Androgenetic Alopecia From A to Z, Vol. 2: Drugs, Herbs, Nutrition and Supplements

Foreword
Foreword
Preface
Acknowledgments
Contents
Part V: Drugs
A Patient’s “Odyssey”
What Hair Loss Patients Expect from a Physician
Classification of Hair-Growth Medications
What to Expect from Medical Treatment?
Medical Treatments and Online Advice
The “Hair Loss Forum Habitat”
Basic Principles of Pharmaceutical Treatment in AGA/FPHL
Beyond Evidence-Based Medicine
23: Minoxidil
23.1 Initial Studies and FDA Approval
23.2 Mechanism of Action
23.3 Minoxidil Effects and Clinical Results
23.4 Minoxidil Topical Solution and Early Research
23.5 Minoxidil and FPHL
23.6 Ideal Candidates for Minoxidil
23.6.1 Is Minoxidil Effective Only on the Vertex?
23.7 Efficacy of Minoxidil
23.7.1 How Soon Will Minoxidil Grow Hair?
23.7.2 Minoxidil Discontinuation and Effects
23.8 How to Use MTS/MTF Properly
23.9 Adverse Effects
23.9.1 Systemic Adverse Effects
23.9.2 Local Adverse Effects
23.9.2.1 Propylene Glycol
23.9.2.2 Ethanol
23.9.3 Ectopic Hypertrichosis
23.10 Minoxidil and Daily Practice
23.11 Minoxidil Topical Foam
23.12 Novel Minoxidil Formulations
23.13 Oral Minoxidil
23.14 A Final Note by the Author
References
24: Finasteride
24.1 Finasteride in BPH
24.2 Finasteride in AGA
24.3 Mechanism of Action of Finasteride
24.3.1 Does Finasteride Act in Any Other Way?
24.4 Clinical Studies on Finasteride
24.5 Clinical Efficacy of Finasteride 1 mg
24.6 Metabolism of Finasteride
24.7 Adverse Effects of Finasteride
24.7.1 Finasteride 5 mg and Sexual Adverse Experiences (SAEs)
24.7.2 Finasteride 1 mg and SAEs
24.7.3 The Nocebo Effect!
24.7.4 Are SAEs Reversible?
24.7.5 Post-Finasteride Syndrome (PFS)
24.7.6 Can Persistent SAEs Be Explained?
24.7.7 Finasteride Effects on Fertility
24.7.8 Finasteride Effects on PSA
24.7.9 Finasteride and Prostate Cancer (PCa)
24.7.10 Finasteride, Gynecomastia and Breast Cancer
24.7.11 Finasteride, Depression and CNS Effects
24.8 Topical Use of Finasteride
24.9 Finasteride Vs. Minoxidil
24.10 How to Best Combine Finasteride and MTS
24.11 Finasteride and FPHL
24.12 Final Notes
References
25: Dutasteride
25.1 Mechanism of Action and Pharmacodynamics
25.2 Pharmacokinetics of Dutasteride
25.3 Dutasteride in BPH
25.4 Dutasteride and ΑGΑ
25.5 Dutasteride and FPHL
25.5.1 Dutasteride and Prostate Cancer (PCa)
25.5.2 Dutasteride, Gynecomastia and Breast Cancer
25.5.3 Dutasteride and Sexual Adverse Experiences (SAEs)
25.5.4 Dutasteride and Fertility
25.5.5 Dutasteride, Depression and CNS Effects
25.6 Topical Use of Dutasteride
25.6.1 Intralesional Dutasteride and Mesotherapy
25.7 Dutasteride + Finasteride, Dutasteride + Minoxidil
25.8 Concerns Over the Use of Dutasteride in AGA
25.9 Conclusion
References
26: Spironolactone
26.1 Mechanism of Action
26.2 Spironolactone as an Antiandrogen
26.3 Spironolactone and FPHL
26.4 Topical Spironolactone
26.5 Adverse Effects
References
27: Cimetidine
27.1 Mechanism of Action
27.2 Use of Cimetidine
27.3 Cimetidine and ΑGΑ/FPHL
27.4 Adverse Effects
References
28: Cyclosporin
28.1 Mechanism of Action on the Hair Follicle
28.2 Cyclosporin A in Alopecia Areata
28.3 Cyclosporin A in AGA/FPHL
28.4 Adverse Effects
References
29: Cyproterone Acetate (CPA)
