Male Pattern Baldness (AGA) Treatment– Treatments for AGA –

What is Androgenetic Alopecia (AGA)?

Androgenetic Alopecia (AGA) is a progressive form of hair loss caused by the influence of DHT (dihydrotestosterone), a type of male hormone, which causes hair to become thinner and shorter until it eventually stops growing. This condition affects approximately 30% of Japanese men, and early treatment yields the best results.

Male Hair Loss Treatment: Evidence-Based Effective Therapies

AGA Treatment Case Study

Standard Treatment | Finasteride + Topical Minoxidil

Finasteride (Hair Loss Prevention Medication)

Characteristics

• FDA approved in 1997, approved in Japan in 2005
• 5α-reductase inhibitor that suppresses DHT production
• Take 1mg once daily

Finasteride Pricing (Revised May 13, 2023)

Medication	Price (tax included)
Finasteride 1mg (Imported)	30 tablets ¥2,640
Finasteride 1mg (Japan)	28 tablets ¥4,312

• Imported Finasteride 1mg is not an approved drug in Japan and is not covered by the Pharmaceutical Adverse Drug Reaction Relief System.

Effectiveness

Clinical trials report that after 1 year of use, 58% of patients showed improvement and 40% had halted progression.

Not Suitable For

• Individuals under 20 years of age
• Women (risk to fetal development)
• Men trying to conceive (discontinuation required one month before)
• Those with psychiatric disorders or sexual dysfunction
• Those with severe liver dysfunction

Side Effects

The incidence rate is approximately 6.5%, with sexual dysfunction (decreased libido 2.9%, erectile dysfunction 0.7%) being the primary side effects.

Topical Minoxidil (Hair Growth Stimulant)

Characteristics

• FDA approved in 1988, approved in Japan in 1999
• Topical hair growth agent that improves blood flow and stimulates hair follicles
• Our clinic offers 2%, 5%, and 10% concentrations (non-irritating formula)

Topical Minoxidil Pricing (Revised May 13, 2023)

Medication	Price (tax included)
Minoxidil 2%	1 bottle ¥3,300
Minoxidil 5%	1 bottle ¥4,400
Minoxidil 10%	1 bottle ¥5,500

• One bottle (55mL) of topical minoxidil lasts approximately one month.
• As these are compounded in-clinic, they are not approved drugs in Japan and are not covered by the Pharmaceutical Adverse Drug Reaction Relief System.
• Minoxidil is toxic to dogs and cats. Please take care not to let pets lick the solution or touch pets with hands that have been in contact with the solution.

Usage Instructions

Apply twice daily, using 5-6 pumps (approximately 1ml) per application to the affected areas, and massage gently with fingertips.

Effectiveness

Clinical trials with 5% topical minoxidil showed improvement in 40% of patients after 3 months, 80% after 6 months, and 90% after 12 months.

Not Suitable For

• Those with allergic tendencies
• Individuals under 20 or over 65 years of age
• Those with cardiovascular diseases
• Pregnant or nursing women

Side Effects

Scalp rash, itching, headache, and dizziness have been reported.

Standard Treatment Pricing

Example treatment cost when combining Finasteride 1mg and 5% Topical Minoxidil:

1. Consultation fees apply for oral medication prescriptions. For topical medication prescriptions only, appointments are not necessary after the second visit.
2. At the initial visit, we prescribe a 2-month supply to monitor side effects. If no problems arise at the follow-up, we can prescribe a 4-month supply, with consultations recommended every 3-6 months thereafter.

Advanced Treatment | Dutasteride + Oral Minoxidil

Dutasteride (Advanced Hair Loss Prevention Medication)

Characteristics:

• Approved in Japan for AGA treatment in 2016
• Simultaneously inhibits Type I and Type II 5α-reductase (more powerful than finasteride)
• Take 0.5mg once daily

Dutasteride Pricing (Revised May 13, 2023)

Medication	Price (tax included)
Dutasteride 0.5mg AV (Japan)	30 tablets ¥3,960
Dutasteride 0.5mg ZA (Japan)	30 tablets ¥8,580

• Dutasteride AV is prescribed off-label for AGA and is not covered by the Pharmaceutical Adverse Drug Reaction Relief System.
• Dutasteride ZA will be discontinued when stock is depleted. Treatment will switch to Dutasteride AV.

Effectiveness

Compared to finasteride, dutasteride shows approximately 1.6 times improvement in hair count and 1.45 times improvement in hair thickness.

Not Suitable For

• Individuals under 20 years of age
• Women (risk to fetal development)
• Men trying to conceive (discontinuation required 6 months before)
• Those with psychiatric disorders or sexual dysfunction
• Those with severe liver dysfunction

Side Effects

Long-term administration studies report side effects in 16.7% of patients, primarily erectile dysfunction (10.8%), decreased libido (8.3%), and ejaculation disorders (4.2%).

Minoxidil Tablets (Oral Hair Growth Medication)

Characteristics

• Originally developed as antihypertensive medication, with confirmed hair growth effects
• Not yet approved for AGA, but safety and efficacy at low doses have been reported
• Requires regular examinations and consultations to manage side effects

Minoxidil Tablet Pricing (Revised May 13, 2023)

Medication	Price (tax included)
Oral Minoxidil 2.5mg	30 tablets ¥3,960
Oral Minoxidil 5mg	30 tablets ¥4,620
Oral Minoxidil 10mg	30 tablets ¥5,280

• Minoxidil tablets (oral medication) are not approved drugs in Japan and are not covered by the Pharmaceutical Adverse Drug Reaction Relief System.

Effectiveness

Offers the most powerful hair growth effect among existing AGA treatments.

Not Suitable For

• Individuals under 20 or over 65 years of age
• Those with cardiovascular or kidney diseases
• Pregnant, nursing, or trying-to-conceive women
• Men trying to conceive (discontinuation required one month before)
• Those unable to undergo regular examinations

Side Effects

Common side effects include hypertrichosis (excessive hair growth), edema, palpitations, and headaches. Though very rare, serious cardiovascular side effects such as heart failure and myocardial infarction can occur.

Advanced Treatment Pricing

Example treatment cost when combining Dutasteride 0.5mg, Minoxidil Tablets 2.5mg, and Nizoral Shampoo:

1. Prescription of oral minoxidil requires tests (blood, electrocardiogram, urine) at the initial visit and once every 6 months.
2. Consultation fees apply for oral medication prescriptions. For topical medication prescriptions only, appointments are not necessary after the second visit.
3. At the initial visit, we prescribe a 2-month supply to monitor side effects. If no problems arise at the follow-up, we can prescribe a 4-month supply, with consultations recommended every 3-6 months thereafter.

Supplementary Treatment | Nizoral Shampoo & Ketoconazole Lotion

Scalp Micro Pigmentation (SMP)

Scalp Micro Pigmentation (SMP) is an effective complement to medication-based treatments. This procedure uses special pigments to create tiny dots on the scalp, producing the visual effect of higher hair density.

Recommended for:

• Those seeking immediate visual improvement alongside medication treatment
• Those with short hairstyles or shaved heads
• Those wanting to reduce the appearance of scalp showing through thinning hair
• Those wishing to conceal scalp scars

Our Scalp Micro Pigmentation service prioritizes natural appearance and longevity. Using high-quality pigments and specialized techniques, we create the look of real hair follicles. Most patients see significant reduction in scalp visibility after an average of 3-4 sessions, helping restore confidence.For more detailed information, please visit our Scalp Micropigmentation page (available in Japanese only – please use translation tools).

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