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viernes, 24 de octubre de 2025

THE SEBORRHEIC DERMATITIS, A REVIEW. / LA DERMATITIS SEBORREICA, REVISION


LA DERMATITIS SEBORREICA Y SUS ALTERNATIVAS TERAPÉUTICAS, ACTUALIZACIÓN.

  

THE SEBORRHEIC DERMATITIS AND THERAPEUTIC ALTERNATIVES, A REVIEW.

 


DERMATITIS SEBORREICA MEJILLAS

  

Dermatitis seborreica

PUBLICADO 2017 ACTUALIZADO 2025



 

EDITORIAL ESPAÑOL
===================
Hola amigos de la red, DERMAGIC EXPRESS de nuevo, hoy con el interesante tema: LA DERMATITIS SEBORREICA, una enfermedad no tan severa pero muy frecuente hoy en dia en la población, tanto niños como adultos, hombres y mujeres.
 
 
1.) HISTORIA:
 
La dermatitis seborreica fue descrita por primera vez en 1732 por Paul Gerson Unna,  medico Alemán, uno de los pioneros en dermatología. 
 
En 1873 el medico Italiano Giuseppe Rivalta sugirió un posible origen micótico de la DERMATITIS SEBORREICA.
 
En 1874 Louis-Charles Malassez medico oriundo de Francia, relacionó la presencia de levaduras llamadas Malassezia con la dermatitis seborreica, al identificar unas estructuras fungicas en el cuero cabelludo las cuales denomino "champignon de la pelade" ("hongo de la calvicie"), y las relaciono con la pitiriasis capitis (una afección ligada a la dermatitis seborreica). 
 
Su contribución fue importante y diriase clave al descubrir la presencia de estas levaduras en la piel, y su probable papel en algunas enfermedades dermatológicas. debido a este hecho, el género de estas levaduras fue nombrado "Malassezia" en su honor,
 
En 1952 Riccardo Galeazzi Leone medico italiano tambien,  encontró la asociación entre Pityrosporum ovale (hoy Malassezia furfur) y esta enfermedad.
 
Con respecto al hongo MALASSEZIA FURFUR, esta fue descubierta en 1846 por el médico ginecólogo y dermatólogo alemán Karl Ferdinand Eichstedt, relacionada con LA PITIRIASIS VERSICOLOR, también patología cutánea; y posteriormente también se le relaciono con la DERMATITIS SEBORREICA, como lo acabamos de mencionar.

2.) SÍNTOMAS CLÍNICOS:

La enfermedad afecta principalmente la cara, el cuero cabelludo, y también tórax anterior y posterior menos frecuentemente. 
 
Caracterizada por ser placas eritematosas y descamativas con prurito, es de evolución crónica y representa un verdadero reto su tratamiento, debido al hecho de que es frecuente su recaída, aun con las mejores opciones de tratamiento

Las areas mas afectadas del organismo son las llamadas "zonas seborréicas" que son las áreas del cuerpo con mayor concentración de glándulas sebáceas y donde suele aparecer la dermatitis seborréica, incluyen:

A - Cuero cabelludo: la línea de implantación del cabello, llamada corona seborréica, pero todo el cuero cabelludo puede estar afectado.

B - Región facial media:  cejas, surcos nasogenianos, alas de la nariz.
 
C - Región del pecho medio y zona interescapular de la espalda: entre  omóplatos.
 
D - Detrás de las orejas y conductos auditivos externos.
 
E - Pliegues axilares, submamarios e inguinales: no tan frecuente.

F   - Área periglútea: pliegue interg
lúteo.

G - Párpados y borde palpebral:  a veces afectando las pestañas, conocida con el nombre de BLEFARITIS SEBORREICA.

Estas zonas se caracterizan por presentar piel grasa, o con secreción sebácea abundante, lo cual favorece el desarrollo de la enfermedad.

En el cuero cabelludo la descamación producida por la DERMATITIS SEBORREICA es conocida con el nombre vulgar de "CASPA", quizá una de las causas mas frecuentes de la consulta dermatologica.


DERMATITIS SEBORREICA DE LA CARA

 

Dermatitis seborreica de la cara


3.) EVOLUCIÓN:

El Curso de la DERMATITIS SEBORREICA es crónico y recurrente, con períodos de remisión y exacerbación. 
 
Puede comenzar desde la infancia, y el rango mas comun esta en adultos jóvenes y mayores. 
 
Los brotes empeoran con estrés, clima frío o muy calurosoy enfermedades subyacentes (p. ej. VIH, Parkinson). En raros casos, en algunos pacientes puede generalizarse, pero suele limitarse a zonas seborreicas ya descritas.

4.)  TRATAMIENTOS:
 
A.- Decada de los años 50-60: comenzaron a utilizarce los corticosteroides topicos para disminuir la inflamacion Uso de corticosteroides tópicos, de baja potencia (HIDROCORTISONA) , la SULFACETAMIDA, y el AZUFRE, para disminuir la el prurito, eritema e inflamación, aun vigentes hoy dia.
 
B.- En la decada de los años 70-80: se introdujeron FORMALMENTE el uso de antimicoticos como KETOCONAZOL, FLUCONAZOL, BIFONAZOL, ITRACONAZOL, SERTACONAZOL, MICONAZOL, TREBINAFINA y CICLOPIROXOLAMINA, para controlar la levadura MALASSEZIA, algo tardio, pues la relacion de este hongo con la dermatitis seborreica se establecio practicamente en los años 50.
 
- En los eños 80 (1985), se introdujo ESPECIFICAMENTE el ITRACONAZOLE.
- En los alos 90 se comenzo a usar el METRONIDAZOLE en gel topico. 
 
C.- Decada de los años 90 - 2000: se introduce  el uso adicionalde queratoliticos y alquitranes (aceite de cade, urea) para mejorar la descamacion y producir la regeneracion cutanea.
 
- En los años 2000 aparecen el TACROLIMUS y PIMECROLIMUS, como alternativas terapeuticas. 
 
D.- Decadas de los años 2000 -2025: Se introduce la combinacion de los anteriores: antimicoticos topicos, con cosrtoesteroides de baja potencia, y formulas magistrales con bioasufre fluido, ciclopiroxolamina, y otros componentes,  preparadas en champu y cremas para uso topico.
 


DERMATITIS SEBORREICA SEVERA DEL CUERO CABELLUDO

 

Dermatitis seborreica cuero cabelludo

 
 
Hoy dia 2.025 les presento en esta revisión las MEJORES ALTERNATIVAS TERAPÉUTICAS que han sido descritas en el tratamiento de esta enfermedad: 

1.) CORTICOSTEROIDES TOPICOS:  CLOBETASOL,  DEXAMETASONA, MOMETASONA.
2.) UREA.
3.) ÁCIDO SALICÍLICO.
4.) PROPILENGLICOL.
5.) PIRITIONATO DE ZINC.
6.) BIOTINA.
7.) KETOCONAZOL.
8.) FLUCONAZOL.
9.) SERTACONAZOL.
10.) ITRACONAZOL.
11.) DITRANOL.
12.) SUCCINADO DE LITIO.
13.) VITAMINA-COMPLEJO B.
14.) PEROXIDO DE BENZOILO.
15.) SULFURO DE SELENIO.
16.) SULFACETAMIDA.
17.) TACROLIMUS y 18.) PIMECROLIMUS  (Hoy día 2025 estos medicamentos tienen una advertencia severa por la FDA tipo "BLACK BOX" o "CAJA NEGRA", en sus enpaques acerca de que el prolongado puede inducir malignidad)
18.) PIMECROLIMUS.
19.) METRONIDAZOL.
20.) TERBINAFINA.
21.) ALQUITRAN DE PINO.
22.) ALQUITRAN DE HULLA.
23.) GLICERINA.
24.) TACALCITOL.
25.) FOTOTERAPIA y FOTOQUIMIOTERAPIA
26.) AZUFRE.
27.) BIFONAZOL.
28.) CICLOPIROXOLAMINA.
29.) L - DOPA.
 
