1
|
Zhang J, Zhao Y, Zhang J, Zhou Y, Yi Y, Lei R, Qu Q, Hu Z, Gao Z, Li Y, Tang Q, Miao Y. Risk Factors and Hazards of Recipient-Area Perifollicular Erythema After Hair Transplantation: A Multicenter Retrospective Cohort Study. Aesthetic Plast Surg 2024; 48:2771-2777. [PMID: 38849551 DOI: 10.1007/s00266-024-04166-z] [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: 02/03/2024] [Accepted: 05/24/2024] [Indexed: 06/09/2024]
Abstract
BACKGROUND Recipient-area perifollicular erythema (RPE) may delay graft growth after hair transplantation. However, there is currently a lack of observational clinical studies of RPE. OBJECTIVE To study the clinical features and risk factors associated with RPE while analyzing its correlation with graft growth. METHODS We conducted a multicenter retrospective cohort study between June 2020 and January 2023. RESULTS A total of 1090 participants were included, 178 (16.33%) showed mild RPE, 56 (5.14%) showed moderate RPE, and 10 (0.92%) showed severe RPE. Patients with RPE had severe hair shaft shedding (P < 0.001) and a lower survival rate (P < 0.001) of grafts. Logistic regression analysis showed that folliculitis is a significant risk factor for mild RPE (OR 6.061, 95% CI 3.343-10.991, P < 0.001) and moderate RPE (OR 3.397, 95% CI 1.299-8.882, P = 0.013). Besides, untimely first postoperative hair washing was associated with the development of moderate RPE (OR 0.724, 95% CI 0.553-0.947, P = 0.018) and severe RPE (OR 1.553, 95% CI 1.156-2.086, P = 0.003). CONCLUSION RPE is a postoperative complication closely related to high hair shaft shedding proportion and low graft survival rate. Both postoperative folliculitis and untimely first postoperative hair washing may induce the occurrence of RPE. LEVEL OF EVIDENCE III 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 .
Collapse
Affiliation(s)
- Jiaxian Zhang
- Department of Plastic and Aesthetic Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China
| | - Yingjie Zhao
- Department of Plastic and Aesthetic Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China
| | - Jiarui Zhang
- Department of Plastic and Aesthetic Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China
| | - Yi Zhou
- Center for Plastic and Reconstructive Surgery, Department of Plastic and Reconstructive Surgery, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, 314408, China
| | - Yanhua Yi
- Department of Burn, Would Repair Surgery and Plastic Surgery, Department of Aesthetic Surgery, Affiliated Hospital of Guilin Medical University, Guilin, 541001, China
| | - Rui Lei
- Department of Plastic Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310003, China
| | - Qian Qu
- Department of Plastic and Aesthetic Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China
| | - Zhiqi Hu
- Department of Plastic and Aesthetic Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China
| | - Zhiyong Gao
- Department of Plastic and Aesthetic Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China
| | - Yufei Li
- Department of Plastic Surgery, Shanghai East Hospital, School of Medicine, Tongji University, Shanghai, 200120, China.
| | - Qiang Tang
- Surgery Department of Burn Plastics and Wound Repair, Affiliated Hospital of Youjang Medical University for Nationalities, Baise City, 533000, Guangxi, China.
| | - Yong Miao
- Department of Plastic and Aesthetic Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China.
