Лечение и профилактика выпадения волос

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The management of hair loss, includes prevention and treatment of alopecia, baldness, and hair thinning, and regrowth of hair.

Scratching of itchy scalp may contribute to hair loss.

Prevention of obesity helps. Obesity is linked to hair thinning.

A humidifier can be used to prevent low indoor humidity during winter (especially with indoor heating), and dry season. Commonly, patients with seborrhoeic dermatitis experience mild redness, scaly skin lesions and in some cases hair loss. Low humidity can cause adverse health effects and may cause atopic dermatitis, and seborrhoeic dermatitis.

The topical bioavailability of synthetic medicines such as antiandrogens, as well as phytochemicals such as quercetin, has been improved with incorporation of drugs in nanoparticles, or microneedling.

Treatments for the various forms of hair loss have only moderate success. Three medications have evidence to support their use in male pattern hair loss: finasteride, dutasteride and minoxidil. Other medications include ketoconazole, and in female androgenic alopecia spironolactone and flutamide.

In June 2022, the FDA authorized baricitinib for the treatment of severe alopecia areata.

Minoxidil, applied topically, is widely used for the treatment of hair loss. It may be effective in helping promote hair growth in both men and women with androgenic alopecia. About 40% of men experience hair regrowth after 3–6 months. It is the only topical product that is FDA approved in America for androgenic hair loss. However, increased hair loss has been reported.

Finasteride is used to treat male pattern hair loss. Treatment provides about 30% improvement in hair loss after six months of treatment, and effectiveness only persists as long as the drug is taken. Dutasteride is also used in the treatment of male pattern hair loss and appears to have better effectiveness than finasteride for the condition. While used off label for male pattern hair loss in most of the world, dutasteride is specifically approved for this indication in South Korea and Japan. There is tentative support for spironolactone in women. It can also cause low blood pressure, high blood potassium, and abnormal heart rhythms. Also, women who are pregnant or trying to become pregnant generally cannot use the medication as it is a teratogen, and can cause ambiguous genitalia in newborn children. There is tentative evidence for flutamide in women; however, it is associated with relatively high rates of liver problems and strong recommendations have been made against its use. Like spironolactone, flutamide is typically only used by women. Bicalutamide is another option for the treatment of female pattern hair loss. It has a far lower risk of liver toxicity than flutamide and is said to have an excellent safety profile. However, bicalutamide retains a small risk of liver toxicity and for this reason periodic liver monitoring is recommended during treatment.

Low level laser therapy or photobiomodulation is also referred to as red light therapy and cold laser therapy. It is a non invasive treatment option. LLLT is shown to increase hair density and growth in both genders. The types of devices (hat, comb, helmet) and duration did not alter the effectiveness, with more emphasis to be placed on lasers compared to LEDs. Ultraviolet and infrared light are more effective for alopecia areata, while red light and infrared light is more effective for androgenetic alopecia. Medical reviews suggest that LLLT is as effective or potentially more than other non invasive and traditional therapies like minoxidil and finasteride but further studies such as RCTs, long term follow up studies, and larger double blinded trials need to be conducted to confirm the initial findings.

Using ones own cells and tissues and without harsh side effects, PRP is beneficial for alopecia areata and androgenetic alopecia and can be used as an alternative to minoxidil or finasteride. It has been documented to improve hair density and thickness in both genders. A minimum of 3 treatments, once a month for 3 months are recommended, and afterwards a 3 6 month period of continual appointments for maintenance. Factors that determine efficacy include amount of sessions, double versus single centrifugation, age and gender, and where the PRP is inserted. Future larger randomized controlled trials and other high quality studies are still recommended to be carried out and published for a stronger consensus. Further development of a standardized practice for procedure is also recommended. After surgery, a bandage is worn for two days to protect the stitched strip during healing. A small strip scar remains after healing, which can be covered by scalp hair growing over the scar.

Bimatoprost 0.03% has been used to grow eyebrows.

The FP receptor agonist, bimatoprost, in the form of an 0.03% ophthalmic solution termed Latisse, is approved by the US Food and Drug Administration to treat hypotrichosis of the eyelashes, in particular to darken and lengthen eyelashes for cosmetic purposes. Also, bimatoprost may be used to treat small or underdeveloped eyelashes.

Some popular plant juices sold as hair serum may instead of growing human hair actually inhibit the growth, including 6 gingerol found in ginger.