30.) SULFATO o GLUCONATO DE ZINC.

Probablemente existan  otras mas, de modo que el tratamiento de la DERMATITIS SEBORREICA hoy dia, constituye un RETO para todo dermatólogo, pues el indice de RECAÍDAS o BROTES es muy FRECUENTE.

5.) NUEVOS TRATAMIENTOS:

- ROFLUMILAST: es un inhibidor de la fosfodiesterasa-4 (PDE4) cuyo mecanismo de accion es reducir la inflamación cutánea. 
 
- Se trata de una espuma tópica  al 0,3% la cual fue aprobada el 16 de diciembre de 2023 por la FDA para el tratamiento de la DERMATITIS SEBORREICA, en adultos y niños mayores de 9 años de edad.
 
- Es el primer medicamento aprobado en más de dos décadas, quiere decir esto desde los años 80, para tratar esta patología; su principal efecto: controlar el enrojecimiento y la y la inflamación cutaea.

De resto se siguen utilizando las ya conocidas, cremas y champu comerciales, quedando como GRANDES opciones LAS FORMULACIONES MAGISTRALES para estos casos, como champús preparados a base de azufre, ácido salicílico y lociones capilares también preparadas, INTERCALADAS con productos ya conocidos.

La dermatitis seborreica en muchos casos es recalcitrante, difícil de tratar pues recaen mucho los pacientes una vez presentan mejoría, el exceso de grasa en la cara y el estrés son GRANDES factores desencadenantes y de recaídas.

Saludos a todos. 

Dr. José Lapenta.
Dr.  José M. Lapenta.
 
 
 
  
EDITORIAL ENGLISH
===================
Hello friends of the network, DERMAGIC EXPRESS is back again, today with the interesting topic: SEBORRHEIC DERMATITIS, a disease that is not very severe but very common nowadays in the population, affecting both children and adults, men and women.

1.) HISTORY:


SEBORRHEIC DERMATITIS was first described in 1732 by Paul Gerson Unna, a German physician and one of the pioneers in dermatology.

In 1873, the Italian physician Giuseppe Rivalta suggested a possible fungal origin for SEBORRHEIC DERMATITIS.

In 1874, Louis-Charles Malassez, a physician from France, linked the presence of yeasts called Malassezia to seborrheic dermatitis. He identified fungal structures on the scalp, which he called "champignon de la pelade" ("baldness fungus"), and associated them with pityriasis capitis (a condition linked to seborrheic dermatitis).

His contribution was significant and arguably key in discovering the presence of these yeasts on the skin and their probable role in some dermatological diseases. Because of this, the genus of these yeasts was named "Malassezia" in his honor.

In 1952, Riccardo Galeazzi Leone, also an Italian physician, discovered the association between PITYROSPORUM OVALE (now MALASSEZIA FURFUR) and this disease.

Regarding the fungus MALASSEZIA FURFUR, it was discovered in 1846 by the German gynecologist and dermatologist Karl Ferdinand Eichstedt, and was associated with PITYRIASIS VERSICOLOR, also a skin condition; and later it was also linked to SEBORRHEIC DERMATITIS, as we just mentioned.

2.) CLINICAL SYMPTOMS:

The disease primarily affects the face and scalp, and less frequently the anterior and posterior chest.

Characterized by itchy, scaly, erythematous plaques, seborrheic dermatitis is a chronic condition that presents a significant treatment challenge due to its frequent relapse, even with the best treatment options.

The most affected areas of the body are the so-called "seborrheic zones," which are areas with the highest concentration of sebaceous glands and where seborrheic dermatitis typically appears. These include:

A - Scalp: the hairline, called the seborrheic corona, but the entire scalp can be affected.

B - Midface: eyebrows, nasolabial folds, and sides of the nose.

C - Mid-chest and interscapular region of the back: between the shoulder blades.

D - Behind the ears and external auditory canals.

E - Axillary, inframammary, and inguinal folds: less common.

F - Perigluteal area: intergluteal fold.

G - Eyelids and eyelid margins: sometimes affecting the eyelashes, known as SEBORRHEIC BLEPHARITIS.

These areas are characterized by oily skin, or abundant sebum secretion, which favors the development of the disease.

On the scalp, the flaking caused by SEBORRHEIC DERMATITIS is commonly known as "DANDRUFF", perhaps one of the most frequent reasons for dermatological consultations.
 
3.) EVOLUTION:

The course of seborrheic dermatitis is chronic and recurrent, with periods of remission and exacerbation.

It can begin in childhood, and it is most common in young adults and older adults.

Outbreaks worsen with stress, cold or very hot weather, and underlying diseases (e.g., HIV, Parkinson's). In rare cases, it can become generalized in some patients, but it is usually limited to the seborrheic areas already described.

4.) TREATMENTS:

A.- 1950s-1960s: Topical corticosteroids began to be used to reduce inflammation. The use of low-potency topical corticosteroids (hydrocortisone), sulfacetamide, and sulfur to reduce itching, erythema, and inflammation is still current.

B. In the 1970s and 80s: the use of antifungals such as KETOCONAZOLE, FLUCONAZOLE, BIFONAZOLE, ITRACONAZOLE, SERTACONAZOLE, MICONAZOLE, TERBINAFINE and CYCLOPRIROXOLAMINE was FORMALLY introduced to control the MALASSEZIA yeast. This was somewhat late, as the relationship between this fungus and seborrheic dermatitis was practically established in the 1950s.

- In the 1980s (1985), ITRACONAZOLE was specifically introduced.

- In the 1990s, METRONIDAZOLE began to be used in topical gel form.

C.- From the 1990s to 2000: the additional use of keratolytic agents and tars (cade oil, urea) was introduced to improve scaling and promote skin regeneration.

- In the 2000s, TACROLIMUS  and PIMECROLIMUS emerged as therapeutic alternatives.

D.- 2000-2025: Combinations of the above were introduced: topical antifungals with low-potency corticosteroids, and MAGISTRAL FORMULATIONS with fluid biosulfur, ciclopiroxolamine, and other components, prepared as shampoos and creams for topical use. 


soborrheic dermatitis of the scalp
 
 
Today, in 2025, I present in this review the BEST THERAPEUTIC ALTERNATIVES that have been described in the treatment of this disease:
 
1.) TOPICAL CORTICOSTEROIDS: CLOBETASOL, DEXAMETASONE, MOMETASONE.
2.) UREA.
3.) SALIYLIC ACID.
4.) PROPYLENE-GLYCOL.
5.) PYRITHIONE ZINC.
6.) BIOTIN.
7.) KETOCONAZOLE.
8.) FLUCONAZOLE.
9.) SERTACONAZOLE.
10.) ITRACONAZOLE.
11.) DITHRANOL.
12.) LITHIUM SUCCINATE.
13.) VITAMIN-COMPLEX B.
14.) BENZOYL PEROXIDE.
15.) SELENIUM SULFIDE.
16.) SULFACETAMIDE.
17.) TACROLIMUS. 18.) PIMECROLIMUS, (Today 2023 these drugs TACROLIMUS AND PIMECROLIMUS have a severe warning from the FDA that their prolonged use can induce cancer)
18.) PIMECROLIMUS.
19.) METRONIDAZOLE.
20.) TERBINAFINE.
21.) PINE TAR.
22.) COALTAR.
23.) GLYCERINE.
24.) TACALCITOL.
25.) PHOTOTHERAPY.
26.) SULFUR.
27.) BIFONAZOLE.
28.) CYCLOPYROXOLAMINE.
29.) L-DOPA.
30.)  ZINC SULFATE OR ZINC GLUCONATE.
 
 
 
Seborrheic dermatitis of the face


There are probably other causes as well, so treating seborrheic dermatitis today presents a challenge for every dermatologist, as the rate of relapses or flare-ups is very frequent.

5.) NEW TREATMENTS:

- ROFLUMILAST: is a phosphodiesterase-4 (PDE4) inhibitor whose mechanism of action is to reduce skin inflammation.

