Topically used herbal products for the treatment of hair loss: preclinical and clinical studies

pH stimulus-responsive hybrid nanoparticles: A system designed for follicular delivery of brazilian plant-derived 5-alpha-reductase enzyme inhibitors

The 5-alpha-reductase enzyme, present in pilosebaceous units, plays a crucial role in the appearance of cutaneous hyperandrogenism manifestations (hirsutism, acne, and androgenetic alopecia). Its inhibition is an excellent strategy to reverse these conditions. Given the limitations of existing treatments, with transient effects and delayed therapeutic response, as well as the possibility of causing undesirable side effects, this study sought to develop new drug delivery systems to overcome these limitations. In other words, innovative stimuli-responsive hybrid nanoparticles were synthesized using silica/natural polysaccharides, encapsulating 5-alpha-reductase enzyme inhibitors derived from the plant Stryphnodendron adstringens (Mart.) Coville (commonly known as 'Barbatimão'). Silica core was synthesized by the modified Stöber method. The pH responsive polysaccharides used to coat the porous silica cores were chitosan, and sodium alginate, this coating was carried out using the Layer-by-Layer technique. The hybrid nanoparticles were characterized at molecular and physical-chemical levels. Furthermore, encapsulation efficiency, pH-dependent release behavior, and cytotoxicity were evaluated. Amorphous mesoporous structure with adequate size for follicular delivery (between 300 and 600 nm) in addition to effective phytocompound loading capacity, above 80 % was obtained. Based on the release studies, it was possible to observe pH responsiveness. The ethyl acetate fraction (EAF) obtained from "Barbatimão" bark extract was released in a controlled and more efficient manner by the alginate-coated nanoparticle (SNP_EAF_SA) at pH 7.4, which corresponds to the pH at the deepest area of hair follicles. Furthermore, SNP_EAF_SA proved to be less cytotoxic compared to EAF and chitosan-coated hybrid nanoparticles (SNP_EAF_CH). Characterization, release, and cytotoxicity results indicate that SNP_EAF_SA is a promising system for on-demand follicular delivery of antiandrogenic actives contained in EAF.

Biomolecules of Fermented Tropical Fruits and Fermenting Microbes as Regulators of Human Hair Loss, Hair Quality, and Scalp Microbiota

Plant-derived secondary metabolites (polyphenols/terpenes/alkaloids) and microbial exometabolites/membrane components of fermented tropical fruits are known as highly bioavailable biomolecules causing skin and hair improvement effects (wound healing, anti-inflammatory, antioxidant, antidiabetic, antiacne, skin/hair microbiota balancing, hair growth-promoting, and hair loss-inhibiting). Caffein is considered as a hair growth promoter. A randomized placebo- and caffein-controlled clinical trial on the efficacy of fermented papaya (FP) plus fermented mangosteen (FM) towards human hair quality and loss was conducted. Shampoo and lotion hair care products containing FP, FM, and caffein as active agents were developed and applied to 154 subjects of both sexes with clinically confirmed androgenic or diffuse alopecia for 3 months. Their clinical efficacy was assessed subjectively by questionnaires filled in by dermatologists/trichologists, and by the objective trichomicroscopical calculations. Hair and scalp skin quality was determined by microbiota pattern and ATP, SH-groups, protein, and malonyl dialdehyde quantification. Comparative clinical data showed that the experimental hair care cosmetics significantly inhibited hair loss, increased hair density/thickness, and improved hair follicle structure versus placebo and caffein controls. The cosmetics with FP and FM substantially normalized the microbiota pattern and increased ATP content in hair follicle, while inhibiting lipid peroxidation in the scalp skin, and SH-group formation in the hair shaft.

