Take Propecia, apply Minoxidil, and if it still doesn't work, consider hair transplantation. Of course, this is correct advice, but you probably have many other questions. Besides taking oral medication and applying topical solutions, are there any other proven treatment methods? You might be curious about how effective it is to only take oral medication without using topical solutions and other detailed aspects. I will provide medically verified facts about these things. The cause of hair loss can vary, but over 90% of the total population with hair loss is due to androgenetic alopecia, a condition where hair becomes thin due to the influence of male hormones. This occurs when one of the male hormones, testosterone, meets the enzyme alpha-reductase and transforms into dihydrotestosterone (DHT), which is a hormone that triggers hair loss by attacking the hair follicles, resulting in a specific pattern.

There is a characteristic of hair loss that occurs while being visible. Unlike in men, it can occur in women, and the frequency is surprisingly high. The types of hair loss differ slightly. In men, both the hairline excluding the back of the head and the crown are affected. In contrast, women experience hair loss only on the crown while maintaining the hairline. It is not yet clear why some people show symptoms on the scalp while others do not. There is no clear explanation as to why hair loss affects certain areas of the head and not others. It is known that around 50% of hair loss patients have a family history, but the remaining 50% can develop hair loss even without a family history, indicating a genetic factor independent of family history. It is influenced by the environment, but the specific environmental factors that affect hair loss have not been clearly identified.

Regarding what causes hair loss, it is complex, and there is no definitive answer yet. Most people misunderstand hair loss. Literally, it may seem like hair is falling out, but the most common androgenetic alopecia is not about hair loss but rather about thinning of hair. The methods to treat hair loss do not create new hair where there was none; instead, they aim to thicken the thinning hair due to hair loss to make it look fuller. There is currently no method to generate new hair. Therefore, it is most effective to start treatment when there is still a good amount of hair, even if it is thin like cotton. Many people delay treatment, thinking they can do it later, but hair transplantation involves using one's own hair from the back of the head, not someone else's.

Because it is a surgery that only changes the position of the forehead, it is not infinitely deep. Also, even if you undergo hair transplantation, continuous treatment is necessary to prevent further hair loss. Then, how can you tell if you are experiencing hair loss, that is, if your hair is thinning? You can speculate based on symptoms such as styling being less effective than in the past or perms coming loose quickly, but the most accurate method is to directly compare the thickness of the hair on the forehead and the crown of the head by inserting your fingers. So far, there are seven recognized treatment methods. They are broadly categorized into medication, topical medication, surgery, laser treatment, and three others. Among them, oral medication is the most common treatment for hair loss. There are two types of medications: the first is the finasteride group, and the second is the dutasteride group.

Testosterone, a male hormone, is used to treat hair loss by inhibiting the conversion to DHT. It is recommended to take a prescribed dose once a day. The effects do not appear immediately; it is necessary to consistently take it for about 3 to 4 months to see results. If the intake is stopped, hair loss may resume, so it is important to continue taking it throughout the treatment period. Many people are aware of the side effects of this medication. Especially, concerns about decreased libido, erectile dysfunction, etc., are common. However, the occurrence rate is very low, around 1% to 2%, and returning to normal once the medication is discontinued, so there is no need to worry too much. For those who still doubt, let me introduce one experiment result: having real medication versus placebo, and who took which medication.

In most clinical trials conducted without the subjects' knowledge, there was not a significant difference in side effects when compared to those who were aware. Some studies even reported more sexual side effects in the group taking a placebo pill. Symptoms caused by excessive worry are referred to as the nocebo effect, likened to the placebo effect where fake pills show therapeutic effects. Hair loss medication is not addictive, has no drug interactions, so it is safe to take with other medications like blood pressure, diabetes, or cholesterol drugs. It is a very safe medication that can be taken even if the liver is slightly compromised. Pregnant women should be cautious about taking high doses of the medication as it may cause genital malformations in the fetus. Therefore, women of childbearing age should be careful when taking it. Regarding oral medication, many people wonder which is better between Finasteride and Dutasteride.

When asking about Dutasteride, the answer varies depending on the patient's situation. Both Dutasteride and Finasteride are effective in treating hair loss, but there is a higher possibility of side effects, and the half-life of the drug staying in the body without being broken down is much longer. Just looking at the prohibition period, Finasteride is one month, while Dutasteride is six months. Therefore, if you want a strong treatment effect for hair loss regardless of side effects, some people may say that Dutasteride is not safe except in Korea and a few other countries because it has not been approved for use, not because it is unsafe. This is because clinical trials for approval have not been conducted in those countries for various reasons. In fact, Dutasteride is still used for hair loss treatment in several countries, including the United States.

Permission was not granted, but it does not mean that the prescription is not possible. Herbal remedies are permitted for the treatment of benign prostatic hyperplasia, so prescriptions are allowed. Most prescriptions are off-label, meaning they are prescribed as non-reimbursable treatments. Dutasteride is unique in that it conducted the world's first three-phase clinical trial in Korea, received approval first, and has since been approved in various countries including Japan. There is no need to worry about its safety. Many questions are raised about whether oral medications have an effect on androgenetic alopecia, or if only certain herbal remedies have an effect. It is true that androgenetic alopecia is more effectively treated than telogen effluvium, but it is not entirely ineffective. Both types of herbal remedies can improve androgenetic alopecia, and perhaps using a stronger medication may yield better results. I believe that androgenetic alopecia, especially in my case, may not have been fully resolved.

Some people are curious about whether consuming omega-3, biotin, brewer's yeast, etc., can show effects on hair loss. However, none of them are effective for androgenic alopecia treatment. In the case of biotin, it is true that a deficiency can lead to hair loss, but if you are maintaining a healthy daily life, the chances of deficiency are minimal, so there is no need to take them additionally for hair loss treatment. Herbal remedies known as brewer's yeast are not the main treatment ingredient for hair loss; rather, keratin, a protein that makes up hair, is the main treatment component. Keratin protein is known to aid in the rapid recovery of temporary hair loss, such as shedding during the shedding season in animals. Many people use both oral and topical medications. While many believe that minoxidil is the only option, there are two more: alpha-trio and recently.

There is a permitted finasteride for use. It has not been clearly proven how minoxidil makes hair fuller yet. However, it has been verified that when men apply the appropriate amount twice a day and women apply it once a day to the balding area, the hair in that area thickens, showing an effect on hair loss. It is a treatment that helps the growth of hair itself, so when used in combination with oral medications that act on hair loss hormones, better results can be seen compared to just taking oral medication. Some people ask if they can just take the sticky oral medication instead of using the topical medication. In fact, there was a study related to this. A group that only took finasteride was compared to a group that also applied minoxidil, and the difference between the two was not significant, indicating that among the two medications, the oral medication is much more important.

Alfatradiol can improve hair loss by inhibiting the hair loss hormone on the scalp, as it acts similarly to female hormones in the scalp. When I say this, men may worry that they will become more feminine when female hormones enter their bodies, but Alfatradiol is designed to only improve hair loss without acting as other female hormones in the body, so there is no need to worry at all. Some people see great effects, even up to minoxidil, while others do not, so it is mainly used in combination with minoxidil rather than alone. It is widely used in the field of digestion by those who do not want to take oral medications, including women of childbearing age and men. Finasteride, which is applied topically, is a recently approved drug, and in studies targeting Westerners, it has almost no side effects, unlike oral finasteride.

It has been effectively known, however, for women of childbearing age, you must be cautious as side effects may occur when absorbing the applied finasteride ingredient. Laser therapy with low power has also been proven to be effective for hair loss, although relatively less known compared to oral and topical medications. By irradiating the laser into the mitochondria, which act as power plants in the hair follicle cells, it activates the hair follicles, promoting faster hair growth. The effect is similar to using topical medication minoxidil, making it a recommended additional treatment option for those who find long-term drug use difficult or concerning. Lastly, I will mention the most proactive treatment, which is hair transplantation surgery. It involves taking hair follicles from areas not affected by hair loss on the scalp and implanting them into thinning areas.

There are two main methods, namely, the incision method and the non-incision method. In the incision method of hair transplantation, the scalp is generally separated in a belt shape, and then transplanted by dividing it into hair follicle units. It has the advantage of being able to transplant a large number of hair follicles in a short time, resulting in a high survival rate of hair follicles. However, there may be rare cases of decreased sensation or ongoing pain in the area where the scalp is separated. The non-incision method of hair transplantation involves collecting individual hair follicles without incising the scalp and transplanting them one by one, leaving almost no scars and causing less pain, allowing for a quick return to daily life. However, the disadvantage is that the surgery time is much longer compared to the incision method. Both the incision and non-incision methods have limitations in that they cannot densely pack the original hair. Generally, what is referred to as thick hair has about 80 to 100 hair follicles per square centimeter.

