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Abstract: After hair transplantation, it is still recommended to use drugs to consolidate for about a year.

According to data released by the National Health and Medical Commission, about 250 million people in China suffer from hair loss, of which about 190 million are men and 60 million are women, which is equivalent to 1 in 6 people losing hair

Among various types of hair loss, androgenetic alopecia (AGA) is the most common type of hair loss in clinical practice, accounting for more than 90%, which is characterized by a progressive decrease in hair density, and can be affected by both men and women

Recently, the Canadian Mediprobe Research Company and the University of Toronto School of Medicine studied the efficacy of minoxidil, dutasteride and finasteride in the treatment of male AGA with various doses and routes of administration, and published the research results in JAMA Dermatology.

Figure 1.

Meta-analysis: different doses and modes of administration

Significant difference in efficacy

We conducted a systematic search in PubMed to select minoxidil, dutasteride, and finasteride as monotherapy at any dose and route of administration

Figure 2.

Meta-analysis showed that at week 24 (the first endpoint), the greatest increase in total hair count was in patients treated with oral dutasteride 0.

Mainstream drug treatment

Finasteride and Minoxidil

It is generally believed that the pathogenesis of AGA is related to androgen changes.

Table 1.

Source of the table: Huatai Securities

Finasteride is a type II 5-alpha reductase inhibitor, originally used to treat male benign prostatic hyperplasia, and was only approved for hair loss treatment in 1997.

At present, the domestic finasteride market is mainly occupied by foreign companies Merck, and domestic companies include Tianfang Pharmaceutical, Shanghai Modern Pharmaceutical and Xianju Pharmaceutical (Table 2)

Table 2.

Data source: official website of each department | Table: Bio-Exploration editorial team

Since it was approved for marketing in 1988, minoxidil has been the most important drug in the field of hair loss prevention, and it is also the only hair loss treatment drug that has obtained triple certification from the U.

At present, 10 domestic minoxidil products have been approved by the China Food and Drug Administration (Table 3).

Table 3.

Data source: official website of each department | Table: Bio-Exploration editorial team

With the in-depth exploration of hair biology, studies have found that many non-androgen-mediated mechanisms are also involved in the occurrence and development of AGA, such as Wnt signaling pathway, prostaglandin D2 pathway, oxidative stress, and micro-inflammation
.
Therefore, inhibiting the androgen pathway is no longer the only way to treat hair loss
.
At present, there are new non-androgenic drugs for the treatment of AGA, but most of these drugs are still in the clinical trial stage, and the effect needs to be further evaluated
.

Hair transplant medical treatment: low penetration rate, broad market

Hair transplant surgery is a cosmetic surgery that completely solves the lack of hair quantity or poor shape
.
Because it adopts autologous transplantation, there will be no rejection phenomenon, it will not cause too much impact on the hair volume of the back occipital area, and can supplement the hair volume of the alopecia area, and the new hair is almost the same as the old hair
.
In addition, hair transplant surgery is also suitable for hair transplant and restoration of eyebrows, eyelashes, beauty tips, beards and temples
.

China's hair transplant industry is mainly divided into four categories: private chain hair transplant institutions, private non-chain hair transplant institutions, hair transplant departments of public hospitals, and hair transplant departments of beauty institutions
.
According to Frost & Sullivan's statistics, in 2020, the share of China's hair transplant market, hair transplant departments in public hospitals accounted for 14.
8%, hair transplant institutions in beauty institutions accounted for 15.
7%, national private chain hair transplant institutions accounted for 23.
9%, and other private hair transplant institutions accounted for the proportion 45.
6%
.

Table 4.
Classification of hair transplant institutions

Source of information: Reference [8] | Tabulation: Bio-Quest editorial team

Four major leaders in China's hair transplant medical industry: Yonghe mainly promotes LATTICE lattice encryption technology, Biliansheng pioneered NHT hair transplant technology without shaving, Damai focuses on microneedle hair transplant, and Xinsheng self-developed 3D hair transplant technology (Figure 3)
.
The underlying technology of the four major hair transplant faucets is FUE technology, the difference lies in the hair transplant equipment, extraction method, planting technology,
etc.
In terms of hair transplant prices, the four leading non-shaved hair transplants are basically priced at 40-60 yuan per hair follicle because they are time-consuming and labor-intensive; shaving hair transplants are priced at 10-20 yuan per hair follicle
.
According to the severity of hair loss, the cost of hair transplant basically ranges from tens of thousands to hundreds of thousands, and there are regional differences
.
Cost rigidity, fierce competition, and price wars may be inevitable in medium and long-term development
.

However, the development of the hair transplant industry is not perfect, there are information asymmetry, price opacity, non-professional physicians operating illegally, and other factors.
In addition, there are factors such as restrictions on the operation area, heavy surgical cost burden, slow results and possible scarring.
China accepts hair transplants.
The number of medical services remains low
.
In 2020, there are only about 516,000 hair transplant operations in China, and the penetration rate of hair transplant services is only 0.
21% (a penetration rate of more than 15% is considered mature).
Therefore, the Chinese hair transplant market has broad prospects (Figure 4)
.

Figure 4.
China's hair transplantation and maintenance market is growing rapidly (Source: Reference [5])

The diagnostic criteria for AGA is the continuous reduction of scalp hair follicles and the transformation of thick terminal hairs into fine vellus hairs
.
But in fact, the total number of hair follicles has not decreased, but the hair follicles have shrunk.
Whether or not hair transplants need to be evaluated for hair follicle atrophy; people with mild hair loss have weak demand for hair transplants, and they will not choose hair transplants
.
In addition, it is still necessary to recommend the use of drugs to consolidate for about a year after hair transplantation.
Considering the burden of hair maintenance and hair retention after hair transplantation, krypton gold hair transplantation is still the choice of a few people
.
Basic drugs to prevent hair loss, although the effect is relatively slow, but high safety, can run through the entire treatment process, coupled with the perfect market supervision, has become the first choice for hair loss groups
.
In general, drug treatment and hair transplantation have their own advantages and disadvantages.
The key is that the demand group chooses based on the individual's degree of hair loss and affordability
.

References:

[1]http:// Chai Xiaowei, Huang Xin.
New progress of non-surgical therapy for androgenetic alopecia [J].
Shanghai Medicine, 2022, 43(02): 3-6+10.

[3] https://en.
jinzhao.
wiki/wiki/Terminal_hair

[4] Annual strategy of medicine and health: trace the source, nuggets innovation
.
https:// Yonghe Medical 02279.
HK is listed on the Hong Kong stock market of Yonghe Medical: From the review of supply and demand to the deduction of the competition pattern, what is the prospect of the hair transplant industry? https:// Gupta AK, Venkataraman M, Talukder M, et al.
Relative Efficacy of Minoxidil and the 5-α Reductase Inhibitors in Androgenetic Alopecia Treatment of Male Patients: A Network Meta-analysis.
JAMA Dermatol.
2022 Feb 2:e215743.
doi: 10.
1001/jamadermatol.
2021.
5743.
Epub ahead of print.
PMID: 35107565; PMCID: PMC8811710.

[7] http:// https://