The Role of Vitamins and Minerals in Hair Loss: A Review

Prophylactic effects of nutrition, dietary strategies, exercise, lifestyle and environment on nonalcoholic fatty liver disease

BACKGROUND

Nonalcoholic fatty liver disease (NAFLD) is a chronic liver disease and its prevalence has risen sharply. However, whether nutrition, dietary strategies, exercise, lifestyle and environment have preventive value for NAFLD remains unclear.

METHODS

Through searching 4 databases (PubMed, Web of Science, Embase and the Cochrane Library) from inception to January 2025, we selected studies about nutrition, dietary strategies, exercise, lifestyle and environment in the prevention of NAFLD and conducted a narrative review on this topic.

RESULTS

Reasonable nutrient intake encompassing macronutrients and micronutrients have an independent protective relationship with NAFLD. Besides, proper dietary strategies including mediterranean diet, intermittent fasting diet, ketogenic diet, and dietary approaches to stop hypertension diet have their inhibitory effects on the developmental process of NAFLD. Moreover, right exercises including walking, jogging, bicycling, and swimming are recommended for the prevention of NAFLD because they could effectively reduce weight, which is an important risk factor for NAFLD, and improve liver function. In addition, embracing a healthy lifestyle including reducing sedentary behavior, not smoking, sleeping well and brushing teeth regularly is integral since it not only could reduce the risk of NAFLD but also significantly contribute to overall prevention and control. Finally, the environment, including the social and natural environments, plays a potential role in NAFLD prevention.

CONCLUSION

Nutrition, dietary strategies, exercise, lifestyle and environment play an important role in the prevention of NAFLD. Moreover, this review offers comprehensive prevention recommendations for people at high risk of NAFLD.

Clinical efficacy of microneedle combined with 5% Minoxidil solution and finasteride in the treatment of androgenetic alopecia in males

Androgenetic alopecia in males is associated with genetic predisposition and increased androgen secretion. This work was to investigate the clinical therapeutic effects of microneedling plus5% Minoxidil and Finasteride in treating male androgenetic alopecia. 45 male patients with androgenetic alopecia were recruited and rolled into control group 1 (Group A) received monotherapy with 5% Minoxidil; control group 2 (Group B) received 5% Minoxidil and Finasteride; and the experimental group (Group C) received combination therapy with microneedling, 5% Minoxidil, and Finasteride. Each group consisted of 15 patients. Comparison was made on trace element levels, testosterone levels, hair microscopy indicators, Norwood Hamilton hair loss (HL) classification, self-rating of hair growth and Ars (ARs). After treatment, the contents of trace elements and hormone levels in the three groups did not change considerably(P > 0.05). After treatment, the ratio of villi to single hair follicle in the three groups decreased markedly. The decline degree of group B and group C was superior to group A (P < 0.05), while that of group C was superior to group B (P > 0.05). After treatment, the hair density and hair shaft diameter of the three groups of patients increased markedly. The increase of group B and group C was superior to group A (P < 0.05), while that of group C was superior to group B (P > 0.05). After treatment, the Norwood-Hamilton alopecia scale in group C was better than that in group A (P < 0.01). A total of 80% patients in group C scored ≥ 3, which was better than the other two groups in general. The incidence of ARs differed slightly among the three groups (P > 0.05). Relative to the use of Minoxidil or combination therapy with Finasteride alone, microneedling combined therapy greatly improved hair loss in patients, promoted new hair growth, and holds clinical value.

Retrospective Review of 2851 Female Patients With Telogen Effluvium: A Single-Center Experience

OBJECTIVE

Telogen effluvium, the most common cause of diffuse and non-scarring alopecia in women, is frequently diagnosed in dermatology outpatient clinics and can be caused by various etiological factors such as medications, trauma, emotional, and physiological stress. In patients presenting with complaints of telogen effluvium, we aimed to investigate abnormal levels of serum ferritin, vitamin B12, folic acid, thyroid function tests, and hemoglobin and determine which of these abnormal values might be significantly associated with telogen effluvium.

MATERIAL AND METHODS

In this study, 2851 female patients diagnosed with telogen effluvium who applied to the Dicle University Dermatology outpatient clinic between January 1, 2010 and June 30, 2024 were retrospectively evaluated. The relationship between these laboratory abnormalities and telogen effluvium, as well as their significance in different age groups, was analyzed using the SPSS-27.0 program. Associations were analyzed using Kolmogorov-Smirnov test, dependent t-test, Wilcoxon test, Pearson chi-square (χ2) test, Yates chi-square (χ2) test, Fisher chi-square (χ2) test analysis, Mc-Nemar test, Pearson/spearman correlation analysis, and logistic regression analysis. A p value of < 0.05 was considered statistically significant.

RESULTS

The mean age of 2851 female patients included in our study was 26.33 years, 12.8% (n = 366) were under 18 years of age, 83.5% (n = 2380) were between 18 and 45 years of age, and 3.7% (n = 105) were over 45 years of age. Hemoglobin values were determined in 2496 of 2851 patients and values below the reference range were found in 317 patients (11.1%). Ferritin was found to be low in 1123 (46.5%) of 2413 patients. Vitamin 12 deficiency was detected in 150 (5.8%), folic acid deficiency in 8 (0.6%), and iron deficiency in 685 (29.5%) patients. As can be seen in our study, deficiency of laboratory parameters, especially ferritin and serum iron, is a common finding in female patients presenting with TE.

CONCLUSION

This study showed that biochemical tests, complete blood counts, and hormonal tests are important tools in investigating the etiology and guiding the treatment in patients diagnosed with telogen effluvium, as various etiological factors may be present. Furthermore, it was determined that parameters such as vitamin B12, ferritin, TSH, and T3 hold varying levels of importance during significant phases of women's physiological development, such as adolescence and post-menopausal periods.

Oral Supplementation with l-Cystine, Serenoa repens, Cucurbita pepo, and Pygeum africanum in Chronic Telogen Effluvium and Androgenetic Alopecia: A Double-Blind, Placebo-Controlled, Randomized Clinical Study

Introduction

Chronic telogen effluvium (TE) and androgenetic alopecia represent two prevalent forms of hair loss that can significantly impact individuals' quality of life. Insufficiency of essential micronutrients has been associated with hair loss. The objective of this study was to evaluate the safety and efficacy of an oral supplement containing l-Cystine, Serenoa repens, Cucurbita pepo, Pygeum africanum, vitamins, and micronutrients in chronic TE (CTE) and androgenetic alopecia (AGA).

Methods

Eighty patients of both sexes aged 18-60 years with CTE or AGA were randomized to receive one capsule daily of the oral supplement or placebo for 6 months. Dermatological evaluations, clinical pictures and phototrichograms were done at baseline, 3 months and 6 months. The overall hair volume and appearance were assessed before and after treatment as well as subject's self-assessment via standardized questionnaire.

Results

Hair density increased by 9.9 hairs/cm2 after 3 months and 12.3 hairs/cm2 after 6 months in the oral supplement group and it is statistically significant when compared to placebo. Overall hair volume after 1, 3, and 6 months is better in the supplement group than in the placebo group. The oral supplement was well tolerated. No moderate or severe adverse events were reported.

Conclusion

Oral supplementation can increase hair density, anagen hairs, and overall hair appearance in patients with AGA or CTE.

