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What is AGA (androgenetic alopecia)? How it progresses and how to choose the right treatment

Lately, have you felt like your hair volume has decreased, or that your hairline is receding? AGA (Androgenetic Alopecia) is a type of hair loss that progresses due to male hormones and genetic factors. Its characteristic feature is that its progression can be stopped or its condition improved by addressing the causative substances. This page provides a detailed explanation of everything from how AGA progresses to the differences between Finasteride and Dutasteride, and the role of Minoxidil.

  • ✓It progresses when DHT (dihydrotestosterone) acts on hair follicles, shortening the hair's growth phase.
  • ✓Finasteride inhibits only 5α-reductase type II, while dutasteride inhibits both type I and type II, resulting in a higher DHT suppression effect.
  • ✓Minoxidil, an oral medication that "promotes hair growth" rather than "stops hair loss," is more effective when used in combination with other treatments.
  • ✓Female pattern hair loss (FAGA) has different causes than male pattern hair loss, and topical minoxidil is the primary treatment.
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A clean clinic with a white-based interior
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Online consultations: same-day shipping at the earliest
Cosmetics and supplements sold exclusively at medical institutions are also available for purchase.
Cosmetics and supplements sold exclusively at medical institutions are also available for purchase.

AGA medication is available for online prescription.

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What is AGA?

AGA (Androgenetic Alopecia) is a type of hair loss that progresses due to the involvement of male hormones and genetic factors. It often begins with a receding hairline and thinning at the crown, and gradually worsens if left untreated. Unlike natural changes due to aging, AGA is characterized by the ability to halt its progression or improve the condition by addressing the causative substances.

How AGA Progresses

Testosterone (a male hormone) in the body is converted into a more active substance called DHT (dihydrotestosterone) by the action of an enzyme called 5α-reductase. When DHT binds to receptors (androgen receptors) in the hair follicles, the hair's growth phase is shortened, leading to "miniaturization," where hair falls out before it can fully grow. It is believed that genetic factors play a significant role in how easily 5α-reductase works and how sensitive hair follicles are to DHT.

Patterns of Progression

There are individual differences in progression patterns, such as a receding hairline, thinning from the crown, or both occurring simultaneously. The Hamilton-Norwood scale, an international classification system, is often used to categorize the degree of progression, ranging from mild to severe.

Treatment: Oral Medications

The primary treatment for AGA involves oral 5α-reductase inhibitors (finasteride and dutasteride), which suppress the production of DHT.

Differences Between Finasteride and Dutasteride

Finasteride (Propecia, etc.)

Dutasteride (Avodart, etc.)

Enzyme types inhibited

Only 5α-reductase type II

Both 5α-reductase types I and II

Approximate DHT suppression rate

Approximately 70%

Approximately 90% or more

Onset of noticeable effects

Approximately six months after starting treatment

Many report feeling effects slightly faster than with finasteride

Half-life

Relatively short

Relatively long (stays in the body longer)

Recommended for

Those who want to start with standard treatment

Those seeking higher efficacy, or those who found finasteride insufficient

There are two types of 5α-reductase: type I and type II. While finasteride inhibits only type II, dutasteride inhibits both type I and type II. Therefore, dutasteride is considered to have a higher DHT-suppressing effect and is also chosen as an alternative when finasteride has not provided sufficient results. On the other hand, because of its higher efficacy, individual experiences with side effects vary, so many people choose to start with finasteride.

Side Effects of Oral Medications

  • Decreased libido and impact on erectile function (not common, but consult a doctor if concerned)

  • Impact on liver function (rare)

  • Breast tenderness/pain (rare)

  • Pregnant women or those wishing to become pregnant must avoid contact with the medication (due to absorption through the skin)

Treatment: Topical Medication (Minoxidil)

Minoxidil is an ingredient that promotes hair growth through a mechanism different from oral medications (finasteride and dutasteride). It was originally developed as a vasodilator and is believed to improve blood circulation in the scalp and extend the hair growth phase (the detailed mechanism of hair growth is not yet fully understood).

Differences in Roles Between Oral Medications and Minoxidil

Finasteride・Dutasteride

Minoxidil

Role

Suppresses DHT and stops hair loss progression (defensive treatment)

Promotes hair growth and encourages regrowth (aggressive treatment)

Form

Oral

Topical (applied), oral type also available

About concomitant use

Expected to achieve higher efficacy when used concomitantly with minoxidil

Same as above

Finasteride/dutasteride, which "stop hair loss," and minoxidil, which "promotes hair growth," act through entirely different mechanisms. Therefore, using both in combination is considered to lead to more effective AGA treatment.

Side Effects of Minoxidil

  • Scalp itching/rash (when used topically)

  • Palpitations/edema (especially reported with oral type)

  • Hypertrichosis (hair may grow more easily in areas other than the application site, such as the face)

About Female AGA (FAGA)

Female hair loss (FAGA: Female Androgenetic Alopecia) differs in mechanism from male AGA, and often presents as diffuse thinning across the entire scalp. Finasteride and dutasteride cannot be used by pregnant women or those wishing to become pregnant, so topical minoxidil is the primary treatment for female hair loss.

Online Treatment Process

  • ① Provisional Payment and Pre-Consultation: Please enter your degree of progression, areas of concern, etc.

  • ② Online Consultation: A doctor will confirm prescription eligibility via video call.

  • ③ Same-day shipping available in as little as possible

  • ④ Supports continuous purchases and regular delivery services.

よくある質問

Frequently Asked Questions

Q Finasteride or dutasteride: Which should I choose?
A

Most people start with finasteride, but for those seeking greater efficacy or who found finasteride's effects insufficient, we may suggest dutasteride.

Q Is minoxidil effective on its own?
A

While you can expect an effect that promotes hair growth, it cannot stop the progression of hair loss caused by DHT. Combining it with other agents will be more effective.

Q When can I expect to feel the effects?
A

While individual results vary, many people experience the effects after about six months of continuous use. AGA treatment is a long-term process, so persistent continuation is important.

Q What happens if I stop taking the medicine?
A

When you stop taking the medication, the DHT-inhibiting effect also disappears, and it is believed that the progression will gradually return to its original pace.

Q Can the same medication be used by women?
A

Finasteride and dutasteride cannot be used by women who are pregnant or wish to become pregnant. Female hair loss treatment primarily focuses on minoxidil and Pantogar.

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