| |
Collapse
|
2
|
Yang X, Qiao R, Cheng W, Lan X, Li Y, Jiang Y. Comparative efficacy of 2% minoxidil alone against combination of 2% minoxidil and low-level laser therapy in female pattern hair loss-A randomized controlled trial in Chinese females. Photodiagnosis Photodyn Ther 2024; 45:103966. [PMID: 38211777 DOI: 10.1016/j.pdpdt.2024.103966] [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: 10/21/2023] [Revised: 01/08/2024] [Accepted: 01/09/2024] [Indexed: 01/13/2024]
Abstract
OBJECTIVES To investigate the effectiveness and safety of combination of 655 nm low level laser helmet device with topical 2 % minoxidil solution at FPHL in Chinese population. MATERIALS AND METHODS Randomized, parallel, controlled, single-blind clinical trial was conducted. FPHL subjects were randomly allocated into 2 % minoxidil group and combination group. The 2 % minoxidil group received 1 ml topical 2 % minoxidil solution twice daily for 24 weeks. The combination group received 1 ml topical 2 % minoxidil solution twice daily together with 20 min 655 nm low-level laser helmet once every other day for 24 weeks. Hair parameters in two scalp areas including midscalp and vertex were evaluated at baseline, 12th week and 24th week. RESULTS In midscalp area, the combination group showed a lower increase in intermediate hair percentage than 2 % minoxidil group, which was statistically significant. Besides, the combination group had statistically significant increase than 2 % minoxidil group in mean hair diameter. Reported relative adverse events included slightly hair loss (27.8 %), desquamation (19.0 %), pruritus (15.2 %), seborrhea (2.5 %) and hypertrichosis (2.5 %). CONCLUSION In our trial, LLLT was demonstrated as a useful supplementary treatment for FPHL and the combination with 2 % minoxidil accomplished better improvement in intermediate hair enlargement and hair diameter of midscalp for FPHL.
Collapse
Affiliation(s)
- Xianhong Yang
- Department of Dermatopathology, Hospital for Skin Diseases, Institute of Dermatology, Chinese Academy of Medical Sciences & Peking Union Medical College, Nanjing 210042, China; Center for Plastic & Reconstructive Surgery, Department of Dermatology, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), Hangzhou 310014, China
| | - Rui Qiao
- Department of Dermatopathology, Hospital for Skin Diseases, Institute of Dermatology, Chinese Academy of Medical Sciences & Peking Union Medical College, Nanjing 210042, China
| | - Wei Cheng
- Department of Dermatopathology, Hospital for Skin Diseases, Institute of Dermatology, Chinese Academy of Medical Sciences & Peking Union Medical College, Nanjing 210042, China
| | - Xuemei Lan
- Department of Dermatopathology, Hospital for Skin Diseases, Institute of Dermatology, Chinese Academy of Medical Sciences & Peking Union Medical College, Nanjing 210042, China
| | - Yufen Li
- Department of Dermatopathology, Hospital for Skin Diseases, Institute of Dermatology, Chinese Academy of Medical Sciences & Peking Union Medical College, Nanjing 210042, China
| | - Yiqun Jiang
- Department of Dermatopathology, Hospital for Skin Diseases, Institute of Dermatology, Chinese Academy of Medical Sciences & Peking Union Medical College, Nanjing 210042, China.
| |
Collapse
|
3
|
Saad S, Cavelier-Balloy B, Smadja J, Assouly P, Reygagne P. Inflammatory complications after hair transplantation: Report of 10 cases. J Cosmet Dermatol 2022; 21:5938-5941. [PMID: 35841210 DOI: 10.1111/jocd.15244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 06/08/2022] [Accepted: 07/13/2022] [Indexed: 12/27/2022]
Abstract
BACKGROUND Androgenetic alopecia (AGA) is a pathology involving the aesthetic prognosis. Hair transplantation is among best treatments. The principle of hair micro-grafts during AGA consists in taking hair from the non-androgen-dependent occipital area to transplant them with their root in the sparse androgen-dependent areas. Herein, we report 10 cases of the different types of post-transplant inflammatory complications. MATERIALS AND METHODS We included patients referred to our center by their dermatologists or hair transplant surgeons for inflammatory cicatricial alopecia or hair loss observed after the hair transplant. RESULTS Ten patients (eight men and two women) were included. These patients represented 0.08% of all consultations in our center. The indication for hair transplantation was AGA in all of our patients. The technique used for the transplant was follicular unit extraction (FUE) in seven cases and follicular unit transplantation (FUT) strip in three cases. None of the patients had pathology of the scalp or an inflammatory dermatosis before the operation. The inflammatory complications found were lichen planopilaris (LPP) in seven cases, erosive pustulosis of the scalp (EPS) in two cases, and superficial folliculitis (SF) in 1 case. CONCLUSION Our series highlight the rarity of inflammatory complications that occur after a hair transplant. We demonstrate through this work that a hair transplant can trigger inflammatory pathology a few months after the act. We show also, the importance of detecting the rough forms of lichen before an intervention, hence the interest of the systematic dermatoscopic examination during the preoperative consultation.
