Minoxidil 5% solution for topical treatment of loose anagen hair syndrome

Fractional CO2 Laser and Minoxidil in the Treatment of Alopecia Areata, A Comparative Study

BACKGROUND

Alopecia areata (AA) is a chronic inflammatory disease that affects the hair follicles and sometimes the nails. It usually presents as a single or multiple patches of hair loss on the scalp, but any hair-bearing skin can be involved. AA treatment depends on the severity and extent of the disease.

OBJECTIVE

To evaluate the efficacy of combined fractional CO2 (FCO2) laser with topical minoxidil 5% solution versus topical minoxidil 5% solution alone in the treatment of AA.

PATIENTS AND METHODS

The study included 150 patients with AA. The patients were collected from outpatient clinics of the Dermatology and Venerology Department, Tanta University Hospitals. Patients were divided into three groups; 60 patients were treated with topical minoxidil 5% solution, 60 patients were treated with FCO2 laser combined with topical minoxidil 5% solution, and the third group of 30 patients represented the control group treated with topical saline.

RESULTS

Compared to the placebo group, there was a statistically significant improvement in hair growth in the combination group and minoxidil group. In the combination group, 80% of patients showed excellent improvement, 13.3% of patients showed very good improvement, and 6.7% of patients showed good improvement. In the minoxidil group, 53% of patients showed excellent improvement, 40% of patients showed very good improvement, and 6.7% of patients showed good improvement after 3 months of therapy. Side effects were minimal and transient in both groups.

CONCLUSION

Topical minoxidil 5% solution either alone or in combination with FCO2 laser could be considered a safe and tolerable method for AA treatment.

Autosomal recessive hypotrichosis with loose anagen hairs associated with TKFC mutations

BACKGROUND

Loose anagen hair is a rare form of impaired hair anchorage in which anagen hairs that lack inner and outer root sheaths can be gently and painlessly plucked from the scalp. This condition usually occurs in children and is often self-limiting. A genetic basis for the disorder has been suggested but not proven. A better understanding the aetiology of loose anagen hair may improve prevention and treatment strategies.

OBJECTIVES

To identify a possible genetic basis of loose anagen hair using next-generation DNA sequencing and functional analysis of variants identified.

METHODS

In this case study, whole-exome sequencing analysis of a pedigree with one affected individual with features of loose anagen hair was performed.

RESULTS

The patient was found to be compound heterozygous for two single-nucleotide substitutions in TKFC resulting in the following missense mutations: c.574G> C (p.Gly192Arg) and c.682C> T (p.Arg228Trp). Structural analysis of human TKFC showed that both mutations are located near the active site cavity. Kinetic assays of recombinant proteins bearing either of these amino acid substitutions showed almost no dihydroxyacetone kinase or D-glyceraldehyde kinase activity, and FMN cyclase activity reduced to just 10% of wildtype catalytic activity.

CONCLUSIONS

TKFC missense mutations may predispose to the development of loose anagen hairs. Identification of this new biochemical pathobiology expands the metabolic and genetic basis of hypotrichosis.

Topical and oral minoxidil for hair disorders in pediatric patients: What do we know so far?

Minoxidil is a strong arterial vasodilator, first introduced as an antihypertensive medication. In dermatology, topical minoxidil (TMX) has been used for many types of alopecia. TMX is not FDA-approved in patients under 18 years old and there are no guidelines for its pediatric use. Low-dose oral minoxidil (OMX) has been used off-label for hair loss treatment in adults expecting to achieve better therapeutic compliance and greater clinical efficacy. However, little is known about TMX and OMX in pediatric population. the literature presented on TMX and OMX in children to date was reviewed. The terms "minoxidil", "child", "children", "childhood", and "infant" were used to perform a literature search in MEDLINE through PubMed. The search was limited to articles about humans and available in English. While 25 relevant articles were selected, duplicate titles were excluded. This article pointed out the use of minoxidil in several pediatric hair diseases. Even when used topically, dermatologists should be aware of potential risks of systemic absorption. In particular situations, OMX in very low doses may be considered. To date, there are no guidelines regarding the ideal dose or minimum age for using the drug topically or systemically.

Minoxidil and its use in hair disorders: a review

Minoxidil was first introduced as an antihypertensive medication and the discovery of its common adverse event, hypertrichosis, led to the development of a topical formulation for promoting hair growth. To date, topical minoxidil is the mainstay treatment for androgenetic alopecia and is used as an off-label treatment for other hair loss conditions. Despite its widespread application, the exact mechanism of action of minoxidil is still not fully understood. In this article, we aim to review and update current information on the pharmacology, mechanism of action, clinical efficacy, and adverse events of topical minoxidil.

A Case of Loose Anagen Hair Syndrome in a Southeast Asian Boy

Loose anagen hair syndrome is an uncommon hair disorder, particularly in non-Caucasian children. We report the case of a 13-year-old Thai boy who presented with a single patch of hair thinning on the frontal scalp with excessive shedding, and the hairs did not grow long. Microscopic examination showed naked anagen bulbs with ruffling of the cuticle, which is compatible with loose anagen hair syndrome. To our knowledge, there is no reported case in Southeast Asian children.

Infantile generalized hypertrichosis caused by topical minoxidil

Rare cases of hypertrichosis have been associated with topically applied minoxidil. We present the first reported case in the Brazilian literature of generalized hypertrichosis affecting a 5-year-old child, following use of minoxidil 5%, 20 drops a day, for hair loss. The laboratory investigation excluded hyperandrogenism and thyroid dysfunction. Topical minoxidil should be used with caution in children.

Loose Anagen Syndrome: A Retrospective Chart Review of 37 Cases

BACKGROUND/OBJECTIVES

Loose anagen syndrome (LAS) is a disorder of abnormal anchorage of the hair to the scalp. Its symptoms include an inability to grow hair long and hair that is easily pulled out.

METHODS

We conducted a retrospective chart review of patients with LAS over the last 10 years at the Children's Hospital of Philadelphia and found 37 cases.

RESULTS

LAS was more common in females and was found in all hair colors and skin types.

CONCLUSION

Diagnosis of LAS should be made based on history, microscopic findings, and hair bulb and shaft features.