29.1 Mechanism of Action
29.2 Uses of CPA
29.3 CPA and FPHL
29.4 Topical CPA Solution
29.5 Adverse Effects
29.6 CPA in Men
References
30: Topical Corticosteroids
30.1 The Chemical Structure of Corticosteroids
30.2 Topical Corticosteroids (TCs)
30.3 Actions of Corticosteroids
30.4 Adverse Effects of TCs
30.5 Systemic Adverse Effects of TCs
30.6 Topical Adverse Effects of TCs
30.7 TCs and Alopecia Areata
30.8 TCs and AGA/FPHL
References
31: Ketoconazole
31.1 Pharmacology of Ketoconazole
31.2 Oral Ketoconazole
31.3 Ketoconazole Shampoo
31.4 Ketoconazole and ΑGΑ/FPHL
31.5 How to Use the Ketoconazole Shampoo
31.6 Adverse Effects
References
32: Retinoic Acid
32.1 Mechanism of Action of Retinoids and ATRA
32.2 ATRA and the Hair Follicle
32.3 ATRA and AGA/FPHL
32.3.1 Use of ATRA in AGA/FPHL
32.4 Adverse Effects
32.5 Combining ATRA and Minoxidil
32.6 New Pharmaceutical Formulations of ATRA and Newer Retinoids
References
33: Azelaic Acid
33.1 Mechanism of Action
33.2 Azelaic Acid and AGA/FPHL
33.3 Adverse Effects
References
34: Bimatoprost
34.1 Mechanism of Action
34.2 Bimatoprost and Hair Follicles
34.3 Bimatoprost Mechanism of Action on Hair Follicles
34.4 Effect of Bimatoprost in Healthy Eyelashes
34.5 Bimatoprost Vs. Latanoprost
34.6 Bimatoprost and AGA/FPHL
34.7 Adverse Effects
References
35: Latanoprost
35.1 Latanoprost and Hair Follicles
35.1.1 Latanoprost Mechanism of Action on Hair Follicles
35.2 Effects of Latanoprost in Eyelashes
35.2.1 Latanoprost and Healthy Eyelashes
35.2.2 Latanoprost and Eyelash Alopecia
35.3 Effects of Latanoprost on The Scalp
References
36: Estrogens
36.1 Mechanism of Action of Estrogens
36.2 Estrogens and Hair Follicles in Lab Animals
36.3 Estrogens and Hair Follicles in Humans
36.4 Estrogens, AGA and FPHL
36.4.1 Oral Estrogens
36.4.2 Topical Estrogens
36.4.2.1 Topical Estrogens in Men
36.4.2.2 Topical Estrogens in Women
36.5 Adverse Effects
References
37: Progestins
37.1 Categories of Progestins
37.2 Mechanism of Action
37.3 Actions in the Skin and Hair Follicles
37.4 Topical Progestin Solutions
37.5 Progestins and AGA/FPHL
37.6 Adverse Effects
References
38: Hormonal Contraceptives
38.1 General Hormonal Effects of OCs
38.2 Hormonal Effects of OCs in Hair Follicles
38.3 Clinical Image
38.4 How to Avoid OCs-Mediated Hair Loss?
38.5 COCs as a Treatment for FPHL
References
39: Flutamide
39.1 Mechanism of Action
39.2 Flutamide and Hair Follicles
39.3 Topical Use of Flutamide
39.4 Adverse Effects
References
40: Recently Reported Hair Growth Drugs
40.1 Adenosine
40.2 Cetirizine
40.3 Roxithromycin
40.4 Botulinum Toxin
40.5 Crescina
References
41: Caffeine
41.1 Caffeine in Dermatology
41.2 Caffeine and the Hair Follicles
41.3 Caffeine and AGA/FPHL
41.4 Conclusion
References
42: Cysteine and Cystine
42.1 Sources of Cysteine
42.2 Cystine/Cysteine Dietary Supplements
42.3 Cystine and the Hair Follicle
References
43: Free Fatty Acids
43.1 Free Fatty Acids (FFAs)
43.2 FFAs, Hair Follicles, AGA and FPHL
References
44: Copper Tripeptides
44.1 Mechanism of Action and Properties of GHK-Cu
44.2 GHK-Cu and Hair Follicles
44.3 Clinical Studies
44.4 GHK-Cu and in Hair Restoration Surgery
References
45: Melatonin
