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Corrêa AC, Machado CJ, Carneiro SCS. Split-scalp pilot study to evaluate effectiveness of Minoxidil 0,5% MMP® versus Topical Minoxidil 5% in the treatment of Female Pattern Hair Loss. Arch Dermatol Res 2024; 316:313. [PMID: 38822940 DOI: 10.1007/s00403-024-03053-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2023] [Revised: 11/07/2023] [Accepted: 04/26/2024] [Indexed: 06/03/2024]
Abstract
Female Pattern Hair Loss (FPHL) is a common form of non-scaring hair loss that occurs in adult women. Although several treatments have already been proposed for FPHL, only Topical Minoxidil accumulated an adequate level of evidence. This study aimed to evaluate the therapeutic response of MMP® (intradermal infiltration) of Minoxidil formulation in the frontal-parietal-vertex regions compared with the gold-standard home administration of Minoxidil 5% Capillary Solution. This self-controlled comparative study evaluated 16 FPHL patients, without treatment for at least 6 months, confirmed by trichoscopy with TrichoLAB® software. They received 4 monthly sessions of MMP® with Minoxidil 0,5% on the right side of the scalp (frontal-parietal-vertex areas), followed by occlusion with plastic film for 12 h and prescription of Minoxidil 5% Solution for home use once a day, on both scalp sides, starting 72 h after the procedure. The reassessment trichoscopy was 6 weeks after the last session and they answered a "self-assessment" questionnaire. Treated scalp areas were compared and showed both treatments, in general, were effective, with no difference between them. If they were analyzed separately by treated areas, there were signs of better response in the parietal-vertex regions with treatment by MMP® with Minoxidil, while clinical treatment indicated a better response in the other regions. When patients were divided into more and less advanced cases, a better response in parietal-vertex regions treated by MMP® with Minoxidil in less advanced patients was confirmed. MMP® with Minoxidil showed a better response in the parietal-vertex regions in less advanced FPHL patients. It represents yet another resource to improve quality of life of these suffering patients.
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Affiliation(s)
- Adriana C Corrêa
- Faculty of Medical Sciences, Dermatology, State University of Rio de Janeiro, Rio de Janeiro, RJ, Brasil.
| | - Carla J Machado
- Faculty of Medicine, Public Health, Federal University of Minas Gerais, Belo Horizonte, MG, Brasil
| | - Sueli C S Carneiro
- Faculty of Medical Sciences, Dermatology, State University of Rio de Janeiro, Rio de Janeiro, RJ, Brasil
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Sadeghzadeh Bazargan A, Tavana Z, Dehghani A, Jafarzadeh A, Tabavar A, Alavi Rad E, Goodarzi A. The efficacy of the combination of topical minoxidil and oral spironolactone compared with the combination of topical minoxidil and oral finasteride in women with androgenic alopecia, female and male hair loss patterns: A blinded randomized clinical trial. J Cosmet Dermatol 2024; 23:543-551. [PMID: 37650533 DOI: 10.1111/jocd.15979] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 08/05/2023] [Accepted: 08/21/2023] [Indexed: 09/01/2023]
Abstract
INTRODUCTION Androgenic alopecia (AGA) is the most common cause of hair loss in women, affecting their quality of life. The present study was conducted with the aim of comparing the combined effect of topical minoxidil and oral spironolactone with the combined effect of topical minoxidil and oral finasteride in women with AGA, female and male hair loss patterns. METHOD This clinical study was performed on 60 women suffering from AGA. The patients were divided into two groups receiving spironolactone 100 mg/day and finasteride 5 mg/day. In addition, a 2% minoxidil solution was used in all patients in addition to treatment with finasteride or spironolactone. At 2 months after initiation and at the end of treatment, patients were evaluated using the Ludwig/Norwood-Hamilton scale and the degree of physician and patient satisfaction. RESULTS After 2 months, hair density, hair thickness, and hair loss had improved in both groups; however, statistically, there was no significant difference between the two groups with respect to these parameters (p > 0.05). After 4 months, a significant difference was found between the two groups in terms of treatment response (physician satisfaction), hair density, and hair loss severity. So that, the drugs used were ineffective in 6.7% of cases in the minoxidil-spironolactone group and in 16.7% of cases in the minoxidil-finasteride group. In addition, 43.3% of cases in the minoxidil-spironolactone group and 53% in the minoxidil-finasteride group responded well to treatment. The treatment effect was excellent in 56.7% and 0% of the mentioned groups, respectively, and the mentioned difference was statistically significant (p: 0.01). The response to treatment in female pattern hair loss (FPHL) was not statistically significant (p: 0.52), but there was a significant difference in the response to both treatments in male pattern hair loss (MPHL; p: 0.007). In terms of patient satisfaction, minoxidil-spironolactone treatment was significantly better than minoxidil-finasteride regarding hair density and severity of hair loss (p: 0.01). Finally, in terms of treatment complications, the patients in two groups did not have any serious adverse effects. CONCLUSION The combination of minoxidil and spironolactone could be considered a more effective treatment than the combination of minoxidil and finasteride in women with AGA, FPHL, and MPHL.
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Affiliation(s)
- Afsaneh Sadeghzadeh Bazargan
- Department of Dermatology, Rasool Akram Medical Complex Clinical Research Development Center (RCRDC), School of Medicine, Iran University of Medical Sciences (IUMS), Tehran, Iran
| | - Zeynab Tavana
- Department of Dermatology, Rasool Akram Medical Complex Clinical Research Development Center (RCRDC), School of Medicine, Iran University of Medical Sciences (IUMS), Tehran, Iran
| | - Abbas Dehghani
- Department of Dermatology, Rasool Akram Medical Complex Clinical Research Development Center (RCRDC), School of Medicine, Iran University of Medical Sciences (IUMS), Tehran, Iran
| | - Alireza Jafarzadeh
- Department of Dermatology, Rasool Akram Medical Complex Clinical Research Development Center (RCRDC), School of Medicine, Iran University of Medical Sciences (IUMS), Tehran, Iran
| | - Anahita Tabavar
- Department of Dermatology, Rasool Akram Medical Complex Clinical Research Development Center (RCRDC), School of Medicine, Iran University of Medical Sciences (IUMS), Tehran, Iran
| | - Ehsan Alavi Rad
- Department of Radiology, School of Medicine, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Azadeh Goodarzi
- Department of Dermatology, Rasool Akram Medical Complex Clinical Research Development Center (RCRDC), School of Medicine, Iran University of Medical Sciences (IUMS), Tehran, Iran
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Kim MH, Jin SC, Baek HK, Yang WM. Astragalus membranaceus and Cinnamomum cassia Stimulate the Hair Follicle Differentiation-Related Growth Factor by the Wnt/β-Catenin Signaling Pathway. Curr Issues Mol Biol 2023; 45:8607-8621. [PMID: 37998718 PMCID: PMC10670826 DOI: 10.3390/cimb45110541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 10/16/2023] [Accepted: 10/16/2023] [Indexed: 11/25/2023] Open
Abstract
Astragalus membranaceus and Cinnamomum cassia are used as spices and flavorful ingredients, or medicinal herbs with pharmacological effects. In this study, the hair-growth-promoting effects of the YH complex, a newly developed formula consisting of membranaceus and C. cassia, are investigated with the prediction of its molecular mechanism. The target gene of the YH complex was about 74.8% overlapped with the gene set of 'Hair growth' on the GO Biological Process database. The oral administration of the YH complex promoted hair regrowth and increased hair-shaft thickness in depilated hair loss mice. In addition, the anagen/telogen hair follicle ratio was significantly increased by the YH complex. The growth factors affecting the growth of hair follicles were dose-dependently increased by treatment with the YH complex. The Wnt/β-catenin signaling pathway expressions in skin tissues were apparently increased by the administration of the YH complex. In conclusion, the YH complex consisting of A. membranaceus and C. cassia induced hair follicle differentiation and preserved the growing-anagen phase by increasing growth factors and the Wnt/β-catenin signaling pathway, leading to the restoration of hair loss. The YH complex can be a remedy for hair loss diseases, such as alopecia areata, androgenetic alopecia, telogen effluvium, and chemotherapy-induced alopecia.
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Affiliation(s)
- Mi Hye Kim
- College of Korean Medicine, Woosuk University, Wanju 55338, Republic of Korea;
| | - Seong Chul Jin
- Department of Convergence Korean Medical Science, College of Korean Medicine, Kyung Hee University, Seoul 02447, Republic of Korea; (S.C.J.); (H.K.B.)
| | - Hee Kyung Baek
- Department of Convergence Korean Medical Science, College of Korean Medicine, Kyung Hee University, Seoul 02447, Republic of Korea; (S.C.J.); (H.K.B.)
| | - Woong Mo Yang
- Department of Convergence Korean Medical Science, College of Korean Medicine, Kyung Hee University, Seoul 02447, Republic of Korea; (S.C.J.); (H.K.B.)
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Lin CS, Chan LY, Wang JH, Chang CH. Diagnosis and treatment of female alopecia: Focusing on the iron deficiency-related alopecia. Tzu Chi Med J 2023; 35:322-328. [PMID: 38035053 PMCID: PMC10683524 DOI: 10.4103/tcmj.tcmj_95_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 05/19/2023] [Accepted: 07/14/2023] [Indexed: 12/02/2023] Open
Abstract
Objectives Alopecia is a soft but meaningful complaint affecting women's physical and psychological health. Female alopecia (FA) has diverse etiologies. Nonetheless, FA is stereotyped as female pattern hair loss, also known as female androgenetic alopecia, and has not been thoroughly investigated. This study aimed to identify the etiologies of FA at a tertiary medical center in Eastern Taiwan. Materials and Methods This retrospective study enrolled female patients with hair loss who visited the dermatology department of (blinded information). A complete history taking was obtained, including the onset and duration of alopecia, menstruation, gynecologic diseases, psychological stress, underlying diseases, vaccination, and dietary habits, etc., Blood tests were performed, including hemoglobin (Hb), ferritin, Zn, autoimmune and thyroid profiles, etc., Iron deficiency (ID) was defined as serum ferritin level <60 ng/mL. The hair condition, ferritin, and Hb levels were monitored every 3 months after supplementation. Results A total of 155 patients were recruited. The etiologies of FA were diverse; the top five etiologies were nutrient deficiencies (83.9%), autoimmune (14.8%) and thyroid (7.7%) diseases, psychological stress (12.3%), and coronavirus disease 2019 (COVID-19) vaccination (6.5%). ID accounted for 70.3% of cases. The disease duration was an important prognostic factor for the improvement of serum ferritin. Patients with subjective improvement of hair regrowth also had more increase of ferritin levels after iron supplementation. The corresponding ferritin level for female anemia (Hb: 12.0 g/dL) was 5.1 ng/mL, lower than the adequate level for hair growth (40-60 ng/mL), the corresponding Hb level of which was 13.1-13.8 g/dL. Conclusion The causes of FA varied, including nutrient deficiencies, autoimmune diseases, psychological stress, thyroid diseases, and COVID-19 vaccination, etc., Therefore, a complete survey before treatment is essential. Seventy percentage of FA cases were ID-FA. We suggest to redefine the serum ferritin level ≥60 ng/mL, with the corresponding Hb ≥13.0 g/dL as the normal range for early diagnosis. Initiation of iron supplementation within 6 months would result in a better prognosis.
