AGA/FAGA Treatment Medications

AGA/FAGA Treatment Medications

AGA (Androgenetic Alopecia) is characterized by hair loss occurring mainly at the frontal hairline and around the crown at the top of the head, with thinning hair progressing gradually over time.

Once AGA develops, the progression of thinning hair cannot be stopped naturally, so starting treatment at an early stage is recommended, and finasteride, dutasteride and minoxidil can be expected to be effective.

FAGA (Female Androgenetic Alopecia) refers to “hair loss that occurs when female hormones decrease and male hormones become dominant”, and it is said to be a cause of thinning hair and hair loss in women that has been attracting attention in recent years. Spironolactone and minoxidil can be expected to be effective.

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Note that the prices indicated in this page are all inclusive of tax.

For those living far away, we offer telephone consultations and a delivery service.

About AGA

Causes of AGA

AGA develops when the bad male hormone “DHT (dihydrotestosterone)” binds to male hormone receptors in the scalp.

When bad male hormone (DHT) binds to male hormone receptors, the division of hair matrix cells in the frontal and crown areas is suppressed, shortening the growth phase of the hair cycle.

As a result, hair enters the regression phase before it has grown sufficiently, leading to thinning hair and hair loss.

AGA Treatment

Treating AGA requires suppressing the bad male hormone (DHT).

DHT is known to be produced when testosterone (male hormone) is converted by an enzyme called 5-alpha reductase, so suppressing DHT means undergoing treatment (oral medication and topical medication) that inhibits this enzyme (5-alpha reductase).

Finasteride and dutasteride act on 5-alpha reductase, returning the hair cycle to a normal state and creating an environment in which hair can grow thick and long.

Minoxidil supports the production of substances such as insulin-like growth factor 1 (IGF-1) and vascular endothelial growth factor (VEGF), which promote cell growth and development and the formation of new capillaries. This activates hair matrix cells and can be expected to be effective for hair growth and regrowth.

For AGA treatment we offer 4 medications: finasteride, dutasteride, minoxidil in oral form and minoxidil in topical form (all treatment medications are prescribed as self-pay care).

Finasteride

Effects: Returns the hair cycle to a normal state so that hair can grow thick and long.

Side effects: Initial shedding, decreased libido, erectile dysfunction (ED)

Dosage and administration: 1 tablet once a day

Dutasteride

Effects: Its pharmacological action on 5-alpha reductase (type II) and its hair-increasing effect are said to be 3 times those of finasteride.

Side effects: Initial shedding, decreased libido, erectile dysfunction (ED)

Dosage and administration: 1 tablet once a day

Minoxidil (oral)

Product: Minoxidil 5mg (MINOXIHEART)

Effects: Promotes the division of hair matrix cells that produce hair and promotes blood flow to the scalp to deliver nutrients to hair matrix cells, making hair easier to grow.

Side effects: Initial shedding, initial shedding, scalp rash, skin symptoms (redness, itching, irritation), excessive hair growth, lowered blood pressure

Dosage and administration: 1 tablet each time

Minoxidil (topical)

Product: Minoxidil topical solution 5% (Fuji Chemical Industry, Class 1 pharmaceutical)

Effects: Promotes the division of hair matrix cells that produce hair and promotes blood flow to the scalp to deliver nutrients to hair matrix cells, making hair easier to grow.

Side effects: Initial shedding, scalp rash, skin symptoms (redness, itching, irritation)

Dosage and administration: Apply 1ml twice a day to areas with thinning hair

Transgender Men and AGA

We are receiving an increasing number of questions about AGA from people taking male hormones (particularly trans men).

Taking male hormones can cause hair reduction, among other effects.

In particular, WPATH (World Professional Association for Transgender Health) also recognizes that AGA medications are effective against hair reduction caused by male hormone administration.

At our Gender Affirmation, we can comprehensively adjust male hormone dosage and provide AGA prevention and treatment.

About FAGA

Female Pattern Hair Loss and FAGA

Female pattern hair loss is a general term referring to all hair loss conditions that occur in women.

Female pattern hair loss includes FAGA (Female Androgenetic Alopecia), alopecia areata, traction alopecia, postpartum alopecia and hair loss caused by scalp problems, each of which is treated differently.

