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Zeppieri M, Gagliano C, Spadea L, Salati C, Chukwuyem EC, Enaholo ES, D’Esposito F, Musa M. From Eye Care to Hair Growth: Bimatoprost. Pharmaceuticals (Basel) 2024; 17:561. [PMID: 38794131 PMCID: PMC11124470 DOI: 10.3390/ph17050561] [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: 03/25/2024] [Revised: 04/17/2024] [Accepted: 04/25/2024] [Indexed: 05/26/2024] Open
Abstract
BACKGROUND Bimatoprost has emerged as a significant medication in the field of medicine over the past several decades, with diverse applications in ophthalmology, dermatology, and beyond. Originally developed as an ocular hypotensive agent, it has proven highly effective in treating glaucoma and ocular hypertension. Its ability to reduce intraocular pressure has established it as a first-line treatment option, improving management and preventing vision loss. In dermatology, bimatoprost has shown promising results in the promotion of hair growth, particularly in the treatment of alopecia and hypotrichosis. Its mechanism of action, stimulating the hair cycle and prolonging the growth phase, has led to the development of bimatoprost-containing solutions for enhancing eyelash growth. AIM The aim of our review is to provide a brief description, overview, and studies in the current literature regarding the versatile clinical use of bimatoprost in recent years. This can help clinicians determine the most suitable individualized therapy to meet the needs of each patient. METHODS Our methods involve a comprehensive review of the latest advancements reported in the literature in bimatoprost formulations, which range from traditional eye drops to sustained-release implants. These innovations offer extended drug delivery, enhance patient compliance, and minimize side effects. RESULTS The vast literature published on PubMed has confirmed the clinical usefulness of bimatoprost in lowering intraocular pressure and in managing patients with glaucoma. Numerous studies have shown promising results in dermatology and esthetics in promoting hair growth, particularly in treating alopecia and hypotrichosis. Its mechanism of action involves stimulating the hair cycle and prolonging the growth phase, leading to the development of solutions that enhance eyelash growth. The global use of bimatoprost has expanded significantly, with applications growing beyond its initial indications. Ongoing research is exploring its potential in glaucoma surgery, neuroprotection, and cosmetic procedures. CONCLUSIONS Bimatoprost has shown immense potential for addressing a wide range of therapeutic needs through various formulations and advancements. Promising future perspectives include the exploration of novel delivery systems such as contact lenses and microneedles to further enhance drug efficacy and patient comfort. Ongoing research and future perspectives continue to shape its role in medicine, promising further advancements and improved patient outcomes.
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Affiliation(s)
- Marco Zeppieri
- Department of Ophthalmology, University Hospital of Udine, p.le S. Maria della Misericordia 15, 33100 Udine, Italy
| | - Caterina Gagliano
- Department of Medicine and Surgery, University of Enna “Kore”, Piazza dell’Università, 94100 Enna, Italy
- Eye Clinic, Catania University, San Marco Hospital, Viale Carlo Azeglio Ciampi, 95121 Catania, Italy
| | - Leopoldo Spadea
- Eye Clinic, Policlinico Umberto I, “ Sapienza” University of Rome, 00142 Rome, Italy
| | - Carlo Salati
- Department of Ophthalmology, University Hospital of Udine, p.le S. Maria della Misericordia 15, 33100 Udine, Italy
| | | | | | - Fabiana D’Esposito
- Imperial College Ophthalmic Research Group (ICORG) Unit, Imperial College, London NW1 5QH, UK
| | - Mutali Musa
- Department of Optometry, University of Benin, Benin City 300238, Nigeria;
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Panchaprateep R. Medical Treatment for Androgenetic Alopecia. Facial Plast Surg 2024; 40:252-266. [PMID: 37871637 DOI: 10.1055/a-2196-4713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2023] Open
Abstract
Androgenetic alopecia is a common type of hair loss, which is generally influenced by genetic factors and systemic androgens resulting in follicular miniaturization.1 It can cause cosmetic problems leading to psychological distress among affected men and women. Effective standard medical treatments available are topical minoxidil 2 to 5%, oral finasteride, oral dutasteride, and hair transplantation.1 However, some patients do not achieve favorable results with standard treatments. For these reasons, other novel treatments have been developed, including new medications, regenerative medicines (autologous platelet-rich plasma, adipose-derived stem cells, micrograft generation, and exosome), and low-level laser therapy.
