毛发与头皮皮肤科

首尔脱发治疗指南

脱发治疗通常先从原因开始判断，而不是直接决定项目。很多患者真正关心的是：掉发是暂时还是长期、需不需要先检查头皮、以及治疗要不要分阶段进行。

尹尚烈院长审校

皮肤科专科医生 · 院长 · AAD会员

概述

如果您在意的是发量变化、头皮状态和后续维持，先把掉发类型分清楚，比先看项目名字更有帮助。

适用于以下困扰

发量变少，洗头或梳头时掉发明显
担心头皮问题或家族性掉发持续进展
不知道应该先检查、治疗还是观察
想了解PRP、再生疗法和药物治疗哪种方向更适合自己

推荐人群

希望先弄清楚掉发原因的人
愿意把检查和治疗顺序排清楚的人
想先了解是否需要长期管理的人

治疗时长: 30-60 min (consultation + scalp injection visit)
建议次数: Drug therapy daily; PRP × 3 at 4-week intervals, then every 3-6 months
恢复期: Minimal (mild scalp tenderness 24-48 h after injection)
峰值效果: 6-12 months for visible density change

效果进展

First 4 weeks
Drug therapy initiated. PRP first session typically performed at the diagnostic visit if appropriate. No visible density change yet — this period is for tolerance and side-effect monitoring.
3 months
Drug therapy: measurable reduction in shedding for most responders. PRP: completion of 3-session loading protocol; early follicle response.
4-6 months
PRP: hairline thickening often visible at the 4-6 month mark with the standard 3-session protocol.
6-12 months
Drug therapy: visible density change for most responders; trajectory established. Maintenance plan adjusted with the dermatologist.
12+ months
Long-term maintenance — drug therapy continued, PRP every 3-6 months when indicated, adjuncts (Botox / exosome / stem cell) sequenced as the diagnosis evolves.

使用设备

Drug therapy — Finasteride / Dutasteride / Minoxidil / Spironolactone

Multiple manufacturers (oral and topical formulations)Finasteride 1 mg: U.S. FDA-approved for male AGA (1997). Dutasteride 0.5 mg: South Korea MFDS-approved for male AGA (2009). Minoxidil 2%/5% topical: U.S. FDA-approved for AGA. Oral low-dose Minoxidil and Spironolactone: prescribed off-label with established dermatology evidence.

关键规格

: Finasteride 1 mg oral, daily — selective 5α-reductase type II inhibitor; reduces scalp DHT and slows miniaturisation in androgenetic alopecia. Strong RCT evidence (Kaufman 1998).
: Dutasteride 0.5 mg oral, daily — dual 5α-reductase inhibitor (types I + II) with greater DHT suppression; useful when Finasteride alone is insufficient.
: Minoxidil — topical 5% solution or low-dose oral (0.25-2.5 mg/day, off-label); vasodilator with proposed potassium-channel-opener mechanism.
: Spironolactone — oral, used for female pattern hair loss as an anti-androgen alternative to Finasteride.
: Side-effect profile, bloodwork (ferritin / thyroid / hormone panel where relevant), and follow-up at 3 and 6 months are reviewed at consultation.

Skin Botox — scalp / hairline injection

Botulinum toxin type A (multiple manufacturers)Used off-label for AGA; small-trial evidence (Singh 2017) — adjunct, not primary.

关键规格

: Low-dose botulinum toxin distributed across the scalp.
Proposed mechanism: reduce scalp tension and increase blood flow to follicles.
: Evidence base is smaller than for drug therapy; positioned as an adjunct.
: Generally well tolerated in published pilot studies.

Exosome scalp application

Multiple stem-cell-derived exosome preparationsAdjunct use; evidence is early-stage. Not a substitute for drug therapy.

关键规格

: Extracellular vesicles derived from stem cell culture media.
: Carry signaling molecules (microRNA, growth factors) that may influence follicle stem cell activity.
: Applied topically after microchannel creation (microneedling / fractional laser).
Honest positioning: adjunct, not standalone.

Stem cell scalp injection

Stem-cell-derived preparations (multiple sources)Adjunct use; evidence base smaller and more heterogeneous than drugs or PRP.

关键规格

: Injected into the scalp to stimulate dormant follicle stem cells.
: Useful as part of a combination plan, not as a replacement for proven drug therapy.
: Sequencing and candidacy determined by dermatologist after diagnosis.