Innovative Strategies for Hair Regrowth and Skin Visualization

Today, about 50% of men and 15-30% of women are estimated to face hair-related problems, which create a significant psychological burden. Conventional treatments, including drug therapy and transplantation, remain the main strategies for the clinical management of these problems. However, these treatments are hindered by challenges such as drug-induced adverse effects and poor drug penetration due to the skin's barrier. Therefore, various efforts have been undertaken to enhance drug permeation based on the mechanisms of hair regrowth. Notably, understanding the delivery and diffusion of topically administered drugs is essential in hair loss research. This review focuses on the advancement of transdermal strategies for hair regrowth, particularly those involving external stimulation and regeneration (topical administration) as well as microneedles (transdermal delivery). Furthermore, it also describes the natural products that have become alternative agents to prevent hair loss. In addition, given that skin visualization is necessary for hair regrowth as it provides information on drug localization within the skin's structure, this review also discusses skin visualization strategies. Finally, it details the relevant patents and clinical trials in these areas. Together, this review highlights the innovative strategies for skin visualization and hair regrowth, aiming to provide novel ideas to researchers studying hair regrowth in the future.

Advances in microneedles research based on promoting hair regrowth

Alopecia is the most common and difficult-to-treat hair disorder. It usually brings a significant psychological burden to the patients. With the growing popularity of alopecia, the study of alopecia has gained more attention. Currently, only minoxidil and finasteride have been approved by the FDA for the treatment of alopecia, but the efficacy has always been unsatisfactory. As a new form of transdermal drug delivery, microneedles have been widely used in the treatment of alopecia and have proven to be effective. Microneedles delivery can improve the efficiency of local drug delivery and patients' compliance, which can achieve better therapeutic effects on hair-related diseases. Therefore, microneedles have gained much attention in the field of alopecia and hair regrowth promotion in recent years. This review summarizes the last decade of research on the microneedles delivery design for the treatment of alopecia or promotion of hair regrowth and provides a comprehensive evaluation of this field.

Health Benefits and Safety of Red Pigmented Rice (Oryza sativa L.): In Vitro, Cellular, and In Vivo Activities for Hair Growth Promoting Treatment

The hair growth-promoting activities of Thai native red (Sang-Yod-SY and Mun-Poo-MP) and black (Black glutinous-BG and Hom-Nil-HN) pigmented rice (Oryza sativa L.) extracts, including in vitro 5α-reductase inhibition, hair growth-promoting activity on human hair germinal matrix cells, and in vivo hair-cycle-converting activity in C3H/HeMlac mice, were investigated. Moreover, these extracts were determined to be safe via cytotoxicity (HaCaT cell) and in vivo irritation tests. The results showed that SY red rice extract with high contents of proanthocyanidin (1.50 ± 0.16 mgECE/g extract) exhibited significantly higher 5α-reductase inhibitory activity (18.5 ± 9.0 mgFEA/g extract) (p < 0.05). The maximum growth-promoting activity for human matrix cells treated with SY extract reached about 216.2 ± 0.7% (1 mg/mL) relative to control (100%) after 3 days culture (p < 0.05). Moreover, topical application of 1 mg/mL SY red pericarp rice extracts on shaven C3H skin in telogen phase led to significant hair regeneration (97.2 ±1.3%) based on the shaven area, while vehicle application only tended to yield a regeneration of 50.9 ± 11.7%. Red rice extracts were found to be safe, without signs of cytotoxicity and irritation. This research demonstrates the health benefits and safety of SY red pericarp extract when used for hair growing activity and its potential for use as a natural hair growth promoter and 5α-reductase inhibitor.

The Hair Growth-Promoting Effect of Gardenia florida Fruit Extract and Its Molecular Regulation

