RF-Mesotherapy With Dutasteride: A Future Alternative Treatment for Androgenetic Alopecia

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.

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.

Minimally invasive procedures for the management of female pattern hair loss

BACKGROUND

Female Pattern Hair Loss (FPHL) is one of the most common types of hair loss in women. It is characterized by progressive follicular miniaturization leading to diffuse hair thinning over the midfrontal scalp with a negative impact on quality of life. Pharmacological treatments are commonly used, and hair follicle transplantation is an option for those cases with adequate donor area. Minimally invasive procedures, such as microneedling, mesotherapy, microinfusion of drugs into the scalp with tattoo machines (MMP®), and platelet-rich plasma (PRP) have been reported as adjuvant treatments.

AIMS

This study aims to summarize and discuss the efficacy of minimally invasive procedures described for the management of FPHL.

METHODS

Published articles indexed on the Pubmed database and Scopus that described minimally invasive procedures for the management of FPHL in humans were considered. Citations were reviewed and added for completeness. The search was for articles in English only. After excluding duplicate titles, 23 relevant articles were considered.

CONCLUSION

Minimally invasive procedures are promising options and may play a role in FPHL treatment. They can be used as adjunctive therapy for FPHL, in case of poor response to clinical therapy, or when patients prefer other care than the standard. We reinforce that these methods should be performed by an experienced medical professional following strict aseptic techniques. However, microneedling, mesotherapy, MMP, and PRP lack standardization and are supported by a low level of evidence yet. For the future, larger randomized clinical trials are essential to determine the efficacy and optimal protocols for these treatments.

Traditional Chinese Medicine Treatment for Androgenetic Alopecia Based on Animal Experiments: A Systematic Review and Meta-Analysis

Background

In the present study, we systematically evaluated the effects of Traditional Chinese Medicine (TCM) on androgenetic alopecia (AGA) in rodent models (rats and mice) to provide potential evidence for the treatment of AGA by TCM.

Methods

Previous research papers focusing on the treatment of AGA by TCM were retrieved from various electronic databases (PubMed, Embase, The Cochrane Library, CNKI, Vip, Wanfang data, and CBM) up to October 30, 2021. Screening of the literature was performed independently, and data were extracted and assessed. A meta-analysis was performed using RevMan 5.3 software.

Results

When compared with the model groups, a group of C57BL/6 mice treated with TCM showed an increase in the total number of hair follicles (mean difference [MD] = 11.99, 95% confidence interval [CI] [5.94,18.03], P=0.0001), as well as a decrease in serum testosterone (T) level (MD = -1.10, 95% CI [-1.43, -0.78], P < 0.00001), skin discoloration time (MD = -2.93, 95% CI [-4.03, -1.84], P < 0.00001), and skin hair growth time (MD = -3.16, 95% CI [-4.16, -2.16], P < 0.00001). Terminal hair/vellus hair also increased in TCM-treated AGA animals (MD = 3.02, 95% CI [2.05, 3.98], P < 0.00001). No significant difference was found in serum estradiol (E₂) level, skin tissue E₂ level, or skin tissue T level between the TCM-treated group and the model group.

Conclusion

TCM can increase the total number of hair follicles and terminal hair/vellus hair ratio, and reduce skin discoloration time and skin hair growth time in AGA animal models. These effects may be related to the reduction of the serum T level in AGA animals. These conclusions need to be verified by high-quality studies as the current analysis may be affected by the number and quality of the studies identified.

Current controversies in trichology: a European expert consensus statement

INTRODUCTION

Hair disorders are one of the most common conditions within dermatology practice but, although new diagnostic tools and therapeutic options have arisen, the management of these patients still represents a major clinical challenge.

OBJECTIVE

This study aimed at gathering information and achieving consensus on relevant recommendations on the latest advances in alopecia, trichoscopy and hair dermocosmetics.

METHODS

Experts of the steering committee consulted the available evidence on trichology-related areas from the past 5 years and formulated recommendations based on the evidence and their experience. A modified two-round Delphi procedure was performed among 45 European dermatologists experts in trichology to consult their degree of agreement on twenty recommendations, using a 4-point Likert scale. Consensus was defined as >80% of participants scoring either 1 (totally agree) or 2 (agree).

RESULTS

In the first round of the Delphi questionnaire, 75% of the recommendations reached consensus. Those that were not agreed upon were reformulated by the steering committee and voted again after an online meeting, where consensus was achieved in all recommendations.

CONCLUSIONS

All recommendations reached consensus after the two-round Delphi questionnaire and may be useful in clinical practice for dermatologists. The participants agreed that besides this consensus, further clinical studies are needed to assess the benefits of the emerging tools and treatments and to clarify the controversies that still exist in the field, aiming at improving patients' quality of life.