By R. Tippler.
These are derived from a legume-bearing climbing plant buy levitra professional 20mg free shipping zinc erectile dysfunction treatment, Caesalpinia bonducella order levitra professional overnight delivery erectile dysfunction even with cialis, found almost throughout India. Ellingwood’s American Materia Medica, Therapeutics and Pharmacognosy - Page 87 The drug is antiperiodic, febrifuge, tonic and anthelmintic. It is described as closely resembling quinine in action, as harmless to pregnant women, as not being contraindicated during fever, and as well borne by patients with quinine idiosyncrasy. Through it the vaso-motor nerves become partially paralyzed and the vessels become loaded with blood. From this increased irritation which attracts a large number of white corpuscles, the adhesive quality of these corpuscles induces adhesive inflammation, as is beautifully shown in lacerated wounds and cuts where calendula is used, producing union by first intention. Internally it is given to assist its local action, and to prevent suppuration in cases where there is a chronic tendency to such action. It is useful in varicose veins, chronic ulcers, capillary engorgement, and in hepatic and splenic congestion. As arnica is applied to bruises and sprains, this agent is also applicable; and in addition it is of much service applied to recent wounds, cuts and open sores. It causes the scar, or cicatrix, to form without contraction of tissues, and in the simplest possible manner. It hastens the healing of wounds and Ellingwood’s American Materia Medica, Therapeutics and Pharmacognosy - Page 88 materially favors union of co-apted surfaces by first intention. It relieves the pain in wounds, and if there are not bad bruises, it quickly relieves the soreness and favors the healing process. It is applicable to catarrhal mucous surfaces, to festering sores, local swellings, glandular inflammations and to epithelioma and carcinoma to correct the fetor. It is especially applicable to severe burns, to promote healing and to prevent the formation of a contracting scar. If the precipitate formed when the drug is added to water be olive-green, it is active; but its strength should always be tested by tentative doses. In some persons the drug causes excitement tending to acts of violence and crime; in others it excites merriment, or a maudlin state. In general it produces hallucination, perverts the natural perception of objects, intensifies the perception of sound, dilates the pupils, abolishes pain, and, in poisonous doses, causes spasms, convulsions, collapse, pale, clammy, insensible skin, extreme debility, feeble pulse, and finally paralysis of respiration. The habitual use of the drug causes bloating of the face, weak, tremulous limbs, injected eyes, imbecility, and ultimately death from marasmus. Those who use cannabis regularly, believe that in medicinal doses it is not poisonous. It can be safely given in full doses, the tincture in from Ellingwood’s American Materia Medica, Therapeutics and Pharmacognosy - Page 89 ten to twenty minims, and the solid extract in from one-half to two grains. Its best effects are secured when given in conjunction with alkalies in full doses or with mild aperients. Therapy—Cannabis Indica is sedative, narcotic, anodyne and, to a limited degree, anti-spasmodic. It is a remedy for disorders of motility, involuntary, irregular, muscular movements, especially if of a distressing character. It is a remedy to arrest or control pain, often acting advantageously in conjunction with other pain-quieting agents, intensifying, modifying or favorably influencing their action. It is a remedy for excitable and irritable hyperaesthetic conditions of the genito-urinary organs, with increased functional activity and uterine disorders. In many forms of urinary irritation, its action is prompt and satisfactory especially, Quincey says, where there are only a few drops passed frequently, constant unsatisfied desire, burning pain and vesical tenesmus. In the wakefulness of old age, in the restlessness of nervous exhaustion, and in melancholia, it is an important remedy. It takes high rank in affections of the brain and nerves of the head, especially if nervous vertigo be present, and in those attacks of hemicrania which occur periodically, very distressing, causing delirium and much prostration. It is especially applicable in sub-acute inflammation of the brain, in delirium tremens and in the hypochondria of the menopause. This remedy has received a great deal of attention in its adaptability to cerebro-spinal meningitis, and with varying but encouraging results, especially in the earlier stages of irritation and congestion. It is useful also in hydrophobia, and in large doses it is sometimes palliative to the distressing symptoms. Ellingwood’s American Materia Medica, Therapeutics and Pharmacognosy - Page 90 It is useful in the distress of Potts’ disease and hip joint disease and in general rickets. In epilepsy, either alone or combined with the bromides, it has been given very extensively for several years. Cook of Seattle suffered from nervous breakdown with extreme exhaustion; tremor on awakening in the morning, with active functional heart disturbance. He took five drops of specific cannabis three times a day on the tongue, followed by a sip of water. Not only was the whole nervous excitability controlled, but the heart was restored to its normal action