- It is a 0.3% topical foam which was approved on December 16, 2023, by the FDA for the treatment of seborrheic dermatitis in adults and children over 9 years of age.

- It is the first medication approved in more than two decades, meaning since the 1980s, to treat this condition; its main effect is to control redness and skin inflammation.

Otherwise, the well-known commercial creams and shampoos continue to be used, with MAGISTRAL FORMULATIONS remaining excellent options for these cases, such as shampoos prepared with sulfur, salicylic acid, and hair lotions, interspersed with other commonly used products.

Seborrheic dermatitis is often recalcitrant and difficult to treat, as many patients relapse after showing improvement. Excess oil on the face and stress are major triggers and causes of relapse.

Greetings to all.

Dr. Jose Lapenta.
Dr. Jose M. Lapenta.


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REFRENCIAS BIBLIOGRÁFICAS / BIBLIOGRAPHICAL REFERENCES
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1.) Topical metronidazole in seborrheic dermatitis - a double-blind study.
2.) Treatment of seborrheic dermatitis: comparison of sertaconazole 2 % cream versus pimecrolimus 1 % cream.
3.) Single-blind, randomized controlled trial evaluating the treatment of facial seborrheic dermatitis with hydrocortisone 1% ointment compared with tacrolimus 0.1% ointment in adults.
4.) New strategies in dandruff treatment: growth control of Malassezia ovalis.
5.) Narrow-band ultraviolet B (ATL-01) phototherapy is an effective and safe treatment option for patients with severe seborrhoeic dermatitis.
6.) Four cases of sebopsoriasis or seborrheic dermatitis of the face and scalp successfully treated with 1a-24 (R)-dihydroxycholecalciferol (tacalcitol) cream.
7.) High prevalence of seborrhoeic dermatitis on the face and scalp in mountain guides.
8.) The antifungal action of dandruff shampoos.
9.) Treatment of scalp seborrheic dermatitis and psoriasis with an ointment of 40% urea and 1% bifonazole.
10.) [Effect of anti-seborrhea substances against Pityrosporum ovale in vitro].
11.) Facial seborrheic dermatitis treated with fluconazole 2% shampoo.
12.) Pityrosporum ovale and skin diseases.
13.)[Therapy of seborrheic eczema with an antifungal agent with an antiphlogistic effect].
14.) [A case of seborrhoeic blepharitis].
15.) Treatment of sebopsoriasis with itraconazole.
16.) Treatment of seborrheic dermatitis.
17.) Pityrosporum ovale (Malassezia furfur) as the causative agent of seborrhoeic dermatitis: new treatment options.
18.) Relation Between Skin Temperature and Location of Facial Lesions in Seborrheic Dermatitis
19.) Insulin Quantification in Patients With Seborrheic Dermatitis
20.) Humoral immunity to Malassezia furfur serovars A, B and C in patients with pityriasis versicolor, seborrheic dermatitis and controls.
21.) Management of common superficial fungal infections in patients with AIDS.
22.) Pityrosporum infections.
23.) Seborrheic dermatitis as a revealing feature of HIV infection in Bamako, Mali [letter]
24.) Cell-mediated immune responses to Malassezia furfur serovars A, B and C in patients with pityriasis versicolor, seborrheic dermatitis and controls.
25.) The efficacy of 1% metronidazole gel in facial seborrheic dermatitis: a double blind study.
26.) A double blind study of the effectiveness of sertaconazole 2% cream vs. metronidazole 1% gel in the treatment of seborrheic dermatitis.
27.) Pimecrolimus 1% cream, methylprednisolone aceponate 0.1% cream and metronidazole 0.75% gel in the treatment of seborrhoeic dermatitis: a randomized clinical study.
28.) Treatment with bifonazole shampoo for seborrhea and seborrheic dermatitis: a randomized, double-blind study.
29.) Quantitative skin cultures of Pityrosporum yeasts in patients seropositive for the human immunodeficiency virus with and without seborrheic dermatitis.
30.) A double-blind, placebo-controlled, multicenter trial of lithium succinate ointment in the treatment of seborrheic dermatitis. Efalith Multicenter Trial Group.
31.) Ketoconazole 2% emulsion in the treatment of seborrheic dermatitis.
32.) Seborrheic dermatitis in acquired immunodeficiency syndrome.
33.) Blood levels of vitamin E, polyunsaturated fatty acids of phospholipids, lipoperoxides and glutathione peroxidase in patients affected with seborrheic dermatitis.
34.) Skin surface lipids in HIV sero-positive and HIV sero-negative patients affected with seborrheic dermatitis.
35.) Seborrheic dermatitis and daylight [see comments]
36.) [Seborrheic dermatitis and cancer of the upper
respiratory and digestive tracts]
37.) The role of Pityrosporum ovale in seborrheic dermatitis.
38.) Correlation of Pityosporum ovale density with clinical severity of seborrheic dermatitis as assessed by a simplified technique.
39.) Immune reactions to Pityrosporum ovale in adult
patients with atopic and seborrheic dermatitis.
40.) [Treatment of seborrheic dermatitis with benzoyl peroxide]
41.)[The significance of yeasts in seborrheic eczema]
42.) Association of Pityrosporum orbiculare (Malassezia furfur) with seborrheic dermatitis in patients with acquired immunodeficiency syndrome (AIDS).
43.) Pityrosporum ovale in infantile seborrheic dermatitis.
44.)Infantile seborrheic dermatitis: seven-year follow-up and some prognostic criteria.
45.) Ketoconazole 2% cream versus hydrocortisone 1% cream in the treatment of seborrheic dermatitis. A double-blind comparative study.
46.) T-cell subset assay. A useful differentiating marker of atopic and seborrheic eczema in infancy?
47.) Propylene glycol in the treatment of seborrheic dermatitis of the scalp: a double-blind study.
48.) Seborrheic dermatitis and malignancy. An investigation of the skin flora.
49.) Efficacy of topical application of glucocorticosteroids compared with eosin in infants with seborrheic dermatitis.
50.) Erythema with features of seborrheic dermatitis and lupus erythematosus associated with systemic 5-fluorouracil.
51.)[Treatment of seborrheic dermatitis with low-dosage dithranol]
52.) Double-blind treatment of seborrheic dermatitis with 2% ketoconazole cream.
53.) Seborrheic dermatitis in neuroleptic-induced parkinsonism.
54.) Successful treatment and prophylaxis of scalp seborrhoeic dermatitis and dandruff with 2% ketoconazole shampoo: results of a multicentre, double-blind, placebo-controlled trial.
55.) Adherence of Malassezia furfur to human stratum corneum cells in vitro: a study of healthy individuals and patients with seborrhoeic dermatitis.
56.) Seborrhoeic dermatitis: treatment with anti-mycotic agents.
57.)Analyses of skin surface lipid in patients with microbially associated skin disease.
58.) Borage oil, an effective new treatment for infantile seborrhoeic dermatitis [letter]
59.) Transepidermal water loss and water content in the stratum corneum in infantile seborrhoeic dermatitis.
60.) [Skin lipids in seborrhea- and sebostasis-associated skin diseases]
61.) Use of topical lithium succinate in the treatment of seborrhoeic dermatitis [letter; comment]
62.) A dose-response study of irritant reactions to sodium lauryl sulphate in patients with seborrhoeic dermatitis and atopic eczema.
63.) Seborrhoeic dermatitis of the scalp--a manifestation of Hailey-Hailey disease in a predisposed individual?
64.) Use of topical lithium succinate in the treatment of seborrhoeic dermatitis [see comments]
65.) Erythema multiforme and dermatitis seborrhoides infantum as concomitant id-reactions to widespread candidosis in a suckling.
66.) The evaluation of various methods and antigens for the detection of antibodies against Pityrosporum ovale in patients with seborrhoeic dermatitis.
67.) Enhanced phagocytosis and intracellular killing of Pityrosporum ovale by human neutrophils after exposure to ketoconazole is correlated to changes of the yeast cell surface.
68.) [Therapy of seborrheic eczema with an antifungal agent with an antiphlogistic effect]
69.) Neutrophil zinc levels in psoriasis and seborrhoeic dermatitis.
70.) Skin surface electron microscopy in Pityrosporum folliculitis. The role of follicular occlusion in disease and the response to oral ketoconazole.
71.) Studies on the yeast flora in patients suffering from psoriasis capillitii or seborrhoic dermatitis of the scalp.
72.) [Histological differential diagnosis of psoriasis vulgaris and seborrheic eczema of the scalp]
73.) Tinea versicolor with regard to seborrheic dermatitis. An epidemiological investigation.
74.)Quantitative microbiology of the scalp in non-dandruff, dandruff, and seborrheic dermatitis.
75.) Treatment of seborrheic dermatitis with biotin and vitamin B complex.
76.) L-dopa for seborrheic dermatitis.
77.) Seborrheic dermatitis of infants: treatment with biotin injections for the nursing mother.
78.) Photochemotherapy in erythrodermic seborrhoic dermatitis [letter]
79.) Old drug--in a new system--revisited.
80.) Oral use of biotin in seborrhoeic dermatitis of infancy: a controlled trial.
81.) Generalized seborrhoeic dermatitis. Clinical and therapeutic data of 25 patients.
82.)The effect of betamethasone valerate on seborrhoeic dermatitis of the scalp. A clinical, histopathological cell kinetic study.
83.) Topical glycerin in seborrhoeic dermatitis.
84.)[Therapeutic aspects of seborrhea oleosa and pityriasis simplex capillitii]
85.) Tinea versicolor and Pityrosporum orbiculare: mycological investigations, experimental infections and epidemiological surveys.
86.)[Some atypical forms of eczema in children (author's transl)]
87.) Efficacy and safety of a low molecular weight hyaluronic Acid topical gel in the treatment of facial seborrheic dermatitis final report.
88.) Treatment of seborrheic dermatitis: the efficiency of sertaconazole 2% cream vs. tacrolimus 0.03% cream.
89.) Comparison the efficacy of fluconazole and terbinafine in patients with moderate to severe seborrheic dermatitis.
90.) Efficiency of terbinafine 1% cream in comparison with ketoconazole 2% cream and placebo in patients with facial seborrheic dermatitis.
91.) A novel cosmetic antifungal/anti-inflammatory topical gel for the treatment of mild to moderate seborrheic dermatitis of the face: a open-label trial utilizing clinical evaluation and erythemadirected digital photography.
92.) Treatment of moderate to severe facial seborrheic dermatitis with itraconazole: an open non-comparative study.
93.) Role of antifungal agents in the treatment of seborrheic dermatitis.
94.) Investigations of seborrheic dermatitis. Part II. Influence of itraconazole on the clinical condition and the level of selected cytokines in seborrheic dermatitis.
95.) Efficacy and Safety of Cream Containing Climbazole/Piroctone Olamine for Facial Seborrheic Dermatitis: A Single-Center, Open-Label Split-Face Clinical Study.
96.) Topical Treatment of Facial Seborrheic Dermatitis: A Systematic Review.
97.) Low-dose oral isotretinoin for moderate to severe seborrhea and seborrheic dermatitis: a
randomized comparative trial.
98.) Effect of itraconazole on the quality of life in patients with moderate to severe seborrheic dermatitis: a randomized, placebo-controlled trial.
99.) Zinc Pyrithione: A Topical Antimicrobial With Complex Pharmaceutics.
100.) Topical pine tar: History, properties and use as a treatment for common skin conditions.
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jueves, 28 de agosto de 2025