45.1 The Effects of Melatonin in the Hair Follicles of Animals
45.2 The Effects of Melatonin in Human Hair Follicles
References
46: Marine Extract Compounds
46.1 Nourkrin®
46.2 Hairgain®
46.3 Viviscal®
46.3.1 Viviscal® in the Twenty-First Century
References
47: The Helsinki Formula®: Polysorbate 60 and Polysorbate 80
47.1 Polysorbate 60 and Hair Follicles
47.2 Polysorbate 60 and the Hair Growth Craze
47.3 Was Polysorbate 60 Effective Against Hair Loss?
47.4 What Happened with Polysorbate 60 Products?
47.5 Adverse Effects
References
Part VI: Nutrition, Lifestyle Factors and AGA/FPHL
48: Diet, Lifestyle, and AGA/FPHL
48.1 Are Systemic Androgens Increased in AGA/FPHL?
48.2 Adrenal Hormones and Androgens
48.2.1 What Can Cause Chronically Increased Cortisol Secretion in Otherwise Healthy Adults?
48.2.1.1 Stress
48.2.1.2 Obesity
48.2.2 Other Factors that Increase Androgens in the Serum
48.2.3 High-Fat Diets and Androgens
48.2.4 Deprivation (Crash) Diets and Androgens
48.2.5 Alcohol Abuse and Androgens
48.2.6 Smoking
48.2.6.1 Smoking and Androgens
48.2.6.2 Smoking, Hair Follicles, and AGA
48.3 Tips That Could Reduce Further Hair Loss in AGA/FPHL
References
Part VII: Dietary Supplements and Androgenetic Alopecia
How Was Initially Hair Loss Correlated with Malnutrition?
An Outrageous Misconception!
Is There Hair Loss Due to Nutritional Disorders?
Nutritional Disorder-Related Hair Loss with Scaling Problems
Nutritional Disorder-Related Hair Loss Without Scaling Problems
Hair Loss Without Nutritional Disorders
History of Dietary Standards
Adequacy of Nutrients
49: The Inconvenient Truth About Food Supplements (or “Hope in a Capsule”)
49.1 Why Are These Products So Popular?
49.2 Regulatory Issues
49.3 Who Is Using Food Supplements?
49.4 Who Really Needs Food Supplements?
49.5 Group …Therapy
49.6 Can Food Supplements Be Dangerous?
49.7 Supplements That Can Eventually Kill
49.8 Questions Nobody Seems to Ask
References
50: Vitamins: Definition and Types
50.1 Vitamins in General
References
51: Vit A
51.1 Actions of Vit A
51.2 Vit A and the Hair Follicle
51.3 Food Sources
51.4 Dietary Recommendations
51.5 Deficiency- Excess of Vit A
51.6 Topical Use of Vit A
References
52: Vit Β3 (Niacin)
52.1 Actions of Vit B3
52.2 Vit B3 and the Hair Follicle
52.3 Food Sources
52.4 Dietary Recommendations
52.5 Deficiency- Excess of Vit B3
References
53: Vit B5 (Pantothenic Acid)
53.1 Actions of Vit B5
53.2 Vit B5 and the Hair Follicle
53.3 Food Sources
53.4 Dietary Recommendations
53.5 Deficiency- Excess of Vit B5
References
54: Vit B6 (Pyridoxine)
54.1 Actions of Vit B6
54.2 Vit B6 and the Hair Follicle
54.3 Food Sources
54.3.1 Dietary Recommendations
54.3.2 Deficiency- Excess of Vit B6
References
55: Vit B7 (Vit H, Biotin, Coenzyme R)
55.1 Actions of Biotin
55.2 Biotin and the Hair Follicle
55.3 Food Sources
55.4 Dietary Recommendations
55.5 Deficiency- Excess of Biotin
References
56: Vit C (L-Ascorbic Acid)
56.1 Actions of Vit C
56.2 Food Sources
56.3 Dietary Recommendations
56.4 Vit C Deficiency
56.5 Vit C Excess
56.6 Vit C and Hair Follicles In Vitro
56.7 Topical Action of Vit C
References
57: Vit E (α-Tocopherol)
57.1 Actions of Vit Ε