Collapse
Affiliation(s)
- Sarra Saad
- Centre Sabouraud, Saint-Louis Hospital, Paris, France
| | | | - Jack Smadja
- Centre Sabouraud, Saint-Louis Hospital, Paris, France
| | | | | |
Collapse
|
4
|
Abstract
The approach to hyperandrogenism in women varies depending on the woman's age and severity of symptoms. Once tumorous hyperandrogenism is excluded, the most common cause is PCOS. Hirsutism is the most common presenting symptom. The woman's concern about her symptoms plays an important role in the management of disease. Although measurement of testosterone is useful in identifying an underlying cause, care must be taken when interpreting the less accurate assays that are available commercially. Surgical resection is curative in tumorous etiologies, whereas medical management is the mainstay for non-tumorous causes.
Collapse
Affiliation(s)
- Anu Sharma
- Division of Endocrinology, Metabolism and Diabetes, University of Utah, EIHG 2110A, 15 N 2030 E, Salt Lake City, UT 84112, USA
| | - Corrine K Welt
- Division of Endocrinology, Metabolism and Diabetes, University of Utah, EIHG 2110A, 15 N 2030 E, Salt Lake City, UT 84112, USA.
| |
Collapse
|
5
|
Fan ZX, Liu F, Li KT, Hu ZQ, Miao Y. Effect of De-epithelialization on Graft Survival Rate After Follicular Unit Extraction. Dermatol Surg 2021; 47:1083-1086. [PMID: 34397543 DOI: 10.1097/dss.0000000000003145] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND To achieve a natural postoperative appearance, hair grafts are often de-epithelialized from the epidermis during follicular unit extraction (FUE). However, the effect of de-epithelialization on the survival rate of transplanted hair follicles (HFs) has not been investigated. OBJECTIVE To investigate the effect of de-epithelialization on the survival rate of transplanted HFs. METHODS A total of 64 male patients with androgenetic alopecia were included in this study. They were randomly divided into de-epithelialization and control groups. Organ culture was performed to assess the elongation of hair shaft and the percentage of anagen HFs in both groups. Patients were followed up postoperatively to evaluate complications, postoperative shedding, survival rates, and satisfaction. RESULTS No significant difference in hair shaft elongation and percentage of anagen HFs was observed between both groups. The immediate postoperative satisfaction in the control group was much lower than that in the de-epithelialization group (71.25% and 100%, respectively). No significant differences in shedding rate, graft survival rate, and complications were noticed between both groups. CONCLUSION Follicular de-epithelialization does not affect the survival rate of graft in FUE. Based on these data, de-epithelialization may improve immediate postoperative appearance and lead to a more pleasing cosmetic outcome.
