Brief Answer:
Bioton is an essential vitamin for hair growth

Detailed Answer:
Hello. Thank you for writing to us

I have taken note of your query and I have understood your concern.

Biotin is an essential vitamin and helps in strengthening of hair. It helps in utilization of amino acids required for hair growth and therefore it supports hair growth.
Deficiency of biotin causes pathological changes in skin and hair loss. Therefore supplementing biotin in those who are deficient would be effective in stopping hair fall but it is not very clear whether supplmenting biotin in those who have normal biotin levels would have an effect on hair loss/ regrowth. Nevertheless, biotin is widely prescribed by dermatologists in patients with hair fall and thinning. Apart from finasteride, biotin is the only other oral form of treatment for hair loss conditions and can be taken by both males and females.

Finasteride is an antiandrogen and is specific for androgenetic alopecia Or male pattern baldness. It inhibits the enzyme 5 alpha reductase, present in hair follicles. The action of this enzyme is to convert serum testosterone to dihydrotestosterone (DHT). DHT in turn is responsible for hair loss and thinning in androgenetic alopecia. Therefore by inhibiting the enzyme 5 alpha reductase ,finasteride reduces hair fall and thinning.

Minoxidil is a hair growth promoter. However unlike Finasteride, minoxidil is not specific to any particular type of hair loss i.e it can be used in different types of hair loss e.g androgenetic alopecia, telogen effluvium, alopecia areata etc. It is a vasodilator and stimulates microcircualtion in the scalp which stimulates hair growth. Minoxidil is avalable in 2 strengths i.e 2% for females and 5% for males.

PRP is a concentration of one's own platelets in a small volume of plasma. It has a higher platelet concentration (4-7 times) of platelets above baseline. It is obtained from the patient's own blood after processing in a centrifuge and it is injected subcutaneously into the area of hair loss/ alopecia. The beneficial effects of PRP in hair loss can be attributed to various platelet-derived growth factors causing improvement in the function of hair follicle and promotion of hair growth.

Laser has no well established role in hair loss.

-Are you taking only Biotin Or are you also on Minoxidil, Finasteride?
-Do you have a family history of early baldness in father, brother, cousins etc?

Regards

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Brief Answer:
PRP is useful; Finasteride can cause gynaecomastia as a rare side effect

Detailed Answer:
Hi.

Definitely there is a positive family history of androgenetic alopecia in your father which is significant in your case.

Biotin is not a known cause of acne breakouts. Acne is otherwise quite common at your age.
I won't attribute your acne breakout to biotin intake therefore you may safely take Biotin for your hair.
Apart from finasteride, Biotin is the only oral form of treatment that is widely accepted and prescribed for hair loss.

PRP is definitely very useful for androgenetic alopecia and this is one of the indications for PRP. Therefore, you may take a few PRP sessions.
You may also use minoxidil solution along with PRP sessions as advised.

There is a small yet definite risk of gynaecomastia with finasteride and patients need to be made aware of this rare possibility at start of treatment.
Nevertheless finasteride has a good safety profile and gynaecomastia is not a common side effect with finasteride for hair loss.

Diagnosis of androgenetic alopecia is clinical. Usually there is no need to test for levels of testosterone Or DHT.
These levels would anyways be normal in patients of androgenetic alopecia.

You may request a blood test for these hormones if you anyways want to get tested.

Regards

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Brief Answer:
Specific replies regarding hair loss remedies

Detailed Answer:
Hi.

Gynecomastia could be either glandular i.e true gynecomastia Or it could be psuedogynecomastia i.e excess adipose tissue.
Therefore first and foremost step would be ascertain whether your gynecomastia is glandular or fatty? Fatty gynecomastia is more common in obese/ overweight individuals.
In true gynaecomastia a relative imbalance between estrogen and testosterone i.e either an increase in estrogen production, a decrease in androgen production, or a combination of these factors is the cause behind increase in size of male breast tissue gland.
Most of the patients of gynecomastia have psuedogynecomastia rather than true gunecomastia.
Even in those who have true gynecomastia they would have had a TRANSIENT rather than consistent imbalance between estrogen and testosterone, which usually happens at puberty, the gynecomastia persisting thereafter i.e persistent pubertal gynecomastia. Therefore your gynecomastia is not necessarily due to continuing imbalance between testosterone and estrogen.

Finasteride reduces serum testosterone levels and DHT levels but it has no effect on sperm count, sperm motility and other parameters when it is given at 1 mg doses recommended for androgenetic alopecia. Higher than 1 mg doses may have side effects like decrease in sperm count and other parameters.

Hair is all protein i.e keratin. Your diet should have adequate amount of proteins besides other nutrients, vitamins and minerals.

Future research in preventing hair loss in androgentic alopecia is mainly focused on finding a remedy which is effective and is also devoid of sexual side effects.
Saw palmetto extract is an alternative to finasteride which is already available and is claimed to be devoid of sexual side effects on libido and sexual drive.
Dutasteride is another investigational drug that may be useful in androgenetic alopecia but it is not yet approved and is said to have even more sexual side effects than finasteride. It is not yet approved for androgenetic alopecia.
Epilobium is a herb which also has 5 alpha reductase activity just like finasteride but is also claimed to be devoid of sexual side effects. It is not yet approved.

As of now, finasteride, saw palmetto extract, topical minoxidil, capixyl (BIOCHANIN A and ACETYL TETRAPEPTIDE-3), biotin and prp are the only available alternatives for androgenetic hair loss.

Regards

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Brief Answer:
Capixyl and Prp can be used along with minoxidil and Oral Biotin

Detailed Answer:
Hi.

You may continue with minoxidil and oral biotin supplement. In addition you may take prp sessions.

Though I myself don't do Prp but I am aware that it has additional benefits to minoxidil. It preserves as well as regrows new hair. You may take 3-4 sessions at an interval of 1-2 months between sessions and thereafter can take maintenance Prp sessions once every 3-4 months. You need to take maintenance sessions to maintain the improvement achieved with Prp. It is best to use minoxidil along with Prp to maximize results.

Capixyl is a new addition to management of androgenetic alopecia.
Capixyl has a direct action on 5-alpha-reductase enzyme present in hair follicles which causes it to modulate DHT to prevent hair miniaturization. Therefore unlike finasteride it has no systemic side effcets like loss of libido Or gynecomastia. Secondly it improves hair anchoring, and thirdly it reduces inflammation, which is a contributing factor of hair loss. Capixyl is effective for androgenetic alopecia and most dermatologist including me use it along with minoxidil i.e during day time capixyl and at night time minoxidil.

As far as exercise is concerned there is no evidence that it would affect course or progression of androgenetic alopecia. However moderate exercises (jogging, cycling, swimming etc) may serum dht levels whereas extreme body building may raise dht levels

Regards
Take care.

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