CYPERUS ROTUNDUS AN HERB FOR ALOPECIA. / CYPERUS ROTUNDUS, UNA HIERBA PARA LA ALOPECIA.

 

THE CYPERUS ROTUNDUS A HERB THAT MAKES GROW HAIR. ! 

 

CYPERUS ROTUNDUS, UNA HIERBA QUE HACE CRECER EL CABELLO. !

 
Cyperus Rotundus y alopecia
 
PUBLICADO 2017-ACTUALIZADO 2025




EDITORIAL ENGLISH
==================

Hello DERMAGIC friends, the topic of today quite interesting: THE CYPERUS ROTUNDUS, An herb with medicinal properties.
 
Also known as TIRIRICA, and "NUTZ GRASS", plant that has been studied for many years, and to which They attribute numerous benefits to our body.

Maybe it's the first time you read about on this herb, but if you check the references well You will find that the CYPERUS ROTUNDUS L. (Cyperaceae) has been found Properties and benefits in clinical conditions such as:
 
 1.) DIABETES.
 2.) DIARRHEA.
 3.) INFLAMMATION.
 4.) MALARIA.
 5.) BOWEL INFLAMMATORY DISEASE.
 6.) HIRSUTISM.
 7.) NEUROPROTECTIVE.
 8.) CARDIOPROTECTION.
 9.) NEURODEGENERATIVE DISEASES (PARKINSON, ALZHEIMER).
 10.) PHOTO-AGING AND MELANOGENESIS.
 11.) HEPATOPROTECTIVE.
 12.) ANTICANCEROUS.
 13.) ANTILIPIDEMIC.
 14.) ANTIMUTAGENIC.
 15.) ANTI-UROPHATOGENIC.
 16.) OBESITY.
 17.) ANTIOXIDANT.
 18.) CONVULSIONS.
 19.) ANTIBACTERIAL.
 20.) ANTIANDROGENIC.

 21.) HYPERPIGMENTATION.
 22.) CANCER.   
 
In case you did not know CYPERUS ROTUNDUS is one of the most researched plant in the world due to the great concentration of active ingredients in the form of essential oils, phenolic acids, ascorbic acids and flavonoids in the tuber and rhizomes.

In some countries it is considered as a "bad herb" that does not let other plants grow well, and there are even works on how to eliminate Cyperus Rotundus in orchards and large fields for crops. But lately his PHYTOPROTECTION was demonstrated in fields contaminated with CRUDE OIL. 

This publication is not new, I did it years ago in the DERMAGIC EXPRESS, a colleague of BRAZIL, through A DERMATOLOGICAL LIST, made the comment that he had used the tubercles of this plant in Hydroalcohol solution with good results in ANDROGENIC ALOPECIA.

For that time, I did not find any scientific work on CYPERUS ROTUNDUS in ANDROGENIC ALOPECIA. Neither today, On the contrary, there are works of its use for HIRSUTISM by its antiandrogenic effect.

Based on the experience of this Dr. I went to a well-known pharmacist, DR. BERLIOZ, and I made the comment. The doctor formulated CYPERUS ROTUNDUS in the form of "CAPILLARY LOTION" and I tested it in several patients, men and women, the result was AWESOME, certainly the hair grew in both groups.

UPDATE 2025

Cyperus rotundus was later described as having ANTI-ANDROGENIC EFFECTS, so it is true that it helps or prevents hair loss in ANDROGENIC ALOPECIA, as explained in this article.

In addition, I found a study comparing it to the ALEXANDRITE LASER for body hair removal, thanks to its flavonoid content. This means that the laser promotes scalp regrowth, and the laser used in the oil formulation
prevents hair growth.

But it is ONLY ONE STUDY, which I will leave in the BIBLIOGRAPHIC references. The rest of the studies found speak of all its benefits, but officially, as of 2025, there are no scientific studies supporting its use in ANDROGENIC ALOPECIA.

CONCLUSIONS:

The question is: if CYPERUS ROTUNDUS has an anti-androgenic effect, why has it not been used or tested for ANDROGENIC ALOPECIA? Officially, why are there no scientific studies on the subject? It is considered an "Ayurvedic" medicine that has been used traditionally for many years, under the conditions we mentioned and also to promote
HAIR REGROWTH.

Could it be that "Big Pharma" DOESN'T benefit from a "common herb" causing them to reduce their multi-million dollar profits from FINASTERIDE, DUTASTERIDE and MINOXIDIL ?
 