PRP scalp injection

Patient-derived autologous platelet-rich plasmaMultiple RCTs and meta-analysis evidence for modest improvement in AGA (Gupta & Carviel 2017 meta-analysis).

关键规格

: Patient's own blood centrifuged to concentrate platelets and growth factors.
: Injected into the scalp at standardised depths.
Typical protocol: 3 sessions at 4-week intervals, then maintenance every 3-6 months.
: Strongest published evidence among the in-clinic regenerative options for androgenetic alopecia.

治疗流程

01
先确认是掉发增多、发际线变化，还是整体发量变稀。
02
再判断是否需要头皮检查、药物、注射或其他辅助治疗。
03
说明治疗节奏、护理重点和后续维持方式后，再决定。
04
如果属于长期管理型问题，通常会先把复诊节奏一起安排。

术后护理

01First 24-48 hours after scalp injection
Avoid vigorous scalp scrubbing, hot showers, saunas, and heavy sweating. Mild tenderness or pinpoint redness at injection sites is normal.
02Week 1
Resume gentle shampooing the day after the procedure. Avoid alcohol-based scalp tonics and aggressive styling products on injection days.
03Drug therapy — ongoing
Take oral medication as prescribed. Report any concerning side effects between visits. Bloodwork follow-up at 3 and 6 months when relevant.
04Long-term
Hair outcomes are cumulative. Treat 6-12 months as the minimum window before re-evaluating the plan. Photographic tracking at each follow-up visit makes the trajectory visible.

常见问题

脱发治疗是不是要一直做？

这要看掉发原因与治疗目标。很多情况下，脱发更接近长期管理，而不是一次性处理。

我应该先看头皮，还是先开始治疗？

通常先判断原因和头皮状态，再决定是否需要治疗或进一步检查。

注意 · 禁忌

如有以下情况，请于诊察时告知医师。可能无法进行治疗或需调整方案。

Pregnancy and breastfeeding (Finasteride, Dutasteride, Spironolactone contraindicated; PRP and most adjuncts deferred)
Active scalp infection or open wounds in the injection field
Bleeding disorders or active anticoagulation without physician clearance (PRP / scalp injections)
Known hypersensitivity to any prescribed medication or component
History of breast or hormone-sensitive cancer — dermatologist review required before anti-androgen therapy

就诊须知

如果您在首尔停留时间有限，请先把检查与复诊时间告诉诊所。
如果之后还要安排其他治疗，最好先问清楚时间顺序。

参考文献

本页所载的医学信息（设备规格、效果进展、安全性等）均依据下列一手资料撰写。各项陈述均对应参考相应文献。

[1]Finasteride in the treatment of men with androgenetic alopecia (Finasteride Male Pattern Hair Loss Study Group). J Am Acad Dermatol (Kaufman et al., PMID 9777765) (1998).
[2]Female pattern hair loss: a pilot study investigating combination therapy with low-dose oral minoxidil and spironolactone. Int J Dermatol (Sinclair RD, PMID 29231239) (2018).
[3]A Pilot Study to Evaluate Effectiveness of Botulinum Toxin in Treatment of Androgenetic Alopecia in Males. J Cutan Aesthet Surg (Singh et al., PMID 29403190) (2017).
[4]Meta-analysis of efficacy of platelet-rich plasma therapy for androgenetic alopecia. J Dermatolog Treat (Gupta & Carviel, PMID 27152474) (2017).

医学审校Dr. SangYoul Yun· Board-Certified Dermatologist · Mayo Clinic Trained· 最近审校日期 2026-05-05

提示: 根据皮肤状况、治疗史和恢复因素，个体差异可能存在。所有治疗方案均通过皮肤科专科医生咨询确定。本页信息仅供参考，不构成医学建议或保证特定效果。

下一步

在决定是否做脱发治疗之前，也可以先发一条简短咨询。

先确认是否适合、时间上是否可行，以及应先看哪种治疗，通常就能让后续沟通顺畅很多。

联系诊所

WhatsApp KakaoTalk LINE

首尔脱发治疗指南

概述

效果进展

使用设备

Drug therapy — Finasteride / Dutasteride / Minoxidil / Spironolactone

Skin Botox — scalp / hairline injection

Exosome scalp application

Stem cell scalp injection

PRP scalp injection

治疗流程

术后护理

常见问题

参考文献

在决定是否做 脱发治疗 之前，也可以先发一条简短咨询。

在决定是否做脱发治疗之前，也可以先发一条简短咨询。