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Affiliation(s)
- Chia-Shuen Lin
- Skin Institute, Department of Dermatology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan
| | - Li-Yi Chan
- Skin Institute, Department of Dermatology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan
| | - Jen-Hung Wang
- Department of Medical Research, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan
| | - Chung-Hsing Chang
- Skin Institute, Department of Dermatology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan
- Doctoral Degree Program in Translational Medicine, Tzu Chi University and Academia Sinica, College of Medicine, Tzu Chi University, Hualien, Taiwan
- Institute of Medical Sciences, College of Medicine, Tzu Chi University, Hualien, Taiwan
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Redmond LC, Limbu S, Farjo B, Messenger AG, Higgins CA. Male pattern hair loss: Can developmental origins explain the pattern? Exp Dermatol 2023; 32:1174-1181. [PMID: 37237288 PMCID: PMC10946844 DOI: 10.1111/exd.14839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 05/04/2023] [Accepted: 05/09/2023] [Indexed: 05/28/2023]
Abstract
Male pattern hair loss (MPHL), also referred to as male androgenetic alopecia (AGA) is the most common type of non-scarring progressive hair loss, with 80% of men suffering from this condition in their lifetime. In MPHL, the hair line recedes to a specific part of the scalp which cannot be accurately predicted. Hair is lost from the front, vertex, and the crown, yet temporal and occipital follicles remain. The visual effect of hair loss is due to hair follicle miniaturisation, where terminal hair follicles become dimensionally smaller. Miniaturisation is also characterised by a shortening of the growth phase of the hair cycle (anagen), and a prolongation of the dormant phase (kenogen). Together, these changes result in the production of thinner and shorter hair fibres, referred to as miniaturised or vellus hairs. It remains unclear why miniaturisation occurs in this specific pattern, with frontal follicles being susceptible while occipital follicles remain in a terminal state. One main factor we believe to be at play, which will be discussed in this viewpoint, is the developmental origin of the skin and hair follicle dermis on different regions of the scalp.
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Affiliation(s)
| | - Summik Limbu
- Department of BioengineeringImperial College LondonLondonUK
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Milani M, Colombo F. Efficacy and tolerability of an oral supplement containing amino acids, iron, selenium, and marine hydrolyzed collagen in subjects with hair loss (androgenetic alopecia, AGA or FAGA or telogen effluvium). A prospective, randomized, 3-month, controlled, assessor-blinded study. Skin Res Technol 2023; 29:e13381. [PMID: 37357646 PMCID: PMC10240182 DOI: 10.1111/srt.13381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Accepted: 05/19/2023] [Indexed: 06/27/2023]
Abstract
BACKGROUND Oral supplementation with some amino acids (like methionine, taurine, and cysteine) could be useful in subjects with hair loss conditions such as androgenic alopecia (AGA or FAGA) or telogen effluvium (TE). Hydrolysed collagen (HC) oral supplementation has demonstrated to have beneficial effects on nail and skin health and could improve hair growth. A food supplement in tablet formulation containing hydrolysed fish-origin collagen (300 mg/dose), taurine, cysteine, methionine, iron, and selenium has been recently available. To date no controlled data are available regarding the clinical efficacy of this product as adjuvant to hair loss specific treatments in these clinical conditions. STUDY AIMS To evaluate and compare the efficacy and tolerability of an oral supplementation based on HC and amino acids in subjects with hair loss due to AGA/FAGA or chronic TE in combination with drug treatments in comparison with drug treatments alone. METHODS AND SUBJECTS In a prospective, 12-week, randomized, assessor-blinded controlled trial 83 subjects (mean age 41 ± 16 years; 26 men and 57 women) were enrolled in the study. Fifty-nine subjects suffered from AGA/FAGA (Hamilton I-VA, Ludwig I-1, II-2) and 24 from chronic TE. Subjects were randomized to oral supplementation (1 tablet day) in combination with the specify drug treatment decided by the investigator according to the type of hair loss (AGA/FAGA or TE) (Group A; N = 48) or to specific drugs treatment only (Group B; N = 35). The main outcome of the trial was the clinical efficacy evaluation using a 7-point global assessment score (GAS) (from +3: Much Improved to -3 Much worsened; with score 0 representing no modification). The GAS score was evaluated using standardized photographs by an investigator unaware of the treatment groups at week 6 and at week 12. A secondary outcome was the evaluation of acceptability of the treatment regimen using a 10-point evaluation score. RESULTS Seventy-six participants (91.6%) completed the 12-week study period. The GAS score at week 6 was 0.5 ± 0.2 in group A and 0.0 ± 0.1 in Group B (p < 0.05; Mann-Whitney). At week 12 the GAS score in Group A was statistically significant higher in comparison with Group B (1.67 ± 0.16 and 0.66 ± 0.20, p < 0.001; Mann-Whitney test). A higher percentage of Group A subjects achieved a GAS score of ≥2 in comparison with group B (50% vs. 23%). The oral supplement was generally well tolerated. CONCLUSION An oral supplement containing hydrolysed fish-origin collagen, taurine, cysteine, methionine, iron, and selenium has demonstrated to improve the clinical efficacy of specific anti-hair loss treatments in subjects with AGA/FAGA or chronic TE.
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Kinoshita-Ise M, Fukuyama M, Ohyama M. Recent Advances in Understanding of the Etiopathogenesis, Diagnosis, and Management of Hair Loss Diseases. J Clin Med 2023; 12:jcm12093259. [PMID: 37176700 PMCID: PMC10179687 DOI: 10.3390/jcm12093259] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Revised: 04/26/2023] [Accepted: 04/29/2023] [Indexed: 05/15/2023] Open
Abstract
Hair-loss diseases comprise heterogenous conditions with respective pathophysiology and clinicopathological characteristics. Major breakthroughs in hair follicle biology and immunology have led to the elucidation of etiopathogenesis of non-scarring alopecia (e.g., alopecia areata, AA) and cicatricial alopecia (e.g., lichen planopilaris, LPP). High-throughput genetic analyses revealed molecular mechanism underlying the disease susceptibility of hair loss conditions, such as androgenetic alopecia (AGA) and female pattern hair loss (FPHL). Hair loss attracted public interest during the COVID-19 pandemic. The knowledge of hair loss diseases is robustly expanding and thus requires timely updates. In this review, the diagnostic and measurement methodologies applied to hair loss diseases are updated. Of note, novel criteria and classification/scoring systems published in the last decade are reviewed, highlighting their advantages over conventional ones. Emerging diagnostic techniques are itemized with clinical pearls enabling efficient utilization. Recent advances in understanding the etiopathogenesis and management for representative hair diseases, namely AGA, FPHL, AA, and major primary cicatricial alopecia, including LPP, are comprehensively summarized, focusing on causative factors, genetic predisposition, new disease entity, and novel therapeutic options. Lastly, the association between COVID-19 and hair loss is discussed to delineate telogen effluvium as the predominating pathomechanism accounting for this sequela.
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Affiliation(s)
- Misaki Kinoshita-Ise
- Department of Dermatology, Kyorin University Faculty of Medicine, Tokyo 181-8611, Japan
| | - Masahiro Fukuyama
- Department of Dermatology, Kyorin University Faculty of Medicine, Tokyo 181-8611, Japan
| | - Manabu Ohyama
- Department of Dermatology, Kyorin University Faculty of Medicine, Tokyo 181-8611, Japan
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Okhovat JP, Marks DH, Manatis-Lornell A, Hagigeorges D, Senna MM. Utility of laboratory testing in patients with female pattern hair loss. J Am Acad Dermatol 2023; 88:153-155. [PMID: 31306723 DOI: 10.1016/j.jaad.2019.07.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Revised: 07/01/2019] [Accepted: 07/03/2019] [Indexed: 10/26/2022]
Affiliation(s)
- Jean-Phillip Okhovat
- Department of Dermatology, Massachusetts General Hospital, Boston, Massachusetts
| | - Dustin H Marks
- Department of Dermatology, Massachusetts General Hospital, Boston, Massachusetts
| | | | - Dina Hagigeorges
- Department of Dermatology, Massachusetts General Hospital, Boston, Massachusetts
| | - Maryanne M Senna
- Department of Dermatology, Massachusetts General Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts.
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Saceda-Corralo D, Domínguez-Santas M, Vañó-Galván S, Grimalt R. What's New in Therapy for Male Androgenetic Alopecia? Am J Clin Dermatol 2023; 24:15-24. [PMID: 36169916 DOI: 10.1007/s40257-022-00730-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/06/2022] [Indexed: 01/29/2023]
Abstract
Male androgenetic alopecia is a common condition and represents a major concern for patients who experience this condition. While there are different treatments to stop hair loss and improve hair density, the 5-alpha reductase inhibitors have demonstrated to be effective in improving androgenetic alopecia in men and can maintain a positive response for many years. Oral finasteride 1 mg is a US FDA-approved option, but dutasteride 0.5 mg has been proven to induce better responses, especially in the frontal area. Both have been shown to be safe in clinical trials but there is widespread concern about sexual adverse effects among patients. The use of topical finasteride has increased during the last few years as a useful option to avoid systemic therapy. The efficacy of topical finasteride 0.25% daily has been demonstrated in clinical trials, with a less marked decrease in serum dihydrotestosterone levels than with oral intake. Mesotherapy with dutasteride has also become more widespread recently, although evidence of its effectiveness is limited to retrospective studies in real clinical practice. The use of oral minoxidil in androgenetic alopecia has not been approved by the FDA, however several clinical studies have shown that it is an effective treatment option. The initial dose recommended to treat male hair loss is 2.5 mg daily, although the dose is frequently increased to 5 mg daily. The main adverse effect of oral minoxidil is hypertrichosis, followed by dizziness or lower limb edema, which are much less common. Platelet-rich plasma is a non-pharmacological option to treat male androgenetic alopecia, with some clinical trials demonstrating an improvement in hair count after several months. Among the published studies, the main limitation to compare its efficacy is the heterogeneity of the procedure. The most frequent regimens propose treatment every 4 weeks for 3 months initially to assess the individual response. Another treatment alternative is the use of light devices with wavelengths of between 630 and 660 nm, known as low-level laser therapy. These devices can be used at home every day for 15-30 min. Their efficacy has been shown in a limited number of clinical trials; however, there is a lack of evidence about the efficacy of these devices compared with other medical options or as a complementary therapy in hair loss. The pipeline of potential new treatments for male androgenetic alopecia is strong. Pyrilutamide and GT20029 are being studied as topical antagonists of the androgen receptor, while cetirizine is another topical option with some initial promising results. Furthermore, according to isolated studies with heterogeneous treatment schemes, the use of botulinum toxin in the scalp might improve androgenetic alopecia, and lastly, scalp threading might increase the total hair count as growth factors are released during implantation.