As a herbal medicine, the extract from the fruits of Gardenia florida has been widely used for its antioxidative, hypoglycemic, and anti-inflammatory properties. However, whether G. florida fruit extract (GFFE) regulates hair growth has been rarely studied. This study was the first application of GFFE on hair growth both in vitro (human dermal papilla cells, hDPCs) and in vivo (C57BL/6 mice). The effects of GFFE on cell proliferation and hair growth-associated gene expression in hDPCs were examined. Moreover, GFFE was applied topically on the hair-shaved skin of male C57BL/6 mice, the hair length was measured, and the skin histological profile was investigated. GFFE promoted the proliferation of hDPCs and significantly stimulated hair growth-promoting genes, including vascular endothelial growth factor (VEGF) and Wnt/β-catenin signals, but suppressed the expression of the hair loss-related gene transforming growth factor-β1 (TGF-β). Furthermore, GFFE treatment resulted in a significant increase in the number, size, and depth of cultured hair follicles and stimulated the growth of hair with local effects in mice. In summary, the results provided the preclinical data to support the much potential use of the natural product GFFE as a promising agent for hair growth.

Development of Tea Seed Oil Nanostructured Lipid Carriers and In Vitro Studies on Their Applications in Inducing Human Hair Growth

Synthetic drugs used to treat hair loss cause many side-effects. Natural tea seed oil possesses many activities that can suppress hair loss. However, it is oily and sticky in direct application. In this study, tea seed oil loaded nanostructured lipid carriers (NLC) using Tween 80 (NLC-T), Varisoft 442 (NLC-V), and a combination of both surfactants (NLC-C) was developed. The obtained nanoformulations showed spherical particles in the size range 130–430 nm. Particle size and size distribution of NLC-C and NLC-T after storage at 4, 25, and 40 °C for 90 days were unchanged, indicating their excellent stability. The pH of NLC-T, NLC-V, and NLC-C throughout 90 days remained at 3, 4, and 3.7, respectively. NLC-C showed significantly greater nontoxicity and growth-stimulating effect on human follicle dermal papilla (HFDP) cells than the intact oil. NLC-T and NLC-V could not stimulate cell growth and showed high cytotoxicity. NLC-C showed melting point at 52 ± 0.02 °C and its entrapment efficiency was 96.26 ± 2.26%. The prepared hair serum containing NLC-C showed better spreading throughout the formulation than that containing the intact oil. Using 5% NLC-C showed a 78.8% reduction in firmness of the hair serum while enhancing diffusion efficiency by reducing shear forces up to 81.4%. In conclusion, the developed NLC-C of tea seed oil is an effective alternative in stimulating hair growth. Hair serum containing NLC-C obviously reduces sticky, oily, and greasy feeling after use.

Assessment of the effects of a hair lotion in women with acute telogen effluvium: a randomized controlled study

BACKGROUND

Telogen effluvium is a hair loss disorder occurring about 3 months after a triggering event. The acute form impairs quality of life, but spontaneous recovery usually begins 3-6 months after identification and elimination of the cause, with complete recovery taking around 12 months.

OBJECTIVES

To investigate the effectiveness and safety of a hair lotion containing creatine, acetyl tetrapeptide-2 and B vitamins for reducing hair loss in acute telogen effluvium.

METHODS

In this open, randomized, controlled study (NCT04652232), women with acute telogen effluvium from two clinical centres were randomly allocated to receive either the lotion and a mild shampoo (intervention group), or the mild shampoo alone (controls). Hair growth parameters and hair loss were measured from phototrichograms at weeks (W) 1, 4, 8 and 16, and through investigator assessments of standardized photographs at W1 and W16. The primary criterion was the change in anagen to telogen (A/T) ratio between W1 and W16.

RESULTS

One hundred women (aged 19-50 years) were included (intervention group, N = 51; controls, N = 49). Compared to baseline, the A/T ratio was higher at W16 in both groups and was significantly higher at both W4 and W8 in the intervention group, compared to only at W8 in controls. Significant decreases in telogen hair density were seen at all time points in the intervention group, compared to only at W16 in controls, and the between-group difference was significant at W8 (P = 0.0465). A larger reduction in the total number of hairs shed was observed at W8 in the intervention group (P = 0.0392). Investigator-assessed scores showed improvements in hair density for the intervention group. Global tolerance of the lotion was excellent.

CONCLUSIONS

The lotion tested had a significant impact on hair loss in women with acute telogen effluvium and appeared to accelerate recovery from this condition.