Interpretation of ferritin concentrations in the dermatology clinic

Ferritin measurement is a common laboratory test in dermatology. Ferritin is a marker of iron storage in the human body but can also be -elevated in inflammatory states. Therefore, changes in ferritin are nonspecific, and correlation of specific clinical findings and risk factors with ferritin concentration and other biomarkers, e.g. iron studies or C-reactive protein tests, is recommended. This article discusses iron metabolism and the indications for ferritin measurement in dermatology and how to interpret the laboratory results.

Male androgenetic alopecia

Male androgenetic alopecia (MAA) is quite common and worsens with age, with a significant impact on quality of life, and is increasingly a reason for consultation with a dermatologist. The etiopathogenesis of MAA is multifactorial and genetic and hormonal influences stand out. MAA starts with the process of follicular miniaturization in diverse phenotypic patterns. The diagnosis of MAA is basically clinical and currently corroborated by well-established trichoscopic findings. Despite this, therapeutic options are limited, especially when one considers medications with a high level of scientific evidence. This review aims to help the general dermatologist towards a better understanding of MAA providing a basis for good individualized and judicious therapeutic decisions.

Application of multi-omics techniques to androgenetic alopecia: Current status and perspectives

The rapid advancement of sequencing technologies has enabled the generation of vast datasets, allowing for the in-depth analysis of sequencing data. This analysis has facilitated the validation of novel pathogenesis hypotheses for understanding and treating diseases through ex vivo and in vivo experiments. Androgenetic alopecia (AGA), a common hair loss disorder, has been a key focus of investigators attempting to uncover its underlying mechanisms. Abnormal changes in mRNA, proteins, and metabolites have been identified in individuals with AGA, and future developments in sequencing technologies may reveal new biomarkers for AGA. By integrating multiple omics analysis datasets such as genomics, transcriptomics, proteomics, and metabolomics-along with clinical phenotype data-we can achieve a comprehensive understanding of the molecular underpinnings of AGA. This review summarizes the data-mining studies conducted on various omics analysis datasets as related to AGA that have been adopted to interpret the biological data obtained from different omics layers. We herein discuss the challenges of integrative omics analyses, and suggest that collaborative multi-omics studies can enhance the understanding of the complete pathomechanism(s) of AGA by focusing on the interaction networks comprising DNA, RNA, proteins, and metabolites.

Molecular Mechanisms of Hair Follicle Development

Hair is an intricate biological structure that originates from hair follicles (HFs), which are complex mini-organs embedded in the skin. Each HF undergoes continuous cycles of growth (anagen), regression (catagen), and rest (telogen), driven by intricate signaling pathways and interactions between epithelial and mesodermal cells. The development of HFs requires the interplay of several key signaling pathways, including Wnt, Shh, Notch, and BMP. The Wnt pathway is primarily involved in induction, Shh is essential for early organogenesis and later stages of cytodifferentiation, Notch signaling governs the fate of HF stem cells, and BMP plays a role in cytodifferentiation. Hair health is closely associated with psychological well-being and personal distress. While hair loss (alopecia) does not impact biological health, it significantly affects social well-being. Therefore, a deep understanding of the molecular mechanisms underlying HF development is crucial for developing treatments for hair-related problems and improving hair health. This knowledge has led to significant advancements in therapeutic applications, particularly in treating hair loss disorders, enhancing wound healing, and developing cosmetic treatments. This paper aims to review the molecular mechanisms involved in HF development, with an emphasis on their potential impact on human health and well-being.

Revitalizing Effect on the Scalp After Injection with a Mechanically Stabilized Hyaluronic Acid Complex in Subjects with Androgenetic Alopecia

Background: Treatments for androgenetic alopecia (AGA) include different drugs, but a treatment based on stabilized hyaluronic acid has not been tested. The aim of this study is to clinically evaluate the effect of six sessions of injections using a hyaluronic acid compound supplemented with vitamins, ions, and amino acids (CH) on hair density and quality in volunteers. Methods: For this purpose, twenty-six healthy volunteers of both sexes with moderate AGA were injected with 3 mL of CH using the micro-papule technique. All received six CH sessions at two-week intervals. Hair loss, hair thickness, and shine were assessed using macro-photographs. A follow-up questionnaire was given to the volunteers at 40 days and at 90 days after the last treatment to determine their level of satisfaction. In addition, a dermatological control was carried out to assess the tolerance of the treatment applied. Results: The results indicate that, after treatment with CH, there is a significant improvement in the thickness, shine, and density of scalp hair, and that the treatment significantly reduces hair loss on the scalp. On a dermatological level, the tolerability of the treatment was excellent with no complications observed. In total, 88.5% of the volunteers indicated that CH treatment improved their appearance. In summary, it can be said that CH treatment reduces hair loss and promotes hair growth. Conclusions: It is suggested that this treatment is effective in reducing the signs and symptoms of alopecia.

Micronutrients and Androgenetic Alopecia: A Systematic Review

SCOPE

Hair loss is a common problem that can negatively impact individuals' psychological well-being. Androgenetic alopecia (AGA) is one of the most prevalent types of nonscarring hair loss. This review summarizes the existing evidence on the relationship between AGA and various micronutrients, including vitamin B, vitamin D, vitamin A, vitamin C, iron, selenium, zinc, manganese, and copper.

METHODS

A literature search was conducted to identify relevant articles published between 1993 and 2023. The search identified 49 relevant articles.

RESULTS

The findings suggest that deficiencies or imbalances in these micronutrients may contribute to the pathogenesis of AGA and represent modifiable risk factors for hair loss prevention and treatment. Vitamin B, vitamin D, iron, and zinc appear to play critical roles in hair growth and maintenance. Deficiencies in these micronutrients have been associated with increased risk of AGA, while supplementation with these nutrients has shown potential benefits in improving hair growth and preventing hair loss. However, the current evidence is not entirely consistent, with some studies reporting no significant associations.

CONCLUSION

Deficiencies or imbalances in specific vitamins and minerals, especially vitamin B, vitamin D, Fe, Se, and Zn are involved in the pathogenesis of AGA and may represent modifiable risk factors for the treatment and prevention of this condition.

A Randomized, Placebo-controlled Clinical Study Evaluating a Dietary Supplement for Hair Growth

Objective

The desire for improved hair appearance, hair growth and strength are common drivers of supplementation for women experiencing thinning hair. This study examined the effect and safety of a gummy supplement containing B vitamins, zinc and botanical ingredients to improve hair growth, strength and perceived hair quality outcomes.

Methods

Healthy females (n=65) ages 18 to 60 with thinning hair were enrolled. After obtaining consent, subjects were evaluated for hair density and tensile strength, then randomized to either a placebo or test product. The test product consisted of two gummies consumed daily. Subjects returned after six months and were again evaluated using phototrichogram for hair density and tensile strength assessment and completed a Self-Assessment Questionnaire reporting hair quality outcomes.

Results

Subjects who consumed the test product showed increased hair density between baseline and 6 months (10.1% increase, p<0.001) as well as compared to placebo (2% decrease) (p<0.001). Hair strength tensile measurements were improved in the test group from baseline (10.2% improvement, p<0.002) compared to placebo (9.3% improvement), yet the difference was not statistically significant between groups. Self-assessed improvements in shedding, strength, breakage and brightness were noted compared to the placebo group (p<0.05). There were no adverse events or reactions.

Limitations

This study did not assess hair for longer than a six-month period and utilized subject perception for outcomes that differ from clinical assessments.