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Affiliation(s)
- David Saceda-Corralo
- Servicio de Dermatología, Hospital Universitario Ramón y Cajal, Departamento de Medicina, Facultad de Medicina, Universidad de Alcalá, IRYCIS, Carretera Colmenar Viejo km 9.100, 28034, Madrid, Spain. .,Trichology Unit, Grupo de Dermatología Pedro Jaén, Madrid, Spain.
| | - Miguel Domínguez-Santas
- Servicio de Dermatología, Hospital Universitario Ramón y Cajal, Departamento de Medicina, Facultad de Medicina, Universidad de Alcalá, IRYCIS, Carretera Colmenar Viejo km 9.100, 28034, Madrid, Spain.,Trichology Unit, Grupo de Dermatología Pedro Jaén, Madrid, Spain
| | - Sergio Vañó-Galván
- Servicio de Dermatología, Hospital Universitario Ramón y Cajal, Departamento de Medicina, Facultad de Medicina, Universidad de Alcalá, IRYCIS, Carretera Colmenar Viejo km 9.100, 28034, Madrid, Spain.,Trichology Unit, Grupo de Dermatología Pedro Jaén, Madrid, Spain
| | - Ramon Grimalt
- Facultat de Medicina i Ciències de la Salut, Universitat Internacional de Catalunya Barcelona, Barcelona, Spain
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Saleem K, Siddiqui B, .ur.Rehman A, Taqi MM, Ahmed N. Exploiting Recent Trends in the Treatment of Androgenic Alopecia through Topical Nanocarriers of Minoxidil. AAPS PharmSciTech 2022; 23:292. [DOI: 10.1208/s12249-022-02444-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Accepted: 10/10/2022] [Indexed: 11/29/2022] Open
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Khunkhet S, Chanprapaph K, Rutnin S, Suchonwanit P. Histopathological Evidence of Occipital Involvement in Male Androgenetic Alopecia. Front Med (Lausanne) 2021; 8:790597. [PMID: 34881276 PMCID: PMC8645552 DOI: 10.3389/fmed.2021.790597] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Accepted: 11/02/2021] [Indexed: 11/13/2022] Open
Abstract
Background: The occipital region of the scalp is generally accepted as an unaffected area of androgenetic alopecia (AGA) for both genders. However, evidence of AGA involving the occipital scalp has been demonstrated in women; meanwhile, it is unclear whether occipital involvement also occurs in men. Objective: We aimed to determine if there is occipital involvement in men with AGA. Methods: This case-control study compared hair counts of scalp biopsy specimens from the occipital region of 82 men with Hamilton-Norwood III-VII and 82 unaffected men. Results: The mean ages of men with AGA and controls were 40.1 ± 8.9 and 38.6 ± 10.5 years, respectively (P = 0.291). A significant decrease in total hair follicles, terminal hair follicles, follicular units and terminal to vellus (T:V) ratio, along with a significant increase in follicular stelae was indicated in the AGA group compared to controls (all P < 0.05). Subgroup analyses revealed that average counts of total hair follicles, terminal hair follicles and T:V ratios were also significantly lower in males with Hamilton-Norwood VI and VII than in controls (all P < 0.05). There were no correlations between increasing age and hair count parameters, but a significant negative association was found between total follicle numbers and disease duration (r = -0.23, P = 0.02). Conclusions: AGA can involve the occipital area of male patients with advanced disease. Therefore, the occiput of particular cases should not be used to determine reference data for normal scalp hair, and preoperative measurements of miniaturized hairs in the donor site are strongly recommended in all persons undergoing hair transplantation.
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Affiliation(s)
- Saranya Khunkhet
- Division of Dermatology, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
- Skin Center, Srinakharinwirot University, Bangkok, Thailand
| | - Kumutnart Chanprapaph
- Division of Dermatology, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Suthinee Rutnin
- Division of Dermatology, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Poonkiat Suchonwanit
- Division of Dermatology, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
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Scalp Microbiome and Sebum Composition in Japanese Male Individuals with and without Androgenetic Alopecia. Microorganisms 2021; 9:microorganisms9102132. [PMID: 34683453 PMCID: PMC8536999 DOI: 10.3390/microorganisms9102132] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 10/01/2021] [Accepted: 10/08/2021] [Indexed: 12/19/2022] Open
Abstract
The skin microbiome and sebum may be associated with inflammation-related diseases of the scalp. To assess the pathogenesis and progression of androgenetic alopecia (AGA), we analyzed the composition of sebum and the bacterial and fungal microbiomes of the scalps of 118 Japanese male individuals with and without AGA, then discussed their roles in the pathogenesis of AGA. Sebum triglyceride and palmitic acid contents were higher in the AGA group than in the non-AGA group. Malassezia restricta, a lipophilic fungus that consumes palmitic acid, was abundant on the scalps of patients with AGA. Cutibacterium, Corynebacterium, and Staphylococcus were the most common genera in both groups, and patients with AGA exhibited scalp dysbiosis (increased abundance of Cutibacterium and decreased abundance of Corynebacterium). Our findings suggest that both sebum and the bacterial and fungal microbiomes of the scalp may be involved in the development of AGA.
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Kiconco S, Teede HJ, Azziz R, Norman RJ, Joham AE. The Need to Reassess the Diagnosis of Polycystic Ovary Syndrome (PCOS): A Review of Diagnostic Recommendations from the International Evidence-Based Guideline for the Assessment and Management of PCOS. Semin Reprod Med 2021; 39:71-77. [PMID: 34404096 DOI: 10.1055/s-0041-1735259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Polycystic ovary syndrome (PCOS) is a common endocrine disorder that is associated with negative metabolic, reproductive, endocrine, and psychological consequences among women of reproductive age. The diagnosis of PCOS remains challenging due to limited and conflicting evidence regarding definitions for each of the diagnostic features. This review of the recommended PCOS assessment criteria from the international evidence-based guideline highlights the crucial need to reassess, redefine, and optimize the diagnosis of PCOS. Notably, normal values and cut-offs need to be defined for each diagnostic feature across the lifespan and diverse ethnic groups. Understanding how these features cluster together and relate to short- and long-term health outcomes in PCOS is also vital. Ultimately, greater knowledge of the natural history of PCOS is needed through well-characterized, community-based longitudinal studies, which will inform future PCOS diagnosis guidelines and optimize women's health in reproductive life.
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Affiliation(s)
- Sylvia Kiconco
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Victoria, Australia
| | - Helena J Teede
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Victoria, Australia.,Department of Diabetes and Vascular Medicine, Monash Health, Victoria, Australia
| | - Ricardo Azziz
- American Society for Reproductive Medicine, Birmingham, Alabama.,Department of Obstetrics and Gynaecology, School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama.,Department of Health Policy, Management, and Behaviour; University at Albany School of Public Health, SUNY, Rensselaer, New York
| | - Robert J Norman
- Department of Obstetrics and Gynaecology, Robinson Research Institute, University of Adelaide, South Australia, Australia
| | - Anju E Joham
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Victoria, Australia.,Department of Diabetes and Vascular Medicine, Monash Health, Victoria, Australia
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14
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Zhou Y, Liu Q, Bai Y, Yang K, Ye Y, Wu K, Huang J, Zhang Y, Zhang X, Thianthanyakij T, Wang J, Zhu Y, Lin J, Wu W. Autologous activated platelet-rich plasma in hair growth: A pilot study in male androgenetic alopecia with in vitro bioactivity investigation. J Cosmet Dermatol 2020; 20:1221-1230. [PMID: 32888247 DOI: 10.1111/jocd.13709] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Revised: 07/13/2020] [Accepted: 08/27/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND Platelet-rich plasma (PRP) is effective in the treatment of androgenetic alopecia (AGA). AIMS The purpose of this study is to assess the effect of PRP on the proliferation of human follicle dermal papilla cells (HFDPCs), to observe the effect of PRP on the growth of hair follicles and hair shaft in vitro, to measure growth factors, and to evaluate the efficacy and safety of PRP injection. PATIENTS/METHODS The effect of PRP on the proliferation of HFDPCs was observed. The length of hair follicle and hair shaft in vitro was measured. Then, the concentration of growth factors (EGF, FGF-2, FGF-7, IGF-1, HGF, PDGF-BB, and VEGF-A) was evaluated. Half-head injection of PRP was conducted to 10 males. Three treatments were conducted at 30-day intervals. Digital photographs were taken; hair diameter, hair density, unit density of hair follicles, and terminal hair/ vellus hair were analyzed. RESULTS Platelet-rich plasma significantly promoted the proliferation of HFDPCs. Under the PRP culture, the hair follicle and hair shaft were grown, and the hair growth length on the 3rd and 6th days was greater than that of the control. PRP contained growth factors such as EGF, FGF-2, FGF-7, IGF-1, HGF, PDGF-B, and VEGF-A. Hair diameter, hair density, and unit hair follicle density on the PRP injection side peaked in the 6th month. The terminal hair/ vellus hair of the PRP injection side reached a peak in the 4th month. The average patient satisfaction during the entire treatment was 5.4 points (0-10 points). CONCLUSION Platelet-rich plasma can promote hair growth. PRP injection is safe and effective for the treatment of AGA.