Female pattern hair loss refers to hair loss in women as a whole, while FAGA refers specifically to “hair loss that occurs when female hormones decrease and male hormones become dominant” within female pattern hair loss, and minoxidil and spironolactone can be expected to be effective.

Female pattern hair loss is classified into 4 representative types, of which the most common is FAGA (Female Androgenetic Alopecia).

Female Androgenetic Alopecia (FAGA)

It is well known that AGA (androgenetic alopecia) occurs in men, but in fact it is also known to occur in women.

Women also have a small amount of male hormone, and estrogen, a female hormone, is known to prevent thinning hair.

However, when female hormones decrease for some reason, male hormones become relatively more abundant, and the resulting thinning hair is called FAGA.

Female hormones decrease due to aging, stress, worsening lifestyle habits and other reasons, but since a certain amount continues to be secreted, it is rare for all the hair to fall out, and hair loss has the following characteristics.


Characteristics of FAGA Hair Loss

– Hair thins overall rather than in patches

– Hair becomes finer

– Thinning hair is noticeable at the crown

Alopecia areata

A condition in which hair falls out in circular patches at one or several places on the head; in severe cases it can extend to the entire scalp and to the whole body, including the eyebrows and eyelashes.

It is said to develop when physical or mental stress causes an abnormality in autoimmune function, and cells called T lymphocytes mistake hair roots for foreign bodies and attack them.

Treatment: “local steroid injection therapy”, “topical immunotherapy”, “topical steroid therapy” and “wigs” are recommended.

Traction alopecia

A condition in which hair falls out due to traction (pulling on the hair).

It occurs when the same area of hair or scalp is constantly burdened over a long period, such as tying hair tightly in a ponytail and placing a burden on the hair roots over a long period.

Treatment: Review of hairstyle and lifestyle habits.

Postpartum alopecia

Hair loss that occurs after childbirth.

Hormone balance fluctuates after childbirth, causing hair in the growth phase of the hair cycle to shift all at once into the resting phase, which sharply increases hair loss.

Estrogen, a female hormone, extends the growth phase of the hair cycle and temporarily suppresses hair loss, so when estrogen levels rise during pregnancy, the growth phase of hair that would normally have fallen out is extended and hair loss decreases.

However, after childbirth the increased estrogen in the body returns to its original level, so hair loss that was temporarily halted during pregnancy begins abruptly after childbirth, and as a result hair becomes thinner.

Treatment: Since the hair cycle returns to its original state over about half a year to 1 year after childbirth, we first monitor the course and carry out additional testing as appropriate for the symptoms.

FAGA Treatment

As with AGA treatment, treating FAGA requires suppressing the bad male hormone (DHT), but finasteride and dutasteride cannot be used in cis women.

For this reason, for FAGA we use the anti-androgen action of a medication called spironolactone to prevent DHT (dihydrotestosterone) from binding to male hormone receptors, returning the hair cycle to a normal state and creating an environment in which hair can grow thick and long.

Minoxidil can also be used in cis women, but for topical treatment in particular, unlike the product for men, using a 1% minoxidil topical medication makes it possible to treat while avoiding side effects such as skin disorders as much as possible.

For FAGA treatment we offer 3 medications: spironolactone, minoxidil in oral form and minoxidil in topical form (all treatment medications are prescribed as self-pay care).

Spironolactone

Features: It is used not only for thinning hair in women but also for treating acne and excessive hair growth. Gradually increasing the oral dose allows treatment to proceed at a comfortable pace. Through its anti-androgen action, it prevents DHT (dihydrotestosterone), the cause of AGA/FAGA, from binding to male hormone receptors in the scalp.

Side effects: Electrolyte abnormalities (especially hyperkalemia), impaired kidney function, low blood pressure, frequent urination, irregular menstruation, abnormal bleeding, breast pain, etc.

We check for electrolyte abnormalities, impaired kidney function and other issues through regular blood tests, taking steps to ensure the medication can be used safely.


Dosage and administration: Depends on the degree of FAGA progression (it is common to start at around 50mg)

Minoxidil (oral)

Product: Minoxidil 5mg (MINOXIHEART)

Effects: Promotes the division of hair matrix cells that produce hair and promotes blood flow to the scalp to deliver nutrients to hair matrix cells, making hair easier to grow.

