Androgenetic alopecia (AGA), also known as androgenic hair loss or seborrheic alopecia, is a common type of hair loss that mostly occurs during and after puberty. In men, it is mainly manifested as a receding hairline and gradually thinning hair on the top of the head. In women, there is progressive thinning of the hair on the top of the head, and generally, the position of the frontal hairline remains unchanged. This kind of hair loss not only affects appearance but may also cause certain psychological stress to patients. Among the numerous treatment methods for AGA, topical medications are one of the commonly used and effective means. So, how should one choose topical medications?
At present, the main topical medications used in clinical practice for treating AGA are minoxidil and spironolactone lotion.
Minoxidil is a widely used and clinically proven effective drug for treating AGA. It was originally an antihypertensive drug. During its use, it was found that it had the side effect of promoting hair growth, and thus was developed for hair loss treatment. Minoxidil promotes hair growth by stimulating the proliferation and differentiation of hair follicle epithelial cells and prolonging the growth phase of hair follicles. Commonly seen on the market, minoxidil comes in two concentrations, 2% and 5%. Generally speaking, the 5% minoxidil solution is more effective for male AGA patients, but it may cause relatively more adverse reactions such as scalp irritation. The 2% concentration is more suitable for female patients with relatively fewer adverse reactions. When using minoxidil, it needs to be applied to the scalp and gently massaged to promote absorption. It is usually used 1 – 2 times a day, and it takes 3 – 6 months of continuous use to see obvious results. Moreover, once the use is stopped, recurrence may occur.
Spironolactone lotion is also an option for topical medications in treating AGA. Spironolactone is an aldosterone antagonist. It can reduce or antagonize the androgenic activity by inhibiting the production of androgen precursors or acting on androgen – metabolizing enzymes and receptors in the skin, thereby reducing follicular miniaturization and promoting hair growth. Compared with minoxidil, spironolactone lotion causes relatively fewer adverse reactions. For example, it does not cause hirsutism like minoxidil may. However, it also has certain limitations. For example, when using it, one may need to avoid contact with the eyes and other mucosal areas, and it is contraindicated for some patients who are allergic to it.
When choosing topical medications to treat AGA, in addition to considering the characteristics of the medications themselves, one also needs to combine their own situation. For example, if you are a male patient with severe hair loss and a good tolerance to drug adverse reactions, then the 5% minoxidil solution may be a relatively good choice. If you are a female patient worried about drug adverse reactions or intolerant to minoxidil, then spironolactone lotion can be an alternative option. At the same time, when using topical medications to treat AGA, one should be patient because hair growth is a slow process. Only by persistent use can one achieve the desired treatment effect. In addition, if any discomfort occurs during use, one should consult a doctor in a timely manner to adjust the treatment plan.