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Affiliation(s)
- Yinghui Zhou
- Department of Dermatology, Huashan Hospital, Fudan University, Shanghai, China
| | - Qingmei Liu
- Department of Dermatology, Huashan Hospital, Fudan University, Shanghai, China
| | - Yanshuang Bai
- Department of Dermatology, Jing' an District Central Hospital of Shanghai (Huashan Hospital Fudan University, Jing' an Branch), Shanghai, China
| | - Kai Yang
- Department of Dermatology, Jing' an District Central Hospital of Shanghai (Huashan Hospital Fudan University, Jing' an Branch), Shanghai, China
| | - Yaqi Ye
- Department of Dermatology, Huashan Hospital, Fudan University, Shanghai, China
| | - Kejia Wu
- Department of Dermatology, Huashan Hospital, Fudan University, Shanghai, China
| | - Junhong Huang
- Department of Dermatology, Huashan Hospital, Fudan University, Shanghai, China
| | - Yue Zhang
- Department of Dermatology, Huashan Hospital, Fudan University, Shanghai, China
| | - Xuewenjun Zhang
- Department of Dermatology, Huashan Hospital, Fudan University, Shanghai, China
| | | | - Ji'an Wang
- Department of Dermatology, Huashan Hospital, Fudan University, Shanghai, China
| | - Yifei Zhu
- Department of Dermatology, Huashan Hospital, Fudan University, Shanghai, China
| | - Jinran Lin
- Department of Dermatology, Huashan Hospital, Fudan University, Shanghai, China
| | - Wenyu Wu
- Department of Dermatology, Huashan Hospital, Fudan University, Shanghai, China.,Department of Dermatology, Jing' an District Central Hospital of Shanghai (Huashan Hospital Fudan University, Jing' an Branch), Shanghai, China
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Affiliation(s)
| | - Dawn Marie R Davis
- Department of Dermatology and.,Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN
| | - Megha M Tollefson
- Department of Dermatology and.,Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN
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16
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Cantwell HM, Wieland CN, Proffer SL, Imhof RL, Torgerson RR, Tolkachjov SN. Lichen planopilaris in men: a retrospective clinicopathologic study of 19 patients. Int J Dermatol 2020; 60:482-488. [PMID: 33128471 DOI: 10.1111/ijd.15285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 09/28/2020] [Accepted: 10/06/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND Lichen planopilaris (LPP) is a scarring alopecia rarely described in men. OBJECTIVE To investigate the clinical and histopathologic features of LPP in men. METHODS We performed a retrospective cohort study of male patients with LPP seen at Mayo Clinic between 1992 and 2016. RESULTS Nineteen men with biopsy-confirmed LPP were included. The disease most commonly presented with diffuse (42.1%) or vertex scalp (42.1%) involvement. None of the patients had eyebrow or body hair involvement. Perifollicular erythema (94.7%) and pruritus (57.9%) were the most frequent clinical findings. Androgenetic alopecia (AGA) co-occurred in 26.3% of patients. Mucosal lichen planus was found in four patients (21.1%). Thyroid disease occurred in three patients (15.8%). Disease improvement (47.3%) occurred with combination topical and systemic therapy, topical clobetasol monotherapy, and minocycline monotherapy. CONCLUSIONS LPP in men has similar clinical and histologic presentations as reported in women. Nonscalp hair loss appears less likely in men with classic LPP than reported in men with frontal fibrosing alopecia, while mucosal lichen planus and thyroid disease appear to be more common in classic LPP. Men with AGA can present with new-onset concomitant LPP. Limitations included small study size, variable follow-up, and lack of standardized clinical assessment due the study's retrospective nature.
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Affiliation(s)
| | - Carilyn N Wieland
- Department of Dermatology, Mayo Clinic, Rochester, MN, USA.,Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | - Sydney L Proffer
- Department of Internal Medicine, The Christ Hospital, Cincinnati, OH, USA
| | - Reese L Imhof
- Mayo Clinic Alix School of Medicine, Rochester, MN, USA
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17
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Meah N, Wall D, Trindade de Carvalho L, Sinclair R. Bitemporal alopecia areata. Australas J Dermatol 2020; 61:263-265. [DOI: 10.1111/ajd.13270] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2019] [Accepted: 02/13/2020] [Indexed: 11/26/2022]
Affiliation(s)
- Nekma Meah
- Sinclair Dermatology Melbourne Victoria Australia
| | - Dmitri Wall
- Sinclair Dermatology Melbourne Victoria Australia
| | | | - Rodney Sinclair
- Sinclair Dermatology Melbourne Victoria Australia
- University of Melbourne Parkville Victoria Australia
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18
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Torabi P, Behrangi E, Goodarzi A, Rohaninasab M. A systematic review of the effect of
platelet‐rich
plasma on androgenetic alopecia of women. Dermatol Ther 2020; 33:e13835. [DOI: 10.1111/dth.13835] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Revised: 05/26/2020] [Accepted: 05/29/2020] [Indexed: 12/19/2022]
Affiliation(s)
- Pooneh Torabi
- Student Research Committee, Faculty of Medicine Iran University of Medical Sciences Tehran Iran
| | - Elham Behrangi
- Department of Dermatology Rasoul Akram Hospital, Iran University of Medical Sciences Tehran Iran
| | - Azadeh Goodarzi
- Department of Dermatology Rasoul Akram Hospital, Iran University of Medical Sciences Tehran Iran
| | - Masoomeh Rohaninasab
- Department of Dermatology Rasoul Akram Hospital, Iran University of Medical Sciences Tehran Iran
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19
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Yoon JS, Ku WY, Lee JH, Ahn HC. Low-level light therapy using a helmet-type device for the treatment of androgenetic alopecia: A 16-week, multicenter, randomized, double-blind, sham device-controlled trial. Medicine (Baltimore) 2020; 99:e21181. [PMID: 32702878 PMCID: PMC7373546 DOI: 10.1097/md.0000000000021181] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
INTRODUCTION Androgenetic alopecia is the most common form of hair loss in both sexes. In recent studies, low-level light therapy (LLLT) has been established as an effective treatment for alopecia. The purpose of this study was to evaluate the safety and efficacy of LLLT using a new helmet-type device for the treatment of androgenetic alopecia. METHOD A randomized, sham device-controlled, double-blind clinical trial was conducted at 2 institutions. Sixty participants diagnosed with androgenetic alopecia aged from 19 to 65 years were recruited. LLLT was performed through a helmet-type device that emitted light with a mean output power of 2.36 mW/cm at a wavelength of 655 nm. Participants were divided into 2 groups, which respectively used the experimental device and a sham device. After tattooing at the central point of the vertex, phototrichograms at that point were obtained at 0, 8, and 16 weeks. The primary endpoint of the study was the difference in the rate of change of hair density between the test group and the control group. RESULTS Comparing the results at baseline and week 16, the experimental group showed an increase in hair density of 41.90 hairs/cm and an increase in hair thickness of 7.50 μm, whereas the control group showed an increase of 0.72 hairs/cm and a decrease of 15.03 μm, respectively (P < .001). No adverse events or side effects occurred. CONCLUSION LLLT showed a significant effect on increasing hair density in patients with androgenetic alopecia. LLLT could be a safe and effective treatment for androgenetic alopecia in both sexes.
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Affiliation(s)
- Jung Soo Yoon
- Department of Plastic and Reconstructive Surgery, DongGuk University Ilsan Medical Center, Goyang, South Korea
| | - Won Young Ku
- Department of Plastic and Reconstructive Surgery, Hanyang University Medical Center, Hanyang University College of Medicine, Seoul
| | - Jang Hyun Lee
- Department of Plastic and Reconstructive Surgery, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri, Korea
| | - Hee Chang Ahn
- Department of Plastic and Reconstructive Surgery, Hanyang University Medical Center, Hanyang University College of Medicine, Seoul
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20
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Katoulis AC, Liakou AI, Koumaki D, Vakirlis E, Tsantes AG, Mortaki D, Bozi E, Ioannides D. A randomized, single‐blinded, vehicle‐controlled study of a topical active blend in the treatment of androgenetic alopecia. Dermatol Ther 2020; 33:e13734. [DOI: 10.1111/dth.13734] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Revised: 04/23/2020] [Accepted: 05/03/2020] [Indexed: 12/14/2022]
Affiliation(s)
- Alexander C. Katoulis
- Department of Dermatology and Venereology National and Kapodistrian University of Athens Medical School, “Attikon” General University Hospital Athens Greece
| | - Aikaterini I. Liakou
- Department of Dermatology and Venereology National and Kapodistrian University of Athens Medical School, “Attikon” General University Hospital Athens Greece
| | - Dimitra Koumaki
- Department of Dermatology and Venereology National and Kapodistrian University of Athens Medical School, “Attikon” General University Hospital Athens Greece
| | - Efstratios Vakirlis
- Department of Dermatology and Venereology Aristotle University of Thessaloniki, Skin and Venereal Diseases Hospital Thessaloniki Greece
| | - Andreas G. Tsantes
- Department of Dermatology and Venereology National and Kapodistrian University of Athens Medical School, “Attikon” General University Hospital Athens Greece
| | - Despina Mortaki
- Department of Dermatology and Venereology National and Kapodistrian University of Athens Medical School, “Attikon” General University Hospital Athens Greece
| | - Evangelia Bozi
- Department of Dermatology and Venereology National and Kapodistrian University of Athens Medical School, “Attikon” General University Hospital Athens Greece
| | - Demetrios Ioannides
- Department of Dermatology and Venereology Aristotle University of Thessaloniki, Skin and Venereal Diseases Hospital Thessaloniki Greece
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21
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Zhou Y, Chen C, Qu Q, Zhang C, Wang J, Fan Z, Miao Y, Hu Z. The effectiveness of combination therapies for androgenetic alopecia: A systematic review and meta‐analysis. Dermatol Ther 2020; 33:e13741. [PMID: 32478968 DOI: 10.1111/dth.13741] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 05/21/2020] [Accepted: 05/28/2020] [Indexed: 12/12/2022]
Affiliation(s)
- Yi Zhou
- Department of Plastic and Aesthetic Surgery Nanfang Hospital of Southern Medical University Guangzhou China
| | - Chenglong Chen
- Musculoskeletal Tumor Center Peking University People's Hospital Beijing China
| | - Qian Qu
- Department of Plastic and Aesthetic Surgery Nanfang Hospital of Southern Medical University Guangzhou China
| | - Chunhua Zhang
- Department of Plastic and Aesthetic Surgery Nanfang Hospital of Southern Medical University Guangzhou China
| | - Jin Wang
- Department of Plastic and Aesthetic Surgery Nanfang Hospital of Southern Medical University Guangzhou China
| | - Zhexiang Fan
- Department of Plastic and Aesthetic Surgery Nanfang Hospital of Southern Medical University Guangzhou China
| | - Yong Miao
- Department of Plastic and Aesthetic Surgery Nanfang Hospital of Southern Medical University Guangzhou China
| | - Zhiqi Hu
- Department of Plastic and Aesthetic Surgery Nanfang Hospital of Southern Medical University Guangzhou China
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22
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23
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Marks DH, Prasad S, De Souza B, Burns LJ, Senna MM. Topical Antiandrogen Therapies for Androgenetic Alopecia and Acne Vulgaris. Am J Clin Dermatol 2020; 21:245-254. [PMID: 31832993 DOI: 10.1007/s40257-019-00493-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Androgenetic alopecia (AGA) and acne vulgaris are two conditions commonly seen by dermatologists. Androgens and the androgen receptors play an essential role in the manifestation of both conditions, and some systemic therapies function by interfering in this pathway. The use of topical antiandrogen therapies has gained traction in recent years due to their potential efficacy in treating AGA and acne vulgaris, as well as their reduced adverse effects compared with systemic drugs. This review discusses the role of androgens in skin physiology and pathology and assesses the potential efficacy and safety of three topical antiandrogen therapies in the treatment of AGA and acne vulgaris. A literature review utilizing the PubMed, US Clinical Trials, and SCOPUS databases was conducted to search for randomized clinical trials, systematic reviews, cohort studies, case reports, and other relevant published studies on the pathogenesis and treatment of each condition with topical finasteride, ketoconazole shampoo, and cortexolone 17α-propionate (C17P). The results demonstrated that topical formulations of finasteride, ketoconazole, and C17P are promising treatments for male pattern hair loss, especially topical finasteride in combination with topical minoxidil. Limited studies have shown C17P to have potential in treating acne vulgaris in both males and females. Minimal adverse effects have been reported in clinical trials for all topical therapies, although topical finasteride is still contraindicated in pregnancy. Recognizing the preliminary evidence, more peer-reviewed studies on topical antiandrogen treatments for AGA and acne vulgaris are necessary before definitive recommendations can be made regarding efficacy and safety. There is also a critical need to include more women in study populations for these treatments.
