Hair Loss Treatment in Bangkok: AGA, Alopecia Areata, PRP and Medical Therapy

Hair loss is one of the most common reasons patients consult Siam Dermatology. At our Bangkok clinic, English-speaking board-certified dermatologists (Faculty, Institute of Dermatology) work through a systematic differential: pattern hair loss (Androgenetic Alopecia — AGA, classified by Norwood scale in men and Ludwig/Olsen scales in women), Alopecia Areata (autoimmune patchy or universalis), Telogen Effluvium (post-stress, thyroid, iron deficiency), scarring alopecias (lichen planopilaris, frontal fibrosing alopecia, CCCA), and traction alopecia. The right diagnosis dictates the right treatment.

Diagnostic Workup: trichoscopy + labs

Every patient receives a complete history (family pattern, medications, hormonal events, supplements), trichoscopy (dermoscopy of the scalp — yellow dots and exclamation hairs in AA; hair shaft miniaturization and peripilar signs in AGA; pinpoint white dots in CCCA), and pull test. Laboratory baseline: TSH, ferritin (target >70 ng/mL), 25-OH vitamin D, ANA, CBC; consider androgen panel if women have hirsutism or irregular menses (testosterone, DHEAS, SHBG, prolactin, 17-OH progesterone). Scalp biopsy 4mm punch for suspected scarring alopecia.

Androgenetic Alopecia: Minoxidil + Finasteride + Dutasteride

First-line for AGA in both sexes: topical Minoxidil 5% foam/solution BID (women may prefer once daily 5% foam to minimize hypertrichosis). For men: oral Finasteride 1 mg/day blocks Type II 5α-reductase — stabilizes 80-90% and regrows 30-50% by 12 months. For more aggressive or refractory cases: oral Dutasteride 0.5 mg/day (blocks Type I + II 5α-reductase, more potent). Female pattern hair loss: spironolactone 50-200 mg/day with contraception, low-dose oral minoxidil 0.625-2.5 mg/day (off-label, monitor BP). Sexual side effects with finasteride are 2-3% and typically reversible on discontinuation.

PRP, JAK inhibitors, Hair Transplant Referral

Platelet-Rich Plasma (PRP): 3 monthly sessions, then quarterly maintenance — delivers growth factors (PDGF, VEGF, IGF-1) to follicles. Meta-analysis shows ~30% increase in hair density at 6 months when used adjunctively with minoxidil/finasteride. Alopecia Areata: severe extensive cases (SALT >50%) qualify for oral JAK inhibitors — Baricitinib (FDA-approved 2022, 2-4 mg/day) and Ritlecitinib (FDA-approved 2023, 50 mg/day); screen for TB, HBV, HCV, lipid profile baseline. Refractory AGA with stable donor: refer to qualified surgeon for FUE/FUT hair transplant after medical stabilization for 6-12 months.

Q: How long until I see results? — Minoxidil 3-6 months (initial shedding is normal at 4-8 weeks). Finasteride 6-12 months. PRP 3-4 months. AA with JAK inhibitor 3-6 months. Q: Does Finasteride affect fertility? — Studies show mild reversible decrease in semen parameters — we recommend stopping before conception attempts. Q: Will I lose hair if I stop treatment? — Yes for AGA. Treatment is lifelong. Stopping leads to gradual return to baseline genetic loss over 6-12 months. Q: Do you offer hair transplant? — We do not perform transplants on-site but coordinate medical optimization and refer to vetted surgeons in Bangkok with whom we collaborate post-op.

📞 Book at Siam Dermatology — LINE @dr.patskinclinic | Call +66 61 448 7000