When speaking, if this method is used, the depth will be about half, but there is an effect of hair overlapping, so it looks sufficiently thick visually, and the satisfaction of patients is very high. In cases where there is a lack of hair that can be transplanted, it is also possible to transplant hair from other parts of the body. Some people may worry that it is possible due to the different shapes of the hair, but even if the shape and length of the hair are different, when transplanted into the scalp, it will be influenced by the surroundings and change similarly. Just because you have received a hair transplant does not mean you should stop treatment, as hair loss in areas where hair transplants have not been done may continue. Therefore, to prevent this, it is recommended to continue existing treatment methods. I would like to introduce two hair loss treatment methods that are currently actively being researched. The first is an injectable drug containing finasteride and dutasteride.

Based on current research results, it is known that injections taken every two weeks or once a month gradually dissolve the embedded drug, showing a continuous effect. The second type is an injection that directly changes the genes causing hair loss on the scalp. Both types of injections are known to have a good effect in animal experiments, so many medical professionals are looking forward to their release. In addition to these seven well-validated hair loss treatments, new drugs that show effectiveness are actively being developed. Therefore, even if you are experiencing hair loss, do not give up, and please follow the advice of medical professionals to maintain healthy hair. Thank you.

프로페시아, 아보다트, 미녹시딜 말고도 있다! 탈모 치료를 위한 확실하고 정확한 방법 [숫자로 보는 건강]

세계 의료의 표준을 선도하는 국민의 병원, 분당서울대학교병원입니다.
Lead the Standard, Build the Trust, Seoul National University Bundang Hospital!

분당서울대학교병원

탈모 치료는 모발이 가늘어지는 것을 굵게 만들어 풍성하게 보이도록 하는 것이 목표이며, 새로운 모발을 생성하는 것은 아니다.

탈모 치료 방법으로는 약물 복용, 바르는 약, 수술, 레이저 치료 등이 있으며, 경구 약물은 피나스테리드와 두타스테리드 계열이 존재한다.

모발 이식 후에도 기존 치료를 병행해야 하며, 주사형 약물 및 유전자 변화 주사 등 새로운 치료법이 연구 중이다.

탈모의 가장 흔한 원인은 남성 호르몬의 영향으로 발생하는 안드로겐성 탈모증입니다. **90% 이상의 탈모 환자가 이에 해당하며, 남성 호르몬인 테스토스테론이 DHT로 전환되어 모낭을 공격하는 것이 주원인**입니다.

많은 사람들이 탈모를 '머리카락이 빠지는 것'으로 오해하지만, **실제로는 머리카락이 가늘어지는 현상**입니다. 탈모 치료는 새로운 머리카락을 생성하는 것이 아니라, 가늘어진 머리카락을 굵게 만들어 풍성하게 보이도록 하는 데 목적이 있습니다.

💊 경구 약물 치료: Finasteride vs. Dutasteride

경구 약물 치료는 탈모 치료의 가장 일반적인 방법이며, Finasteride 계열과 Dutasteride 계열의 약물이 있습니다. 이 약물들은 **남성 호르몬이 DHT로 전환되는 것을 억제하여 탈모를 치료**합니다.

Finasteride와 Dutasteride 모두 효과적이지만, Dutasteride는 부작용 발생 가능성이 더 높고 체내 잔류 기간이 더 깁니다. **Dutasteride는 한국을 포함한 일부 국가에서만 탈모 치료제로 승인되었지만, 안전성에는 문제가 없습니다.** 임상 시험 진행 여부에 따라 승인 여부가 결정됩니다.

경구 약물의 부작용에 대한 우려가 많지만, 임상 시험 결과 **실제 부작용 발생률은 매우 낮으며, 약물 복용을 중단하면 정상으로 돌아옵니다.** 과도한 걱정으로 인한 노시보 효과도 나타날 수 있습니다.

🧴 바르는 약: Minoxidil, Alfatradiol, Finasteride

Minoxidil은 남성의 경우 하루 두 번, 여성의 경우 하루 한 번 탈모 부위에 바르면 해당 부위의 머리카락이 굵어지는 효과가 있습니다. **Minoxidil은 머리카락 자체의 성장을 돕기 때문에 경구 약물과 병행하면 더욱 효과적**입니다.