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Iamsumang W, Leerunyakul K, Suchonwanit P. Finasteride and Its Potential for the Treatment of Female Pattern Hair Loss: Evidence to Date. DRUG DESIGN DEVELOPMENT AND THERAPY 2020; 14:951-959. [PMID: 32184564 PMCID: PMC7060023 DOI: 10.2147/dddt.s240615] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/30/2019] [Accepted: 02/19/2020] [Indexed: 12/13/2022]
Abstract
The currently approved treatment for female pattern hair loss (FPHL) includes topical minoxidil administration; however, this treatment fails to achieve hair regrowth in some patients. Finasteride, a selective 5α-reductase inhibitor (5-ARI), may be considered as an alternative treatment. However, because of its potential teratogenic effects, clinical studies and use of finasteride for FPHL are limited. In this review, we aim to summarize the literature regarding the pharmacology, clinical efficacy, and adverse effects of oral finasteride for the treatment of FPHL and to provide novel therapeutic options including topical finasteride and dutasteride, a new generation 5-ARI, for the treatment of FPHL.
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Affiliation(s)
- Wimolsiri Iamsumang
- Division of Dermatology, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Kanchana Leerunyakul
- Division of Dermatology, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Poonkiat Suchonwanit
- Division of Dermatology, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
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25
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El-Garf A, Mohie M, Salah E. Trichogenic effect of topical ketoconazole versus minoxidil 2% in female pattern hair loss: a clinical and trichoscopic evaluation. BIOMEDICAL DERMATOLOGY 2019. [DOI: 10.1186/s41702-019-0046-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Abstract
Background
Female pattern hair loss (FPHL) is a common non-scaring alopecia. Topical minoxidil is the only approved treatment for FPHL; however, it has frequent side effects. Ketoconazole is an antifungal with anti-androgenic properties.
Methods
The aim of this work was to evaluate the safety and possible trichogenic effects of ketoconazole in FPHL. Patients were randomly assigned into Group A with 20 patients who received 2% topical minoxidil solution and Group B involving 20 patients who were treated by 2% topical ketoconazole preparation. All patients were treated for 6 months and evaluated clinically plus via trichoscopy. Side effects were recorded, and patients’ satisfaction was measured.
Results
Regarding hair growth, a significant difference was detected between baseline and at 4th and 6th months in Group A. While in Group B, the improvement was delayed until the 6th month. Only 10% of Group B reported side effects. Patients’ satisfaction did not differ between the two groups.
Conclusions
Topical ketoconazole mediates a trichogenic effect in FPHL with few side effects. However, ketoconazole showed a delayed improvement versus minoxidil at similar concentrations. Further studies should evaluate the efficacy of higher concentrations of ketoconazole solutions for FPHL which is a promising therapy.
Trial registration
IRB approval status: reviewed and approved by IRB of Faculty of Medicine, Zagazig University; approval no. #3642
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Khattab FM, Bessar H. Accelerated hair growth by combining thread monofilament and minoxidil in female androgenetic alopecia. J Cosmet Dermatol 2019; 19:1738-1744. [PMID: 31789457 DOI: 10.1111/jocd.13228] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Revised: 11/06/2019] [Accepted: 11/07/2019] [Indexed: 11/30/2022]
Abstract
BACKGROUND Monofilament thread therapy (PLLA) and minoxidil have been used as alternative treatments for female androgenetic alopecia. AIM The aim was to determine the efficacy and safety of thread therapy combined with minoxidil in female androgenetic alopecia. PATIENT AND METHODS Twenty-seven women were enrolled in this randomized half-split study based on a left-head to the right-head pattern. Thread therapy (PLLA) treatment was unilaterally performed (once); minoxidil was bilaterally applied for 6 months. Global photographs and dermoscopy assessments were performed in the baseline and every 2 months till the end of treatment. Global photographs underwent blinded review by three independent dermatologists. RESULTS Mean hair density increased from 114 ± 27 to 143 ± 25/cm2 (P < .001) in the combined group and from 113 ± 24 to 123 ± 19/cm2 in the minoxidil group (P < .001). The mean change from baseline between the two groups was also compared (P = .003). Global photographs showed improvement in 93% (25/27) patients in the combined group and 52% (14/27) patients in the minoxidil group. CONCLUSION Poly-l-lactic acid microthread therapy combined with minoxidil may improve hair density, hair thickness, and hair appearance better than minoxidil alone.
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Affiliation(s)
- Fathia M Khattab
- Department of Dermatology, Venereology and Andrology, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Hagar Bessar
- Department of Dermatology, Venereology and Andrology, Faculty of Medicine, Zagazig University, Zagazig, Egypt
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27
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Ferreira MN, Ramseier JY, Leventhal JS. Dermatologic conditions in women receiving systemic cancer therapy. Int J Womens Dermatol 2019; 5:285-307. [PMID: 31909148 PMCID: PMC6938835 DOI: 10.1016/j.ijwd.2019.10.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Revised: 10/12/2019] [Accepted: 10/13/2019] [Indexed: 12/24/2022] Open
Abstract
As advances in cancer therapies have improved cancer-related survival, novel therapeutics have also introduced a variety of dermatologic toxicities, and an increased number of patients are living with these sequalae. Women with cancer in particular experience a spectrum of dermatologic conditions that affect their skin, hair, nail, and mucosal surfaces. Studies have shown that these toxic effects can significantly affect quality of life and alter a woman's self-image, cultural identity, femininity, sexuality, and mental health. In severe instances, dermatologic toxicities may even disrupt cancer therapy and can therefore affect overall survival and treatment response. In this article, we review the dermatologic adverse effects from traditional chemotherapy, targeted therapy, immune checkpoint inhibitors, and endocrine therapy that disproportionately affect women. The timely diagnosis and management of these dermatologic conditions is crucial in the multidisciplinary care of women with cancer.
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28
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Lahiji SF, Um DJ, Kim Y, Jang J, Yang H, Jung H. Scalp Micro-Pigmentation via Transcutaneous Implantation of Flexible Tissue Interlocking Biodegradable Microneedles. Pharmaceutics 2019; 11:pharmaceutics11110549. [PMID: 31652807 PMCID: PMC6920983 DOI: 10.3390/pharmaceutics11110549] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2019] [Revised: 10/21/2019] [Accepted: 10/22/2019] [Indexed: 12/30/2022] Open
Abstract
Alopecia, characterized by hair follicle blockage and hair loss, disrupts the normal cycle of hair growth. Although not a life-threatening condition, a growing body of evidence suggests that the psychological state of individuals experiencing alopecia can be highly influenced. Despite considerable research on hair loss treatment, interest in micro-pigmentation has increased in recent decades. Micro-pigmentation is an effective method to camouflage the visual contrast between the scalp and hair strands. However, the localization, intensity and dimension of microdots depend highly upon the physician performing the implantation. Incorrectly localized microdots within the skin may lead to patchy or faded micro-pigmentation. To overcome the limitations of conventional micro-pigmentation, we aimed to develop micro-pigment-encapsulated biodegradable microneedles (PBMs), capable of accurately implanting pigments below the epithelial-dermal junction of the scalp in a minimally invasive manner. A tissue interlocking microneedle technique was utilized to fabricate double-layered PBMs over a biodegradable flexible sheet, which could be washed off post-implantation. We confirmed that the intensity, dimension and insertion depth of 1000 μm-long PBMs was maintained on pig cadaver skin over time. This study suggested that the developed PBMs would serve as an attractive platform for scalp micro-pigmentation in the future.
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Affiliation(s)
- Shayan Fakhraei Lahiji
- Department of Biotechnology, Building 123, Yonsei University, 50 Yonsei-ro, Seodaemun-gu, Seoul 03722, Korea.
| | - Daniel Junmin Um
- Department of Biotechnology, Building 123, Yonsei University, 50 Yonsei-ro, Seodaemun-gu, Seoul 03722, Korea.
| | - Youseong Kim
- Department of Biotechnology, Building 123, Yonsei University, 50 Yonsei-ro, Seodaemun-gu, Seoul 03722, Korea.
| | - Jeesu Jang
- Department of Biotechnology, Building 123, Yonsei University, 50 Yonsei-ro, Seodaemun-gu, Seoul 03722, Korea.
| | - Huisuk Yang
- Juvic Biotech, Inc., No. 208, Digital-ro 272, Guro-gu, Seoul, 08389, Korea.
| | - Hyungil Jung
- Department of Biotechnology, Building 123, Yonsei University, 50 Yonsei-ro, Seodaemun-gu, Seoul 03722, Korea.
- Juvic Biotech, Inc., No. 208, Digital-ro 272, Guro-gu, Seoul, 08389, Korea.
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Ghonemy S, Alarawi A, Bessar H. Efficacy and safety of a new 10% topical minoxidil versus 5% topical minoxidil and placebo in the treatment of male androgenetic alopecia: a trichoscopic evaluation. J DERMATOL TREAT 2019; 32:236-241. [DOI: 10.1080/09546634.2019.1654070] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Soheir Ghonemy
- Department of Dermatology, Venereology and Andrology, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Abeer Alarawi
- Department of Dermatology, Venereology and Andrology, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Hagar Bessar
- Department of Dermatology, Venereology and Andrology, Faculty of Medicine, Zagazig University, Zagazig, Egypt
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Abstract
According to (a) the beauty ideal of a full head of hair and (b) the physical attractiveness stereotype (PAS; "what is beautiful is good"), bald men should appear less attractive than nonbald men, not only physically but also socially. To explain inconsistent results on this prediction in previous research, we suggest two antagonistic processes: the automatic activation of the PAS at the implicit level and its suppression at the explicit level, the latter process selectively triggered by individuating information about the target person. In line with this account, we only found negative social attractiveness ratings for bald men by same-aged women when individuating target information was lacking (Experiment 1). In contrast, irrespective of whether individuating information was available or not, we reliably found evidence for the PAS in different implicit paradigms (the implicit association test in Experiment 2 and a source monitoring task in Experiment 3). We conclude that individuating information about bald men suppresses PAS application, but not PAS activation.
