Medications and hair transplantation

INTRODUCTION Patients with hair loss will often present to a hair transplant surgeon for a consultation. As a result, hair transplant surgeons must be aware of both surgical and medical options to treat male and female pattern hair loss. Their knowledge must include not only an understanding of medical causes for hair loss but also medical management options. The ideal medical or surgical solution for the treatment of hair loss would be simple to use, without side effects and complications, and would be universally effective and affordable. To date, such an agent has not been discovered. It is because of these shortcomings that medical agents are frequently used in combination with one another and as adjuvant therapy to surgical hair restoration. As the commonly available and promoted treatments for hair restoration are intended for the management of pattern hair loss or androgenic alopecia, the prescribing physician must be able to recognize all other forms of alopecia as well. CURRENTLY AVAILABLE AGENTS Minoxidil The most commonly utilized topical therapy is minoxidil. This medicine was originally developed as an oral antihypertensive agent.When given for treatment of refractory hypertension in renal transplant patients, itwas found to cause a secondary hypertrichosis. Soon, studies demonstrated that the topical version of this agent resulted in increased hair counts. A 2% minoxidil solution received FDA approval in 1988 for male pattern hair loss. Later, the FDA approved both a 2% and a 5% solution formulation for over-the-counter distribution. A 5% minoxidil foam vehicle delivery system was recently introduced. The foam product is easier to use than the solution, which appears to increase compliance. Figure 2.1 illustrates the Rogaine Foam (McNeil-PPC, Inc. Morris Planes, NJ) product.