This publication is dedicated to all RESEARCHERS, colleagues and patients, with the following message:

 "...Tubers of CYPERUS ROTUNDUS, crushed and extracted their chemical compounds and prepared in hydroalcoholic or oily solution are useful in ANDROGENIC ALOPECIA ..."

An herb that you get in parks and even the garden of your house ...

"MOTHER NATURE PLACES ON OUR WAY, THE PATHS TO CURE OUR ILLNESSES, CYPERUS ROTUNDUS IS ONE OF THEM. "..

In the references the facts, in the attach: THE CYPERUS ROTUNDUS.
 


Cyperus Rotundus and alopecia


Greetings to all.

Dr, Jose Lapenta.
Dr. José M. Lapenta. 



EDITORIAL ESPAÑOL  
================= 
Hola amigos DERMAGICOS, el tema de hoy bastante interesante: EL CYPERUS ROTUNDUS, una hierba con propiedades medicinales. 
 
También conocida bajo el nombre de TIRIRICA, y "HIERBA DE LA NUEZ" o "COROCILLO", planta que viene siendo estudiada desde hace muchos años, y a la cual se le atribuyen numerosos beneficios en nuestro organismo.

Quizás es la primera vez que lees algo sobre esta hierba, pero si revisas bien las referencias bibliográficas te encontraras que el CYPERUS ROTUNDUS L. (Cyperaceae) se le han encontrado propiedades y beneficios en condiciones clínicas como:

1.) DIABETES.
2.) DIARREA.
3.) INFLAMACIÓN.
4.) MALARIA.
5.) ENFERMEDAD INFLAMATORIA INTESTINAL.
6.) HIRSUTISMO.
7.) NEUROPROTECCION.
8.) CARDIOPROTECCION.
9.) ENFERMEDADES NEURO-DEGENERATIVAS (PARKINSON, ALZHEIMER).
10.) FOTOENVEJECIMIENTO Y MELANOGENESIS.
11.) HEPATO-PROTECTOR.
12.) ANTICANCEROSO.
13.) ANTILIPIDEMICO.
14.) ANTIMUTAGENICO.
15.) ENFERMEDADES DE VÍAS URINARIAS.
16.) OBESIDAD.
17.) ANTIOXIDANTE.
18.) CONVULSIONES.
19.) ANTIBACTERIANO.
20.) ANTI-ANDROGÉNICO.
 
21.) HIPERPIGMENTACION. 
22.) CANCER.  

Por si no lo sabias EL CYPERUS ROTUNDUS es una de las plantas más investigada en todo el mundo debido a la GRAN concentración de ingredientes activos en forma de aceites esenciales, ácidos fenólicos, ácidos ascórbicos y flavonoides en el tubérculo y rizomas.

En algunos países es considerado como una "hierba mala" que no deja crecer bien otras plantas, e incluso hay trabajos de como eliminar el         Cyperus Rotundus en algunos sembradíos. Pero últimamente se demostró su FITOPROTECCION en campos contaminados con PETROLEO.

Esta publicación no es nueva, la hice hace años en el DERMAGIC EXPRESS, una colega de BRASIL, a través de una LISTA DERMATOLOGICA, hizo el comentario de que había utilizado los tubérculos de esta planta en solución hidro-alcoholica con buenos resultados en la ALOPECIA ANDROGÉNICA.  

Para esa época no encontré ningún trabajo científico sobre el CYPERUS ROTUNDUS en ALOPECIA ANDROGÉNICA. Hoy tampoco, al contrario hay trabajos de su uso para el HIRSUTISMO por su efecto anti-androgénico.

Basado en la experiencia de esta Dra. fui donde un farmaceuta conocido, DR. BERLIOZ, y le hice el comentario. El Dr. formulo EL CYPERUS ROTUNDUS en forma de "LOCIÓN CAPILAR" y lo probé en varios pacientes, hombres y mujeres, el resultado fue IMPRESIONANTE, ciertamente el cabello creció en ambos grupos.

ACTUALIZACION 2025 
 
El Cyperus Rotundus se le describió posteriormente su EFECTO ANTI-ANDROGÉNICO, por lo tanto, si es cierto que ayuda o previene la caída del cabello en la alopecia ANDROGÉNICA, tal como ha sido explicado en este articulo.
 
Pero ademas de ello encontré un estudio donde se le compara con el LASER DE ALEXANDRITA,  para la depilación del cuerpo, gracias a su contenido de flavonoides, es decir, el en el cuero cabelludo promueve la REPOBLACIÓN y el el cuerpo según ese estudio usado en formulación de aceite evita la salida del vello. !!!!
 
Pero es SOLO UN ESTUDIO, el cual te dejare en las referencias BIBLIOGRÁFICAS, de resto los estudios encontrados, hablan de todos sus beneficios, pero oficialmente para hoy 2025 no hay estudios científicos que avalen su uso en ALOPECIA ANDROGÉNICA. 
 

CONCLUSIONES:
 
La pregunta es la siguiente: si el CYPERUS ROTUNDUS tiene efecto anti-androgénico, porque no ha sido utilizado o experimentado en la ALOPECIA ANDROGÉNICA. ??  oficialmente, porque no hay estudios científicos al respecto ?. cuando es considerada una medina "ayurvédica" de uso tradicional desde hace muchos años, en las condiciones que mencionamos y también para promover la REPOBLACIÓN DEL CABELLO.
 
Sera que a la "Big Pharma" NO LE CONVIENE que una "vulgar hierba" les haga disminuir sus millonarias ganancias con FINASTERIDE, DUTASTERIDE, y MINOXIDIL. ?'?
 
 Esta publicación va dedicada a todos los INVESTIGADORES, colegas y pacientes, con el siguiente mensaje:

..." Los tubérculos del CYPERUS ROTUNDUS, triturados y extraídos sus componentes químicos y preparados en solución hidroalcoholica u oleosa son útiles en la ALOPECIA ANDROGÉNICA..."

Una hierba que la consigues en parques y hasta el jardín de tu casa...

"LA MADRE NATURALEZA NOS PONE EN EL CAMINO, VÍAS PARA CURAR NUESTRAS ENFERMEDADES,  EL CYPERUS ROTUNDUS ES UNA DE ELLAS.." 

En las referencias los hechos, en el adjunto: EL CYPERUS ROTUNDUS.

Saludos a todos.

Dr. José Lapenta.
Dr. José M. Lapenta. 