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Affiliation(s)
- Dirk Kranz
- Department of Psychology, University of Trier,
Germany
| | - Lena Nadarevic
- Department of Psychology, University of Mannheim,
Germany
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31
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Daniels G, Akram S, Westgate GE, Tamburic S. Can plant-derived phytochemicals provide symptom relief for hair loss? A critical review. Int J Cosmet Sci 2019; 41:332-345. [DOI: 10.1111/ics.12554] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2019] [Revised: 05/23/2019] [Accepted: 06/22/2019] [Indexed: 12/16/2022]
Affiliation(s)
- G. Daniels
- Cosmetic Science Research Group; University of the Arts, London; 20 John Princes Street London U.K
| | - S. Akram
- Cosmetic Science Research Group; University of the Arts, London; 20 John Princes Street London U.K
| | - G. E. Westgate
- Gill Westgate Consultancy Ltd; Stevington Bedfordshire U.K
| | - S. Tamburic
- Cosmetic Science Research Group; University of the Arts, London; 20 John Princes Street London U.K
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32
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Carmina E, Azziz R, Bergfeld W, Escobar-Morreale HF, Futterweit W, Huddleston H, Lobo R, Olsen E. Female Pattern Hair Loss and Androgen Excess: A Report From the Multidisciplinary Androgen Excess and PCOS Committee. J Clin Endocrinol Metab 2019; 104:2875-2891. [PMID: 30785992 DOI: 10.1210/jc.2018-02548] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Accepted: 02/15/2019] [Indexed: 02/04/2023]
Abstract
OBJECTIVE To determine the current state of knowledge and provide evidence-based recommendations that could be valid for all specialists taking care of female pattern hair loss (FPHL), a common form of hair loss in women that is characterized by the reduction of hair density in the central area of the scalp, whereas the frontal hairline is generally well conserved. PARTICIPANTS An expert task force appointed by the Androgen Excess and PCOS Society, which included specialists from dermatology, endocrinology, and reproductive endocrinology. DESIGN Levels of evidence were assessed and graded from A to D. Peer-reviewed studies evaluating FPHL published through December 2017 were reviewed. Criteria for inclusion/exclusion of the published papers were agreed on by at least two reviewers in each area and arbitrated by a third when necessary. CONCLUSIONS (i) The term "female pattern hair loss" should be used, avoiding the previous terms of alopecia or androgenetic alopecia. (ii) The two typical patterns of hair loss in FPHL are centrifugal expansion in the mid scalp, and a frontal accentuation or Christmas tree pattern. (iii) Isolated FPHL should not be considered a sign of hyperandrogenism when androgen levels are normal. (iv) The assessment of patients with FPHL is primarily clinical. (v) In all patients with FPHL, assessment of a possible androgen excess is mandatory. Measurement of vitamin D, iron, zinc, thyroid hormones, and prolactin are optional but recommended. (vi) Treatment of FPHL should start with minoxidil (5%), adding 5α-reductase inhibitors or antiandrogens when there is severe hair loss or hyperandrogenism.
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Affiliation(s)
- Enrico Carmina
- Department of Health Sciences and Mother and Child Care, University of Palermo, Palermo, Italy
| | - Ricardo Azziz
- Department of Health Policy, Management, and Behavior, School of Public Health, University at Albany, State University of New York, Albany, New York
| | - Wilma Bergfeld
- Department of Dermatology, Cleveland Clinic, Cleveland, Ohio
- Department of Pathology, Cleveland Clinic, Cleveland, Ohio
| | - Héctor F Escobar-Morreale
- Department of Endocrinology and Nutrition, Hospital Universitario Ramón y Cajal, Universidad de Alcalá, Madrid, Spain
- Centro de Investigación Biomédica en Red Diabetes y Enfermedades Metabólicas Asociadas, Madrid Spain
- Instituto Ramón y Cajal de Investigación Sanitaria, Madrid, Spain
| | | | - Heather Huddleston
- Department of Obstetrics and Gynecology, University of California at San Francisco, San Francisco, California
| | - Rogerio Lobo
- Department of Obstetrics and Gynecology, Columbia University, New York, New York
| | - Elise Olsen
- Department of Dermatology, Duke University Medical Center, Durham, North Carolina
- Department of Medicine, Duke University Medical Center, Durham, North Carolina
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Phamacopuncture and Dermal Application of Sebalgukhwa-san: Effects on Hair Growth in a Mouse Model of Alopecia. JOURNAL OF ACUPUNCTURE RESEARCH 2019. [DOI: 10.13045/jar.2019.00059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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34
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Alkahtane AA, Albasher G, Al-Sultan NK, Alqahtani WS, Alarifi S, Almeer RS, Alghamdi J, Ali D, Alahmari A, Alkahtani S. Long-term treatment with finasteride induces apoptosis and pathological changes in female mice. Hum Exp Toxicol 2019; 38:762-774. [PMID: 30943778 DOI: 10.1177/0960327119842195] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Androgenetic alopecia is the most common type of alopecia, and it affects humans of both genders. Finasteride is a type II selective 5α-reductase inhibitor that is administered orally to treat androgenetic alopecia and benign prostatic hyperplasia in human males. However, its effect on the vital organs of females is unknown. This study was designed to investigate the effects of finasteride on the vital organs such as liver, kidney, and heart of female mice. To study the prospective effects of finasteride, female mice were orally administered two doses of finasteride (0.5 and 1.5 mg/kg) once daily for 35 days, and serum levels of various biochemical parameters and histopathology of various organs were examined. The results showed that serum levels of alkaline phosphatase were significantly increased by both high- and low-dose finasteride, whereas cholesterol was significantly increased by the high dose only. Creatine kinase was significantly increased by the high and low doses, whereas glucose was significantly decreased by both doses. Histopathological analysis and DNA damage assays showed that finasteride has adverse effects within both the short and the long periods in female mice. In addition, the proapoptotic genes Bax and caspase-3 were significantly increased by high dose finasteride, whereas the antiapoptotic gene Bcl-2 was significantly decreased by the low and high doses. In conclusion, finasteride is not currently approved for therapeutic use in females, and the findings in this study suggest caution in any future consideration of such use.
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Affiliation(s)
- A A Alkahtane
- 1 Department of Zoology, College of Science, King Saud University, Riyadh, Saudi Arabia
| | - G Albasher
- 1 Department of Zoology, College of Science, King Saud University, Riyadh, Saudi Arabia
| | - N K Al-Sultan
- 1 Department of Zoology, College of Science, King Saud University, Riyadh, Saudi Arabia
| | - W S Alqahtani
- 2 Department of Forensic Biology, College of Forensic Sciences, Naif Arab University for Security Sciences, Riyadh, Saudi Arabia
| | - S Alarifi
- 1 Department of Zoology, College of Science, King Saud University, Riyadh, Saudi Arabia
| | - R S Almeer
- 1 Department of Zoology, College of Science, King Saud University, Riyadh, Saudi Arabia
| | - J Alghamdi
- 1 Department of Zoology, College of Science, King Saud University, Riyadh, Saudi Arabia
| | - D Ali
- 1 Department of Zoology, College of Science, King Saud University, Riyadh, Saudi Arabia
| | - A Alahmari
- 3 Department of Biology, Science College, King Khalid University, Abha, Saudi Arabia
| | - S Alkahtani
- 1 Department of Zoology, College of Science, King Saud University, Riyadh, Saudi Arabia
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Panchaprateep R, Pisitkun T, Kalpongnukul N. Quantitative proteomic analysis of dermal papilla from male androgenetic alopecia comparing before and after treatment with low-level laser therapy. Lasers Surg Med 2019; 51:600-608. [PMID: 30843235 DOI: 10.1002/lsm.23074] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/27/2019] [Indexed: 12/14/2022]
Abstract
BACKGROUND Currently, low-level laser therapy (LLLT) has been approved as a new treatment for androgenetic alopecia (AGA). However, it has not been elucidated how LLLT promotes hair growth in vivo. OBJECTIVES To investigate the change in protein expression from dermal papilla (DP) tissues in male AGA patients after LLLT treatment using liquid chromatography tandem mass spectrometry (LC-MS/MS) analysis. METHODS This is an open-label, prospective, single-arm study obtained punch scalp biopsy specimens from patients with AGA before and after LLLT treatment. Each subject was self-treated with helmet type of LLLT (655 nm, 5 mW) device at home for 25 minutes per treatment every other day for 24 weeks. LC-MS/MS analysis based on the dimethyl labeling strategy for protein quantification was used to identify proteins expressed in DP tissues from AGA patients. RESULTS Proteomic analysis revealed 11 statistically significant up-regulated and 2 down-regulated proteins in LLLT treated DP compared with baseline (P < 0.05). A bioinformatic analysis signifies that these proteins are involved in several biological processes such as regulation of cellular transcription, protein biosynthesis, cell energy, lipid homeostasis, extracellular matrix (ECM), ECM structural constituent, cell-cell/cell-matrix adhesion as well as angiogenesis. ATP-binding cassette sub-family G member, a transporter involved in cellular lipid homeostasis, was the most up-regulated protein. Additionally, LLLT increased the main ECM proteins in DP which results in a bigger volume of DP and a clinical improvement of hair diameter in AGA patients. CONCLUSION We identified the proteome set of DP proteins of male patients with AGA treated with LLLT which implicates the role of LLLT in promoting hair growth and reversing of miniaturization process of AGA by enhancing DP cell function. Our results strongly support the benefit of LLLT in the treatment of AGA. Lasers Surg. Med. © 2019 Wiley Periodicals, Inc.