Conclusion

Daily use of a dietary supplement gummy was associated with significant improvement in hair growth as well as self-assessed improvements in hair strength, shedding, and appearance.

Hair Growth Effect and the Mechanisms of Rosa rugosa Extract in DHT-Induced Alopecia Mice Model

Rosa rugosa is a medicinal plant known for its potential anti-inflammatory, antioxidant, anti-cancer, and antimicrobial benefits. The pharmacological effects of Rosa rugosa extract on hair loss have not yet been documented. This research sought to assess the inhibitory effects and mechanisms of action of Rosa rugosa water extract (RWE) in a mouse model of dihydrotestosterone (DHT)-induced alopecia. The study was conducted using C57BL/6 mice, which were assigned to five groups: control, DHT-treated, Rosa rugosa water extract (RWE) at doses of 25 mg/kg and 100 mg/kg body weight, and bicalutamide-treated. To induce hair loss, dihydrotestosterone (1 mg/day per body weight) was administered via intraperitoneal injections, and dorsal hair removal was timed to align with the telogen phase. Each group received oral treatments for a period of 23 days. In this study, we assessed hair growth activity, examined histological changes, and performed immunoblot analysis. We noted improvements in hair length and thickness. Additionally, the protein expression of growth factors associated with hair growth, including vascular endothelial growth factor (VEGF), epidermal growth factor (EGF), and insulin-like growth factor-1 (IGF-1), showed significant increases in the group treated with RWE. Additionally, treatment with RWE suppressed the protein expression of hair growth inhibitory factors, including dickkopf WNT signaling pathway inhibitor 1 (DKK1) and interleukin (IL)-6. Moreover, hair growth regulatory pathway related factors, including ERK, AKT, and GSK-3β, were activated. These findings indicate that RWE could serve as a promising natural therapy for preventing hair loss by enhancing the production of factors that promote hair growth while inhibiting those that suppress it.

The role of salivary vitamin D and interleukin-6 on non-scarring Alopecia

BACKGROUND

Alopecia, or hair loss, is an emerging global disease. Its etiopathogenesis includes nutritional deficiencies, oxidative stress, and deficiency of physiological factors. Around 2% of the general population has the probability of developing alopecia at any one period. Vitamin D and interleukin-6 (IL-6) have a major role in alopecia. The present goal of research is to investigate the role of vitamin D and IL-6 in the saliva of patients with non-scarring alopecia.

METHODOLOGY

The study involved 51 cases of non-scarring alopecia and 50 healthy controls with an age range between 18 and 40 years. A detailed history and clinical examination were done. Salivary vitamin D and IL-6 were determined to compare within the groups.

RESULTS

The average vitamin D level in cases (104.64 ± 46.95 pmol/L) was significantly lower as compared to controls (223 ± 12.03 pmol/L) (p < 0.001). Whereas the average amount of IL-6 was significantly higher (170.54 ± 63.68 ng/L) than the control group (56.38 ± 46.52 ng/L) (p < 0.001). No correlation of vitamin D level with IL-6 was detected in study subjects.

CONCLUSION

Vitamin D significantly influences the development of non-scarring alopecia. Patients with non-scarring alopecia had low amount of vitamin D indicate its role in etiology of hair loss. IL-6 may cause a collapse of the hair bulb, having a significant part in the pathogenesis of alopecia indicating chronic inflammatory or autoimmune condition. This research will aid in diagnosing scalp disease using salivary biomarkers and improve the treatment of alopecia.

Risk factors and lipid metabolism characteristics of early-onset male androgenetic alopecia: A pilot study

BACKGROUND

Male androgenetic alopecia (MAA) is a multifactorial disease, with patients presenting at a younger age, which is a risk factor for many metabolic diseases.

AIMS

To explore the risk factors associated with early-onset of MAA and its metabolic characteristics.

METHODS

Forty patients with MAA and 45 healthy controls were collected. The serum levels of fasting blood glucose (FBG), total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), total testosterone (TT), uric acid (UA), and 25-hydroxyvitamin D (25(OH)D) were measured. Meanwhile, lipid metabolites were detected by ultra-high-performance liquid chromatography-tandem mass spectrometry (UHPLC-MS/MS).

RESULTS

37.50% MAA patients had metabolic syndrome, compared to 17.78% in control group (p < 0.05). The levels of HDL-C, UA, and 25(OH)D were decreased in patients with MAA compared to healthy controls (p < 0.05). However, there was no significant difference in the level of TT between the two groups. Additionally, there were no significant differences in the levels of HDL-C, UA, 25(OH)D, and TT among different grades of hair loss (p > 0.05). The lipid profile of early-onset MAA differed significantly from healthy controls. In early-onset MAA, the levels of ceramide (Cer) and sphingomyelin (SM) were significantly lower. Cer(d38:5) and TG(15:0/18:1/18:1) may be the biomarkers.

CONCLUSION

Low HDL-C, UA, and 25(OH)D may be the independent risk factors for early-onset MAA. Abnormal lipid metabolism was observed in early-onset MAA, wherein Cer and SM may serve as protective factors.

Knowledge, attitude, and practice of primary health physicians in Saudi Arabia in prescribing vitamins and minerals as treatment for hair loss

Purpose/Background

Hair loss is a common presentation in primary care. This condition is caused by telogen effluvium and alopecia, among others. Several factors such as drugs, trauma, and emotional and physiological stress can lead to the development of hair loss in addition to vitamin and mineral deficiency. This study aimed to assess the knowledge and practice of primary health physicians in Saudi Arabia on the use of vitamins and minerals for the treatment of hair loss with the research question of what is the knowledge and practice level among primary physicians in Kingdom of Saudi Arabia regarding hair loss.

Methods

This cross-sectional study was carried out in primary health care centers in Saudi Arabia. Data were collected by a self-administered online questionnaire. The questionnaire included two parts; the first one is the personal information such as age, sex, year of experience, and current medical ranking. The second part included questions assessing the knowledge and practice of using vitamins and minerals for treatment of hair loss. Data were analyzed by using Statistical Package for Social Sciences (SPSS).

Results

A total of 146 physicians were included in the final analysis with a mean age of 41.65 (SD = 12.71). Slightly over half (54.1%) were juniors being general practitioners or residents. The mean knowledge score was 12.6 (SD = 2.83), and the mean practice score was 8 (SD = 3.43), with no difference between the total score between the senior and junior physicians, while some significant differences were noted in some items of both scores. No significant association was noted between knowledge and practice scores.

Conclusion

The findings show the low scores of knowledge and practice among doctors about the causes and treatment of hair loss. Guidelines should guide practice regardless of seniority. Future studies should address each group separately.

Biotin for Hair Loss: Teasing Out the Evidence

Objective

Biotin has widespread popularity as a hair supplement. We sought to review the literature regarding biotin's efficacy as a hair supplement.

Methods

We conducted a literature search of PubMed for articles specifically studying the use of oral biotin for hair growth or quality. Case reports and case series were excluded.

Results

Three studies met our inclusion criteria. The first study was the highest quality, with a double-blind and placebo-controlled study design, but their results found no difference between the biotin and placebo groups for hair growth. The other two studies investigated specific patient populations (patients on isotretinoin and female patients post-sleeve gastrectomy). Both studies were susceptible to multiple potential biases and neither had striking results in favor of biotin.

Limitations

Our review is limited by lack of available studies.