57.2 Topical Action of Vit E
57.3 Vit E and the Hair Follicle
57.4 Food Sources
57.5 Dietary Recommendations
57.6 Deficiency- Excess of Vit E
References
58: Inositol (Vitamin B8)
58.1 Actions of Inositol
58.2 Inositol and the Hair Follicle
58.3 Food Sources
58.4 Dietary Recommendations
58.5 Deficiency- Excess of Inositol
References
59: Minerals, Trace Elements, and Hair Follicles
60: Calcium (Ca+2)
60.1 Actions of Ca+2
60.2 Ca+2 and the Hair Follicle
60.3 Dietary Recommendations
60.4 Food Sources
60.5 Deficiency- Excess of Ca+2
60.5.1 Hypocalcemia
60.5.2 Hypercalcemia
References
61: Boron (B)
61.1 Actions of Boron
61.2 Boron and the Hair Follicle
61.3 Food Sources
61.4 Dietary Recommendations
61.5 Deficiency- Excess of Boron
References
62: Sulfur (S)
62.1 Actions of Sulfur
62.2 Sulfur, the Skin, and the Hair Follicle
62.3 Food Sources
62.4 Dietary Recommendations
62.5 Deficiency- Excess of Sulfur
References
63: Iodine (I)
63.1 Actions of Iodine
63.2 Thyroid Hormones and the Hair Follicle
63.3 Food Sources
63.4 Dietary Recommendations
63.5 Deficiency- Excess of Iodine
References
64: Magnesium (Mg+2)
64.1 Actions of Magnesium
64.2 Mg+2 and the Hair Follicle
64.3 Food Sources
64.4 Dietary Recommendations
64.5 Deficiency- Excess of Magnesium
References
65: Silicon (Si)
65.1 Actions of Silicon
65.2 Silicon, the Skin and the Hair Follicle
65.3 Food Sources
65.4 Dietary Recommendations
65.5 Deficiency- Excess of Silicon
References
66: Selenium (Se)
66.1 Actions of Selenium
66.2 Selenium and the Hair Follicle
66.3 Food Sources
66.4 Dietary Recommendations
66.5 Deficiency- Excess of Selenium
References
67: Iron (Fe+2)
67.1 Actions of Iron
67.2 Iron Distribution
67.3 Iron Deficiency (ID)
67.4 How Can Iron Deficiency Affect Hair Follicles?
67.5 Iron and Hair loss in General
67.6 Association Between Iron Deficiency, Ferritin and Hair Loss
67.7 Iron and AGA/FPHL
67.8 Topical Iron
67.9 Food Sources
67.10 Dietary Recommendations
67.11 Deficiency- Excess of Iron
67.12 Future Challenges
67.13 Conclusions So Far
67.14 Author’s Notes
References
68: Copper (Cu)
68.1 Actions of Copper
68.2 Copper and the Hair Follicle
68.3 Food Sources
68.4 Dietary Recommendations
68.5 Deficiency- Excess of Copper
References
69: Zinc (Zn)
69.1 Actions of Zinc
69.2 Zinc and the Hair Follicle
69.3 Zinc and Alopecias
69.4 Zinc and AGA/FPHL
69.4.1 Topical Use of Zinc
69.5 Food Sources
69.6 Dietary Recommendations
69.7 Deficiency- Excess of Zinc
References
70: “Alternative Medicine”, Herbs, and Hair Loss
70.1 Herbals and Botanicals in General
70.2 Medicine and “Alternative Medicine”
70.3 Medicine and Herbal …“Medicine”
70.4 Why Do Patients Prefer Herbs Over Drugs?
70.5 Just How Effective Are Herbs Actually?
70.6 Challenges in Studying the Efficacy of Herbs
70.7 Are Herbal Supplements Actually Safe?
70.8 The Legal Status of Herbals and Botanicals
70.9 Standardization of Herbs
70.10 Why is Herbal Standardization Impossible?
70.11 Herbs and Benign Prostate Hypertrophy (BPH)
70.12 Herbs for BPH = Herbs for AGA?
70.13 Herbal Products and ΑGΑ/FPHL
70.14 “Instructions for Use” of the Following Chapters
70.15 Final Note
References
71: Saw Palmetto (Serenoa repens Sabal serrulatum)