Collapse
Affiliation(s)
- Zhe-Xiang Fan
- All authors are affiliated with the Department of Plastic and Aesthetic Surgery, Nanfang Hospital of Southern Medical University, Guangzhou, China
| | | | | | | | | |
Collapse
|
6
|
Mysore V, Kumaresan M, Garg A, Dua A, Venkatram A, Dua K, Singh M, Madura C, Chandran R, Rajput RS, Sattur S, Singh S. Hair Transplant Practice Guidelines. J Cutan Aesthet Surg 2021; 14:265-284. [PMID: 34908769 PMCID: PMC8611706 DOI: 10.4103/jcas.jcas_104_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
The field of hair transplant (HT) has grown exponentially in the past decade, especially after the introduction of follicular unit excision (FUE). There is much variation in criteria for case selection, the technique, pre- and post-procedure protocols, by different surgeons. Techniques continue to evolve and evidence in the form of controlled data is not available for all techniques and protocols being used; there is also a debate as to who can do what, what should be the training for staff, role of technicians. This has led to a situation wherein medico legal issues have cropped up as to what is minimum acceptable. An attempt is made to summarize standard protocols with the available evidence. It is emphasized that the objective of these guidelines is to recommend minimum standards for practice of hair transplantation. The principles outlined in these guidelines are of a general nature only, minimal in their level and are not meant to cover all situations. It should be understood that these recommendations are by no means binding and universal, represent minimum standards only and as in all surgical techniques, variations in techniques are possible. It is also further clarified that these are based on current literature, and as science evolves, these guidelines could also change in future. Where published evidence is not available, consensus expert opinion is presented. The task force emphasizes that each patient has to be treated on his/her own merit and that these guidelines do not limit the physician from making an appropriate choice or the necessary innovation for a given patient. The task force recognizes that the treating surgeon is best suited to decide what is needed for a given patient in a given situation. Innovations in medicine need flexibility in approach and these guidelines do not limit the surgeon from undertaking innovative research.
Collapse
Affiliation(s)
- Venkatram Mysore
- The Venkat Center for Skin and Plastic Surgery, Bengaluru, Karnataka, India
| | - Muthuvel Kumaresan
- Cutis Skin Clinic & Hair Transplant Center, Coimbatore, Tamil Nadu, India
| | - Anil Garg
- Rejuvenate Hair Transplant Center, Indore, Madhya Pradesh, India
| | - Aman Dua
- AK Clinics & Hair Transplant Center, Delhi, India
| | - Aniketh Venkatram
- Cutis Skin Clinic & Hair Transplant Center, Coimbatore, Tamil Nadu, India
| | - Kapil Dua
- AK Clinics & Hair Transplant Center, Delhi, India
| | | | - C Madura
- Cutis Academy of Cutaneous Sciences, Bangalore, India
| | - Ram Chandran
- Apollo Speciality Center, Chennai, Tamil Nadu, India
| | | | | | | |
Collapse
|
7
|
Fan ZX, Gan Y, Qu Q, Wang J, Lunan Y, Liu B, Chen R, Hu ZQ, Miao Y. The effect of hyperbaric oxygen therapy combined with hair transplantation surgery for the treatment of alopecia. J Cosmet Dermatol 2020; 20:917-921. [PMID: 32770782 DOI: 10.1111/jocd.13665] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 07/25/2020] [Accepted: 07/30/2020] [Indexed: 12/19/2022]
Abstract
BACKGROUND Transplanted hair follicles suffer from various injuries, which are difficult to prevent. Hyperbaric oxygen therapy (HBOT) was reported to be an excellent procedure to promote capillary regeneration and reduce ischemia-reperfusion injury. AIM To evaluate the clinical efficacy of HBOT as an adjuvant therapy for hair transplantation surgery. METHODS Thirty-four patients with II-IV alopecia were divided into the control group and HBOT group randomly. The control group was treated with routine FUE procedure, while HBOT group combined with HBOT. Patients were treated with 100% oxygen under 2.0 atmospheres absolute pressure for 60 minutes through a facemask during HBOT and take the therapy daily for 7 days continuously after operation. Satisfaction and clinical improvement were evaluated at the fourth week and the sixth month postoperatively. RESULTS Itching and folliculitis were significantly decreased in HBOT group (11.8% vs 35.3%). In addition, HBOT resulted in a lower postoperative shedding rate (27.6 ± 2.6% vs 69.1 ± 2.4%); nevertheless, the survival rate at 9 months showed no significant difference between HBOT (96.9 ± 0.5%) and control (93.8 ± 0.6%). The early postoperative satisfaction in control group was much lower than HBOT group (52.9% vs 88.2%), whereas all patients showed satisfaction with the final result. CONCLUSION Hyperbaric oxygen therapy is able to minimize the postsurgical follicle shedding and lead to less folliculitis and itching, which provides evidence for HBOT to act as an adjuvant therapy for hair transplantation surgery.
