There is still misinformation and choice regarding MPHL

Shim Woo-young, professor of dermatology at Gangdong Kyunghee University Hospital

20 years since Propecia was released, opening the era of full-scale medical treatment

The future trend is safety. Securing long-term data is key

Professor Shim Woo-young

The male-type hair loss treatment'Propecia (finasteride 1mg)' was introduced in Korea, and hair loss was treated in earnest in 2000.

 

Propecia identified the correlation between type II 5-alpha reductase and male pattern hair loss, suggested the therapeutic potential of male pattern hair loss, which was considered an incurable hereditary disease, and brought a major change in the treatment environment.

 

Now, 20 years later, interest in hair loss treatment is growing even more.

 

It is estimated that 14.1% of patients suffer from male pattern hair loss in Korea.

 

In particular, unlike in the past, which was considered exclusively for middle-aged men, the number of young patients who visit hospitals for hair loss treatment is steadily increasing in recent years.

 

In fact, about half (44%) of patients who received hair loss treatment in Korea in 2019 were in their 20s to 30s.

 

The hair loss treatment market has also achieved explosive growth in line with this.

 

After the launch of Propecia, the market competition was fierce as the Avodart(Dutasteride), and domestic generic drugs such as Finasteride and Dutasteride were also launched.

 

As a result, sales of the entire domestic hair loss treatment market exceeded ₩100 billion last year.

 

There were also unpleasant issues with a lot of interest.

 

In recent years, as the hair loss community and online platforms such as YouTube have become active, there have been cases of patients who suffer damage with false information related to unconfirmed diseases and treatments, and there have also been cases of illegally purchasing hair loss pills through overseas direct purchases and experiencing side effects.

 

False hype advertisements such as cosmetics and foods for which hair loss symptoms improvement or hair growth effect has not been verified are also a chronic problem that hinders the correct diagnosis and treatment of hair loss patients.

 

Dailypharm met Shim Woo-young, professor of dermatology at Gangdong Kyunghee University Hospital, to hear about changes in hair loss treatment trends and future tasks.

 

--As of 2020, what is the standard treatment method for male pattern hair loss and what are the latest treatment guidelines?

 

Drug therapy is the most commonly used medical treatment method.

 

As drugs to be taken, there are Finasteride and Dutasteride, which are mechanisms that inhibit the occurrence of DHT (dihydro-testosterone), and Minoxidil formulations are drugs that are applied directly to the scalp.

 

Hair transplantation, in which the hair is transplanted into the hair loss site, can also be considered.

 

In the case of transplantation, it is effective to continue drug treatment even after surgery.

 

-You have been examining patients for 20 years, are there any differences from the past?

 

First, compared to the past, the number of patients who visited the hospital for hair loss has increased.

 

In particular, there are more young patients, with patients in their 20s and 30s accounting for about half of the total.

 

As the number of young people who are relatively interested in appearance has increased, patients' willingness and aggressiveness to treat them have also increased overall.

 

Also, as there is a lot of information online, such as portal sites and YouTube, the level of knowledge of patients about diseases and treatments is much higher than in the past.

 

-What does the emergence of 5-alpha-reductase inhibitors such as Propecia and Avodart mean for hair loss management?

 

In the case of male pattern hair loss, it can be said that the era of full-fledged medical treatment began with the advent of oral drug treatments.

 

In the past, there was little recognition that hair loss was a disease, and treatment was mainly based on folk remedies.

 

However, after the launch of Propecia in 2000, hair loss has been recognized as a disease that can be overcome with good management, and interest in treatment has also increased.

 

-As mentioned earlier, two drugs are competing for 5-alpha-reductase inhibitors, Propecia and Avodart.

 

You always hear the superiority and opinions are divided.

 

-As mentioned previously, there are Propecia and Avodat for 5-alpha-reductase inhibitors, and these drugs are competing.

 

Opinions are divided.

 

Also, it can be said that my own know-how has been prescribed according to the situation and symptoms through sufficient consultation with the patient.

 

However, it is important to take hair loss pills consistently.

 

Recently, as many patients start treatment at a young age, I am paying more attention to the long-term efficacy and safety of patients.

 

-Many men worry that 'hair loss drug = decreased sexual function' Side effects can occur.

 

However, if they are contemplating hair loss treatment itself due to side effects, I would like to say that it is not necessary.

 

Erectile dysfunction and decreased libido are frequently mentioned as sexual side effects of oral treatments, It is only about 1-2 out of 100.

 

In fact, there are far fewer patients experienced at the clinic.

 

It is also explained as a nocebo effect is said to occur when negative expectations of the patient regarding a treatment cause the treatment to have a more negative effect than it otherwise would have.

 

It is believed that the patient received incorrect information through the Internet and such side effects appeared.

 

In many cases, side effects disappear after sufficient explanation to the patient.

 

Non-medical management methods such as hair loss shampoo and scalp nutrition are still prevalent.

 

It is very unfortunate that many patients rely on non-medical management methods and get hurt if they do not work.

 

There are cases of giving up hair loss treatment as it is.

 

There is also a big problem for companies such as hair loss shampoo in creating this situation.

 

Although there is no medical evidence that hair loss shampoo or scalp nutrients are effective for hair growth, they advertise as hype.

 

This will require the regulation by government.

 

And even hair loss patients need to be wary of accepting unconfirmed advertisements or information easily.

 

Overseas illegal purchase of hair loss drugs is also a big issue.

 

The Korea Consumer Agency made a presentation pointing out the dangers of this in last year.

 

First of all, it is illegal to purchase oral hair loss treatment drugs without a prescription from a medical staff because they belong to Rx drugs.

 

But more importantly, the patient's safety can be threatened.

 

Taking fake medicines or unconfirmed products may cause severe hair loss or experience fatal side effects.

 

Therefore, in order to treat alopecia, it is correct to visit a hospital and consult a specialist to find an effective treatment method.

 

-What do you think will be the trends or key keywords of hair loss treatment in the future?

 

'Safety' is the top priority.

 

The number of young patients is increasing as mentioned earlier.

 

This means that the treatment period is prolonged.

 

Long-term safety and effectiveness will be considered first when choosing a hair loss agent.