and the urinary irritability was overcome. It is of much use in paralysis agitans, in relief of the lightning pains of locomotor ataxia, and especially in chorea and in general muscular tremblings. In functional disorder of the stomach accompanied by pain, it is an excellent sedative, and in intestinal disorders it is equally applicable. It does not suppress secretions or disarrange the functional operations of the organs. In aching and painful irritation, or in the passage of gravel, it is a most soothing remedy. It is beneficial here also in painful hematuria, whether from cancer or tuberculosis, from profound congestion or nephritis. It is a soothing tonic to the uterine muscular structure, and in inertia and subinvolution it increases muscular power and energy and promotes contraction. It is a valuable sedative adjuvant to combine with the well known uterine tonics in general disorders of the pelvic organs amenable to medical treatment not of a surgical character, especially if the pains are of neuralgic or spasmodic character. It will allay abnormal sexual appetite, and will overcome the hysteria and emotional excitement which occur in some women at the menstrual period. In neuralgic dysmenorrhea it will occasionally cure patients who have been treated by other methods without results. There are few remedies that will excel it in this disorder, but the remedy must be given continuously, beginning before the expected paroxysm some little time and continued for a time after the paroxysm is relieved. Ellingwood’s American Materia Medica, Therapeutics and Pharmacognosy - Page 91 It is an excellent remedy in gonorrhea with sexual hyperaesthesia. It controls violent erection and soothes the mental anxiety which aggravates the symptoms. It is soothing to irritable bronchial coughs and laryngeal spasm, and in coughs from tickling in the throat; also in whooping cough and in spasmodic coughs of whatever character. Co-operatives—The agent acts similarly in a general way to opium, gelsemium, passiflora, the bromides, chloral and hyoscyamus.
Physiological Action—Valerian in large doses stimulates the brain buy levitra professional 20 mg on-line erectile dysfunction treatment in allopathy, causing headache buy 20mg levitra professional fast delivery low libido erectile dysfunction treatment, giddiness, perverted vision, restlessness, agitation, nausea. Large doses of the oil cause increase of urine with slow pulse and drowsiness, ending in deep sleep. It lessens sensibility, motility and reflex excitability, and, if the dose be large enough, causes central paralysis. Its influence upon the nervous system is best obtained when the circulation of those centers is inactive and feeble, especially when there is a paleness of the face and the skin is cool. It is directly indicated in hysterical conditions of whatever character with feebleness; with nervous excitement, and morbid vigilance, in hysterical epilepsy, and in nervous headaches with some pallor. It is excellent in the hysteria and nervous disturbances incident to the menopause. It controls distress and imaginary pain and produces quiet, permitting sleep and rest. It is gentle and Ellingwood’s American Materia Medica, Therapeutics and Pharmacognosy - Page 448 soothing in its influence upon the nervous system, especially upon the spinal centers. It is applicable in the nervousness of depression because of its gentle stimulating influence, and in these cases its influence is heightened by combining it with stimulants. This result is effectually obtained from the valerianate of ammonium, which is the most active of the valerian compounds. In conditions where the nervousness is induced by hyperactivity—actual increased nerve force—or where there is organic disease, it is not the remedy. The agent exercises a good influence in combination with cimicifuga in the treatment of chorea. Its influence upon disordered motility, although not marked, is similar to that of cannabis indica, hyoscyamus and scutellaria. It has been used in stomach disorders and in diabetes, but its influence is not marked in these cases. A preparation of thirty drops of the tincture in four ounces of water, may be given in teaspoonful doses, to infants. Specific Symptomatology—Diarrhea with large watery discharges expelled with violence, spasmodic pains in the bowels, cramps, cramp colic, pain producing prostration, with cold skin, cold sweat and sunken eyes. Therapy—This remedy, in small doses frequently repeated, is specific in cholera infantum, cholera morbus, and in various forms of acute diarrhea. It is said to be found Ellingwood’s American Materia Medica, Therapeutics and Pharmacognosy - Page 449 beneficial in some forms of nervous headache and in cases of mental derangement. Physiological Action—Taken in moderate doses, Veratrum Viride reduces the pulse rate in a marked degree, which becomes extremely rapid and feeble on any exertion; this condition is followed by severe nausea and vomiting, together with muscular weakness. Taken in a poisonous dose these symptoms are increased in severity, the pulse becomes almost imperceptible, the skin cold and clammy together with vomiting, retching, hiccough, faintness, dizziness, blindness and unconsciousness. These symptoms indicate that the drug is a powerful spinal and cerebral depressant. Although veratrum is a powerful poison, it is so regular and uniform in its action, and so devoid of erratic