================================================================== 
REFERENCIAS BIBLIOGRÁFICAS / BIBLIOGRAPHICAL REFERENCES 
================================================================== 
A.- Topical Cyperus rotundus oil: a new therapeutic modality with comparable efficacy to Alexandrite laser photo-epilation (2014).  
E.- The treatment role of Cyperus rotundus L. to triple-negative breast cancer cells (2019).
================================================================== 
 1.) TIRIRICA / CYPERUS ROTUNDUS
2.) Table-maker: Phytochemicals of Cyperus rotundus
3.) Cyperus rotundus L. (CYPERACEAE) (SEDGE FAMILY)
"Purple nutsedge" "Sa'ad" "hasir" "si'd"
4.) TIRIRICA Cyperus rotundus
5.) BALAKALPAM (PRODUCT NO 1 WITH CYPERUS ROTUNDUS)
6.) HEPATONE (PRODUCT NO 2 WITH CYPERUS ROTUNDUS)
7.) Cyperus rotundus L. / Healthcare Properties
8.) The ameliorating effects of the cognitive-enhancing chinese herbs on
scopolamine-induced amnesia in rats.
9.) Rotundines A-C, three novel sesquiterpene alkaloids from Cyperus rotundus.
10.) Effect of feeding tagernut (Cyperus rotundus, L) meal on the performance of rabbits.
11.) Antimalarial sesquiterpenes from tubers of Cyperus rotundus: structure of
10,12-peroxycalamenene, a sesquiterpene endoperoxide.
12.) [Effects of the combination of Astragalus membranaceus (Fisch.) Bge. (AM),Angelica sinensis
(Oliv.) Diels (TAS), Cyperus rotundus L. (CR), Ligusticum chuangxiong Hort (LC) and Peaonia
veitchii lynch (PV) on the
hemorheological changes in "blood stagnating" rats].
13.) [Revision on the type of leaf trace bundles of Cyperus rotundus L].
14.) [Effects of the combination of Astragalus membranaceus (Fisch.) Bge. (AM),tail of Angelica
sinensis (Oliv.) Diels. (TAS), Cyperus rotundus L. (CR),Ligusticum chuanxiong Hort. (LC) and
Paeonia veitchii Lynch (PV) on the
hemorrheological changes in normal rats].
15.) [Treatment of intestinal metaplasia and atypical hyperplasia of gastric
mucosa with xiao wei yan powder].
16.) Monitoring and assessment of mercury pollution in the vicinity of a
chloralkali plant. IV. Bioconcentration of mercury in in situ aquatic and
terrestrial plants at Ganjam, India.
17.) Antimalarial compounds containing an alpha,beta-unsaturated carbonyl moiety from Tanzanian
medicinal plants.
18.) Antimalarial activity of Tanzanian medicinal plants.
19.) Effect of Nagarmotha (Cyperus rotundus Linn) on reserpine-induced emesis in pigeons.
20.) Pharmacological studies to isolate the active constituents from Cyperus
rotundus possessing anti-inflammatory, anti-pyretic and analgesic activities.
21.) Characterization of ferredoxin from nutsedge, Cyperus rotundus L., and
other species with a high photosynthetic capacity.
22.) A pharmacological study of Cyperus rotundus.
23.) CYPERUS ROTUNDUS L. ROOT OIL
24.) POSSIBILITIES OF SOIL SOLARIZATION FOR THE ERRADICATION OF Cyperus
rotundus L. AND THE IMPROVEMENT OF SALINE SOILS
25.) Control Of Nut Grass (Cyperus Rotundus) In Asparagus.
26.) Neuroprotective and cognitive-enhancing effects of the combined extract of Cyperus rotundus and Zingiber officinale.
27.) Novel Food Supplement "CP1" Improves Motor Deficit, Cognitive Function, and
Neurodegeneration in Animal Model of Parkinson's Disease.
28.) Effect of Cyperus Rotundus on Cytokine Gene Expression in Experimental Inflammatory Bowel Disease.
29.) α-Cyperone of Cyperus rotundus is an effective candidate for reduction of inflammation by destabilization of microtubule fibers in brain.
30.) Identification of Neuroactive Constituents of the Ethyl Acetate Fraction from Cyperi Rhizoma Using Bioactivity-Guided Fractionation.
30.) Isocyperol, isolated from the rhizomes of Cyperus rotundus, inhibits LPS-induced inflammatory responses via suppression of the NF-κB and STAT3 pathways and ROS stress in LPS-stimulated
RAW 264.7 cells.
31.) Valencene from the Rhizomes of Cyperus rotundus Inhibits Skin Photoaging-Related Ion Channels and UV-Induced Melanogenesis in B16F10 Melanoma Cells.
32.) New Iridoid Glycosides with Antidepressant Activity Isolated from Cyperus rotundus.
32.) Antidiabetic activity of ethanolic extract of Cyperus rotundus rhizomes in streptozotocin-induced diabetic mice.
33.) LC-ESI-MS/MS analysis of total oligomeric flavonoid fraction of Cyperus rotundus and its antioxidant, macromolecule damage protective and antihemolytic effects.
34.) Cyperus rotundus L.: Traditional uses, phytochemistry, and pharmacological activities.
35.) 6-Acetoxy Cyperene, a Patchoulane-type Sesquiterpene Isolated from Cyperus rotundus Rhizomes Induces Caspase-dependent Apoptosis in Human Ovarian Cancer Cells.
36.) Cyperus rotundus L. prevents non-steroidal anti-inflammatory drug-induced gastric mucosal damage by inhibiting oxidative stress.
37.) Solanioic Acid, an Antibacterial Degraded Steroid Produced in Culture by the Fungus Rhizoctonia solani Isolated from Tubers of the Medicinal Plant Cyperus rotundus.
38.) Structurally diverse terpenoids from the rhizomes of Cyperus rotundus L.
39.) New cycloartane glycosides from the rhizomes of Cyperus rotundus and their antidepressant activity.
40.) Investigation on Chinese herbal medicine for primary dysmenorrhea: implication from a nationwide prescription database in Taiwan.
41.) Topical Cyperus rotundus oil: a new therapeutic modality with comparable efficacy to Alexandrite laser photo-epilation.
 
42.) Phytoremediation of crude oil contaminated soil using nut grass, Cyperus rotundus.
============================================================

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lunes, 11 de agosto de 2025

FINASTERIDE 5 MG AND 1 MG IN ANDROGENIC ALOPECIA. / FINASTERIDE 5 MG Y 1 MG EN ALOPECIA ANDROGENICA.


 Finasteride 5 Mgr vs 1 Mgr in Androgenic Alopecia. !


Finasteride 5 Mgr vs 1 Mgr en Alopecia Androgénica. !


Finasteride y alopecia androgenica


 

 EDITORIAL ENGLISH
 =================== 
Hello friends of the DERMAGIC network, back with a very hot topic: FINASTERIDE 5 MG VS FINASTERIDE 1 MG IN ANDROGENIC ALOPECIA.

The first article I found on this drug dates back to 1993, and others from 1994 discussed 
FINASTERIDE as a promising drug for various conditions such as acne, HIRSUTISM, PROSTATE CANCER and BENIGN PROSTATIC HYPERPLASIA (BPH).

Later, it was discovered that finasteride was and is useful in the treatment of androgenetic alopecia.

But at that time, only the 5 MG version (PROSCAR) was available, and many people began using it twice a week: they would break the original pill into 4 parts, taking 1/4 of a pill daily. This motivated the company to market the 1 mg dosage form for exclusive use in ANDROGENIC ALOPECIA, under the name PROPECIA.

There are studies in which patients were given 5 mg 
FINASTERIDE daily for 2 years without side effects. Furthermore, the first report from 1993 showed that daily doses of 80 mg FINASTERIDE for 3 months caused no side effects.

However, subsequent studies showed that at doses of 1 mg, 
FINASTERIDE (PROPECIA), like all medications, has its side effects, mainly erectile dysfunction, mood swings, decreased semen volume, and in some cases, gynecomastia  and adenomas.

These reports appeared during the decade from 2010 to 2012, describing the so-called
POST-FINASTERIDE SYNDROME (PFS): which is still being discussed today, with symptoms that appear after prolonged treatment with this medication. I describe them as follows:

Symptoms included:

- Decreased libido.
- Erectile dysfunction.
- Changes in penile tissue.
- Loss of enjoyment or desire for sexual intercourse.
- Decreased sperm count.
- Gynecomastia, adenomas.
- Skin changes.
- Cognitive impairment: loss of memory and concentration.
- Fatigue.
- Anxiety, panic attacks.
- Depression.
- Suicidal ideation.
- Loss of muscle mass.
- Metabolic disorders.

MECHANISM PRODUCING THIS SYNDROME:

1.) FINASTERIDE inhibits the enzyme 5-alpha reductase type 2, blocking the conversion of testosterone to dihydrotestosterone (DHT), which is its main effect. This would cause an alteration in the levels of neuroactive steroids that regulate neurotransmitters such as GABA and serotonin in the brain.

2.) Alterations in hippocampal neurogenesis and changes in the gut microbiota that could influence symptoms have been detected.

3.) Genetic susceptibility and changes in androgen receptors and enzymes could be involved in the clinical manifestations.

Although this POST FINASTERIDE SYNDROME is documented and recognized by patients, it remains a topic of debate in the medical community today.

