Is androgenic alopecia a result of endocrine effects on the vasculature?

Clinical Use of Extracellular Vesicles in the Management of Male and Female Pattern Hair Loss: A Preliminary Retrospective IRB Safety and Efficacy Study

Background

Pattern hair loss is a common disorder in female and male subjects that may benefit from the use of cell-free XoFlo (Direct Biologics, LLC, Austin, TX) therapy.

Objectives

To assess the safety, efficacy and satisfaction of a single extracellular vesicle (EV) treatment over 6 months.

Methods

A retrospective open-label study among 22 female and 9 male subjects who demonstrated early stages of alopecia or were in remission from prior medical and surgical treatments. The amount of undiluted or diluted volumes of EV solution used was determined by extent and degree of alopecia. Global photography, SGAIS and IGAIS questionnaires, and trichoscan measurements were compared at baseline and six months in three response categories.

Results

Frequent growth responses were observed: older aged females and younger aged males, shorter history of alopecia; earlier stages of hair loss; larger and undiluted volumes of XoFlo; prior positive responses to medical and surgical treatments; and absence or control of disease factors affecting hair. The benefit of micro-needling to therapy was indeterminate. Global photography, trichoscan for density, follicle diameter, terminal: vellus ratio, and SGAIS/IGAIS satisfaction questionnaires at baseline and six months were useful in assessing clinical efficacy. No significant adverse reactions were observed.

Conclusions

Intradermal injections with varying doses of EVs were safe and effective among indicated alopecic female and male subjects. Findings suggest that the presence of positive factors, absence of conditions known to negatively affect hair growth, and administration of larger volumes of XoFlo may have a significant influence on the use of this new cell-free therapy. FDA-approved biologic, multi-centered IRB/ Investigational New Drug (IND) trials are clearly required to determine its future in the management of hair loss.

The Effects of Lower vs Higher Cell Number of Platelet-Rich Plasma (PRP) on Hair Density and Diameter in Androgenetic Alopecia (AGA): A Randomized, Double-Blinded, Placebo, Parallel-Group Half-Scalp IRB-Approved Study

BACKGROUND

Androgenetic alopecia (AGA) is a common disorder in both males and females and may be improved by platelet-rich plasma (PRP) treatment.

OBJECTIVES

The aim of this study was to compare safety, efficacy, and satisfaction following treatment with a lower or higher number of platelets over 6 months.

METHODS

This was a prospective randomized, double-blinded, placebo, parallel-group, half-scalp IRB-approved study involving 8 subjects with moderate AGA. Participants received intradermal PRP injections (baseline and Month 3), according to 2 treatment protocols (high vs low platelet numbers) to the frontal and crown portions of the hemiscalp and normal saline to control sites. Phototrichoscans were recorded at baseline and at 6 months, and global photography and subject and investigator satisfaction questionnaires were obtained at baseline, 3, and 6 months.

RESULTS

At the end of 6-month evaluation period, both groups demonstrated absolute increases in total hair density, follicle diameter, and terminal hair density, as well as absolute and percentage changes at the frontal and crown targeted sites compared with baseline. These improvements tended to occur more often in areas treated with higher platelet numbers than with lower numbers. Vellus hair densities did not exhibit any significant changes with either PRP dosages. The investigator and 6 of the subjects were "satisfied" with the results at 3 months and no adverse reactions were associated with the treatments.

CONCLUSIONS

Intradermal injections with 2 therapeutic quantities of platelets were equally safe and efficacious for treating men and women with AGA. Higher numbers of platelets may have a greater effect than lower numbers of platelets in regard to hair density, follicle diameter, and terminal hair density but exhibited minimal effects on vellus hair densities at the 6-month evaluation point. Further studies are required to determine whether any significant advantages occur when delivering either lower or higher numbers of platelets in AGA treatments as long as therapeutic levels are administered.

LEVEL OF EVIDENCE: 2

Review of Human Hair Follicle Biology: Dynamics of Niches and Stem Cell Regulation for Possible Therapeutic Hair Stimulation for Plastic Surgeons

Plastic surgeons are frequently asked to manage male- and female-pattern hair loss in their practice. This article discusses the epidemiology, pathophysiology, and current management of androgenetic alopecia and emphasizes more recent knowledge of stem cell niches in hair follicles that drive hair cycling, alopecia, and its treatment. The many treatment programs available for hair loss include newer strategies that involve the usage of growth factors, platelet-rich plasma, and fat to stimulate follicle growth. Future research may clarify novel biomolecular mechanisms that target specific cells that promote hair regeneration.Level of Evidence V This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Hair growth effect of traditional Chinese medicine BeauTop on androgenetic alopecia patients: A randomized double-blind placebo-controlled clinical trial