Conclusion

Given the widespread popularity of biotin as a hair supplement, one would presume that this claim must be grounded in strong evidence; however, there is a large discrepancy between the public's perception of its efficacy and the scientific literature. The utility of biotin as a hair supplement is not supported by high-quality studies.

Effects of RF Electric Currents on Hair Follicle Growth and Differentiation: A Possible Treatment for Alopecia

Androgenic alopecia (AGA) is the most common type of alopecia and its treatments involve drugs that have various adverse effects and are not completely effective. Radiofrequency-based therapies (RF) are an alternative for AGA treatment. Although there is increasing clinical evidence of the effectiveness of RF for alopecia, its effects at the tissue and cellular level have not been studied in detail. The objective of this study was to analyze ex vivo the potential effect of RF currents used in capacitive resistive electrical transfer (CRET) therapy on AGA. Hair follicles (HFs) were donated by patients with AGA and treated with CRET. AGA-HFs were exposed in vitro to intermittent 448 kHz electric current in subthermal conditions. Cell proliferation (Ki67), apoptosis (TUNEL assay), differentiation (β-catenin), integrity (collagen and MMP9), thickness of the epidermis surrounding HF, proportion of bulge cells and melanoblasts in AGA-HF were analyzed by immunohistochemistry. CRET increased proliferation and decreased death of different populations of AGA-HF cells. In addition, the melanoblasts increased in bulge and the epidermis surrounding the hair follicle thickened. These results support the effectiveness of RF-based therapies for the treatment of alopecia. However, clinical trials are necessary to know the true effectiveness of CRET therapy and other RF therapies for AGA treatment.

Management of Skin Toxicities in Cancer Treatment: An Australian/New Zealand Perspective

Cancer systemic therapeutics and radiotherapy are often associated with dermatological toxicities that may reduce patients' quality of life and impact their course of cancer treatment. These toxicities cover a wide range of conditions that can be complex to manage with increasing severity. This review provides details on twelve common dermatological toxicities encountered during cancer treatment and offers measures for their prevention and management, particularly in the Australian/New Zealand context where skincare requirements may differ to other regions due to higher cumulative sun damage caused by high ambient ultraviolet (UV) light exposure. Given the frequency of these dermatological toxicities, a proactive phase is envisaged where patients can actively try to prevent skin toxicities.

Elucidating causal relationships of diet-derived circulating antioxidants and the risk of non-scarring alopecia: A Mendelian randomization study

Previous observational studies revealed controversy about the effect of circulating antioxidants on risk of alopecia. In the present study, we investigated the causal relationships between diet-derived circulating antioxidants and 2 non-scarring alopecia using Mendelian randomization (MR). Instrumental variables for antioxidants (lycopene, retinol, ascorbate, β-carotene, α-tocopherol, and γ-tocopherol) were selected from published studies. Data for alopecia areata (AA) and androgenetic alopecia (AGA) was obtained from the FinnGen study project (R9 released in 2023), including 195 cases and 201,019 controls for AGA and 682 cases and 361,140 controls for AA. We used the inverse variance weighted method as the primary MR method. Three additional methods were used as sensitivity analysis to validate the robustness of the results. We found a causal relationship between absolute β-carotene levels and AGA risk (P = .039), but not with AA (P = .283). The results of Wald ratio showed a protective effect of absolute β-carotene levels against AGA, with per 0.1 ln-transformed β-carotene being associated with a 76% lower risk of AGA (OR: 0.24, 95% CI: 0.06-0.93). Based on the fixed effects inverse variance weighting results, we found that α-tocopherol was protective against both AGA (P = .026) and AA (P = .018). For each unit increase in α-tocopherol, the effects of change in AGA and AA were 0.02 (95% CI: 0.00-0.61) and 0.10 (95% CI: 0.01-0.67), respectively. The results did not reveal any other causal relationships. Our study identified 3 causal associations of antioxidants with the risk of non-scarring alopecia. These results provide new insights into the prevention of non-scarring alopecia through diet.

Post Covid telogen effluvium: the diagnostic value of serum ferritin biomarker and the preventive value of dietary supplements. a case control study

Telogen effluvium is characterized by excessive hair shedding usually following a stressful event. Ferritin has been used in clinical practice as a biomarker of nonanemic iron deficiency in cases of telogen effluvium. During the years of the COVID19 pandemic, telogen effluvium was reported as a part of post covid manifestations. As ferritin was also a biomarker for inflammation in cases with covid infection, this study was designed to evaluate the value of ferritin in cases with postcovid telogen effluvium one hundred patients recovering from covid 19 for 4-12 weeks were included in the study, detailed drug and laboratory history was obtained and serum ferritin level was measured. the mean serum level of ferritin among telogen effluvium patients was significantly lower than controls (68.52 ± 126 and 137 ± 137.597 ug/L respectively). Patients with telogen effluvium used significantly more azithromycin and ivermectin and significantly less vitamin C, D, lactoferrin and zinc than the controls Although serum ferritin is lower among telogen effluvium patients, it was still higher than the cutoff value for diagnosing nonanemic iron deficiency, we suggest that it will not be a good biomarkers in these cases. Our secondary outcomes showed that dietary supplements used during active infection such as vitamin C, D, lactoferrin and zinc might have a preventive value on postcovid hair loss, while azithromycin and ivermectin could have a negative long term effect on telogen effluvium.

Treatment for central centrifugal cicatricial alopecia-Delphi consensus recommendations

BACKGROUND

There is no established standard of care for treating central centrifugal cicatricial alopecia (CCCA), and treatment approaches vary widely.

OBJECTIVE

To develop consensus statements regarding the use of various pharmacological therapies in treating adults with CCCA.

METHODS

We invited 27 dermatologists with expertise in hair and scalp disorders to participate in a 3-round modified Delphi study between January and March 2023. Statements met strong consensus if 75% of respondents agreed or disagreed. Statements met moderate consensus if 55% or more but less than 75% agreed or disagreed.

RESULTS

In round 1, 5 of 33 (15.2%) statements met strong consensus, followed by 9 of 28 (32.1%) in round 2. After the final round 3 meeting, strong consensus was reached for 20 of 70 (28.6%) overall statements. Two statements achieved moderate consensus.

LIMITATIONS

This study included only English-speaking, US-based dermatologists and did not consider nonpharmacological therapies.

CONCLUSION

Despite varying opinions among dermatologists, consensus was reached for several statements to help clinicians manage CCCA. We also highlight areas that lack expert consensus with the goal of advancing research and therapeutic options for CCCA.

The efficacy of HDDPiW-jSB solution on docetaxel-induced alopecia of rats

OBJECTIVE

Chemotherapy induced alopecia (CIA) is one of the most common side effects in cancer patients, however; it doesn't have an effective pharmacological treatment yet. In this study we aimed to research the protective effect of newly developed HDDPiW-jSB solution on docetaxel (DTX) -induced rat alopecia model.

MATERIAL AND METHODS

Docetaxel (10 mg/kg/week) was administered to the 6-8 months old rats for three weeks. HDDPiW-jSB solution was applied once or twice a week for 4 weeks beginning prior to one week before DTX. Rat hair follicles were evaluated with hematoxylin-eosin and immune-histochemical staining.

RESULTS

In the first stage of this study, alopecia was successfully developed by DTX (10 mg/kg/three times) application. In the second stage of the study, application of HDDPiW-jSB solution, did not change the study parameters significantly on control group. The solution improved the anagen hair follicle count and Bcl-2 levels in the skin samples of DTX-induced alopecic rat groups, especially when applied twice weekly. Additionally, level of Caspase 3 was decreased. HDDPiW-jSB solution was safe when applied on the skin.