Dietary supplements are not typically recommended. Many people use unproven treatments, but there is little evidence of the effectiveness of vitamins, minerals, or other dietary supplements regrowing hair or retaining hair.

Radiation induces hair loss through damage to hair follicle stem cell progenitors and alteration of keratin expression. Radiation therapy has been associated with increased mucin production in hair follicles. Studies have suggested electromagnetic radiation as a therapeutic growth stimulant in alopecia.

thumb|There have been advances in the fashion industry in wig design. Certain hair shampoos and ointments visually thicken existing hair, without affecting the growth cycle. There have also been developments in the fashion industry with wig design. The fashion accessory has also been shown to be a source of psychological support for women undergoing chemotherapy, with cancer survivors in one study describing their wig as a "constant companion". Other studies in women have demonstrated a more mixed psychosocial impact of hairpiece use. Specialized tattoos, commonly known as scalp micropigmentation, can mimic the appearance of a short buzzed haircut.

thumb|Hair follicle with mesenchymal dermal papilla, labelled at top, location of hair follicle stem cells and thought to be site of action of DHT. Type 1 and 2 5α reductase enzymes are present at pilosebaceous units in papillae of individual hair follicles. They catalyse formation of the androgens testosterone and DHT, which in turn regulate hair growth. Androgens have different effects at different follicles: they stimulate IGF 1 at facial hair, causing hair regrowth, but stimulate TGF β1, TGF β2, dickkopf1 and IL 6 at the scalp, causing hair follicle miniaturisation. Female androgenic alopecia is characterized by diffuse crown thinning without hairline recession, and like its male counterpart rarely leads to total hair loss. Specialized scalp tattoos can also mimic the appearance of a short buzzed haircut. Androgenic alopecia also occurs in women, and more often presents as diffuse thinning without hairline recession. Like its male counterpart, the condition rarely leads to total hair loss. Treatment options are similar to those for men, although topical or systemic estrogen is used more often.

Latanoprost and bimatoprost are specific PGF2a analogues applied topically, and have been found to lengthen eyelashes, darken hair pigmentation and elongate hair. Latanoprost has shown ability to promote scalp hair density and pigmentation, and is theorized to function at the dermal papilla. A study found latanoprost ineffective on eyelashes in a patient with alopecia areata. It has also been found ineffective in treatment of eyebrow hair loss.

Estrogens are indirect anti androgens and can be used to treat androgenetic hair loss in women with oral contraceptives. Systemic estrogen increases SHBG, which binds androgens, including testosterone and DHT, in turn reducing their bioavailability. Topical formulations are available in Europe. Low energy radiofrequency irradiation induces IGF 1 in cultured human dermal papilla cells. Adenosine stimulates dermal papillae in vitro to induce IGF 1, along with fibroblast growth factors FGF7, FGF 2 and VEGF. β catenin transcription increased, which promotes dermal papillae as well. Topical capsaicin also stimulates IGF at hair follicles via release of vanilloid receptor 1, which in turn leads to more CGRP. Ascorbic acid has led to increased IGF expression in vitro.

Although follicles were previously thought gone in areas of complete baldness, they are more likely dormant, as recent studies have shown the scalp contains the stem cells from which the follicles arose. Research on these follicular stem cells may lead to successes in treating baldness through hair multiplication (HM), also known as hair cloning. Per a May 2015 review, no successful strategy to generate human hair follicles, for hair regrowth, from adult stem cells has yet been reported. However, in April 2016, scientists from Japan published results of their work in which they created human skin from induced pluripotent stem cells; implanted into laboratory mice, the cells generated skin with hair and glands.

From 2005 to 2007, Curis and Procter & Gamble collaborated on developing a topical hedgehog agonist for hair loss; the agent did not meet safety standards, and the program was terminated. In 2008, researchers at the University of Bonn announced they have found the genetic basis of two distinct forms of inherited hair loss. They found the gene P2RY5 causes a rare, inherited form of hair loss called hypotrichosis simplex. It is the first receptor in humans known to play a role in hair growth. Researchers found that disruption of the gene SOX21 in mice caused cyclical hair loss. Research has suggested SOX21 as a master regulator of hair shaft cuticle differentiation, with its disruption causing cyclical alopecia in mice models. Deletion of SOX21 dramatically affects hair lipids.