The aim of the present study was to evaluate the treatment effects of BeauTop in alopecia by observing its effectiveness in improving androgenetic alopecia. Hair growth was observed using a dermatoscope and clinical photos, and was scored by three dermatologists. Dermatologists evaluated and selected suitable participants for this study using the Norwood scale or Ludwig scale. A total of 40 participants with androgenetic alopecia were recruited in this study, and 32 participants completed the 6-month trial. The results revealed that in the BeauTop treatment group, 9/17 participants (52.9%) showed increased hair growth. Changes in hair growth were as follows: No change, 47.1% patients; minimally improved, 5.9% patients; moderately improved, 29.4% patients; and significantly improved, 17.6% patients. In the placebo group, 2/15 participants (13%) showed increased hair growth. A Chi-square test was performed and attained a value of 0.01 Collapse

Key Words

• BeauTop
• androgenetic alopecia
• ludwig scale
• norwood scale

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Affiliation(s)

Chien-Ying Lee Department of Pharmacology, Chung Shan Medical University, Taichung 40242, Taiwan, R.O.C Department of Pharmacy, Chung Shan Medical University Hospital, Taichung 40242, Taiwan, R.O.C Department of Medicine, Chung Shan Medical University, Taichung 40242, Taiwan, R.O.C
Cheng-Chung Wei Department of Medicine, Chung Shan Medical University, Taichung 40242, Taiwan, R.O.C Department of Internal Medicine, Chung Shan Medical University Hospital, Taichung 40242, Taiwan, R.O.C
Min-Chien Yu Department of Medicine, Chung Shan Medical University, Taichung 40242, Taiwan, R.O.C Department of Dermatology, Chung Shan Medical University Hospital, Taichung 40242, Taiwan, R.O.C Department of Integrated Chinese and Western Medicine, Chung Shan Medical University Hospital, Taichung 40242, Taiwan, R.O.C
Ching-Che Lin Brion Research Institute, New Taipei City 23143, Taiwan, R.O.C
Shuenn-Jyi Sheu Brion Research Institute, New Taipei City 23143, Taiwan, R.O.C
Jen-Hung Yang College of Medicine, Tzu Chi University, Hualien 97004, Taiwan, R.O.C
Chien-Ying Chiang Brion Research Institute, New Taipei City 23143, Taiwan, R.O.C
Kuang-Hua Huang Department of Health Service Administration, China Medical University, Taichung 40402, Taiwan, R.O.C
Yu-Hsiang Kuan Department of Pharmacology, Chung Shan Medical University, Taichung 40242, Taiwan, R.O.C Department of Pharmacy, Chung Shan Medical University Hospital, Taichung 40242, Taiwan, R.O.C Department of Medicine, Chung Shan Medical University, Taichung 40242, Taiwan, R.O.C

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Effect of a nutritional supplement on hair loss in women

BACKGROUND

Female pattern hair loss is a frequent and distressing condition.

AIM

To evaluate vs. control, the effects on hair loss of a 6-month supplementation with specific omega 3&6 and antioxidants.

METHODS

One hundred and twenty healthy female subjects participated in this 6-month, randomized, comparative study. The primary endpoint was the change in hair density evaluated on standardized photographs. Secondary endpoints included changes in telogen hair percentage and diameter distribution of anagen hair (>40 µm vs. ≤40 µm) measured by trichogram. Overall changes in hair density and diameter were also measured by trichometer and by subjects' self-assessment.

RESULTS

After 6 months of treatment, photograph assessment demonstrated a superior improvement in the supplemented group (P < 0.001). The telogen hair percentage was significantly (P < 0.001) reduced in the supplemented group. The proportion of nonvellus anagen hair (>40 µm) increased compared to the control group. The trichometer index increased in the supplemented group, while it decreased in the control group. A large majority of supplemented subjects reported a reduction in hair loss (89.9% of subjects at 6 months), as well as an improvement in hair diameter (86.1%) and hair density (87.3%).

CONCLUSION

A 6-month supplementation with omega 3&6 and antioxidants acts efficiently against hair loss in improving hair density and reducing the telogen percentage and the proportion of miniaturized anagen hair. Objectively measured improvements were confirmed by the subjects' perception of efficacy.

Clinical efficacy of a cosmetic treatment by Crescina(®) human follicle stem cell on healthy males with androgenetic alopecia

Introduction

Androgenetic alopecia (AGA) is the most common cause of hair loss among males, characterized by progressive thinning of the scalp hairs and defined by various patterns. The main factors underling hair loss in AGA are genetic predisposition and increased sensitivity of the hair follicles to androgens, leading to a shortening of the anagen phase. In the present study, the authors investigated the efficacy of a commercially available cosmetic lotion, Crescina^® HFSC (human follicle stem cell; Labo Cosprophar AG, Basel, Switzerland), in promoting hair growth and in decreasing hair loss.

Methods

A placebo-controlled, randomized trial was carried out on healthy males suffering from alopecia grade II to IV. Anagen rate and hair resistance to traction (pull test) were assessed after 2 and 4 months of treatment using phototricogram and pull test technique.

Results

Crescina^® HFSC applied for 4 months was effective in promoting hair growth and in decreasing hair loss. After 2 and 4 months of treatment, the anagen rate was increased by 6.8% and 10.7%, respectively. Hair resistance to traction was decreased by 29.6% and 46.8%, respectively.

Conclusions

The present study demonstrated the positive effect of Crescina^® HFSC in modulating the activity of the hair follicle and promoting hair growth.