Collapse
Affiliation(s)
- Zhe-Xiang Fan
- Department of Plastic and Aesthetic Surgery, Nanfang Hospital of Southern Medical University, Guangzhou, China
| | - Yuyang Gan
- Department of Plastic and Aesthetic Surgery, Nanfang Hospital of Southern Medical University, Guangzhou, China
| | - Qian Qu
- 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
| | - Yang Lunan
- Department of Plastic and Aesthetic Surgery, Nanfang Hospital of Southern Medical University, Guangzhou, China
| | - Bingcheng Liu
- Department of Plastic and Aesthetic Surgery, Nanfang Hospital of Southern Medical University, Guangzhou, China
| | - Ruosi Chen
- Department of Plastic and Aesthetic Surgery, Nanfang Hospital of Southern Medical University, Guangzhou, China
| | - Zhi-Qi Hu
- 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
| |
Collapse
|
8
|
Starace M, Orlando G, Alessandrini A, Piraccini BM. Female Androgenetic Alopecia: An Update on Diagnosis and Management. Am J Clin Dermatol 2020; 21:69-84. [PMID: 31677111 DOI: 10.1007/s40257-019-00479-x] [Citation(s) in RCA: 54] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Female androgenetic alopecia (FAGA) is a common cause of non-scarring alopecia in women. The onset may be at any age following puberty and the frequency increases with age. Clinically, it shows a diffuse hair thinning over the central scalp, while the frontal hairline is usually retained. FAGA can have a significant psychological impact, leading to anxiety and depression. For this reason, early diagnosis is very important to stop the progression of the disease. The sex hormonal milieu is the main pathogenetic mechanism studied in FAGA. The role of androgens is not clearly defined and only one-third of women with FAGA show abnormal androgen levels. Endocrinological diseases with hyperandrogenism associated with FAGA comprise polycystic ovarian syndrome (PCOS), hyperprolactinemia, adrenal hyperplasia and, rarely, ovarian and adrenal tumours. Usually the diagnosis of FAGA is made clinically. A complete clinical examination and a blood examination can reveal other signs of hyperandrogenism. Trichoscopy shows the typical hair miniaturization. A scalp biopsy can be useful when the clinical evaluation does not provide a definitive diagnosis or when cicatricial alopecias with hair loss in the distribution of FAGA or alopecia areata are suspected. FAGA is a slowly progressive disease. The goal of therapy is to stop the progression and to induce a cosmetically acceptable hair regrowth. The most important drugs are topical minoxidil and oral anti-androgens. The purpose of this review is to provide an update on FAGA and to create a guideline on diagnosis and management of this frequent hair disease, not always easily recognizable from cicatricial alopecias with a similar distribution.
Collapse
Affiliation(s)
- Michela Starace
- Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, V. Massarenti 1, 40138, Bologna, Italy
| | - Gloria Orlando
- Unit of Dermatology, Department of Medicine-DIMED, University of Padova, Padua, Italy
| | - Aurora Alessandrini
- Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, V. Massarenti 1, 40138, Bologna, Italy
| | - Bianca Maria Piraccini
- Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, V. Massarenti 1, 40138, Bologna, Italy.