Side effects: Initial shedding, initial shedding, scalp rash, skin symptoms (redness, itching, irritation), excessive hair growth, lowered blood pressure

Dosage and administration: Half a tablet to 1 tablet each time

Minoxidil for Women (topical)

Product: Minoxidil topical solution 1% (Fuji Chemical Industry, Class 1 pharmaceutical)

Features: Thinning hair and hair loss in women is said to be caused by age, stress, lifestyle habits and other factors. Minoxidil for women is specialized for women and is effective for hair growth, for preventing the progression of hair loss and for hair loss in middle age.

Effects: Promotes the division of hair matrix cells that produce hair and promotes blood flow to the scalp to deliver nutrients to hair matrix cells, making hair easier to grow.

Side effects: Initial shedding, scalp rash, skin symptoms (redness, itching, irritation)

Dosage and administration: Apply 1ml twice a day to areas with thinning hair

Prices

The prices of our AGA/FAGA treatment medications are as follows.

All are prescribed as self-pay care.

Prices of AGA Treatment Medications

Finasteride and dutasteride are described as medications that “prevent hair loss and strengthen hair”, while minoxidil is described as a medication that “grows hair”.

When using minoxidil, if it is not used together with finasteride or dutasteride, hair loss will increase while the hair growth cycle remains un-normalized.

Using a package can be expected to produce a synergistic effect, promoting hair growth as well as preventing hair loss.

Single item / package Medication name / form Category Quantity Price (JPY)
Single item Finasteride
(oral)
Domestic 1 month
3 months
6 months
12 months
4,000
10,500
18,000
34,500
Dutasteride
(oral)
Domestic 1 month
3 months
6 months
12 months
5,000
13,500
24,000
45,000
Minoxidil tablets
(oral: 5mg)
Imported 1 month
3 months
6 months
12 months
4,000
10,500
18,000
33,000
Minoxidil topical medication
(topical: 5%)
Domestic 1 month
3 months
6 months
12 months
5,000
13,500
24,000
45,000
Finasteride
package
(oral)
Finasteride
(oral)
Imported
(combination)
1 month
3 months
6 months
12 months
6,000
16,000
27,000
50,000
Minoxidil
(oral: 5mg)
Finasteride
package
(topical)
Finasteride
(topical)
Imported
(combination)
1 month
3 months
6 months
12 months
7,000
19,000
33,000
60,000
Minoxidil
(topical: 5%)
Finasteride
package
(topical + oral)
Finasteride
(topical)
Imported
(combination)
1 month
3 months
6 months
12 months
10,000
27,000
48,000
90,000
Minoxidil
(topical: 5%)
Minoxidil
(oral: 5mg)
Imported
Dutasteride
package
(oral)
Dutasteride
(oral)
Imported
(combination)
1 month
3 months
6 months
12 months
7,000
19,000
33,000
60,000
Minoxidil
(oral: 5mg)
Dutasteride
package
(topical)
Dutasteride
(oral)
Domestic 1 month
3 months
6 months
12 months
9,000
25,500
46,000
85,000
Minoxidil
(topical: 5%)
Dutasteride
package
(topical + oral)
Dutasteride
(oral)
Imported
(combination)
1 month
3 months
6 months
12 months
11,000
30,000
54,000
100,000
Minoxidil
(oral: 5mg)
Minoxidil
(topical: 5%)
Domestic

Prices of FAGA Treatment Medications

Medication name / form Category Quantity Price (JPY)
Spironolactone
(oral)
Domestic 50mg
100mg
150mg
200mg
2,500/month
5,000/month
7,500/month
10,000/month
Minoxidil tablets
(oral: 5mg)
Imported 1 month
3 months
6 months
12 months
4,000
10,500
18,000
33,000
Minoxidil topical solution
(topical: 1%)
Domestic 1 month
3 months
6 months
12 months
4,500
12,000
22,000
42,000

Consultation Flow

The consultation flow for prescribing AGA/FAGA treatment medications at our clinic is as follows.

step1

Doctor's Medical Interview and Consultation

After consulting with the doctor, we consider which medication suits you.

step2

Prescription and Payment

We hand over the AGA/FAGA treatment medication at the reception desk. A consultation fee applies for the first visit, but from the second time onward medication can be prescribed without a consultation (and no consultation fee is required).

We also provide testing and treatment for STIs, vaccine administration of various types (including for those traveling overseas) and consultations regarding gender. For details, please see the page below.