whoever did this had no plan or any Aesthetic concept of how SMP is supposed to work. Anyone can see this on a man’s crown. When you are going to get SMP, ask to meet some of the provider’s patients and you will know if that person’s work meets your expectations before you take the plunge
Due to hairfall my scalp is visible in my temple area. Rest all is fine. Should i go for fin and min treatment?
Lighting, a short hair cut and straight hair can produce what you are showing. If you had your hair cut to the same length in the past with the same lighting and it was different, then maybe it is hair loss. Before you start a lifetime treatment for hair loss, see a doctor and find out if you have genetic balding first.
Although you did not pull your hair back, it looks like the hairline is close to the highest crease of the furrowed brow meaning that it has not receded yet to a mature position. If you want a more exacting answer from me, show me a photo, full frontal face, with your hair pulled back and your eyebrows lifted high so that the forehead shows. This will give me an anatomic reference for where your hairline belongs.
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