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Affiliation(s)
- Ratchathorn Panchaprateep
- Faculty of Medicine, Division of Dermatology, Department of Medicine, Chulalongkorn University, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
| | - Trairak Pisitkun
- Center of Excellence in Systems Biology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Nuttiya Kalpongnukul
- Center of Excellence in Systems Biology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
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36
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Sasaki GH. Review of Human Hair Follicle Biology: Dynamics of Niches and Stem Cell Regulation for Possible Therapeutic Hair Stimulation for Plastic Surgeons. Aesthetic Plast Surg 2019; 43:253-266. [PMID: 30324295 DOI: 10.1007/s00266-018-1248-1] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Accepted: 09/19/2018] [Indexed: 12/13/2022]
Abstract
Plastic surgeons are frequently asked to manage male- and female-pattern hair loss in their practice. This article discusses the epidemiology, pathophysiology, and current management of androgenetic alopecia and emphasizes more recent knowledge of stem cell niches in hair follicles that drive hair cycling, alopecia, and its treatment. The many treatment programs available for hair loss include newer strategies that involve the usage of growth factors, platelet-rich plasma, and fat to stimulate follicle growth. Future research may clarify novel biomolecular mechanisms that target specific cells that promote hair regeneration.Level of Evidence V This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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37
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Wipf A, Boysen N, Hordinsky MK, Dando EE, Sadick N, Farah RS. The rise of transcutaneous drug delivery for the management of alopecia: a review of existing literature and an eye towards the future. J COSMET LASER THER 2018; 21:247-254. [PMID: 30300013 DOI: 10.1080/14764172.2018.1525743] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Introduction: Fractional lasers and microneedling devices are increasingly used with topical drugs to treat various conditions, including alopecia, as they grant access to dermal structures such as hair follicles and cutaneous vasculature. Objective: To perform a comprehensive review on transcutaneous drug delivery for the management of alopecia. Methods: PubMed, Embase, and Ovid Medline databases were searched using terms including: alopecia, microneedling, lasers, androgenetic alopecia (AGA), alopecia areata (AA), drug delivery. Articles were examined for inclusion criteria: diagnosis of alopecia regardless of type, use of fractional laser or microneedling devices, and subsequent administration of topical medication. Results: 8 studies, 6 prospective clinical trials and 2 case series, examining either AA or AGA were identified. For AA, five studies examined microneedling together with topical triamcinolone in three of these, while two studies used photodynamic therapy. Regarding AGA, two studies used topical minoxidil plus microneedling, and one examined topical finasteride with fractional erbium glass laser. Improvement was seen in 6 of the 8 studies. Discussion: Transcutaneous drug delivery via fractional laser and microneedling is a promising modality with preliminary evidence for increased hair regrowth over topical therapy alone. Further studies are needed to elucidate treatment parameters and appropriate device selection for drug delivery.
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Affiliation(s)
- Angela Wipf
- a Department of Dermatology , University of Minnesota , Minneapolis , Minnesota , United States
| | - Nicholas Boysen
- a Department of Dermatology , University of Minnesota , Minneapolis , Minnesota , United States
| | - Maria K Hordinsky
- a Department of Dermatology , University of Minnesota , Minneapolis , Minnesota , United States
| | - Emily E Dando
- b University of Pittsburgh School of Medicine , Pittsburgh , PA , United States
| | - Neil Sadick
- c Sadick Dermatology , New York , NY , United States
| | - Ronda S Farah
- a Department of Dermatology , University of Minnesota , Minneapolis , Minnesota , United States
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38
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Lee HE, Lee SH, Jeong M, Shin JH, Ahn Y, Kim D, Oh SH, Yun SH, Lee KJ. Trichogenic Photostimulation Using Monolithic Flexible Vertical AlGaInP Light-Emitting Diodes. ACS NANO 2018; 12:9587-9595. [PMID: 30125485 DOI: 10.1021/acsnano.8b05568] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Alopecia is considered an aesthetic, psychological, and social issue among modern people. Although laser-induced skin stimulation is utilized for depilation treatment, such treatment has significant drawbacks of high energy consumption, huge equipment size, and limited usage in daily life. Here, we present a wearable photostimulator for hair-growth applications using high-performance flexible red vertical light-emitting diodes (f-VLEDs). Flexible microscale LEDs were effectively fabricated by a simple monolithic fabrication process, resulting in high light output (∼30 mW mm-2), low forward voltage (∼2.8 V), and excellent flexibility for wearable biostimulation. Finally, trichogenic stimulation of a hairless mouse was achieved using high-performance red f-VLEDs with high thermal stability, device uniformity, and mechanical durability.
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Affiliation(s)
- Han Eol Lee
- Department of Materials Science and Engineering , Korea Advanced Institute of Science and Technology (KAIST) , 291 Daehak-ro , Yuseong-gu, Daejeon 34141 , Republic of Korea
| | - Seung Hyun Lee
- Department of Materials Science and Engineering , Korea Advanced Institute of Science and Technology (KAIST) , 291 Daehak-ro , Yuseong-gu, Daejeon 34141 , Republic of Korea
| | - Minju Jeong
- Department of Biological Sciences , Korea Advanced Institute of Science and Technology (KAIST) , 291 Daehak-ro , Yuseong-gu, Daejeon 34141 , Republic of Korea
| | - Jung Ho Shin
- Department of Materials Science and Engineering , Korea Advanced Institute of Science and Technology (KAIST) , 291 Daehak-ro , Yuseong-gu, Daejeon 34141 , Republic of Korea
| | - Yuri Ahn
- Department of Dermatology and Cutaneous Biology Research Institute , Severance Hospital Yonsei University College of Medicine , 50-1 Yonsei-ro , Seodaemun-gu, Seoul 03722 , Republic of Korea
| | - Daesoo Kim
- Department of Biological Sciences , Korea Advanced Institute of Science and Technology (KAIST) , 291 Daehak-ro , Yuseong-gu, Daejeon 34141 , Republic of Korea
| | - Sang Ho Oh
- Department of Dermatology and Cutaneous Biology Research Institute , Severance Hospital Yonsei University College of Medicine , 50-1 Yonsei-ro , Seodaemun-gu, Seoul 03722 , Republic of Korea
| | - Seok Hyun Yun
- Wellman Center for Photomedicine , Harvard Medical School and Massachusetts General Hospital , 65 Landsdowne Street Up-5 , Cambridge , Massachusetts 02139 , United States
| | - Keon Jae Lee
- Department of Materials Science and Engineering , Korea Advanced Institute of Science and Technology (KAIST) , 291 Daehak-ro , Yuseong-gu, Daejeon 34141 , Republic of Korea
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Synergistic effect of platelet-rich plasma injections and scalp lifting in androgenetic alopecia. Clin Dermatol 2018; 36:673-679. [DOI: 10.1016/j.clindermatol.2018.03.015] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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40
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Abstract
In the United States, an increasing number of individuals are identifying as transgender. Males at birth who identify as females are called male-to-female (MTF) transgender individuals or trans women, and females at birth who identify as males are called female-to-male (FTM) transgender individuals or trans men. The transgender patient population possess unique health concerns disparate from those of the general populace. Exogenous hormone therapy for transgender patients leads to changes in the distribution and pattern of hair growth. Exogenous testosterone can lead to male pattern hair loss and hirsutism, while estrogen therapy usually results in decreased facial and body hair growth and density. A thorough understanding of the hormonal treatments that may be used in transgender individuals as well the unique and complex biologic characteristics of the hair follicle is required for appropriate diagnosis, counseling and treatment of patients. The aim of this article is to provide a framework for understanding hair disorders in transgender individuals and effective treatment options.
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Katoulis AC, Liakou AI, Alevizou A, Bonovas S, Bozi E, Kontogiorgi D, Rigopoulos D. Efficacy and Safety of a Topical Botanical in Female Androgenetic Alopecia: A Randomized, Single-Blinded, Vehicle-Controlled Study. Skin Appendage Disord 2018; 4:160-165. [PMID: 30197894 PMCID: PMC6120395 DOI: 10.1159/000480024] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2017] [Accepted: 08/03/2017] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Androgenetic alopecia (AGA) in females is a difficult to treat skin disorder. A novel topical botanical lotion has been approved for its treatment. It acts by increasing Bcl-2, perifollicular Langerhans and mast cells, and perifollicular collagen. The aim of this study was to evaluate the efficacy and safety of this lotion in females. METHODS Forty women with AGA were randomized to apply the active lotion or placebo, twice daily for 24 weeks. Subjects were evaluated at 0, 12, and 24 weeks by clinical examination, photographic documentation, quality of life evaluation (DLQI), and trichogram (anagen to telogen ratio). RESULTS The clinical evaluation demonstrated an increased hair density in the intervention group (great improvement in 7.7$, moderate in 88.5$, and stable in 3.8$). The self-assessment score increased from 4.5 to 6.0 (24 weeks), and the DLQI improved from 4 to 3 in the intervention group (p < 0.001). The mean anagen to telogen ratio in the intervention group was 2.1, 3.9, and 6.0 at 0, 12, and 24 weeks, respectively, whereas in the control group it was 2.2, 3.8, and 3.3, respectively. CONCLUSION The new topical botanical lotion showed remarkable efficacy, with a high degree of patient satisfaction and improvement of their quality of life.
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Affiliation(s)
- Alexandros C. Katoulis
- 2nd Department of Dermatology and Venereology, National and Kapodistrian University of Athens Medical School, “Attikon” General University Hospital, Athens, Greece
| | - Aikaterini I. Liakou
- 2nd Department of Dermatology and Venereology, National and Kapodistrian University of Athens Medical School, “Attikon” General University Hospital, Athens, Greece
| | - Antigoni Alevizou
- 2nd Department of Dermatology and Venereology, National and Kapodistrian University of Athens Medical School, “Attikon” General University Hospital, Athens, Greece
| | | | - Evangelia Bozi
- 2nd Department of Dermatology and Venereology, National and Kapodistrian University of Athens Medical School, “Attikon” General University Hospital, Athens, Greece
| | - Dimitra Kontogiorgi
- 2nd Department of Dermatology and Venereology, National and Kapodistrian University of Athens Medical School, “Attikon” General University Hospital, Athens, Greece
| | - Dimitrios Rigopoulos
- 2nd Department of Dermatology and Venereology, National and Kapodistrian University of Athens Medical School, “Attikon” General University Hospital, Athens, Greece
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Kim BK, Lee S, Jun M, Chung HC, Oh SS, Lee WS. Perception of Hair Loss and Education Increases the Treatment Willingness in Patients With Androgenetic Alopecica: A Population-Based Study. Ann Dermatol 2018; 30:402-408. [PMID: 30065579 PMCID: PMC6029958 DOI: 10.5021/ad.2018.30.4.402] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2017] [Revised: 12/28/2017] [Accepted: 01/30/2018] [Indexed: 12/29/2022] Open
Abstract
Background Androgenetic alopecia (AGA) has a negative impact on self-image and decrease in quality of life. However, relatively few men have sought treatment for AGA. Improvement in treatment willingness is important for maintaining long-term management in patients with AGA. Objectives We aimed to identify the prevalence of patients' perception of hair loss and evaluate various factors that affect the treatment willingness in patients with AGA. Methods We conducted a population-based cross-sectional survey of 503 patients with AGA (329 men, 174 women). We collected the various demographic data, family history of AGA, history of past treatment, self-perception of hair loss and treatment willingness using structured questionnaires. Then, we provided the knowledge about AGA to the half of subjects and compared the treatment willingness between educated group and nond-educated group. Results Two-hundred and forty-seven out of 503 patients (49.1%) did not have illness perception and 262 out of 503 patients (52.1%) did not have treatment willingness in future. The patients with perception of hair loss, accurate information on hair loss and severe hair loss showed 1.745-fold, 1.700-fold, and 2.078-fold higher tendency of receiving treatment in future. Conclusion Our findings imply that patients with perception and greater understanding of AGA tend to pursue treatment for AGA. Thus, these elements should be taken into account when treating patients. In addition, emphasis on education is needed to increase public awareness of the AGA.