Among cases of female pattern baldness, 
FINASTERIDE was significantly more common with fetal damage and uterine disorders. Furthermore, drug-gene network analysis indicated that finasteride could profoundly alter pathways related to sex hormone signaling and oocyte maturation.

It was later discovered that 
FINASTERIDE is not useful in FEMALE pattern baldness, but is useful in HIRSUTISM.

HISTORICAL ACCOUNT:

Since it became known in the scientific world that 
FINASTERIDE produced hair growth, FINASTERIDE 5 mg (PROSCAR) began to be used, as I mentioned before, because FINASTERIDE 1 mg (PROPECIA) had not yet been marketed. The dosage: 10 mg weekly in 2 doses, Tuesdays and Thursdays, with good results.

Once FINASTERIDE 1 MG (PROPECIA) was released, the company began an
AGGRESSIVE CAMPAIGN, stating that the dose had to be 1 MG daily for 7 days a week, which would be 7 MG total, versus the 10 MG twice weekly doses of FINASTERIDE 5 MG (PROSCAR).

The TRUTH is that
FINASTERIDE 5 MG twice weekly is as good as or equal to FINASTERIDE 1 MG daily, and it's much cheaper, safer, and has fewer risks. A box of 30 tablets lasts 15 weeks (3 months and 3 weeks).

Perhaps one of the advantages that can be attributed to this regimen is that your body "rests" from the drug because you only take it twice a week, compared to taking 
FINASTERIDE 1 mg (PROPECIA) daily, from which your body doesn't rest; you always have the medicine "inside."

I went for the scientific route and used 
FINASTERIDE 5 mg in patients with androgenetic alopecia with the aforementioned regimen: 5 mg twice a week. After the fourth month, I observed significant improvement in the patients. See the attached photos.

CONCLUSIONS:

1.) 
FINASTERIDE is a wonderful product.

2.) 
FINASTERIDE5 mg twice a week is better than or equal to finasteride 1 mg daily.

3.) Merck S.D. launched PROPECIA for commercial and marketing purposes.

4.) FINASTERIDE IMPROVES BENIGN PROSTATIC HYPERPLASIA (BPH), AND PRODUCES notable improvement in ANDROGENIC ALOPECIA...!!!

5.)
TOPICAL FINASTERIDE, under the name FINASTOPIC, was be marketed by ISDIN in 2024. This has been talked about since 2000; the topical formulation most likely has fewer side effects than the oral formulation. In some presentations it comes combined with the popular MINOXIDIL, which is also useful in hair loss.

Finally, FINASTERIDE has recently been used in the treatment of
HIDRADENITIS SUPURATIVA, in both men and women, with good results. Its use as a hormonal agent is also proposed for the treatment of acne.

And its competition also emerged: DUTASTERIDE, which, in addition to being an oral formulation, comes in ampoules for local injection into the scalp. This formulation is the most commonly used, as the oral formulation is not officially approved for the treatment of this condition and is used off-label, given the beneficial clinical effects obtained.

Here is the link to the update on SERENOA REPENS or SAW PALMETTO versus FINASTERIDE for ANDROGENIC ALOPECIA.

In these references, you will learn about FINASTERIDE, its uses, and some of its adverse effects.

Greetings to all.

Dr, José Lapenta. 
Dr, José M.  Lapenta.  


Finasteride 5 Mg en Alopecia Androgenica



























 EDITORIAL ESPAÑOL
===================
Hola amigos de la red DERMAGIC, de nuevo con ustedes con un tema bien caliente: FINASTERIDE 5 MG VS FINASTERIDE 1 MG EN ALOPECIA ANDROGENICA.
 
 El primer trabajo que encontré sobre esta droga data del año 1.993 y otros mas de 1.994 donde se hablaba del FINASTERIDE COMO UNA DROGA promisoria en algunas PATOLOGÍAS COMO Acné, Hirsutismo, Cáncer de Próstata e  Hiperplasia prostatica benigna (BHP). 

Posteriormente se descubrió que el FINASTERIDE era y es útil en el tratamiento de  la ALOPECIA ANDROGÉNICA.
 
Pero para esa fecha solo existía la presentación de 5 MG, (PROSCAR), y mucha gente lo comenzó a usar 2 VECES por semana:  picaba la pastilla original en 4 PARTES, para tomar 1/ 4 de pastilla diaria. Esto motivo al laboratorio a sacar al mercado la presentación de 1 MG para su uso exclusivo en la ALOPECIA ANDROGÉNICA, con el nombre de PROPECIA.

EXISTEN estudios donde a pacientes se les dio FINASTERIDE 5 MGRS DIA POR 2 AÑOS SIN EFECTOS COLATERALES, MAS AUN,, en el primer reporte de 1.993 se DEMOSTRÓ que dosis diarias de 80 MGR /dia de FINASTERIDE por 3 meses NO OCASIONABAN EFECTOS SECUNDARIOS.
 
Pero en estudios posteriores se comprobó que a dosis de 1 MG, el FINASTERIDE, (PROPECIA), como todo medicamento tiene sus efectos secundarios principalmente LA DISFUNCIÓN ERÉCTIL, cambios en el humor, disminución del volumen del semen, y en algunos casos GINECOMASTIA Y ADENOMAS. 
 
Estos reportes aparecieron para la decada del 2010 al 2012 describiéndose el llamado SÍNDROME POST FINASTERIDE (SPF): el cual es discutido hoy en dia, con síntomas que se presentan luego de tratamientos prolongados con este medicamentos y te describo: 
 
Los síntomas incluyeron:
 
- Disminución de la libido.
- Disfunción eréctil.
- Cambios en el tejido del pene. 
- Perdida del disfrute o deseo por la relación sexual.
- Disminución del recuento de espermatozoides.
- Ginecomastia, adenomas.
- Cambios en la piel.
- Deterioro cognitivo: perdida de la memoria y concentración. 
- Fatiga.
- Ansiedad, ataques de pánico. 
- Depresión.
- Ideación suicida. 
- Perdida de masa muscular.
- Trastornos metabólicos. 
 
MECANISMO PRODUCTOR DE ESTE SÍNDROME: 
 
1.) El FINASTERIDE inhibe la enzima 5-alfa reductasa tipo 2, bloqueando la conversión de testosterona a dihidrotestosterona (DHT), ese es su principal EFECTO, esto provocaría una alteración de los niveles de esteroides neuroactivos que regulan neurotransmisores como GABA y serotonina en el cerebro.
 
2.) Se ha detectado alteración en la neuro génesis del hipocampo y cambios en la microbiota intestinal que podrían influir en los síntomas.
 
3.) La susceptibilidad genética y cambios, en receptores androgénicos y enzimas, pudieran estar implicados en las manifestaciones clínicas..

A pesar de que este
SÍNDROME POST FINASTERIDE esta documentado y reconocido por pacientes, hoy dia sigue siendo un tema de debate en la comunidad medica.
 
Entre los casos de alopecia femenina, EL FINASTERIDE fue significativamente más concurrente con el daño al feto y el trastorno del útero. Además, el análisis de la red de fármacos-genes indicó que el FINASTERIDE podría alterar profundamente las vías relacionadas con la señalización de las hormonas sexuales y la maduración de los ovocitos. 
 
Posteriormente se descubrió que el FINASTERIDE no es ÚTIL en la ALOPECIA ANDROGÉNICA femenina, pero si en el HIRSUTISMO.

RECUENTO HISTÓRICO:

Desde que se conoció en el mundo científico QUE EL FINASTERIDE producía crecimiento del cabello, comenzó a usarse el FINASTERIDE 5 MG (PROSCAR), como antes les mencione, porque el FINASTERIDE 1 MG (PROPECIA) no había salido al mercado. La dosis: 10 MG SEMANALES en 2 dosis, martes y jueves con BUEN RESULTADO. 

Una vez que salio al mercado el FINASTERIDE 1 MG, (PROPECIA), el laboratorio comenzó una CAMPAÑA AGRESIVA, diciendo que la dosis tenia que ser un 1 MG dia por 7 días a la semana, que serian 7 MG en total, versus los 10 MG en las 2 tomas semanales del FINASTERIDE 5 MG (PROSCAR). 