and unaccountable or uncontrol-lable influences, that it can be given within the limits of its maximum dosage with safety. In overdoses it produces vomiting, usually before enough is absorbed to produce serious results. It is better given in small doses, repeated every half hour or hour, in acute cases, as its influence is exercised in a more uniform manner, is more permanent, is more easily controlled and is not so apt to disturb the stomach. A large dose produces Ellingwood’s American Materia Medica, Therapeutics and Pharmacognosy - Page 450 quick depression, although the effect is transient. If the dose be often repeated, the stomachic irritation quickly becomes so great as to interfere with all medication. It is not as easily adapted to infants and the feeble as aconite, and its manner of action is not as satisfactory. Veratrum, in its direct heart depression, resembles the coal-tar depressants, although much more regular and uniform in its action and perfectly controllable. It steadily slows the heart and circulation, the temperature declining correspondingly. Aconite influences the heat production and heat-radiation, stimulates all emunctories and the function of all the glandular organs and hastens the removal of inflammatory products. Effusion or suppuration are thus prevented, and if this agent is begun early, when the temperature has declined, there will be no local lesions remaining to contend with as the results of the inflammatory action. Veratrum will assist in the removal of morbific products, but not with the immediate influence upon the results of inflammatory actions that are apparent from the use of aconite. Veratrum should not be given when inflammation has resulted in marked structural change and the products of inflammation are plainly present. Specific Symptomatology—Veratrum is indicated in the onset of sthenic fever when the pulse is full, large and bounding, and the tissues are engorged, where there is fullness of the capillary circulation. It is especially serviceable when there seems to be obstruction of the venous capillary circulation. The face and skin are flushed, but usually of a full, dull, dark hue, and not always the bright-red flush with hot, dry skin which indicates aconite and gelsemium. Ellingwood’s American Materia Medica, Therapeutics and Pharmacognosy - Page 451 The skin is usually soft and covered with warm perspiration. In these cases Veratrum reduces the arterial pressure and permits, or even assists, the more rapid removal of the venous obstruction. In administering veratrum, because of its direct action on the heart it is necessary, if given for a short time only, in full doses, that the patient remain in a recumbent position. In sthenic inflammations, especially such as results from infections—and this includes a long list—and exophthalmic goitre, it exercises a most delightful influence when given in small doses, frequently repeated, the patients should thus get the best results when in a recumbent position, but that position is not then obligatory. Therapy—The characteristic indications for veratrum are found in the onset of pneumonitis in strong men previously healthy and vigorous. In these cases, given in doses of a drop of the tincture every half hour, it will slow the pulse and slowly reduce the temperature after four or five hours. This effect can be continued for a few doses longer, and then the doses should be smaller or given farther apart. The pulse should be slowed, in a case with violent premonitory symptoms, down to the normal beat and held there for awhile, and if the symptoms do not quickly abate, the influence may be continued until a pulse of sixty or fifty-five, or even, in a strong man, fifty beats is reached, if the stomach be not yet irritated. In pleuritis, in bronchitis, in peritonitis, especially pelvic peritonitis from sepsis; in hepatitis and nephritis and cystitis always at the beginning of the acute stage before much structural change has occurred, it may be given, and will retard and often throw off the attack. It is of value in the earlier stages of meningitis and cerebritis, if given understandingly. If the violent heart action be controlled, the processes of disease and any tendency to convulsive action will be at once restrained. In continued fevers this agent, like other depressants of nerve force, is not always the best remedy to use. The reactionary power of the nerve centers is greatly lowered by disease, and if depressants are given they are apt to still further decrease the nerve force and minimize its restorative influence over the system. Advantage will sometimes follow its early use in a case of extremely high temperature with violent and noisy delirium, but it is not the remedy to persist in nor to continue when the prostrating influence of the fever is apparent. Diluted-one dram in a half-glass of water it is an excellent gargle in any inflamed throat. For external use in this disease a somewhat dilute non-alcoholic preparation is preferable, or the fluid extract, full strength or diluted one-half.
