[New and established methods in therapy of hair diseases].

Recently rational drug therapy and potent technologies have been introduced for the treatment of the most frequent hair problems, i.e. finasteride in the treatment of male pattern hair loss, and laser-assisted hair removal systems for hypertrichosis and hirsutism. Together with the availability of such treatments, high technical standards for evaluating their efficacy have been developed, e.g. computer-assisted epiluminiscence microscopy. Besides these physical aspects, life quality has also become an important issue in clinical studies, and is assessed by standardized patient questionnaires. In the treatment of hair loss, women have become reluctant about taking systemic hormones since the results of large epidemiological studies on the risks of hormonal replacement therapy have become public. Topical 17alpha-estradiol offers an alternative, though its efficacy has not been proven. The results of double-blinded, placebo-controlled studies demonstrating efficacy are yet only available for topical minoxidil. In the treatment of alopecia areata, there is no treatment that guarantees regrowth and stable growth of recovered hair. Only topical immunotherapy produces a higher remission rate that the natural evolution of disease. Scarring alopecias are not frequent but they need a careful evaluation, including scalp biopsy, for a precise diagnosis, because of irreversibility and potentially grave cosmetic consequences. The introduction of the modern broad spectrum antimycotic agents has greatly improved the management of infectious scarring alopecias. Finally, developments in hair care and anti-aging medicine are discussed, with special referral to the evolving difficulty of delineating medical science from marketing strategies in this trendy field.