Male Pattern Hair Loss (AGA)
At Tamachi Ekimae Dermatology, Clinica Riviera Shibaura, we provide care for male pattern hair loss (AGA). If you have any of the following concerns, please consult us.
Your hairline has been receding
The scalp at the crown has become more visible
Your hair has become thinner
Hair loss has increased
You have family members with thinning hair
Because AGA is a progressive form of hair loss, early treatment is important.
*When booking, please select “Examination” → “AGA/FPHL hair loss.”
What Is Male Pattern Hair Loss?
AGA (Androgenetic Alopecia: male pattern hair loss) is a condition in which, under the influence of male hormones, the hair on the crown and front of the head gradually thins and hair loss progresses. It often develops after puberty, and although it progresses slowly, the amount of hair gradually decreases if left untreated. In recent years, the cause has been understood, and treatments using oral and topical medications are carried out to suppress progression and promote hair growth.
There are conditions other than male pattern hair loss that cause hair loss, such as alopecia areata and inflammatory hair loss due to eczema, folliculitis, fungal infection, and the like. If you are unsure whether you have AGA, we recommend first seeing a dermatology specialist.
Oral Treatment
Finasteride (Propecia®) / Dutasteride (Zagallo®)
Both are oral drugs called “5α-reductase inhibitors” that suppress the conversion of testosterone into dihydrotestosterone (DHT) and prevent the progression of hair loss.
Finasteride (Propecia®)
Inhibits type II 5α-reductase, which is abundant in the scalp. Its effect in suppressing the progression of AGA has been confirmed.
Dutasteride (Zagallo®)
Inhibits both type I and type II and is said to suppress the production of DHT efficiently.
Guide to effect: it generally takes about three to six months to feel the effect. Continuous use is recommended.
Main side effects: decreased libido, erectile dysfunction, breast discomfort or pain, liver dysfunction, and the like have been reported. Receive regular follow-up during use, and if there is any change in your condition, please consult the doctor.
Precautions: because a pregnant woman touching the drug may affect the fetus (a male child), do not crush or split the tablets. If you stop taking it, the condition tends to gradually return to its original state over a few months to a year.
Minoxidil
Originally developed as a drug for high blood pressure, this ingredient is known to promote blood flow to the hair follicles through its vasodilatory action and aid hair growth. At our clinic, under a doctor’s examination and with attention to safety, we prescribe 2.5 mg or 5 mg of minoxidil.
Guide to effect: many people feel an increase in fine hair and an improvement in hair thickness in three to six months, though this varies by individual. By combining it with finasteride or dutasteride, you can approach both suppressing hair loss and promoting hair growth, and a higher effect may be expected.
Main side effects: excess hair (increased facial and body hair), swelling, palpitations, headache, weight gain, low blood pressure, etc. Those with heart or kidney disease need to use it with caution. We carry out regular examinations and blood tests as needed.
About initial shedding
When you start minoxidil treatment, hair loss may temporarily increase; this is called initial shedding. It is thought to be a phenomenon that occurs as the hair cycle changes, when resting-phase hairs fall out and switch over to the growth of new hair. In most cases it occurs about two to eight weeks after starting treatment and then settles down over about a few weeks to two months. Do not stop treatment on your own judgment; if you are concerned, please consult the doctor.
Topical Treatment
Minoxidil
Topical minoxidil is a treatment that is applied directly to the scalp to act on the hair follicles and promote hair growth. It improves blood flow around the follicles and activates the hair matrix cells to promote hair growth.
Minoxi Top 10%
A topical drug containing 10% minoxidil. It is a higher concentration than common over-the-counter minoxidil products (5%) and is sometimes used as a treatment to promote hair growth. It is prescribed under a doctor’s examination.
Minoxi Top F 5%
In addition to 5% minoxidil, it is a topical drug that also contains finasteride. Against DHT, the cause of AGA,
Minoxidil: promotes hair growth
Finasteride: suppresses DHT
through these two actions, it approaches both suppressing the progression of hair loss and promoting hair growth. It is a topical option for those who are reluctant to take oral finasteride or who are worried about side effects. For those already using oral finasteride, a single-agent minoxidil topical is usually combined instead, and the treatment is chosen according to the patient’s condition.
*As with oral minoxidil, initial shedding may occur.
Ell-Cranell
Ell-Cranell is a topical drug that can be used by both men and women. Its active ingredient, alfatradiol, suppresses the conversion of testosterone into dihydrotestosterone (DHT) within the hair follicle, reducing the amount of DHT that causes hair loss. It is positioned not as a hair-growth promoter but as a “drug that prevents the progression of hair loss.” Alfatradiol is an isomer of the female hormone 17β-estradiol, but because it does not function in the body, it does not affect hormonal balance, making it an easy drug to use.
Examples of AGA Treatment Selection
Mild: oral finasteride + topical Ell-Cranell
Moderate: oral finasteride or dutasteride + oral or topical minoxidil
Advanced: oral dutasteride + oral minoxidil + topical minoxidil or topical Ell-Cranell
Treatment Process
STEP 1 Examination by a doctor
STEP 2 Blood test as needed
STEP 3 Selection of oral and topical medications
STEP 4 Regular follow-up (every 3–6 months)
Frequently Asked Questions
Q. How long does it take for AGA treatment to work?
Generally, many people feel a change in about three to six months.
Q. What happens if I stop treatment?
If you stop treatment, the condition may gradually return to its original state over a few months to about a year.
Please Note
AGA medications are not covered by insurance (self-pay).
Treatment effects vary by individual, and not everyone will obtain a hair-growth effect.
Disclosure Regarding Unapproved Drugs
Some of the AGA medications used at our clinic include drugs that are not approved in Japan. These are drugs imported for medical institutions from overseas pharmaceutical suppliers under the doctor’s judgment. Among the drugs approved domestically for AGA treatment are finasteride (Propecia®), dutasteride (Zagallo®), and topical minoxidil.
For Those Seeking AGA Treatment in Minato-ku / Tamachi
Tamachi Ekimae Dermatology, Clinica Riviera Shibaura is a dermatology, pediatric dermatology, aesthetic dermatology, and cosmetic internal medicine clinic in Shibaura, Minato-ku, close to Tamachi Station. If you are considering AGA treatment in the Minato-ku, Tamachi, or Mita area, please feel free to consult us.
*When booking, please select “Examination” → “AGA/FPHL hair loss.”