1. 1 門診案例討論 Spironolactone Treatment of Hair Loss Name : 林玉千 Date : 96. 07. 20

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3. 3 Hair Growth Cycle: 1. Growth （ anagen ） 2. involution （ catagen ） 3. rest （ telogen ） Alastair J. J. Wood, M.D.,The New England Journal of Medicine 1999;9;964

4. 4 Androgenetic alopecia: Higher levels of 5α-reductase. More androgen receptors. lower levels of cytochrome P-450 aromatase. Alastair J. J. Wood, M.D.,The New England Journal of Medicine 1999;9;964

5. 5 Androgenetic alopecia diagonosis: Based on visual inspection of the scalp. Birmingham. AL. Dermatol Clin 24 2006,137-138 Hair disease : scarring or follicuar plugging. Illnesses: hyperthyoidism, hypothyoidism Medication side effect: beta blocker, anticonvulsants, antidepressants, anticoagulants.

6. 6 Treatment in women: （ 1. ） minoxidil respect to the stimulation of hair growth. Alastair J. J. Wood, M.D.,The New England Journal of Medicine 1999;9;967-969 （ 2. ） Spironolactone weak compectitve inhibitor of the binding of androgen receptor and androgen production. inhibitor of type 5α-reductase enzyme. topical dose is 100 to 200 mg per day. Carlijn Hoedemaker, Sylvia van Egmond and Rodney Sinclairt Australasian Journal of Dermatology 48 2007,45

7. 7 Treatment in men: （ 1. ） finasteride inhibitor of type 5α-reductase. （ 2. ） minoxidil respect to the stimulation of hair growth. Alastair J. J. Wood, M.D.,The New England Journal of Medicine 1999;9;964-967

8. 8 Mechanism of Spironolactone :

9. 9 Finasteride is a specific inhibiter of 5α-reductase and approved for the treatment of androgenetic alopecia in men. Minoxidil is a nospecific drug in men, women, and children with various conditions. Spironolactone has been used to treat alopecia in females. Conclusions: