Androgenetic alopecia, or AGA, is a common form of progressive hair loss. In men, it often causes thinning around the hairline, temples, or crown.
Pitonne provides physician-guided AGA treatment through an online medical consultation. When medically appropriate, the standard treatment set includes oral minoxidil 5 mg and dutasteride, sold under the brand name Zagallo.
Pitonne may also recommend combining AGA medication with Exosome IV Therapy according to the patient’s health condition and treatment goals.
Some patients who have continued Exosome IV Therapy have noticed changes in hair volume, thickness, texture, or the appearance of gray hair. However, responses vary, and these changes cannot be guaranteed.
AGA treatment and Exosome IV Therapy should not be assessed after one appointment or a short treatment period. Hair changes occur gradually, so treatment may need to continue for a year or longer while progress is monitored.
What Is AGA?
AGA is also known as male pattern hair loss. It is associated with genetics and sensitivity to dihydrotestosterone, commonly called DHT.
In follicles affected by DHT, the hair-growth phase becomes shorter. The follicles gradually produce finer and shorter hair, making the scalp more visible over time.
Common signs include:
- A receding hairline
- Thinning around the temples
- Reduced density at the crown
- Gradually increasing scalp visibility
- Finer and shorter hair
- A gradual increase in hair shedding
AGA usually develops slowly.
Sudden hair loss, round bald patches, scalp pain, inflammation, or other physical symptoms may have another cause and can require an in-person medical assessment.
Pitonne’s AGA Medication
Pitonne provides AGA medication through a private online consultation with a partner physician.
The standard treatment set includes:
- Oral minoxidil 5 mg
- Dutasteride, sold as Zagallo
The physician reviews the pattern of hair loss, medical history, current medications, and potential treatment risks before deciding whether a prescription is appropriate.
If prescribed, medication may be arranged for collection at the clinic or local delivery, depending on the patient’s location and selected option.
How Does Dutasteride Work?
Dutasteride inhibits type I and type II 5-alpha-reductase. These enzymes convert testosterone into DHT, which contributes to follicle miniaturization in male AGA.
By reducing DHT production, dutasteride may help slow the progression of AGA and support the maintenance of existing hair.
The Japanese Dermatological Association’s guideline strongly recommends oral dutasteride for male AGA. Clinical trials have reported improvements in hair count and hair width in some men who continued treatment.
Dutasteride is not intended for women or children.
It may also affect prostate-specific antigen, or PSA, test results. Tell the physician ordering a PSA test that you are taking dutasteride.
Possible adverse effects include:
- Reduced libido
- Erectile or ejaculation problems
- Breast tenderness or enlargement
- Mood changes
- Liver-related abnormalities
- Changes in semen volume or sperm count
These effects do not occur in everyone, but they should be discussed before treatment.
PMDA: Zagallo prescribing information
What Should You Know About Oral Minoxidil?
Minoxidil was originally developed as a blood-pressure medication. Its effect on hair growth later led to the development of topical minoxidil products.
Oral minoxidil is prescribed for hair loss in some clinical settings, but its use for AGA is off-label.
The Japanese Dermatological Association’s 2017 guideline did not recommend oral minoxidil because the benefits and cardiovascular risks had not been adequately evaluated at that time.
More recent studies have examined low-dose oral minoxidil for AGA. However, the appropriate dose and potential risks still require individual medical assessment.
Do not begin oral minoxidil, change the dose, or stop treatment without consulting the prescribing physician.
Possible effects include:
- Increased facial or body hair
- Swelling or fluid retention
- Increased heart rate or palpitations
- Dizziness or low blood pressure
- Headache
- Shortness of breath
Before treatment, tell the physician if you have heart disease, low blood pressure, kidney problems, a history of swelling, or take medication that affects blood pressure.
Japanese Dermatological Association: AGA treatment guideline
Review of low-dose oral minoxidil
Why Are Dutasteride and Oral Minoxidil Used Together?
Dutasteride and oral minoxidil approach AGA differently.
Dutasteride reduces the production of DHT, which contributes to the progression of male pattern hair loss. Oral minoxidil is used to support hair growth.
When a physician determines that both medicines are appropriate, they may be prescribed together.
Treatment should still be monitored for changes involving:
- Blood pressure and heart rate
- Swelling or fluid retention
- Sexual function
- Liver function
- Hair shedding and density
- Medication tolerance
The same treatment plan is not suitable for every patient. Medication and dose should be determined according to medical history, current prescriptions, hair-loss progression, and treatment goals.
When Can Results Be Expected?
AGA medication does not produce immediate changes. Hair grows slowly, and several months of continued treatment may be needed before progress can be assessed.
The response may depend on:
- The extent of hair loss
- How long the hair loss has been progressing
- Age and genetic factors
- Treatment consistency
- Medication tolerance
- Other scalp or medical conditions
The PMDA information for Zagallo states that treatment should be reconsidered when no improvement is seen after six months. Patients who continue treatment should also have its necessity reviewed periodically.