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Affiliation(s)
- Ratchathorn Panchaprateep
- Division of Dermatology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Absolute Hair Clinic, Bangkok Thailand
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3
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Mineroff J, Maghfour J, Ozog DM, Lim HW, Kohli I, Jagdeo J. Photobiomodulation CME part II: Clinical applications in dermatology. J Am Acad Dermatol 2024:S0190-9622(24)00187-7. [PMID: 38307144 DOI: 10.1016/j.jaad.2023.10.074] [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: 05/09/2023] [Revised: 10/07/2023] [Accepted: 10/08/2023] [Indexed: 02/04/2024]
Abstract
Photobiomodulation (PBM) is an emerging treatment modality in dermatology with increasing office and home-based use. PBM is the use of various light sources in the red light (620-700 nm) and near-infrared (700-1440 nm) spectrum as a form of light therapy. PBM is often administered through low-level lasers or light-emitting diodes. Studies show that PBM can be used effectively to treat conditions secondary to cancer therapies, alopecia, ulcers, herpes simplex virus, acne, skin rejuvenation, wounds, and scars. PBM offers patients many benefits compared to other treatments. It is noninvasive, cost-effective, convenient for patients, and offers a favorable safety profile. PBM can be used as an alternative or adjuvant to other treatment modalities including pharmacotherapy. It is important for dermatologists to gain a better clinical understanding of PBM for in-office administration and to counsel patients on proper application for home-use devices to best manage safety and expectations as this technology develops. PBM wavelengths can induce varied biological effects in diverse skin types, races, and ethnicities; therefore, it is also important for dermatologists to properly counsel their skin of color patients who undergo PBM treatments. Future clinical trials are necessary to produce standardized recommendations across conditions and skin types.
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Affiliation(s)
- Jessica Mineroff
- Department of Dermatology, State University of New York, Downstate Health Sciences University, Brooklyn, New York
| | - Jalal Maghfour
- The Henry W. Lim, MD, Division of Photobiology and Photomedicine, Department of Dermatology, Henry Ford Health, Detroit, Michigan
| | - David M Ozog
- The Henry W. Lim, MD, Division of Photobiology and Photomedicine, Department of Dermatology, Henry Ford Health, Detroit, Michigan; College of Human Medicine, Michigan State University, East Lansing, Michigan
| | - Henry W Lim
- The Henry W. Lim, MD, Division of Photobiology and Photomedicine, Department of Dermatology, Henry Ford Health, Detroit, Michigan; College of Human Medicine, Michigan State University, East Lansing, Michigan
| | - Indermeet Kohli
- The Henry W. Lim, MD, Division of Photobiology and Photomedicine, Department of Dermatology, Henry Ford Health, Detroit, Michigan; Department of Physics and Astronomy, Wayne State University, Detroit, Michigan
| | - Jared Jagdeo
- Department of Dermatology, State University of New York, Downstate Health Sciences University, Brooklyn, New York.
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Ruthvik S, John RS, George M, Kumar SP, Krishnan M. Comparison of Efficacy of Platelet-Rich Plasma With and Without Topical Minoxidil for Hair Growth in Patients With Androgenetic Alopecia: A Prospective Study. Cureus 2024; 16:e53875. [PMID: 38465061 PMCID: PMC10924654 DOI: 10.7759/cureus.53875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Accepted: 02/08/2024] [Indexed: 03/12/2024] Open
Abstract
Introduction Androgenetic pattern of alopecia is a common problem occurring in men, which mostly arises from their younger age. There are many therapies advocated in the literature for hair loss reduction, and one of them is platelet-rich plasma (PRP) therapy. This study aimed to assess the efficacy of combined PRP therapy with topical minoxidil over PRP as monotherapy in hair loss reduction and regeneration of new hair. Materials and methods The study was conducted at our institute in the Department of Oral and Maxillofacial Surgery at Saveetha Dental College and Hospital. The study consisted of 40 participants, 20 of whom had only PRP therapy as part of their treatment, while the other 20 participants received PRP combined with topical minoxidil as treatment. Both group participants were evaluated for postoperative hair shaft diameter and hair follicle density. Parameters were measured preoperatively and postoperatively after one month, two months, and three months. Data analysis was done with the help of SPSS, with P-values less than 0.05 considered statistically significant. The Mann-Whitney U test was used to compare the two groups for measurement of hair shaft diameter, and for comparison between hair follicle density, an unpaired t-test was used. Results It was found that the mean hair shaft diameter in the PRP with minoxidil group was higher than that of the PRP group for one month (P = 0.023), two months (P = 0.001), and three months (P = 0.001) postoperative periods, and the results were statistically significant. Hair follicle density (mean hair quantity) was higher in the PRP group than in the PRP with the minoxidil group in the first postoperative month. However, this difference was not statistically significant (P = 0.08). While the mean hair quantity in the PRP with minoxidil group was higher than that in the PRP group for two months (P = 0.45) and three months (P = 0.001) postoperative periods, the results were statistically significant only at the three-month postoperative period. Conclusion It can be concluded that injectable autologous PRP with minoxidil as a topical agent is a better treatment option for the improvement of both hair quality (hair shaft diameter) and hair quantity (hair follicle density) compared to plain autologous injectable PRP monotherapy.