A Systemic Review on Topical Marketed Formulations, Natural Products, and Oral Supplements to Prevent Androgenic Alopecia: A Review

Androgens have an intense consequence on the human scalp and body hair. Scalp hair sprouts fundamentally in awol of androgens whereas the body hair hike is vulnerable to the activity of androgens. Androgenetic alopecia (AGA) invoked as males emulate Alopecia due to the cause of the dynamic reduction of scalp hair. Androgens are medium of terminus growth of hair although the body. Local and system androgens convert the extensive terminal follicles into lesser vellus like structure. The out start of this type of alopecia is intensely irregular and the reason behind this existence of enough circulating steroidal hormones androgens and due to genetic predisposition. Effective treatments are available in the market as well as under clinical and preclinical testing. Many herbal formulations are also available but not FDA approved. Different conventional and NDDS formulations are already available in the market. To avoid various systemic side effects of both Finasteride and Minoxidil, topical formulations and natural products (nutrients, minerals, vitamins) now a days are being widely used to treat Androgenic alopecia. CAM (complementary and alternative medicine) provides the option to elect favorable, low-risk, adjuvant and alternative therapies. Herein, we offer a widespread review of topical marketed formulations, natural products, and CAM treatment options for AGA.

Efficacy and safety of a novel herbal solution for the treatment of androgenetic alopecia and comparison with 5% minoxidil: A double-blind, randomized controlled trial study

FDA-approved drugs for the most common type of hair loss, androgenetic alopecia (AGA), present many side effects and disadvantages. However, herbal compounds are characterized by patient compliance, fewer side effects, and several mechanisms of action. The present study set to evaluate the effectiveness and safety of the topical herbal solution and to compare it with 5% minoxidil in men with AGA. A randomized, double-blind controlled trial was conducted from 28 November 2018 to 2 September 2019, in Sina Hospital, Tabriz, Iran. 24 healthy males (mean [SD] age 33.04 [5.81]) with mild to moderate AGA were selected from 44 volunteer participants. Participants were randomly assigned (1:1) into two groups. They received 1 ml of topical solutions at morning and evening intervals for 9 months. Primary outcomes consisted of measured hair diameters at baseline and repeated at weeks 12, 24, and 36. Furthermore, hair density was measured at baseline and week 36. The MTS + THS group was significantly superior to the MTS group after 36 weeks of therapy in the hair diameter improvement. At week 36, the mean hair diameter of the MTS + THS group significantly increased compared to the MTS group (P = .001). Hair density increased in both groups; however, only in the MTS + THS group, it was significant (P < .05). The findings established that the topical herbal solution has significant influence on patients with AGA and improvement of their quality of life. This solution can be considered a significant step towards the prevention and treatment of AGA. clinicaltrials.gov Identifier: NCT03753113.

A comprehensive review of biochemical factors in herbs and their constituent compounds in experimental studies on alopecia

ETHNOPHARMACOLOGICAL RELEVANCE

Alopecia is a chronic condition that may cause emotional and psychological distress to patients, which may significantly impact a patient's quality of life. As conventional treatments have only a transient therapeutic effect and result in unwanted side effects, many patients have attempted to find therapeutic herbs or compounds that function as safer and more potent treatments for alopecia. Many such herbs have been used in complementary and alternative medicine (CAM) for centuries; however, there is a lack of information on the therapeutic mechanisms of herbs used for the treatment of alopecia.

AIM OF THE STUDY

The aim of this review was to perform a critical assessment of the methods and results of experimental studies related to alopecia and to provide the potential mechanisms of action of herbs and their constituent compounds used in the identified studies, in particular, in relation to the stages of the cell cycle. We hope to better guide the clinical application and scientific research of herbs for the treatment of alopecia.