The pain and distress abate cheap levitra professional impotence with antihypertensives, the cough disappears safe levitra professional 20mg erectile dysfunction treatment washington dc, the respiration becomes free and natural, the inspiration being especially pleasant; the heart takes on increased tone, and the entire contents of the thoracic cavity seemed benefited. I have treated with this remedy the “stitch in the side,” which had been present for many months after pleurisy, and have removed it satisfactorily. This agent will cure pains in the chest unaccompanied by prominent symptoms, acute, sharp and cutting, recurrent or persistent in their character, if given in doses of half a dram every two or three hours and persisted in for a few days. Therapy—It is beneficial in acute pleuritis specifically, also in bronchitis, pneumonitis and peritonitis. In tight and painful coughs with difficult respiration, especially where there is a general suspension of secretion, with dry skin and mucous membranes, and in soreness of the chest from coughing, it is a most excellent remedy. In all these conditions if there is the least elevation of temperature its influence will be greatly enhanced if given in conjunction with aconite. It was in great repute among the older Eclectic physicians in the treatment of acute pleuritis, as suggested above. They also used it in acute inflammations of serous membranes, especially if there were acute, quick pains, and a tendency to serous effusion. Its eliminative action upon the skin greatly enhances its influence in these cases. It may be combined with such agents as cimicifuga and colchicum, and will markedly intensify their action, especially if aconite be indicated. Therapy—A most active gastro-intestinal irritant, it is given to remove tapeworm, The oleoresin is given in doses of half a dram in capsules. One-half to one dram of the fluid extract may be given, or half an ounce of the leaves are steeped in half a pint of water and this is taken before breakfast. Oils should not be given after this agent, as they facilitate the absorption of its toxic principle which exercises a profound influence upon the nervous system. The usual preparation of the patient is essential and it is necessary to follow the removal of the worm with mild tonics and restoratives. Unlike those often used, this agent does not produce unpleasant results, being in every way a safe remedy if taken in proper doses. Extractum Belladonnae Foliorum Alcoholicum, Alcoholic Extract of Belladonna Leaves. Admistration—The official fluid preparations in most part of Belladonna Ellingwood’s American Materia Medica, Therapeutics and Pharmacognosy - Page 60 vary so much in strength that they cannot be relied upon for activity as compared with each other. Using the product of a single reliable manufacturer one ultimately learns the strength of that product and is thus able to adjust it accurately. The normal tincture of The Merrell Company, the Homeopathic mother tincture, and the specific medicine are all reliable preparations, but vary greatly in comparative strength. The specific medicine is very active, and I would advise that each prescriber dilute a given quantity with four parts of alcohol and prescribe this as a strong tincture. Ten drops of this in a four-ounce mixture given in dram doses will be found uniformly active for children. Physiologic Influence—In its full primary influence, belladonna is an excitant to the cerebrum, promoting active hyperemia—a profoundly full, active condition of the cerebral capillary circulation. I will show later on that this influence of dilating the capillaries, combined with the stimulating influence of the agent upon the heart, with a characteristic influence in contracting the capillaries of the splanchnic area, makes this the most powerful agent known, in its direct influence upon pathologic hyperemia or a tendency to stagnation in any of the capillaries, whatever organ they may be distributed to. I will also show that this influence can serve as a guide in the prescribing of this remedy in a rational manner, more profoundly than any other influence the remedy exercises. When given in full doses the fulness of the capillary circulation induced produces a flushing of the face, a bright redness of the skin, which in sufficient dose is general over the entire body. This resembles very closely the erythematous rash of scarlet-fever, and from this fact the Homeopathists have one of their guides in prescribing this agent for that disease. It suppresses the secretions of all the organs, especially of the mucous membranes, inducing dryness of the throat and mouth and a tendency toward constipation. The evidences of cerebral fulness are: restless excitation, mental exhilaration, headache, dilated pupils, intolerance of light, impairment of vision, uncertainty of muscular movement, the latter finally amounting to incoordination, with motor paralysis. There is delirium of a talkative character, in some, cases violent or furious, with illusions and hallucinations. In extreme delirious excitement, if the dose is a fatal one, there is feeble pulse, cold skin shallow respiration, and paralysis of the inhibitory nerves of the heart and heart-muscle, resulting in death. Ellingwood’s American Materia Medica, Therapeutics and Pharmacognosy - Page 61 In the influence of this remedy upon the capillaries of the skin, loading them up so actively, there is a contributory influence upon the capillaries of the spinal cord, which decreases the amount of blood in this locality, exercising often an exceedingly beneficial influence, especially when the patient suffering from spinal or cerebral congestion has cold skin, cold extremities, a cold, clammy sweat, dilated pupils, and great sluggishness of action. It is a pure stimulant