CONCLUSION

Topical HDDPiW-jSB solution could be effective and safe for the protection of DTX-induced alopecia in rat models.

Metabolomics reveals metabolites associated with hair follicle cycle in cashmere goats

BACKGROUND

The hair follicle is a skin accessory organ that regulates hair development, and its activity varies on a regular basis. However, the significance of metabolites in the hair follicle cycle has long been unknown.

RESULTS

Targeted metabolomics was used in this investigation to reveal the expression patterns of 1903 metabolites in cashmere goat skin during anagen to telogen. A statistical analysis was used to investigate the potential associations between metabolites and the hair follicle cycle. The findings revealed clear changes in the expression patterns of metabolites at various phases and in various feeding models. The majority of metabolites (primarily amino acids, nucleotides, their metabolites, and lipids) showed downregulated expression from anagen (An) to telogen (Tn), which was associated with gene expression, protein synthesis and transport, and cell structure, which reflected, to some extent, that the cells associated with hair follicle development are active in An and apoptotic in An-Tn. It is worth mentioning that the expression of vitamin D3 and 3,3',5-triiodo-L-thyronine decreased and then increased, which may be related to the shorter and longer duration of outdoor light, which may stimulate the hair follicle to transition from An to catagen (Cn). In the comparison of different hair follicle development stages (An, Cn, and Tn) or feeding modes (grazing and barn feeding), Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis revealed that common differentially expressed metabolites (DEMs) (2'-deoxyadenosine, L-valine, 2'-deoxyuridine, riboflavin, cytidine, deoxyguanosine, L-tryptophan, and guanosine-5'-monophosphate) were enriched in ABC transporters. This finding suggested that this pathway may be involved in the hair follicle cycle. Among these DEMs, riboflavin is absorbed from food, and the expression of riboflavin and sugars (D-glucose and glycogen) in skin tissue under grazing was greater and lower than that during barn feeding, respectively, suggesting that eating patterns may also alter the hair follicle cycle.

CONCLUSIONS

The expression patterns of metabolites such as sugars, lipids, amino acids, and nucleotides in skin tissue affect hair follicle growth, in which 2'-deoxyadenosine, L-valine, 2'-deoxyuridine, riboflavin, cytidine, deoxyguanosine, L-tryptophan, and guanosine-5'-monophosphate may regulate the hair follicle cycle by participating in ABC transporters. Feeding practices may regulate hair follicle cycles by influencing the amount of hormones and vitamins expressed in the skin of cashmere goats.

Non-Cicatricial Alopecia and Its Association with Anthropometric Measurements and Nutritional Laboratory Markers

Alopecia constitutes one of the most common dermatological disorders, and its steadily increasing prevalence is a cause for concern. Alopecia can be divided into two main categories, cicatricial/scarring and non-cicatricial/non-scarring, depending on the causes of hair loss and its patterns. The aim of this study was to investigate the relationship between anthropometric and nutritional laboratory parameters in Caucasian adult women and men with non-cicatricial alopecia. A total of 50 patients (37 with non-cicatricial alopecia and 13 healthy controls) were included in the study. Clinical examination and scalp trichoscopy were performed. The anthropometric and nutritional laboratory parameters were collected and analyzed. No statistically significant differences in the laboratory findings were found. The patients with non-cicatricial alopecia were statistically significantly younger as compared to the controls. An elevated risk of hair loss, which was detected among the younger participants, might be associated with a modern lifestyle and the so-called 'Western diet'. It seems safe to assume that suboptimal nutrition and poor eating habits during childhood might constitute risk factors for early hair loss.

Association of Obesity and Bariatric Surgery on Hair Health

Obesity and obesity-related conditions today constitute a public health problem worldwide. Obesity is an "epidemic" chronic disorder, which is defined by the WHO as normal or excessive fat accumulation that may impair health. It is also defined for adults as a BMI that is greater than or equal to 30. The most common obesity-related diseases are type 2 diabetes mellitus, cardiovascular diseases, metabolic syndrome, chronic kidney disease, hyperlipidemia, hypertension, nonalcoholic fatty liver disease, and certain types of cancer. It has been also proven that obesity can have a negative effect on hair. It can lead to hair thinning. Patients with obesity can undergo bariatric surgery if they meet the inclusion criteria. The four common types of weight loss surgery include a duodenal switch with biliopancreatic diversion, laparoscopic adjustable gastric banding, Roux-en-Y gastric bypass, and sleeve gastrectomy. Bariatric surgery can affect skin and hair and is associated with telogen effluvium due to weight loss, microelement deficiency, anesthesia, low calorie intake, and low protein intake. Patients who undergo bariatric surgery can experience post-bariatric surgery depression. Hair loss can have a major impact on self-esteem, negatively affecting one's self-image. The purpose of this narrative review is to critically review how obesity, obesity-related diseases, and bariatric surgery affect hair health in general and the hair development cycle, and how they influence hair loss.

The effect of oxygen supply using perfluorocarbon-based nanoemulsions on human hair growth

Hair dermal papilla cells (hDPCs) play a crucial role in hair growth and regeneration, and their function is influenced by nutrient and oxygen supply. A microenvironment with significantly low oxygen (O2) levels, known as anoxic conditions (<0.2%) due to oxygen deficiency, hinders hDPC promotion and retards hair regrowth. Here, a nanoemulsion (NE) based on perfluorooctyl bromide (PFOB), a member of the perfluorocarbon family, is presented to provide a sustainable O2 supply and maintain physical stability in vitro. The PFOB-NE has been shown to continuously release oxygen for 36 h, increasing and maintaining the O2 concentration in the anoxic microenvironment of up to 0.8%. This sustainable O2 supply using PFOB-NE has promoted hDPC growth and also induced a complex cascade of effects. These effects encompass regulation via inhibiting lactate accumulation caused via oxygen deficiency, increasing lactate dehydrogenase activity, and promoting the expression of genes, such as the hypoxia-inducible factor 1 family and NADPH oxidase 4 under anoxic conditions. Sustained O2 supply is shown to enhance human hair organ elongation approximately four times compared to the control under anoxic conditions. In conclusion, the perfluorocarbon-based NE containing oxygen proves to be an important strategic tool for improving hair growth and alleviating hair loss.

Status of research on the development and regeneration of hair follicles

Hair loss, or alopecia, is a prevalent condition in modern society that imposes substantial mental and psychological burden on individuals. The types of hair loss, include androgenetic alopecia, alopecia areata, and telogen effluvium; of them, androgenetic alopecia is the most common condition. Traditional treatment modalities mainly involve medical options, such as minoxidil, finasteride and surgical interventions, such as hair transplantation. However, these treatments still have many limitations. Therefore, exploring the pathogenesis of hair loss, specifically focusing on the development and regeneration of hair follicles (HFs), and developing new strategies for promoting hair regrowth are essential. Some emerging therapies for hair loss have gained prominence; these therapies include low-level laser therapy, micro needling, fractional radio frequency, platelet-rich plasma, and stem cell therapy. The aforementioned therapeutic strategies appear promising for hair loss management. In this review, we investigated the mechanisms underlying HF development and regeneration. For this, we studied the structure, development, cycle, and cellular function of HFs. In addition, we analyzed the symptoms, types, and causes of hair loss as well as its current conventional treatments. Our study provides an overview of the most effective regenerative medicine-based therapies for hair loss.