MATERIALS AND METHODS

We reviewed experimental studies to determine the methods used and the mechanism of action of the herbs and constituent compounds. Databases, including Medline (via PubMed), EMBASE, OASIS, and RISS, were searched for the following keywords: "medicinal plants," "alopecia," "alopecia areata," "androgenetic alopecia," "animal experiment," and "in vitro study." We also assessed the risks of bias, toxicity, and taxonomy to determine the quality of information.

RESULTS

C57BL/6 mice and human dermal papilla cells were the most commonly used models for in vivo and in vitro studies, respectively. Many herbs and their constituent compounds were used to treat alopecia by managing the hair cycle, keratinocyte proliferation, apoptosis, angiogenesis, hormones, and inflammation. These compounds prolong the anagen phase, shorten the transition from the telogen to phase anagen, and inhibit premature catagen phase.

CONCLUSIONS

This review has further elucidated the therapeutic mechanisms of herbs and their constituent compounds that are relevant to alopecia and discussed the effectiveness of using herbal treatments. There is a need to develop evidence regarding the quality control, taxonomy, and toxicology of these compounds. Such improvements will provide a better quality of evidence to ensure the efficacy and safety of herbs and compounds used for the treatment of alopecia.

Induction of Hair Keratins Expression by an Annurca Apple-Based Nutraceutical Formulation in Human Follicular Cells

Hair disorders may considerably impact the social and psychological well-being of an individual. Recent advances in the understanding the biology of hair have encouraged the research and development of novel and safer natural hair growth agents. In this context, we have previously demonstrated—at both preclinical and clinical level—that an Annurca apple-based dietary supplement (AMS), acting as a nutraceutical, is endowed with an intense hair-inductive activity (trichogenicity), at once increasing hair tropism and keratin content. Herein, in the framework of preclinical investigations, new experiments in primary human models of follicular keratinocytes and dermal papilla cells have been performed to give an insight around AMS biological effects on specific hair keratins expression. As well as confirming the biocompatibility and the antioxidant proprieties of our nutraceutical formulation, we have proven an engagement of trichokeratins production underlying its biological effects on human follicular cells. Annurca apples are particularly rich in oligomeric procyanidins, natural polyphenols belonging to the broader class of bioflavonoids believed to exert many beneficial health effects. To our knowledge, none of the current available remedies for hair loss has hitherto shown to stimulate the production of hair keratins so clearly.

Review of Hair Follicle Dermal Papilla cells as in vitro screening model for hair growth

Hair disorders such as hair loss (alopecia) and androgen dependent, excessive hair growth (hirsutism, hypertrichosis) may impact the social and psychological well-being of an individual. Recent advances in understanding the biology of hair have accelerated the research and development of novel therapeutic and cosmetic hair growth agents. Preclinical models aid in dermocosmetic efficacy testing and claim substantiation of hair growth modulators. The in vitro models to investigate hair growth utilize the hair follicle Dermal Papilla cells (DPCs), specialized mesenchymal cells located at the base of hair follicle that play essential roles in hair follicular morphogenesis and postnatal hair growth cycles. In this review, we have compiled and discussed the extensively reported literature citing DPCs as in vitro model to study hair growth promoting and inhibitory effects. A variety of agents such as herbal and natural extracts, growth factors and cytokines, platelet-rich plasma, placental extract, stem cells and conditioned medium, peptides, hormones, lipid-nanocarrier, light, electrical and electromagnetic field stimulation, androgens and their analogs, stress-serum and chemotherapeutic agents etc. have been examined for their hair growth modulating effects in DPCs. Effects on DPCs' activity were determined from untreated (basal) or stress induced levels. Cell proliferation, apoptosis and secretion of growth factors were included as primary end-point markers. Effects on a wide range of biomolecules and mechanistic pathways that play key role in the biology of hair growth were also investigated. This consolidated and comprehensive review summarizes the up-to-date information and understanding regarding DPCs based screening models for hair growth and may be helpful for researchers to select the appropriate assay system and biomarkers. This review highlights the pivotal role of DPCs in the forefront of hair research as screening platforms by providing insights into mechanistic action at cellular level, which may further direct the development of novel hair growth modulators.