to this organ, through its influence on the cardiac muscle and accelerator nerves. Notwithstanding the lack of proof in the laboratory, in the individual there is more force in the pulse, and there is extreme activity, as stated above, in the capillary circulation, especially when there is profound congestion, with cold relaxed skin, difficult breathing from pulmonary hyperemia, with a small compressible pulse and a deathlike pallor, followed, in extreme cases, by cyanosis. Then the stimulating influence of 1/ or 1/ of a grain of atropine will show itself unquestionably in a 80 60 very few moments. Strychnine expends its influence upon the nerve-centers, but the influence of atropine is upon the peripheries in an unquestionable manner, making it probably the most active of the diffusible stimulants. It thus relieves the pulmonary hyperemia, overcomes cyanosis and promotes free, deep breathing. Specific Symptomatology—There is a characteristic syndrome present in congestive types of many diseases which rationally indicates the need for belladonna. Preliminary congestion is a common condition in very many diseases and the influence of this drug, in antagonizing congestion and in producing a normal and effective equalization of the circulation brings it first to the mind of those who are studying actual conditions, in an endeavor to decide upon the needed remedy. The syndrome referred to consists in chilliness, mental dulness, and inactivity; dull eyes with dilated pupils, eyes partly open when asleep; skin cool and relaxed, with occasional free sweating; cool extremities; general sluggish capillary circulation. Ellingwood’s American Materia Medica, Therapeutics and Pharmacognosy - Page 62 The Homeopathists claim that belladonna is especially indicated where the patients are full-blooded; seldom in anemic patients. Children, very active and with big brains, who are disturbed nights by night-terrors or dreams or show other evidences of restlessness are relieved by belladonna. The remedy acts best in full-blooded patients, where there is active localized heat, pain, redness, and swelling, evidences of local inflammation. When there are a full, bounding pulse, dull flushed face, dull eyes, dilated pupils, and throbbing carotids, the remedy is beneficial. Negroes, and those in warm climates, are especially susceptible to the action of belladonna. Belladonna is not a specific fever-remedy, but in a febrile disorder there is some local engorgement somewhere; there is local capillary hyperemia and, if the remedy is not contraindicated by an already too active condition of the capillary circulation, it will be found of service in all acute congestive disorders with temperature. I have made it a practice for thirty-five years to combine this remedy with the directly indicated fever- remedy, until the symptoms of local engorgement were overcome, then to continue with the fever-remedy alone. When so prescribed, the influence of the remedy to restrain secretion need not be considered, as this influence is usually antagonized by the agent that is used to control the temperature. This is especially true of aconite administered in conjunction with it, which makes a most reliable combination. Given early with aconite, when fever alone is present, hyperemia does not occur and the inflammation is aborted.
There are four types of hair follicles: terminal buy 20 mg levitra professional erectile dysfunction ginseng, vellus 20mg levitra professional free shipping impotence at 35, miniaturized, and senescent. Terminal follicles bear terminal hairs at some time during the life of an individual, whereas vellus follicles do not bear terminal hairs at any time during an individual’s life. Miniaturized follicles are those terminal follicles that have lost their ability to produce terminal hairs and instead produce vellus hairs. Senescent follicles are any of the three types of follicles that no longer produce hairs and have lost histological evidence of the ability to produce hairs. The character of human hair is constantly changing from the prenatal period to old age; and under given physiological conditions, the same hair follicle can successively form different types of hair. Despite differences among individuals, follicle development for all types of hair is virtually the same. The relative dura- tion of each cycle varies with the age of the individual and the region of the body where the hair grows. The length of the cycle is often modiﬁed by a variety of physiological and pathological factors. The cyclic phase of the hair follicle is Hair Growth Enhancers 59 identiﬁed by an active growth period known as anagen, an intermediate period known as catagen, and a resting stage known as telogen. In the anagen phase, which lasts from 2 to 8 years (2), the follicle reaches its maximum length, and there is a proliferation of the matrix cells. Anagen hair generally has a thick shaft, and in given segments its medulla is clearly visible. The bulb gradually tapers and becomes lighter in color at and beyond the keratogenous zone of the follicle. Catagen hair, in its involutional form, differs from telogen (clubbed) hair in two ways: (1) its keratinized (proximal) part is darker than that of clubbed hair; and (2) its inner and outer root sheaths are better preserved (5). Unlike the anagen phase, the catagen phase is short, lasting from 2 to 4 weeks (2). Telogen hair, or clubbed hair, is easily