Telogen effluvium: a 360 degree review

Telogen effluvium (TE) is one of the most common presentations of diffuse non-cicatricial alopecia and is generally self-limited. Multiple causes are associated with TE onset and its maintenance, with stress being felt the most common factor. The multifactorial etiologies involved in TE makes it a complex disorder to diagnose and treat often placing this entity into a "waste basket" diagnosis. By critically assessing the available scientific literature we aimed to review the multifaceted aspects of TE. Our objectives were to review the pathogenesis with the role of stress (including Coronavirus 19-associated TE), as well as to describe the main clinical findings, its differential diagnosis and the current knowledge on TE treatments along with the future treatment's insights.

Basic principles of hair follicle structure, morphogenesis, and regeneration

Diseases affecting the hair follicle are common in domestic animals, but despite the importance of an intact skin barrier and a fully functional hair coat, knowledge about the detailed morphological features and the diversity of these complex mini-organs are often limited, although mandatory to evaluate skin biopsies with a history of alopecia. The factors that regulate the innate hair follicle formation and the postnatal hair cycle are still not completely understood in rodents, only rudimentarily known in humans, and are poorly understood in our companion animals. This review aims to summarize the current knowledge about hair follicle and hair shaft anatomy, the arrangement of hair follicles, hair follicle morphogenesis in the embryo, and the lifelong regeneration during the postnatal hair cycle in domestic animals. The role of follicular stem cells and the need for a multitude of interacting signaling events during hair follicle morphogenesis and regeneration is unquestioned. Because of the lack of state of the art methods that can be applied in rodents but are not feasible in companion animals, most of the information in this review is based on rodent studies. However, the few data from domestic animals that are available will be discussed, and it can be assumed that at least the principal molecular mechanisms are similar in rodents and other species.

Dissolving microneedles for alopecia treatment

Alopecia is a treatable benign disease, however, approximately 15-30% of women and 50% of men suffer from alopecia, which greatly affects patient's self-esteem and quality of life. Currently, commercial products for alopecia treatment include topical minoxidil solution, oral finasteride tablets and oral baricitinib tablets. However, the barrier of stratum corneum, systemic adverse effects and poor cure rate limit the application of commercial products. Therefore, researchers investigated the mechanism of alopecia, and developed new drugs that could target lactate dehydrogenase-related pathways, remove excessive reactive oxygen in hair follicles, and reduce the escape of hair follicle stem cells, thus injecting new strength into the treatment of alopecia. Moreover, starting from improving drug stratum corneum penetration and reducing side effects, researchers have developed hair loss treatment strategies based on dissolved microneedles (MNs), such as drug powders/microparticles, nanoparticles, biomimetic cell membranes, phototherapy and magnetically responsive soluble microneedles, which show exciting alopecia treatment effects. However, there are still some challenges in the practical application of the current alopecia treatment strategy with soluble microneedles, and further studies are needed to accelerate its clinical translation.

Micronutrient Deficiencies and Digital Computerized Phototrichogram Analysis in Telogen Effluvium: a Retrospective Correlation Study in a Tertiary Medical Center

INTRODUCTION

Telogen effluvium (TE) is a common form of non-scarring alopecia that may manifest as acute or chronic hair shedding. Several studies evaluated a possible relationship between various vitamin and mineral deficiencies and TE, but it is still a controversial topic.

OBJECTIVES

This study aimed to investigate the status of vitamin and mineral deficiencies in patients diagnosed with TE and to evaluate their correlation with anagen hair ratios (AHR) calculated with an automated digital phototrichogram (ADCP).

METHODS

Electronic records of 973 TE patients were retrospectively analyzed. Demographic, clinical data, parameters such as ferritin, vitamin B12 (Vit-B12), vitamin D (Vit-D), folic acid, zinc and hemoglobin (HGB) serum levels were evaluated. Anagen to telogen hair ratios were also assessed in forty-two patients via ADCP.

RESULTS

The rates of anemia, low ferritin level, and Vit-B12, folate, Vit-D, and zinc deficiencies were 11.9% (N = 109), 44% (N = 332), 1.5% (N = 13), 2.5% (N = 14), 87% (N = 51), and 4.5% (N = 2), respectively. A positive correlation was found between HGB levels and AHR in female patients (Spearman rank, r = 0.417, P = 0.008). No statistically significant relationship was found between ferritin, Vit-B12, folate, zinc serum levels and AHR. The relationship between Vit-D and AHR could not be assessed due to the insufficient number of patients with Vit-D data.

CONCLUSIONS

HGB value is the only marker that is positively correlated with the AHR of patients with TE. Ordering HGB can be used as an initial test for managing TE patients cost-effectively.

Antiseizure Medication-Induced Alopecia: A Literature Review

Background: Adverse effects of antiseizure medications (ASMs) remain one of the major causes of non-adherence. Cosmetic side effects (CSEs) are among the most commonly reported side effects of ASMs. In this context, alopecia is one of the CSEs that has a high intolerance rate leading to poor therapeutical compliance. Methods: We performed a literature review concerning alopecia as a secondary effect of ASMs. Results: There are 1656 individuals reported with ASM-induced alopecia. Valproate (983), lamotrigine (355), and carbamazepine (225) have been extensively reported. Other ASMs associated with alopecia were cenobamate (18), levetiracetam (14), topiramate (13), lacosamide (7), vigabatrin (6), phenobarbital (5), gabapentin (5), phenytoin (4), pregabalin (4), eslicarbazepine (3), brivaracetam (2), clobazam (2), perampanel (2), trimethadione (2), rufinamide (2), zonisamide (2), primidone (1), and tiagabine (1). There were no reports of oxcarbazepine and felbamate with drug-induced alopecia. Hair loss seen with ASMs was diffuse and non-scarring. Telogen effluvium was the most common cause of alopecia. A characteristic feature was the reversibility of alopecia after ASM dose adjustment. Conclusions: Alopecia should be considered one important adverse effect of ASMs. Patients reporting hair loss with ASM therapy should be further investigated, and specialist consultation is recommended.

Androgenetic Alopecia: Therapy Update

Androgenetic alopecia (AGA), also known as male pattern hair loss (MPHL) or female pattern hair loss (FPHL), is the most common form of alopecia worldwide, and arises from an excessive response to androgens. AGA presents itself in a characteristic distribution unique to both sexes. Despite its prevalence, AGA can be quite challenging to treat. The condition is chronic in nature and stems from an interplay of genetic and environmental factors. There are only two US Food and Drug Administration (FDA)-approved drugs for the condition: topical minoxidil and oral finasteride. However, numerous non-FDA-approved treatments have been shown to be effective in treating AGA in various studies. Some of these treatments are relatively new and still to be explored, thus emphasizing the need for an updated review of the literature. In this comprehensive review, we discuss the evaluation of AGA and the mechanisms of action, costs, efficacies, and safety profiles of existing, alternative, and upcoming therapeutics for this widespread condition.