| |
Collapse
|
9
|
Zhu DC, He Y, Fan ZX, Wang J, Qu Q, Hu ZQ, Miao Y. Large-Scale Beard Extraction Enhances the Cosmetic Results of Scalp Hair Restoration in Advanced Androgenetic Alopecia in East Asian Men: A Retrospective Study. Dermatol Ther (Heidelb) 2020; 10:151-161. [PMID: 31784942 PMCID: PMC6994566 DOI: 10.1007/s13555-019-00344-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2019] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION Beard hair serves as an important additional donor supply to support hair transplantation in hirsute patients with extensive alopecia and lacking sufficient occipital hair. However, the efficacy and safety of large-scale beard hair extraction have not been studied extensively in the East Asian population. METHODS Data obtained from hirsute patients with extensive alopecia who underwent hair transplantation between March 2017 and December 2018 at Nanfang Hospital were analyzed. Occipital and beard hair were evaluated separately during the pre-, intra-, and post-operative periods. Individual beard hair follicular units (FUs) were harvested under tumescence using a hollow punch with an outer diameter of 0.8-0.9 mm. Follow-up examinations were scheduled at 3-5 days, 1 month, and 9 months postoperatively to check for complications, determine the survival rate of mixed, transplanted FU grafts, and assess patient satisfaction. Data were collected and analyzed statistically. RESULTS A total of 36 hirsute, male patients with advanced androgenetic alopecia (AGA) (Norwood-Hamilton V-VI) were included in this study. The density of the occipital and beard areas was 78.6 ± 4.6 and 48.4 ± 9.3 FU, respectively. It took 3.1 ± 0.9 h to harvest 3135 ± 863 FUs from the occipital area and 2.1 ± 0.6 h to harvest 2352 ± 599 FUs from the beard area. The transection rate for occipital FUs and beard FUs was 3.7 ± 0.4 and 3.9 ± 0.2%, respectively. Completion of the operation took approximately 10.0 ± 0.9 h, and no serious complications were reported 5 days after the procedure. An FU survival rate of 95.7 ± 1.6% was observed at 9 months after transplantation, with no visible hypopigmented scars observed in the bare areas. All patients were satisfied with the resulting cosmetic appearance. CONCLUSION Large-scale beard extraction, when combined with occipital hair extraction, is a safe and effective treatment to enhance the cosmetic appearance of East Asian men with advanced AGA.
Collapse
Affiliation(s)
- De-Cong Zhu
- Department of Plastic and Aesthetic Surgery, Nanfang Hospital of Southern Medical University, Guangzhou, Guangdong, 510515, China
| | - Ye He
- Department of Plastic and Aesthetic Surgery, Nanfang Hospital of Southern Medical University, Guangzhou, Guangdong, 510515, China
| | - Zhe-Xiang Fan
- Department of Plastic and Aesthetic Surgery, Nanfang Hospital of Southern Medical University, Guangzhou, Guangdong, 510515, China
| | - Jin Wang
- Department of Plastic and Aesthetic Surgery, Nanfang Hospital of Southern Medical University, Guangzhou, Guangdong, 510515, China
| | - Qian Qu
- Department of Plastic and Aesthetic Surgery, Nanfang Hospital of Southern Medical University, Guangzhou, Guangdong, 510515, China
| | - Zhi-Qi Hu
- Department of Plastic and Aesthetic Surgery, Nanfang Hospital of Southern Medical University, Guangzhou, Guangdong, 510515, China.
| | - Yong Miao
- Department of Plastic and Aesthetic Surgery, Nanfang Hospital of Southern Medical University, Guangzhou, Guangdong, 510515, China.
| |
Collapse
|
10
|
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.
Collapse
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
| |
Collapse
|
11
|
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.
Collapse
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
| |
Collapse
|
12
|
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.
Collapse
|
13
|
Aesthetic Sideburn Reconstruction With an Expanded Reversed Temporoparieto-occipital Scalp Flap. J Craniofac Surg 2014; 25:1168-70. [DOI: 10.1097/scs.0000000000000805] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
|
14
|
Abstract
Female hair loss is a devastating issue for women that has only relatively recently been publicly acknowledged as a significant problem. Hair transplant surgery is extremely successful in correcting the most cosmetically problematic areas of alopecia. This article discusses the surgical technique of hair transplantation in women in detail, including pearls to reduce postoperative sequelae and planning strategies to ensure a high degree of patient satisfaction. A brief overview of some of the medical treatments found to be helpful in slowing or reversing female pattern hair loss is included, addressing the available hormonal and topical treatments.