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Affiliation(s)
- Soorumsetty Ruthvik
- Oral and Maxillofacial Surgery, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, IND
| | - Rubin S John
- Oral and Maxillofacial Surgery, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, IND
| | - Melvin George
- Oral and Maxillofacial Surgery, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, IND
| | - Santhosh P Kumar
- Oral and Maxillofacial Surgery, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, IND
| | - Murugesan Krishnan
- Oral and Maxillofacial Surgery, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, IND
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Dong W, Jin X, Mo S. Acupuncture for androgenetic alopecia: a report of two cases. Acupunct Med 2023:9645284231210880. [PMID: 38149591 DOI: 10.1177/09645284231210880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2023]
Affiliation(s)
- Wendi Dong
- Foshan Clinical Medical College, Guangzhou University of Chinese Medicine, Foshan, China
| | - Xiaxia Jin
- Chinese Medicine Resource Center, China Academy of Chinese Medical Sciences, Beijing, China
| | - Shan Mo
- Foshan Clinical Medical College, Guangzhou, China
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Li K, Liu F, He Y, Qu Q, Sun P, Du L, Wang J, Chen R, Gan Y, Fu D, Fan Z, Liu B, Hu Z, Miao Y. The homing of exogenous hair follicle mesenchymal stem cells into hair follicle niches. JCI Insight 2023; 8:e173549. [PMID: 37917167 PMCID: PMC10807717 DOI: 10.1172/jci.insight.173549] [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: 07/06/2023] [Accepted: 10/31/2023] [Indexed: 11/04/2023] Open
Abstract
Hair loss is a debilitating condition associated with the depletion of dermal papilla cells (DPCs), which can be replenished by dermal sheath cells (DSCs). Hence, strategies aimed at increasing the populations of DPCs and DSCs hold promise for the treatment of hair loss. In this study, we demonstrated in mice that introduced exogenous DPCs and DSCs (hair follicle mesenchymal stem cells) could effectively migrate and integrate into the dermal papilla and dermal sheath niches, leading to enhanced hair growth and prolonged anagen phases. However, the homing rates of DPCs and DSCs were influenced by various factors, including recipient mouse depilation, cell passage number, cell dose, and immune rejection. Through in vitro and in vivo experiments, we also discovered that the CXCL13/CXCR5 pathway mediated the homing of DPCs and DSCs into hair follicle niches. This study underscores the potential of cell-based therapies for hair loss by targeted delivery of DPCs and DSCs to their respective niches and sheds light on the intriguing concept that isolated mesenchymal stem cells can home back to their original niche microenvironment.