La VERDAD es que FINASTERIDE 5 MG 2 VECES SEMANAL es tan bueno o igual al FINASTERIDE 1 MG DIARIO, y el costo es muchísimo menor, mas seguro, menos riesgos. Una caja de 30 Tabs dura 15 semanas, (3 meses y 3 semanas). 
 
 Quizá una de las ventajas que puede atribuirsele a este esquema es que tu organismo ¨descansa¨ de la droga pues solo la tomas 2 veces semanal, en relación al FINASTERIDE 1 MG (PROPECIA) diario, del cual tu organismo no descansa, siempre tienes la medicina ¨adentro¨. 

Yo me fui por el lado científico y utilice el producto FINASTERIDE 5 MG       en pacientes con Alopecia Androgénica con el esquema antes dicho 5 MG 2 veces semanal y al 4to mes observe mejoría notable de los pacientes, vean las fotos del attach.

CONCLUSIONES:

1.) EL FINASTERIDE ES UN producto maravilloso. 

2.) EL FINASTERIDE 5 MG 2 veces semanal, es MEJOR o IGUAL que el FINASTERIDE 1 MG  DIARIO. 

3.) EL LABORATORIO MERCK.S.D LANZO la PROPECIA con fines COMERCIALES Y DE MERCADEO. 

4.)  EL FINASTERIDE MEJORA LA HIPERPLASIA PROSTÁTICA BENIGNA (HPB), Y PRODUCE mejoría notable en la ALOPECIA ANDROGÉNICA.. !!! 

5.) PARA el año 2024, salio al mercado el
FINASTERIDE TÓPICO, con el nombre de FINASTOPIC, por el laboratorio ISDIN. De esto se venia hablando desde el año 2000, muy probablemente la presentación tópica tiene menos efectos secundarios que la presentación oral; en algunas presentaciones viene combinado con el popular MINOXIDIL, el cual también es útil en la caída del cabello.
  
Para finalizar el FINASTERIDE a sido utilizado últimamente en el tratamiento de la HIDRADENITIS SUPURATIVA, tanto en hombres como mujeres con buen resultado. También se propone su uso como agente hormonal en el tratamiento del Acné.
 
Y también le salio su competencia: EL DUTASTERIDE,  el cual ademas de presentación oral, viene en ampollas para inyección local en el cuero cabelludo, siendo esta presentación la mas utilizada, pues la PRESENTACIÓN ORAL NO ESTA APROBADA OFICIALMENTE  para el tratamiento de esta patología, mas se usa off label, dado los efectos clínicos beneficiosos obtenidos.
 
Aquí te dejo el enlace a la actualización de la SERENOA REPENS o SAW PALMETTO versus el FINASTERIDE en la ALOPECIA ANDROGÉNICA. 

En estas referencias conocerás el FINASTERIDE , sus usos y algunos de sus efectos adversos. 

Saludos a todos ! 

Dr. José Lapenta.. 
Dr. José M. Lapenta.. 


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REFERENCIAS BIBLIOGRÁFICAS / BIBLIOGRAPHICAL REFERENCES 
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 F.- Relative safety and efficacy of finasteride for treatment of hirsutism (2004).
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1.) Five-year follow-up of patients with benign prostatic hyperplasia treated with  finasteride. 
2.) Therapeutic effects of finasteride in benign prostatic hyperplasia: a randomized  double-blind controlled trial. 
3.) The effect of finasteride on prostate volume, urinary flow rate and symptom score in  men with benign prostatic hyperplasia. 
4.) [5-alpha-reductase inhibitors]. 
5.) Benign prostatic hyperplasia. 
6.) The potential for hormonal prevention trials. 
7.) 5 alpha-reductase inhibition by finasteride (Proscar) in epithelium and stroma of human  benign prostatic hyperplasia. 
8.) Pharmacological treatment of benign prostatic hyperplasia with finasteride: a clinical  review. 
9.) Medical therapy for benign prostatic hyperplasia: A review of the literature. 
10.) Pretreatment with finasteride decreases perioperative bleeding associated with  transurethral resection of the prostate. 
11.) Urinary retention in patients with BPH treated with finasteride or placebo over 4  years. Characterization of patients and ultimate outcomes.The PLESS Study Group. 
12.) Dihydrotestosterone and the concept of 5alpha-reductase inhibition in human benign  prostatic hyperplasia. 
13.) Chronic treatment with finasteride daily does not affect spermatogenesis or semen  production in young men. 
14.) Management of androgenetic alopecia. 
15.) Finasteride in the treatment of men with frontal male pattern hair loss. 
16.) Androgenetic alopecia in men: the scale of the problem and prospects for treatment. 
17.) [Androgenetic alopecia, hirsutism and hypertrichosis]. 
18.) Medical treatments for balding in men. 
19.) Understanding and managing common baldness. 
20.) Finasteride: a review of its use in male pattern hair loss. 
21.) Finasteride in the treatment of men with androgenetic alopecia. Finasteride Male  Pattern Hair Loss Study Group. 
22.) Genetic analysis of male pattern baldness and the 5alpha-reductase genes. 
23.) Effect of finasteride on human testicular steroidogenesis. 
24.) [Finasteride: a new drug for the treatment of male hirsutism and  androgenetic  alopecia]? 
25.) The 5 alpha-reductase system and its inhibitors. Recent development and its  perspective in treating androgen-dependent skin disorders. 
26.) Finasteride: a clinical review. 
27.) The effect of finasteride, a 5 alpha-reductase inhibitor, on scalp skin testosterone and  dihydrotestosterone concentrations in patients with male pattern baldness. 
28.) Finasteride: the first 5 alpha-reductase inhibitor. 
29.) Cytologic atypia in a 53-year-old man with finasteride-induced gynecomastia. 
30.) Reversible painful gynaecomastia induced by low dose finasteride (1 mg/day). 
31.) Measuring reversal of hair miniaturization in androgenetic alopecia by follicular counts 
in horizontal sections of serial scalp biopsies: results of finasteride 1 mg treatment of men  and postmenopausal women. 
32.) Improvement in androgenetic alopecia in 53-76-year-old men using oral finasteride. 
33.) New topical antiandrogenic formulations can stimulate hair growth in human bald  scalp grafted onto mice. 
34.) Current management of androgenetic alopecia in men. 
35.) Immunohistochemical localization of types 1 and 2 5alpha-reductase in human scalp. 
36.) The psychosocial consequences of androgenetic alopecia: a review of the research  literature. 
37.) Clinical dose ranging studies with finasteride, a type 2 5alpha-reductase inhibitor, in  men with male pattern hair loss. 
38.) The effects of finasteride on scalp skin and serum androgen levels in men with  androgenetic alopecia. 
39.) Adverse Effects and Safety of 5-alpha Reductase Inhibitors (Finasteride, Dutasteride): A Systematic Review.
40.) Interventions for Female Pattern Hair Loss.
41.) Differences in reproductive toxicology between alopecia drugs: an analysis on adverse events among female and male cases.
42.) Finasteride in Hidradenitis Suppurativa: A "Male" Therapy for a Predominantly "Female" Disease.
43.) Hidradenitis suppurativa treated with finasteride.
44.) The use of hormonal agents in the treatment of acne.
45.) Risk of gynecomastia and breast cancer associated with the use of 5-alpha reductase inhibitors for benign prostatic hyperplasia.
46.) Investigation of the Plausibility of 5-Alpha-Reductase Inhibitor Syndrome.
47.) Post-Finasteride Adverse Effects in Male Androgenic Alopecia: A Case Report of Vitiligo.
48.) Side Effects Related to 5 α-Reductase Inhibitor Treatment of Hair Loss in Women: A Review.
49.) 5 mg/day finasteride treatment for normoandrogenic Asian women with female pattern hair loss.
50.) Adverse effects of 5α-reductase inhibitors: What do we know, don't know, and need to know?
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