71.1 Saw Palmetto Mechanism of Action
71.2 Saw Palmetto and Lower Urinary Tract Symptoms
71.3 The Saw Palmetto Controversy
71.4 Saw Palmetto and ΑGΑ
71.4.1 Is SPE a True 5α-R Inhibitor?
71.4.2 Can Saw Palmetto Be Useful in AGA/FPHL?
71.5 Dosage- Adverse Effects—Safety
References
72: Pygeum Africanum (Prunus Africana)
72.1 Pygeum Africanum’s Mechanism of Action
72.2 Pygeum Africanum, BPH, and Prostate Cancer
72.3 Pygeum Africanum and AGA
72.4 Dosage- Adverse Effects—Safety
References
73: Proanthocyanidins
73.1 Proanthocyanidins and the Hair Follicle.
73.2 Mechanism of Action of Proanthocyanidins on the Hair Follicle
73.3 Proanthocyanidins and AGA
73.4 Dosage- Adverse Effects—Safety
References
74: Green Tea (Camellia sinensis)
74.1 General Properties of Green Tea
74.2 Green Tea and the Skin
74.3 Green Tea as an Antiandrogen
74.4 Green Tea and the Hair Follicle
74.5 Dosage- Adverse Effects—Safety
References
75: Ginkgo Biloba (Maidenhair Tree)
75.1 General Properties of Ginkgo Biloba
75.2 Ginkgo Biloba, Scientific Research and Applications
75.3 Ginkgo Biloba, the Skin, and the Hair Follicle
75.4 Dosage- Adverse Effects—Safety
References
76: Allium Cepa (Red Onion)
76.1 General Properties of Allium Cepa
76.2 Allium Cepa, Hair Follicles and AGA/ FPHL
76.3 Dosage- Adverse Effects—Safety
References
77: Sophora Flavescens
77.1 General Properties of Sophora Flavescens
77.2 Sophora Flavescens and ΑGΑ
77.3 Dosage- Adverse Effects—Safety
References
78: Oryza Sativa Bran (Rice Bran)
78.1 General Properties of Oryza Sativa Bran
78.2 Oryza Sativa Bran and Hair Follicles
78.3 Oryza Sativa Bran and AGA
78.4 Dosage- Adverse Effects—Safety
References
79: Polygonum Multiflorum (Ho-Shou-Wu)
79.1 General Properties of Polygonum Multiflorum
79.2 Polygonum Multiflorum and the Hair Follicle
79.3 Dosage- Adverse Effects—Safety
References
80: Panax Ginseng (Korean or Asian Ginseng)
80.1 General Properties of Ginseng
80.2 Ginseng and the Hair Follicle
80.2.1 PG Effects In Vitro and Ex Vivo
80.2.2 PG Effects in Clinical Trials
80.3 Dosage- Adverse Effects—Safety
References
81: Rosemary (Rosmarinus Officinalis)
81.1 General Properties of Rosmarinus Officinalis
81.2 The Action of Rosmarinus Officinalis on the Hair Follicle
81.3 Rosmarinus Officinalis and AGA/FPHL
81.4 Dosage- Adverse Effects—Safety
References
82: Capsicum (Red Pepper)
82.1 General Properties of Capsaicin
82.2 Mechanism of Action of Capsaicin
82.3 Action of Capsaicin on the Hair Follicle
82.4 Dosage- Adverse Effects—Safety
References
83: A Few More and Recently Reported Herbs
83.1 Acanthopanax Koreanum
83.2 Asiasari Radix (Asiasarum Root)
83.3 Chaemacyparis Obtuse (Japanese Cypress, Hinoki)
83.4 Citrullus Colocynthis (Bitter Cucumber) (9-
83.5 Curcuma Aeruginosa
83.6 Cuscuta Reflexa
83.7 Ecklonia Cava
83.8 Eclipta Alba (False Daisy)
83.9 Erica Multiflora
83.10 Equisetum Arvense (Horsetail)
83.11 Hibiscus Rosa-Sinensis (China Rose)
83.12 Illicium Anisatum (Japanese Star Anise)
83.13 Lygodii Spora
83.14 Piper Nigrum (Black Pepper)
83.15 Puerariae Flos
83.16 Salvia Officinalis (Sage)
83.17 Sanguisorba Officinalis
83.18 Schisandra Nigra
83.19 T-Flavanone
83.20 Tectona Grandis (Teak Tree)
83.21 Trigonella Foenum-Graecum (Fenugreek)
83.22 Urtica Dioica (Stinging Nettle)
83.23 Zizyphus Jujube (Chinese Date)
References
Index