recognized because it generally contains a thin shaft, which is transparent near the root and devoid of a medulla and kerato- genous zone. The telogen phase also is much shorter than the anagen phase, lasting from 2 to 4 months (2). Its prevalence in any population has not been accurately studied, but it occurs much more often in Caucasians than in other races (6). Androgenetic alopecia affects approximately 50% of men over 40 years of age and may also affect just as many women (7). Morphology and Control Androgenetic alopecia appears to be autosomal dominant with gene expression apparently determined by hair follicle location (7). Expression of androgenetic alopecia can vary considerably from one person to another. In androgenetic alope- cia, genetically predisposed hair follicles become progressively miniaturized over time. In men, the thick, pigmented terminal hairs in the affected area of the scalp eventually are replaced by the ﬁne, unpigmented vellus hairs. Women, however, rarely become completely bald but usually experience thinning charac- terized by an intermixing of the normal terminal hairs with ﬁner vellus hairs (7). In both men and women, the hair growth cycle is altered, with fewer hairs in the anagen stage and more hairs in the telogen stage for longer periods of time (7). Although scalp hair growth is not androgen-dependent, androgens are nec- essary for the full expression of androgenetic alopecia whereby they diminish 60 Trancik the size of the hair follicle and diameter of the hair ﬁber, as well as shift hairs from the growing to resting state (6). The main androgen circulating in the plasma of men is testosterone, whereas the most important androgen in women is andro- stenedione. This ﬁnding may explain the different clinical presentation of androgenetic alopecia in men and women. Clinical Presentation The clinical presentation of androgenetic alopecia is different for men and women. It may occur as early as 17 years of age in normal males and by 25 to 30 years of age in endocrinologically normal females (6). There is no evidence, however, to suggest that there is an age at which the onset of the balding process is no longer initiated or a threshold age at which the progression of baldness ceases to continue (7,10). Invariably, both men and women see increased shed- ding of hair, which prompts them to seek out medical advice. In men, androgenetic alopecia is usually progressive, typically receding from the normal hairline in an M-shaped pattern with an enlarging balding vertex (6). Several classiﬁcation systems have been used to characterize the balding state of men, the most popular being the Hamilton scale as modiﬁed by Norwood (Fig. Women often do not present with a distinct pattern, but rather have diffuse hair loss or thinning of the temporal and parietal areas with retention of the frontal hairline in most cases. Women may present with the typical male patterning of hair loss, with this occurring more frequently in postmenopausal women than premenopausal women (13). In both sexes, concomitant loss of hair in the tem- ple–sideburn areas and nape of neck can be observed as well as occasional in- creases in body hair. Psychological Factors of Hair Loss Hair loss can profoundly affect people and the clinical signiﬁcance of androgene- tic alopecia should not be trivialized as just a cosmetic nuisance. The World Health Organization (14) in fact classiﬁed androgenetic alopecia as a disease Hair Growth Enhancers 61 Figure 1 Hamilton baldness scale as modiﬁed by Norwood. Although androgenetic alopecia is seen as a normal variant of aging by most individuals, it can have both psychological and pathological consequences and these effects are taken seriously by both the patient and physician (15,16). Despite the age of onset and the ongoing progression of the baldness per se, the main area of concern in individuals is a psychological one. The majority of men and women (90% or more) want to reverse or halt their hair loss, feel frustrated or helpless about the condition, and are self-conscious about their looks. Psychopathological symptoms in patients with androgenetic alopecia have been well documented. Cash (18) reported that, in men with androgenetic alopecia, the effects of balding resulted in considerable preoccupation, moderate stress or distress, and copious coping efforts. Relative to a control group, women with androgenetic alopecia had a more nega- tive body image as well as more social anxiety, poorer self-esteem, less of a sense of control over their lives, and less life satisfaction. Treatment of Androgenetic Alopecia Nonspeciﬁc Biological Response Modulators Minoxidil Topical Solution How minoxidil topical solution affects hair growth has not been fully characterized, but it can be categorized as a nonspeciﬁc biological response modulator, with a direct effect on the hair follicle. This results 64 Trancik in increased size of the hair follicle with treatment, increased proliferation of dermal papilla cells, and opening of potassium channels (20). As mentioned previously, minoxidil topical solution was ﬁrst available as a 2% product for use in both men and women with androgenetic alopecia, but now a higher, more effective concentration (5%), is available in over 20 countries. The 5% product is approved for use in both men and women in most of these countries, although in Australia, Denmark, and the United States it is indicated for men only.