Stopping medication may allow AGA to progress again. Do not stop treatment without speaking with the prescribing physician.
Exosome IV Therapy as Part of an AGA Treatment Plan
Exosomes contain substances involved in communication between cells. Their possible relationship with hair follicles and hair growth is being studied.
Pitonne may recommend combining AGA medication with Exosome IV Therapy according to the patient’s health condition, goals, and treatment plan.
Some patients who have continued Exosome IV Therapy have reported or shown changes such as:
- Increased hair volume
- Hair that appears denser
- Changes in hair strength or texture
- Less visible gray hair
- Changes in the amount of hair shedding
The type and degree of change differ between patients. The same result cannot be promised for everyone.
Exosome IV Therapy should not be assessed after one appointment or a short treatment period. Because AGA also progresses gradually, Pitonne considers long-term treatment and monitoring important. Patients may need to continue for a year or longer before evaluating the overall course.
Photographs taken with similar lighting, angles, distance, and hair length can make gradual changes easier to compare.
Published studies of exosomes and hair growth remain relatively small. The source of the exosomes, preparation method, dose, delivery method, number of treatments, and follow-up period vary between studies. Research is continuing, and standardized treatment protocols have not yet been established.
Pitonne recommends using physician-guided AGA medication while considering Exosome IV Therapy according to the patient’s preferences and health condition.
Systematic review of exosomes for hair restoration
What Should You Discuss Before Treatment?
Before the online consultation, prepare information about:
- When the hair loss began
- Which areas are becoming thinner
- Family history of hair loss
- Prescription and over-the-counter medications
- Supplements and other hair treatments
- Heart, liver, kidney, or blood-pressure conditions
- Previous reactions to hair-loss medication
- Fertility plans
- Recent PSA testing
- Previous exosome or regenerative wellness treatments
Do not leave out medications or medical conditions because they seem unrelated to hair loss. This information can affect whether treatment is appropriate.
How Should Progress Be Monitored?
AGA treatment and Exosome IV Therapy should be evaluated over time rather than by short-term impressions.
Useful points to monitor include:
- The amount of hair shedding
- Hairline and crown appearance
- Hair thickness and volume
- Hair strength and texture
- The amount or appearance of gray hair
- Medication side effects
- How you feel after Exosome IV Therapy
- Whether the treatment plan can be continued comfortably
When taking photographs, try to keep the lighting, angle, distance, hairstyle, and hair length consistent.
Review medication effects, adverse effects, and hair changes with the physician before changing the treatment plan.
When Is an In-Person Examination Important?
An in-person examination may be more appropriate if you have:
- Sudden hair loss
- Round or patchy areas of hair loss
- Scalp redness, itching, pain, or crusting
- Scarring of the scalp
- Loss of eyebrows or body hair
- Unexplained weight changes or significant fatigue
- Rapid progression over a short period
These signs may indicate a condition other than typical AGA.
Frequently Asked Questions
Can AGA be cured permanently?
AGA is generally managed rather than permanently cured. Medication may help slow further hair loss and support hair growth, but continued treatment may be necessary to maintain the changes.
Can dutasteride and oral minoxidil be used together?
They may be prescribed together when a physician determines that the combination is appropriate. Medical history, current medications, blood pressure, potential adverse effects, and treatment goals should be reviewed first.
Can Exosome IV Therapy change the appearance of hair?
Some Pitonne patients who have continued Exosome IV Therapy have noticed greater hair volume, changes in hair strength or texture, or less visible gray hair.
Responses vary, and the result cannot be guaranteed. Treatment generally needs to be continued and monitored over the long term rather than assessed after one or two appointments.
Can AGA medication and Exosome IV Therapy be combined?
They may be combined after a physician reviews the patient’s health condition and medications.
Pitonne recommends combining physician-guided AGA medication with Exosome IV Therapy when appropriate. Progress should be reviewed regularly so the treatment plan can be adjusted when necessary.
Can AGA medication be prescribed through an online consultation?
Pitonne provides online consultations with a partner physician. Medication is prescribed only when the physician determines that it is medically appropriate.
Some patterns of hair loss may require an in-person examination.
Conclusion
Pitonne’s physician-guided AGA treatment includes oral minoxidil 5 mg and dutasteride when medically appropriate.
Pitonne may also recommend combining AGA medication with Exosome IV Therapy according to the patient’s health condition, treatment goals, and preferences.
Some patients who have continued Exosome IV Therapy have noticed changes in hair volume, strength, texture, or the appearance of gray hair. These changes vary between patients and cannot be guaranteed.
AGA treatment should not be evaluated after one appointment or a short treatment period. Monitoring over a year or longer may be necessary to understand the overall course.
Take photographs regularly, monitor medication effects and adverse effects, and discuss any changes with the prescribing physician.
References
- Pitonne: AGA Medication
- Pitonne: Exosome IV Drip
- Japanese Dermatological Association: AGA treatment guideline
- PMDA: Zagallo prescribing information
- Review of low-dose oral minoxidil
- Systematic review of exosomes for hair restoration
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