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- Presentation
Treatment of Hair Loss in Transgender Patients
Description
The presentation discusses the treatment of hair loss in transgender patients, highlighting the increasing number of individuals seeking treatment and the necessity for knowledgeable care. Trans men typically undergo testosterone therapy, which promotes male physical characteristics but can lead to hair loss in specific scalp regions, while stimulating hair growth in facial and body areas. Non-hormonal treatments such as minoxidil and low-level laser therapy are effective and safe. Hormonal treatments like 5A reductase inhibitors are controversial due to their potential to block desired masculine traits, and must be approached cautiously, ideally after two years of testosterone therapy. Trans women, conversely, use estrogen for feminization, which can have both stimulating and inhibiting effects on hair growth; thus, treatment varies greatly. They may require anti-androgens like spironolactone or bicalutamide as part of the regimen. First-line treatments for both groups include topical and oral minoxidil, while second-line options may entail hair transplant or PRP therapy. The presentation emphasizes the importance of collaboration with endocrinologists to optimize treatment and monitor health.
View moreConclusions
- Transgender patients require specific treatment protocols for hair loss due to hormonal changes.
- Testosterone is the primary hormone used for masculinization in trans men, promoting male-pattern hair growth and reducing female characteristics.
- Minoxidil and low-light laser therapy are effective non-hormonal treatments for androgenetic alopecia in both trans men and trans women.
- Hormonal treatments for trans men, including finasteride, can be complex due to the risk of blocking desired masculinizing effects from testosterone.
- It is recommended to wait at least two years on testosterone therapy before considering finasteride treatment for trans men to ensure desired effects are achieved.
- For trans women, estrogens are crucial for feminization and can influence hair growth both positively and negatively.
- Finasteride and spironolactone are commonly used antiandrogens for trans women to help manage hair loss and promote desired hair characteristics.
- Second-line treatments for hair loss in both trans men and women may include PRP therapy or hair transplant procedures.
- Am J Clin Dermatol. 2018;19(4):517-527. Gao Y, Maurer T, Paradi Mirmirani P. Understanding and Addressing Hair Disorders in Transgender Individuals
- Gao JL, Streed CG Jr, Thompson J, Dommasch ED, Peebles JK. Androgenetic alopecia in transgender and gender diverse populations: A review of therapeutics. J Am Acad Dermatol. 2021:S0190-9622(21)02574-3