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Therapeutic Approach

A plethora of options is available for the treatment of androgenetic alopecia (AGA), including topical and systemic drugs, over-the-counter products and interventional therapies. The range of products is wide and reaches from pharmaceutical to cosmetic agents, natural products, different herbal preparations, functional food, etc. Currently, topical minoxidil and oral finasteride are the only Food and Drug Administration (FDA)-approved drugs and low-level laser light therapy (LLLLT) the only FDA-cleared device for the treatment of AGA.

The decision for the best-suited individualized therapeutic approach must be taken by physician and patient together, taking under consideration available evidence, expected therapeutic results, practicability, adverse effects, compliance and costs.1 Monotherapy or combination therapy can be considered.

In order to achieve best results, treatment of AGA should be started as early as possible, when miniaturization of hair follicles has not progressed yet. The therapeutic objective is stabilization of the clinical course, deceleration of hair loss and in best case hair regrowth, thus contributing to an improved quality of life.1 The response to treatment (defined as maintenance of stable condition and in best case induction of hair growth) should be assessed at approximately 6 months. Since AGA is a naturally progressive condition, successful treatment needs to be continued to maintain efficacy.1 See Table 77-1.

Table 77-1Androgenetic Alopecia Treatment Table

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