Collapse
Affiliation(s)
- Robin H Unger
- Department of Dermatology, Mount Sinai Hospital, 710 Park Avenue, New York City, NY 10021, USA.
| |
Collapse
|
15
|
Editor's invited commentary: Micropigmentation: camouflaging scalp alopecia and scars in Korean patients. Aesthetic Plast Surg 2014; 38:205-206. [PMID: 24414114 DOI: 10.1007/s00266-013-0265-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2013] [Accepted: 12/13/2013] [Indexed: 10/25/2022]
|
16
|
Abstract
Hair loss is a commonly encountered problem in clinical practice, with men presenting with a distinctive pattern involving hairline recession and vertex balding (Norwood-Hamilton classification) and women exhibiting diffuse hair thinning over the crown (increased part width) and sparing of the frontal hairline (Ludwig classification). Female pattern hair loss has a strikingly overwhelming psychological effect; thus, successful treatments are necessary. Difficulty lies in successful treatment interventions, as only two medications - minoxidil and finasteride - are approved for the treatment of androgenetic alopecia, and these medications offer mediocre results, lack of a permanent cure, and potential complications. Hair transplantation is the only current successful permanent option, and it requires surgical procedures. Several other medical options, such as antiandrogens (eg, spironolactone, oral contraceptives, cyproterone, flutamide, dutasteride), prostaglandin analogs (eg, bimatoprost, latanoprost), and ketoconazole are reported to be beneficial. Laser and light therapies have also become popular despite the lack of a profound benefit. Management of expectations is crucial, and the aim of therapy, given the current therapeutic options, is to slow or stop disease progression with contentment despite patient expectations of permanent hair regrowth. This article reviews current perspectives on therapeutic options for female pattern hair loss.
Collapse
Affiliation(s)
- Lauren L Levy
- Department of Dermatology, Mount Sinai School of Medicine, New York, NY, USA
| | | |
Collapse
|
17
|
Atanaskova Mesinkovska N, Bergfeld WF. Hair: What is New in Diagnosis and Management? Dermatol Clin 2013; 31:119-27. [DOI: 10.1016/j.det.2012.08.005] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
18
|
Sinclair R, Patel M, Dawson TL, Yazdabadi A, Yip L, Perez A, Rufaut NW. Hair loss in women: medical and cosmetic approaches to increase scalp hair fullness. Br J Dermatol 2012; 165 Suppl 3:12-8. [PMID: 22171680 DOI: 10.1111/j.1365-2133.2011.10630.x] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Androgenetic alopecia affects both men and women. In men it produces male pattern hair loss with bitemporal recession and vertex baldness. In women it produces female pattern hair loss (FPHL) with diffuse alopecia over the mid-frontal scalp. FPHL occurs as a result of nonuniform hair follicle miniaturization within follicular units. Diffuse alopecia is produced by a reduction in the number of terminal fibres per follicular unit. Baldness occurs only when all hairs within the follicular units are miniaturized and is a relatively late event in women. The concepts of follicular units and primary and secondary hair follicles within follicular units are well established in comparative mammalian studies, particularly in sheep. However, discovery of these structures in the human scalp hair and investigation of the changes in follicular unit anatomy during the development of androgenetic alopecia have provided a clearer understanding of the early stages of androgenetic alopecia and how the male and female patterns of hair loss are related. FPHL is the most common cause of alopecia in women and approximately one-third of adult caucasian women experience hair loss. The impact of FPHL is predominantly psychological. While men anticipate age-related hair loss, hair loss in women is usually unexpected and unwelcome at any age. Treatment options to arrest hair loss progression and stimulate partial hair regrowth for FPHL include the androgen receptor antagonists spironolactone and cyproterone acetate, the 5α-reductase inhibitor finasteride and the androgen-independent hair growth stimulator minoxidil. These treatments appear to work best when initiated early. Hair transplantation should be considered in advanced FPHL that is resistant to medical treatments. Hair transplantation requires well-preserved hair growth over the occipital donor area. The psychological impact of FPHL may also be reduced by cosmetic products that improve the appearance of the hair. These agents work to minimize hair fibre breakage, improve hair volume or conceal visible bald scalp.