Nutritional Factors: Benefits in Glaucoma and Ophthalmologic Pathologies

Glaucoma is a chronic optic neuropathy that can lead to irreversible functional and morphological damage if left untreated. The gold standard therapeutic approaches in managing patients with glaucoma and limiting progression include local drops, laser, and/or surgery, which are all geared at reducing intraocular pressure (IOP). Nutrients, antioxidants, vitamins, organic compounds, and micronutrients have been gaining increasing interest in the past decade as integrative IOP-independent strategies to delay or halt glaucomatous retinal ganglion cell degeneration. In our minireview, we examine the various nutrients and compounds proposed in the current literature for the management of ophthalmology diseases, especially for glaucoma. With respect to each substance considered, this minireview reports the molecular and biological characteristics, neuroprotective activities, antioxidant properties, beneficial mechanisms, and clinical studies published in the past decade in the field of general medicine. This study highlights the potential benefits of these substances in glaucoma and other ophthalmologic pathologies. Nutritional supplementation can thus be useful as integrative IOP-independent strategies in the management of glaucoma and in other ophthalmologic pathologies. Large multicenter clinical trials based on functional and morphologic data collected over long follow-up periods in patients with IOP-independent treatments can pave the way for alternative and/or coadjutant therapeutic options in the management of glaucoma and other ocular pathologies.

The biology of mammalian multi-copper ferroxidases

The mammalian multicopper ferroxidases (MCFs) ceruloplasmin (CP), hephaestin (HEPH) and zyklopen (ZP) comprise a family of conserved enzymes that are essential for body iron homeostasis. Each of these enzymes contains six biosynthetically incorporated copper atoms which act as intermediate electron acceptors, and the oxidation of iron is associated with the four electron reduction of dioxygen to generate two water molecules. CP occurs in both a secreted and GPI-linked (membrane-bound) form, while HEPH and ZP each contain a single C-terminal transmembrane domain. These enzymes function to ensure the efficient oxidation of iron so that it can be effectively released from tissues via the iron export protein ferroportin and subsequently bound to the iron carrier protein transferrin in the blood. CP is particularly important in facilitating iron release from the liver and central nervous system, HEPH is the major MCF in the small intestine and is critical for dietary iron absorption, and ZP is important for normal hair development. CP and HEPH (and possibly ZP) function in multiple tissues. These proteins also play other (non-iron-related) physiological roles, but many of these are ill-defined. In addition to disrupting iron homeostasis, MCF dysfunction perturbs neurological and immune function, alters cancer susceptibility, and causes hair loss, but, despite their importance, how MCFs co-ordinately maintain body iron homeostasis and perform other functions remains incompletely understood.

The Efficacy and Safety of Dr. SKS Hair Booster Serum (a Cocktail of Micronutrients and Multivitamins) in Adult Males and Females With Androgenetic Alopecia: An Open-Label, Non-randomized, Prospective Study

Background Androgenetic alopecia (AGA) is frequently encountered in dermatological practice; however, there is a lack of approved treatment. At present, only three therapies have been approved for on-label use in androgenetic alopecia: minoxidil, finasteride, and lower-level laser therapy. Micronutrients are primary elements in the normal hair follicle cycle, and their role in androgenetic alopecia is a growing matter of research nowadays. This study aims to investigate the clinical efficacy and safety of Dr. SKS Hair Booster Serum, a cocktail of micronutrients and multivitamins (copper, niacinamide, hyaluronic acid, thiamine, riboflavin, and biotin), in male and female patients with androgenetic alopecia. Methods We did an open-label, non-randomized, multicenter, prospective study across five hair clinic chains in India (Mumbai, Hyderabad, Jabalpur, Balaghat, and Nagpur). Eligible participants were patients with a confirmed diagnosis of androgenetic alopecia based on clinical examination and trichoscopic findings, age of 18 years or older, and any gender. Each patient received Dr. SKS Hair Booster Serum, 1 ml in volume, once a month by mesotherapy or derma roller/derma pen for up to six months. All patients were subjected to a 60-second hair count test (comb test), hair pull test, global photographic assessment (GPA), trichoscopy assessment, patient self-assessment questionnaire, and safety assessment at baseline and six months after the treatment. Results One thousand patients (500 males and females each) with androgenetic alopecia were analyzed. There was a significant reduction in hair fall with bulb (<0.0001) and without bulb (<0.0001) six months after the treatment versus baseline. There was a significant improvement in the number of hairs removed per pull (<0.0001), global photographic assessment score (<0.0001), hair growth rate (<0.0001), follicular hair density (<0.0001), vellus hair density (<0.0001), and terminal hair density (<0.0001) six months after the treatment versus baseline. The majority of patients (95%) were satisfied with six-month treatment of Dr. SKS Hair Booster Serum. No major adverse events were reported during the study. Conclusion Dr. SKS Hair Booster Serum was found to be a safe and effective treatment for androgenetic alopecia, with 95% patient self-assessment score.

Stem Cell Applications in Human Hair Growth: A Literature Review

Stem cells are being investigated in applications in male pattern baldness and other forms of alopecia of the human scalp. This report explores the literature regarding the various applications of stem cells and their potential for future use in the correction of multifactorial etiologies for male or female pattern baldness. Different contemporary studies revealed that stem cells may be directly injected into the scalp to allow the growth of new hair follicles in males or females for the correction of alopecia. Stem cells may also be used in growth factor stimulation of existing inactive and atrophic follicles to yet again become viable and active follicles. Additional studies indicate that various regulatory mechanisms may be used to reinitiate the existing inactive follicle cells to regrow hair in male pattern baldness. Stem cells injected into the scalp could aid these regulatory mechanisms. In the future, stem cell treatment may serve as a viable option superior to the US Food and Drug Administration (FDA)-approved invasive and noninvasive techniques currently used to combat alopecia.

Female pattern hair loss: therapeutic update

Female androgenetic alopecia or female-pattern hair loss (FPHL) is highly prevalent and has a great impact on the quality of life. The treatment is a routine challenge in dermatological practice, as many therapeutic options have a limited level of evidence and often do not meet patients expectations. Lack of knowledge of the pathogenesis of the hair miniaturization process and the factors that regulate follicular morphogenesis restricts the prospect of innovative therapies. There is also a lack of randomized, controlled studies with longitudinal follow-up, using objective outcomes and exploring the performance of the available treatments and their combinations. Topical minoxidil, which has been used to treat female pattern hair loss since the 1990s, is the only medication that has a high level of evidence and remains the first choice. However, about 40% of patients do not show improvement with this treatment. In this article, the authors critically discuss the main clinical and surgical therapeutic alternatives for FPHL, as well as present camouflage methods that can be used in more extensive or unresponsive cases.

Effects of vitamin A in promoting proliferation and osteogenic differentiation of human periodontal ligament cells

Human periodontal ligament cells (hPDLCs) are known as ideal seed cells for the regeneration of periodontal tissues. Several factors (i.e., vitamin D₃, luteolin, and 6-bromoindirubin-3'-oxime) have been shown to promote osteogenic differentiation of hPDLCs. In this study, we aim to investigate the effect of vitamin A on cell proliferation, migration, and osteogenic differentiation of hPDLCs. hPDLCs were cultured in osteogenic induction medium supplemented with different concentrations of vitamin A. Cell proliferation and migration assays were conducted after 24, 48, and 72 h of incubation, whereas osteogenic differentiation and osteogenesis-related gene expression were assessed after 21 d only. Our results demonstrated that 1-µM vitamin A stimulation exerted the most potent promotion effect on cell proliferation, migration, and osteogenic differentiation of hPDLCs. It also induced significant upregulation of osteogenic differentiation-related genes and mitochondrial complexes II and IV in hPDLCs. Vitamin A may serve as a promising potential candidate for periodontal tissue regeneration.