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Affiliation(s)
- Kaitao Li
- Department of Plastic and Aesthetic Surgery, Nanfang Hospital of Southern Medical University, Guangzhou, China
| | - Fang Liu
- Medical Cosmetic and Plastic Surgery Center, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Ye He
- 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
| | - Pingping Sun
- Department of Plastic and Aesthetic Surgery, Nanfang Hospital of Southern Medical University, Guangzhou, China
| | - Lijuan Du
- 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
| | - Ruosi Chen
- 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
| | - Danlan Fu
- Department of Plastic and Aesthetic Surgery, Nanfang Hospital of Southern Medical University, Guangzhou, China
| | - Zhexiang Fan
- 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
| | - Zhiqi 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
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Hidayah RMN, Widjaya MRH, Gunawan H, Sutedja E, Dwiyana RF, Sutedja EK. Evaluation of Scalp Hydration and pH Values in Hijab-Wearing and Non-Hijab-Wearing Women. Int J Womens Health 2023; 15:1661-1672. [PMID: 37937224 PMCID: PMC10625903 DOI: 10.2147/ijwh.s431755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Accepted: 10/23/2023] [Indexed: 11/09/2023] Open
Abstract
Introduction Indonesia is the most populous Muslim-majority country, where some women wear hijab covering their scalp and neck. Some hijab-wearing women complain of scalp problems eg, itch, dandruff, and hair loss, which might be related to severe and chronic skin barrier impairment due to occlusion. Excessive water accumulation in the occluded stratum corneum might result in increased permeability, followed by increased skin pH values. This study aimed to evaluate scalp hydration and pH values in hijab-wearing and non-hijab-wearing women. Material and Methods This was a cross-sectional comparative analytical study using stratified random sampling methods conducted on 63 subjects, who were divided into two groups, consisting of 33 hijab-wearing and 30 non-hijab-wearing women. Both groups underwent physical examination and their medical history recorded. Scalp hydration was measured using a Corneometer (Courage + Khazaka, Koln, Germany), and scalp pH value was measured using a Skin & Scalp pH Tester (Hanna Instruments® HI981037, Rumania). This study was conducted at the Dermatology and Venereology Clinic of Hasan Sadikin General Hospital Bandung. Results The mean scalp hydration and pH values were 18.34 ± 2.91 AU and 4.93 ± 0.17, respectively, in hijab-wearing women. Meanwhile, the mean scalp hydration and pH values were 17.71 ± 3.35 AU and 4.91 ± 0.16, respectively, in non-hijab-wearing women. The difference of scalp hydration and pH values between the groups was not statistically significant based on the independent t-test, with p-values of 0.430 and 0.597, respectively. Conclusion Scalp hydration and pH values in hijab-wearing and non-hijab-wearing women did not differ significantly. Hijab-wearing women should not worry about scalp barrier impairment as long as they do not have any history of underlying scalp and skin disorders, and do not wear hijab in wet condition.
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Affiliation(s)
- Risa Miliawati Nurul Hidayah
- Department of Dermatology and Venereology, Faculty of Medicine, Universitas Padjadjaran - Dr. Hasan Sadikin Hospital, Bandung, Indonesia
| | - Muhamad Radyn Haryadi Widjaya
- Department of Dermatology and Venereology, Faculty of Medicine, Universitas Padjadjaran - Dr. Hasan Sadikin Hospital, Bandung, Indonesia
| | - Hendra Gunawan
- Department of Dermatology and Venereology, Faculty of Medicine, Universitas Padjadjaran - Dr. Hasan Sadikin Hospital, Bandung, Indonesia
| | - Endang Sutedja
- Department of Dermatology and Venereology, Faculty of Medicine, Universitas Padjadjaran - Dr. Hasan Sadikin Hospital, Bandung, Indonesia
| | - Reiva Farah Dwiyana
- Department of Dermatology and Venereology, Faculty of Medicine, Universitas Padjadjaran - Dr. Hasan Sadikin Hospital, Bandung, Indonesia
| | - Eva Krishna Sutedja
- Department of Dermatology and Venereology, Faculty of Medicine, Universitas Padjadjaran - Dr. Hasan Sadikin Hospital, Bandung, Indonesia
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Krefft-Trzciniecka K, Piętowska Z, Nowicka D, Szepietowski JC. Human Stem Cell Use in Androgenetic Alopecia: A Systematic Review. Cells 2023; 12:cells12060951. [PMID: 36980291 PMCID: PMC10047891 DOI: 10.3390/cells12060951] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 03/07/2023] [Accepted: 03/16/2023] [Indexed: 03/30/2023] Open
Abstract
Androgenetic alopecia is a condition that results in hair loss in both men and women. This can have a significant impact on a person's psychological well-being, which can lead to a decreased quality of life. We conducted a systematic review to evaluate the efficacy of using stem cells in androgenic alopecia. The search was conducted in MEDLINE via PubMed, Web of Science, and Scopus databases. The review was performed on data pertaining to the efficacy of using different types of stem cells in androgenic alopecia: quantitative results of stem cell usage were compared to the control treatment or, different types of treatment for female and male androgenetic alopecia. Of the outcomes, the density of hair was analyzed. Fourteen articles were selected for this review. During and after treatment with stem cells, no major side effects were reported by patients with alopecia. The use of stem cells in androgenic alopecia seems to be a promising alternative to the standard treatment or it could play the role of complementary therapy to improve the effect of primary treatment. However, these results should be interpreted with caution until they can be reproduced in larger and more representative samples.