Collapse
Affiliation(s)
- R Sinclair
- Department of Dermatology, St Vincent's Hospital, PO Box 2900 Fitzroy, Melbourne 3065, Australia.
| | | | | | | | | | | | | |
Collapse
|
19
|
Genetik der androgenetischen Alopezie. MED GENET-BERLIN 2009. [DOI: 10.1007/s11825-009-0197-0] [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
Zusammenfassung
Die androgenetische Alopezie (AGA, erblich- bzw. hormonbedingter Haarausfall [MIM 109200; MIM 300710; MIM 612421]) ist die häufigste Form des Haarverlusts beim Menschen, wobei die Prävalenz stark altersabhängig ist. Im Alter von über 70 Jahren sind über 80% der europäischen Männer betroffen, bei Frauen liegt die AGA-Häufigkeit mit 30–40% deutlich niedriger. Die AGA führt, v. a. bei betroffenen Frauen, zu einer erheblichen psychologischen Belastung und entfaltet dabei Krankheitswert. Der Haarverlust geht auf einen veränderten Haarzyklus und eine Miniaturisierung des Haarfollikels zurück. Die Pathogenese ist androgenabhängig, und die genetische Anlage ist wesentliche Voraussetzung für den Phänotyp. In mehreren Studien konnten der Androgenrezeptor-/Ektodysplasin-A2-Rezeptor(EDA2R)-Locus auf dem X-Chromosom als stärkster beitragender Faktor und durch genomweite Assoziationsuntersuchungen ein weiterer Locus auf Chromosom 20p11 identifiziert werden. Das zum Assoziationssignal nächstgelegene in der Kopfhaut exprimierte Gen ist „paired box 1“ (PAX1). Zwischen PAX1 und dem Androgensignalweg gibt es keine offensichtliche Verbindung, jedoch sind die dem Assoziationssignal auf Chromosom 20p11 zugrunde liegenden pathophysiologischen Prozesse noch nicht geklärt. Bis heute ermöglichen die zur Verfügung stehenden medikamentösen Therapien der AGA bestenfalls ein Aufhalten des Haarverlusts. Mit der Identifizierung der AGA-assoziierten Gene und der Aufklärung ihrer Funktionen wird man die biologischen Ursachen der AGA schrittweise erschließen. Damit ist die Hoffnung auf die Entwicklung neuer Therapien verbunden.
Collapse
|
20
|
Affiliation(s)
- Jerry Shapiro
- Department of Dermatology and Skin Science, University of British Columbia, Vancouver, Canada
| |
Collapse
|
21
|
Abstract
Because of changes in technique, hair transplanting can now be offered as a reasonable option to more male and female patients who are not responsive to, or likely to benefit from, medical treatment. These changes have also resulted in exceptionally natural-looking results, even after a single session in an alopecic area, or in many individuals with prior and cosmetically unacceptable transplanting results. Current concepts and techniques are described in the article. Possible disadvantages of some of them are also discussed. In particular, the apparent advantages of "megasessions" of 3000 or more grafts per session, "dense packing" of more than 40 follicular units per cm2 and a new method of harvesting single follicular units directly from the donor area (Follicular Unit Extraction), may not be advantageous as they first seem.
Collapse
Affiliation(s)
- Walter P Unger
- Department of Dermatology, Mount Sinai School of Medicine, New York, New York, USA.
| |
Collapse
|
22
|
Olsen EA, Messenger AG, Shapiro J, Bergfeld WF, Hordinsky MK, Roberts JL, Stough D, Washenik K, Whiting DA. Evaluation and treatment of male and female pattern hair loss. J Am Acad Dermatol 2005; 52:301-11. [PMID: 15692478 DOI: 10.1016/j.jaad.2004.04.008] [Citation(s) in RCA: 170] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- Elise A Olsen
- Duke University Medical Center, Durham, North Carolina 27710, USA
| | | | | | | | | | | | | | | | | |
Collapse
|
23
|
Goldsmith LA. Summary of the Third International Research Workshop on Alopecia Areata. J Investig Dermatol Symp Proc 1999; 4:200-1. [PMID: 10674365 DOI: 10.1038/sj.jidsp.5640210] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- L A Goldsmith
- University of Rochester, School of Medicine and Dentistry, New York, USA
| |
Collapse
|