Hair loss, medically known as alopecia, is a common problem that affects 40% of the population over 35 years old. This condition can be caused by various factors, including genetics, hormonal changes, and medical conditions. Fortunately, medical science has made great progress in developing treatments to combat hair loss, including the creation of anti-alopecia drugs such as minoxidil, finasteride, and dutasteride.
In this article, we will explore the relationship between genetics and the aforementioned anti-alopecia drugs. Understanding this connection allows for the personalized selection of the most suitable treatment to combat hair loss according to your genetic profile.
Anti-alopecic drug: Minoxidil
Minoxidil is one of the most popular and effective treatments available to combat hair loss and promote hair growth. Especially in people under 40 years of age whose hair loss is recent.
Minoxidil is a vasodilator (it helps to dilate blood vessels) that was originally developed as a treatment for hypertension. Although the exact mechanism by which minoxidil promotes hair growth is not fully understood, it is believed that its ability to improve blood circulation in the scalp helps stimulate inactive or weakened hair follicles.
In addition to improving blood circulation, it produces an increase in a hair growth-stimulating substance called prostaglandin E2, which induces hair follicles to prolong their growth phase ("anagen phase") and shorten their shedding phase ("telogen phase") – you can refer to the phases of hair growth in this article.
Minoxidil and genetics
The PTGES2 gene gives rise to an enzyme that synthesizes a substance called prostaglandin E2, which promotes hair growth. This enzyme exhibits individual variability due to a specific variant of the PTGES2 gene that modifies the enzyme's activity. Lower enzymatic activity shows a greater response to minoxidil, as it increases the need to elevate prostaglandin E2 levels.
Antialopecic drugs: Finasteride and Dutasteride
Dutasteride and finasteride are anti-alopecia drugs that act on an enzyme in our body called 5-alpha-reductase. This enzyme transforms testosterone into dihydrotestosterone (DHT), a compound that in high quantities causes hair thinning and the progressive reduction and miniaturization of hair follicles.
Both drugs belong to a class of medications called 5-alpha-reductase inhibitors, as they block the function of this enzyme and reduce DHT levels. By decreasing DHT production, these medications help prevent hair thinning, miniaturization of hair follicles, hair loss, and in some cases, promote the growth of new hair.
Dutasteride and finasteride: How do genetics play a role?
Before addressing the genetic aspect, it is important to mention that there are two types of the enzyme 5-alpha-reductase: type 1 and type 2. These enzymes are encoded by the genes SRD5A1 and SRD5A2, respectively.
Variants in the SRD5A1 and SRD5A2 genes influence how testosterone is converted into dihydrotestosterone (DHT). A high conversion of testosterone to DHT may indicate the need to use drugs that inhibit the action of these enzymes.
The choice of the appropriate drug depends on which gene has the variant, as the main difference between dutasteride and finasteride lies in the enzyme they inhibit. Dutasteride is an inhibitor of both 5-alpha-reductase enzymes, type 1 and type 2, while finasteride only inhibits the 5-alpha-reductase enzyme type 2.
Discover your genetic variants associated with these anti-alopecia drugs (minoxidil, dutasteride, and finasteride) with the genetic tests from ADNTRO.