Symptomatic Characteristics of Hypozincemia Detected in Long COVID Patients

OBJECTIVES

The aim of this study was to determine the characteristics of hypozincemia in long COVID patients.

METHODS

This study was a single-center retrospective observational study for outpatients who visited the long COVID clinic established in a university hospital during the period from 15 February 2021 to 28 February 2022. Characteristics of patients with a serum zinc concentration lower than 70 μg/dL (10.7 μmol/L) were compared with characteristics of patients with normozincemia.

RESULTS

In a total of 194 patients with long COVID after excluding 32 patients, hypozincemia was detected in 43 patients (22.2%) including 16 male patients (37.2%) and 27 female patients (62.8%). Among various parameters including the background characteristics of the patients and medical histories, the patients with hypozincemia were significantly older than the patients with normozincemia (median age: 50 vs. 39 years). A significant negative correlation was found between serum zinc concentrations and age in male patients (R = -0.39; p < 0.01) but not in female patients. In addition, there was no significant correlation between serum zinc levels and inflammatory markers. General fatigue was the most frequent symptom in both male patients with hypozincemia (9 out of 16: 56.3%) and female patients with hypozincemia (8 out of 27: 29.6%). Patients with severe hypozincemia (serum zinc level lower than 60 μg/dL) had major complaints of dysosmia and dysgeusia, which were more frequent complaints than general fatigue.

CONCLUSIONS

The most frequent symptom in long COVID patients with hypozincemia was general fatigue. Serum zinc levels should be measured in long COVID patients with general fatigue, particularly in male patients.

Rethinking of positive effects of eggs on hair in East Asia

BACKGROUND

Our bodies are a collection of nutrients. For healthy body production and activities, good nutrients must be balanced and supplied steadily. However, as modern people eat more irregular meals and fast food, they are running out of nutrients needed by the human body. As a result, research was conducted on the effect of eggs with good cost-effectiveness on the human body and hair.

PURPOSE

The purpose of this paper is to review the literature investigated to convey knowledge of the positive nutrients of modern people's nutrition and eggs.

METHODS

These data were reviewed to identify agreement between each section and the unique guiding area. Regarding the survey criteria, it was finally decided that 31 papers were suitable for evaluating the purpose of research as follows. PRISMA flowcharts allow you to determine the number of records identified, included, and excluded.

RESULTS

Eggs are considered the most cost-effective foods that deliver protein, biotin, choline, and vitamin A to the world, and eggs that can be easily consumed are known as nutritional foods because they contain protein, lipids, minerals, and embryonic development growth factors. It is widely consumed as a food that can be eaten by anyone, including the elderly and children.

CONCLUSIONS

In this study, eggs can be used as important data for modern people by delivering nutrients to the human body and hair of modern people and understanding positive nutrients.

Hair Loss in Patients with Gastroparesis: A Sign of Nutritional Deficiency in Gastroparesis?

INTRODUCTION

Some patients with gastroparesis (Gp) report hair loss. The aim of this study was to investigate the prevalence of patient-reported hair loss in Gp patients, analyze hair loss association to severity of Gp and nutritional deficiencies, and study effects of multivitamin treatment on hair loss.

METHODS

Patients with Gp were questioned about hair characteristics, Gp symptoms, and diet. Patients with hair loss had blood drawn for vitamin levels. Patients with hair loss were treated with daily multivitamin and assessed 8 weeks later.

RESULTS

Hair loss was reported in 65 of 143 patients with Gp (45.5%), occurring similarly in idiopathic and diabetic Gp. Hair loss was most commonly noticed while washing and/or combing hair. Patients with hair loss had more severe nausea, abdominal pain, stomach fullness, loss of appetite, abdominal discomfort, bloating, retching, stomach distension, vomiting, early satiety, postprandial fullness, and constipation. Hair loss patients lost more weight over prior 6 months. Patients with hair loss had similar gastric retention on gastric emptying scintigraphy. Overall, 29 of 61 (47.5%) patients with hair loss had at least one abnormal bloodwork result. After 8 weeks of treatment with a daily multivitamin, 17 of 41 (41%) patients had improvement in hair loss.

CONCLUSION

Hair loss occurred in 46% of patients with Gp, being associated with more severe symptoms, loss of weight, and several vitamin deficiencies, although not a specific one. Treatment with multivitamins improved hair loss in 40% of patients. Presence of hair loss in patients with Gp should prompt nutritional evaluation and supplementation.

Effects of a Combination of Arginine Silicate Inositol Complex and a Novel Form of Biotin on Hair and Nail Growth in a Rodent Model

The purpose of this study was to examine the effects of a combination of inositol-stabilized arginine silicate complex (ASI) and magnesium biotinate (MgB) on hair and nail growth in an animal model. Twenty-eight female Sprague-Dawley rats (8 weeks old) were randomized into one of the following groups: (i) group (control), shaved; (ii) group (ASI), shaved + ASI (4.14 mg/rat/day); (iii) group (ASI + MgB I), shaved + ASI (4.14 mg/rat/day) + MgB (48.7 μg/rat/day); and (iv) group (ASI + MgB II), shaved + ASI (4.14 mg/rat/day) + MgB (325 μg/rat/day). On day 42, compared with the control group, while hair density (p < 0.05, p < 0.01, and p < 0.0001, respectively) and anagen ratio (p < 0.01, p < 0.01, and p < 0.001) increased in the ASI, ASI + MgB I, and ASI + MgB II groups, telogen ratio decreased (p < 0.01, p < 0.01, and p < 0.001, respectively). In the molecular analysis, VEGF, HGF, and KGF-2 increased in the ASI (p < 0.01, p < 0.01, and p < 0.05, respectively), ASI + MgB I (p < 0.0001 for all), and ASI + MgB II (p < 0.0001 for all) groups when compared to the control group. FGF-2 (p < 0.01) and IGF-1 (p < 0.001) were found to be increased in the ASI + MgB I and ASI + MgB II groups. SIRT-1 and β-catenin increased in the ASI (p < 0.05 and p < 0.01), ASI + MgB I (p < 0.001 for both), and ASI + MgB II (p < 0.0001 for both) groups. Wnt-1 increased in the ASI + MgB I (p < 0.001) and ASI + MgB II (p < 0.0001) groups. In conclusion, the combination of ASI and MgB could promote hair growth by regulating IGF-1, FGF, KGF, HGF, VEGF, SIRT-1, Wnt, and β-catenin signal pathways. It was also established that ASI did not affect nail growth, whereas the MgB combination was effective using a higher dose of biotin.

Considerations for cutaneous physiologic changes of pregnancy that fail to resolve postpartum

Pregnancy prompts many adaptive and unique physiologic modifications, with cutaneous changes being possibly the most noticeable. These cutaneous changes are of interest to physicians, since they must be diagnosed as anticipated normal physiologic changes or potentially harmful and managed accordingly. Research has been conducted on physiologically normal and abnormal cutaneous manifestations of pregnancy but is lacking in regard to the persistence of these changes after delivery. This prompts the question as to whether these are normal physiologic changes taking longer to resolve, abnormal changes that may have been previously misdiagnosed, or a separate underlying change that is incorrectly attributed to a common dermatosis caused by pregnancy. Some of the conditions that may persist longer than expected during or after pregnancy, and thus require further workup for an underlying condition, include telogen effluvium, severe hirsutism, palmar erythema, and striae. The objective of this review is to focus on these four common cutaneous physiologic changes of pregnancy, and what to consider when they do not resolve as expected.