Alfatradiol은 두피에서 여성 호르몬과 유사하게 작용하여 탈모 호르몬을 억제합니다. **Alfatradiol은 신체 내에서 다른 여성 호르몬으로 작용하지 않도록 설계되었으므로 남성도 안심하고 사용할 수 있습니다.**

바르는 Finasteride는 최근 승인된 약물로, 서양인을 대상으로 한 연구에서 경구 Finasteride와 달리 부작용이 거의 없는 것으로 나타났습니다. **하지만 가임기 여성은 흡수 시 부작용이 발생할 수 있으므로 주의해야 합니다.**

✂️ 모발 이식: 절개 vs. 비절개

모발 이식은 탈모가 없는 부위의 모낭을 채취하여 탈모 부위에 이식하는 적극적인 치료 방법입니다. 절개법은 짧은 시간에 많은 모낭을 이식할 수 있지만, 감각 저하나 통증이 발생할 수 있습니다. **비절개법은 흉터가 거의 없고 통증이 적지만, 수술 시간이 더 오래 걸립니다.**

모발 이식 후에도 탈모 치료를 중단하면 이식하지 않은 부위에서 탈모가 계속될 수 있습니다. **따라서 모발 이식 후에도 기존 치료 방법을 유지하는 것이 좋습니다.**

🧪 미래의 탈모 치료: 주사제 연구

현재 Finasteride와 Dutasteride를 함유한 주사제와 탈모 유발 유전자를 직접 변화시키는 주사제가 활발히 연구되고 있습니다. **이러한 주사제들은 동물 실험에서 좋은 효과를 보이고 있어 많은 의료 전문가들이 기대를 걸고 있습니다.**

탈모의 90% 이상은 남성 호르몬의 영향으로 인한 안드로겐성 탈모이며, 테스토스테론이 DHT로 변환되어 모낭을 공격하여 발생한다.

탈모는 남녀에게 다르게 나타나며, 유전적 요인과 환경적 요인이 복합적으로 작용한다.

탈모 치료는 새로운 모발 생성이 아닌 기존 모발의 두께를 증가시키는 데 초점을 맞추며, 초기 치료가 중요하다.

탈모 치료 방법: 약물, 도포제, 수술 등

탈모 치료는 크게 약물, 도포제, 수술, 레이저 등으로 나뉘며, 경구 약물(피나스테리드, 두타스테리드)이 가장 일반적이다.

피나스테리드 계열 약물의 효과와 부작용

피나스테리드는 DHT 생성을 억제하여 탈모를 치료하며, 꾸준한 복용이 필요하다. 부작용 발생률은 낮으며, 복용 중단 시 정상으로 회복된다.

피나스테리드는 중독성이 없고 다른 약물과 상호작용이 없으며, 간 기능이 약간 저하된 경우에도 복용 가능하다. 임산부는 복용에 주의해야 한다.

두타스테리드의 특징 및 안전성

두타스테리드는 피나스테리드보다 효과가 강하지만 부작용 가능성이 높고, 체내 잔류 기간이 길다. 안전성에는 문제가 없으나, 일부 국가에서 승인이 늦어졌다.

두타스테리드는 한국에서 최초로 임상 3상 시험을 완료하고 승인받았으며, 여러 국가에서 사용되고 있다.

탈모 치료에 대한 오해와 추가적인 치료법

오메가-3, 비오틴, 맥주 효모 등은 안드로겐성 탈모 치료에 효과가 없으며, 건강한 식단을 유지하면 비오틴 결핍 가능성은 낮다.

미녹시딜은 모발 자체의 성장을 돕는 도포제로, 경구 약물과 함께 사용하면 더 나은 효과를 볼 수 있다.

알파트라디올은 여성 호르몬과 유사하게 작용하여 두피에서 탈모 호르몬을 억제하며, 국소 피나스테리드는 경구 피나스테리드와 달리 부작용이 거의 없다.

저출력 레이저 치료는 모낭 세포를 활성화하여 모발 성장을 촉진하며, 장기 약물 사용이 어려운 사람들에게 추천된다.

모발 이식은 절개법과 비절개법으로 나뉘며, 각각 장단점이 있다. 절개법은 많은 모낭을 빠르게 이식할 수 있지만, 감각 저하나 통증이 발생할 수 있다. 비절개법은 흉터가 거의 없고 회복이 빠르지만 수술 시간이 길다.

모발 이식 후에도 탈모 치료를 지속해야 하며, 다른 부위의 모발을 이식할 수도 있다. 이식 후에도 기존 치료법을 유지하는 것이 좋다.

최근 연구 중인 탈모 치료법 및 희망

피나스테리드와 두타스테리드 주사제, 탈모 유발 유전자를 직접 변화시키는 주사제가 개발 중이며, 동물 실험에서 좋은 효과를 보이고 있다. 포기하지 말고 전문가의 조언을 따라 건강한 모발을 유지해야 한다.