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Affiliation(s)
- Bo-Kyung Kim
- Department of Dermatology and Institute of Hair and Cosmetic Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Solam Lee
- Department of Dermatology and Institute of Hair and Cosmetic Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Myeongsoo Jun
- Department of Dermatology and Institute of Hair and Cosmetic Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Hee-Chul Chung
- Department of Dermatology and Institute of Hair and Cosmetic Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Sung-Soo Oh
- Department of Occupational and Environmental Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Won-Soo Lee
- Department of Dermatology and Institute of Hair and Cosmetic Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
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Manabe M, Tsuboi R, Itami S, Osada SI, Amoh Y, Ito T, Inui S, Ueki R, Ohyama M, Kurata S, Kono T, Saito N, Sato A, Shimomura Y, Nakamura M, Narusawa H, Yamazaki M. Guidelines for the diagnosis and treatment of male-pattern and female-pattern hair loss, 2017 version. J Dermatol 2018; 45:1031-1043. [DOI: 10.1111/1346-8138.14470] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Accepted: 04/11/2018] [Indexed: 11/26/2022]
Affiliation(s)
- Motomu Manabe
- Department of Dermatology and Plastic Surgery; Akita University Graduate School of Medicine; Akita Japan
| | - Ryoji Tsuboi
- Department of Dermatology; Tokyo Medical University; Tokyo Japan
| | - Satoshi Itami
- Department of Regenerative Dermatology; Graduate School of Medicine; Osaka University; Osaka Japan
| | - Shin-Ichi Osada
- Department of Dermatology and Plastic Surgery; Akita University Graduate School of Medicine; Akita Japan
| | - Yasuyuki Amoh
- Department of Dermatology; Kitasato University School of Medicine; Sagamihara Japan
| | - Taisuke Ito
- Department of Dermatology; Hamamatsu University School of Medicine; Hamamatsu Japan
| | - Shigeki Inui
- Shinsaibashi Inui Dermatologic Clinic; Osaka Japan
| | - Rie Ueki
- Juntendo Tokyo Koto Geriatric Medical Center; Tokyo Japan
| | - Manabu Ohyama
- Department of Dermatology; Kyorin University School of Medicine; Tokyo Japan
| | | | - Takeshi Kono
- Department of Dermatology; Nippon Medical School Chiba Hokusoh Hospital; Chiba Japan
| | - Norimitsu Saito
- Department of Dermatology; Yokohama Rosai Hospital; Yokohama Japan
| | - Akio Sato
- Tokyo Memorial Clinic Hirayama; Tokyo Japan
| | - Yutaka Shimomura
- Department of Dermatology; Yamaguchi University Graduate School of Medicine; Yamaguchi Japan
| | - Motonobu Nakamura
- Department of Dermatology; University of Occupational and Environmental Health; Kitakyushu Japan
| | - Hiroshi Narusawa
- Department of Dermatology; Faculty of Medicine; Saga University; Saga Japan
| | - Masashi Yamazaki
- Department of Dermatology; Tokyo Medical University; Tokyo Japan
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Won YY, Lew BL, Sim WY. Clinical efficacy of oral administration of finasteride at a dose of 2.5 mg/day in women with female pattern hair loss. Dermatol Ther 2018; 31:e12588. [PMID: 29464847 DOI: 10.1111/dth.12588] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2017] [Revised: 10/30/2017] [Accepted: 12/14/2017] [Indexed: 11/27/2022]
Abstract
Female pattern hair loss (FPHL) presents with diffuse thinning over the mid-frontal scalp, for which various treatment modalities have been tried. Although currently, oral 5 α-reductase inhibitors such as finasteride are being used, their clinical efficacy remains controversial. We retrospectively investigated 544 premenopausal or postmenopausal patients with FPHL who were prescribed finasteride at a dose of 2.5 mg/day. Our study excluded patients with a follow-up period of < 3 months and patients who were prescribed other FPHL treatment modalities including topical minoxidil. Finally, 112 patients were evaluated based on their medical records and clinical photographs. Based on assessment using the Ludwig scale at the time of their initial visit, among 112 patients studied, 59 patients were classified as belonging to grade I, 47 were grade II, and 6 were grade III. Using global photographs, we found that 33 (29.5%) of the 112 patients studied showed slight improvement, 73 (65.2%) showed significant improvement, whereas no change was recorded in 6 (5.4%). We could demonstrate efficacy of administration of finasteride at a dose of 2.5 mg/day for patients with FPHL and also found that finasteride has a better effect on hair growth when patients had a lower Ludwig score and an older age at onset.
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Affiliation(s)
- Yong-Yon Won
- Department of Dermatology, Kyung Hee University hospital at Gang-dong, Kyung Hee University School of Medicine, Seoul, Korea
| | - Bark-Lynn Lew
- Department of Dermatology, Kyung Hee University hospital at Gang-dong, Kyung Hee University School of Medicine, Seoul, Korea
| | - Woo-Young Sim
- Department of Dermatology, Kyung Hee University hospital at Gang-dong, Kyung Hee University School of Medicine, Seoul, Korea
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Differences in reproductive toxicology between alopecia drugs: an analysis on adverse events among female and male cases. Oncotarget 2018; 7:82074-82084. [PMID: 27738338 PMCID: PMC5347675 DOI: 10.18632/oncotarget.12617] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2016] [Accepted: 09/29/2016] [Indexed: 12/21/2022] Open
Abstract
Alopecia is a dermatological condition with limited therapeutic options. Only two drugs, finasteride and minoxidil, are approved by FDA for alopecia treatment. However, little is known about the differences in adverse effects between these two drugs. We examined the clinical reports submitted to the FDA Adverse Event Reporting System (FAERS) from 2004 to 2014. For both female and males, finasteride was found to be more associated with reproductive toxicity as compared to minoxidil. Among male alopecia cases, finasteride was significantly more concurrent with several forms of sexual dysfunction. Among female alopecia cases, finasteride was significantly more concurrent with harm to fetus and disorder of uterus. In addition, drug-gene network analysis indicated that finasteride could profoundly disturb pathways related to sex hormone signaling and oocyte maturation. These findings could provide clues for subsequent toxicological research. Taken together, this analysis suggested that finasteride could be more liable to various reproductive adverse effects. Some of these adverse effects have yet to be warned in FDA-approved drug label. This information can help improve the treatment regimen of alopecia and post-marketing regulation of drug products.
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Darwin E, Heyes A, Hirt PA, Wikramanayake TC, Jimenez JJ. Low-level laser therapy for the treatment of androgenic alopecia: a review. Lasers Med Sci 2017; 33:425-434. [DOI: 10.1007/s10103-017-2385-5] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2017] [Accepted: 11/06/2017] [Indexed: 12/27/2022]
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Najem I, Chen H. Use of low-level laser therapy in treatment of the androgenic alopecia, the first systematic review. J COSMET LASER THER 2017; 20:252-257. [PMID: 29227728 DOI: 10.1080/14764172.2017.1400174] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Alopecia is a common disease affecting more than half of the world total number of people. Alopecia exists in different types, but one of the most common of these types is the Androgenic Alopecia which has affected approximately 51% of the total number of males ranging between the age bracket of 40 years and 75 years. This type of alopecia is more common in females who are above the age of 65 years and above. Despite this widespread effect, much has not been done regarding identifying the possible drugs for treating this disease. At present, there exist only two possible medications that have been scientifically approved to cure this disease, include finasteride and minoxidil. Also, another possible form of treatment has been the case of hair transplantation. Despite the new possible treatment options available for treatment of different types of hair loss, there is a need for the invention for more efficient management and treatment options that are less costly, environmentally friendly, and most importantly human consumption friendly. Due to the recent evaluation that low-level laser therapy stimulated hair growth. This systematic review and meta-analysis was to determine whether the use of low-level laser therapy is an effective therapy for treatment of the Androgenic alopecia and also to some degree we reviewed the level of the patient's satisfaction. Some earlier studies had shown that the use of low-level laser therapy stimulated the hair growth when mice were treated with chemotherapy which was induced by the alopecia and also the other type of alopecia called alopecia areata. The researchers hypothesized that the primary mechanism of treating Androgenic alopecia to be the stimulation of the epidermal stem cells which are in the hair follicle making them bulge and shift the follicles into the anagen phase.
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Affiliation(s)
- Ibrahim Najem
- a Union Hospital , Tongji Medical College, Huazhong University of Science and Technology, Dermatology , Wuhan , China
| | - Hongxiang Chen
- a Union Hospital , Tongji Medical College, Huazhong University of Science and Technology, Dermatology , Wuhan , China
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Xu L, Liu KX, Senna MM. A Practical Approach to the Diagnosis and Management of Hair Loss in Children and Adolescents. Front Med (Lausanne) 2017; 4:112. [PMID: 28791288 PMCID: PMC5522886 DOI: 10.3389/fmed.2017.00112] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2017] [Accepted: 07/04/2017] [Indexed: 12/13/2022] Open
Abstract
Hair loss or alopecia is a common and distressing clinical complaint in the primary care setting and can arise from heterogeneous etiologies. In the pediatric population, hair loss often presents with patterns that are different from that of their adult counterparts. Given the psychosocial complications that may arise from pediatric alopecia, prompt diagnosis and management is particularly important. Common causes of alopecia in children and adolescents include alopecia areata, tinea capitis, androgenetic alopecia, traction alopecia, trichotillomania, hair cycle disturbances, and congenital alopecia conditions. Diagnostic tools for hair loss in children include a detailed history, physical examination with a focused evaluation of the child’s hair and scalp, fungal screens, hair pull and tug test, and if possible, light microscopy and/or trichoscopy. Management of alopecia requires a holistic approach including psychosocial support because treatments are only available for some hair loss conditions, and even the available treatments are not always effective. This review outlines the clinical presentations, presents a diagnostic algorithm, and discusses management of these various hair loss disorders.
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Affiliation(s)
- Liwen Xu
- Harvard Medical School, Boston, MA, United States
| | - Kevin X Liu
- Harvard Medical School, Boston, MA, United States
| | - Maryanne M Senna
- Department of Dermatology, Massachusetts General Hospital, Boston, MA, United States
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Huang Y, Zhuo F, Li L. Enhancing hair growth in male androgenetic alopecia by a combination of fractional CO2 laser therapy and hair growth factors. Lasers Med Sci 2017; 32:1711-1718. [DOI: 10.1007/s10103-017-2232-8] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2017] [Accepted: 05/12/2017] [Indexed: 01/04/2023]
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