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Affiliation(s)
| | - Zuzanna Piętowska
- Department of Dermatology, Venereology and Allergology, Wrocław Medical University, 50-368 Wrocław, Poland
| | - Danuta Nowicka
- Department of Dermatology, Venereology and Allergology, Wrocław Medical University, 50-368 Wrocław, Poland
| | - Jacek C Szepietowski
- Department of Dermatology, Venereology and Allergology, Wrocław Medical University, 50-368 Wrocław, Poland
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9
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Feldman PR, Gentile P, Piwko C, Motswaledi HM, Gorun S, Pesachov J, Markel M, Silver MI, Brenkel M, Feldman OJ, Kamen CL, Uleryk E, Guevara-Aguirre J, Fiebig KM. Hair regrowth treatment efficacy and resistance in androgenetic alopecia: A systematic review and continuous Bayesian network meta-analysis. Front Med (Lausanne) 2023; 9:998623. [PMID: 36755885 PMCID: PMC9900126 DOI: 10.3389/fmed.2022.998623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Accepted: 12/07/2022] [Indexed: 01/24/2023] Open
Abstract
Background Androgenetic alopecia (AGA) affects almost half the population, and several treatments intending to regenerate a normal scalp hair phenotype are used. This is the first study comparing treatment efficacy response and resistance using standardized continuous outcomes. Objective To systematically compare the relative efficacy of treatments used for terminal hair (TH) regrowth in women and men with AGA. Methods A systematic literature review was conducted (from inception to August 11, 2021) to identify randomized, Placebo-controlled trials with ≥ 20 patients and reporting changes in TH density after 24 weeks. Efficacy was analyzed by sex at 12 and 24 weeks using Bayesian network meta-analysis (B-NMA) and compared to frequentist and continuous outcomes profiles. Results The search identified 2,314 unique articles. Ninety-eight were included for full-text review, and 17 articles met the inclusion criteria for data extraction and analyses. Eligible treatments included ALRV5XR, Dutasteride 0.5 mg/day, Finasteride 1 mg/day, low-level laser comb treatment (LLLT), Minoxidil 2% and 5%, Nutrafol, and Viviscal. At 24 weeks, the B-NMA regrowth efficacy in TH/cm2 and significance (**) in women were ALRV5XR: 30.09**, LLLT: 16.62**, Minoxidil 2%: 12.13**, Minoxidil 5%: 10.82**, and Nutrafol: 7.32**, and in men; ALRV5XR: 21.03**, LLLT: 18.75**, Dutasteride: 18.37**, Viviscal: 13.23, Minoxidil 5%: 13.13**, Finasteride: 12.38, and Minoxidil 2%: 10.54. Two distinct TH regrowth response profiles were found; Continuous: ALRV5XR regrowth rates were linear in men and accelerated in women; Resistant: after 12 weeks, LLLT, Nutrafol, and Viviscal regrowth rates attenuated while Dutasteride and Finasteride plateaued; Minoxidil 2% and 5% lost some regrowth. There were no statistical differences for the same treatment between women and men. B-NMA provided more accurate, statistically relevant, and conservative results than the frequentist-NMA. Conclusion Some TH regrowth can be expected from most AGA treatments with less variability in women than men. Responses to drug treatments were rapid, showing strong early efficacy followed by the greatest resistance effects from flatlining to loss of regrowth after 12-16 weeks. Finasteride, Minoxidil 2% and Viviscal in men were not statistically different from Placebo. LLLT appeared more efficacious than pharmaceuticals. The natural product formulation ALRV5XR showed better efficacy in all tested parameters without signs of treatment resistance (see Graphical abstract). Systematic review registration www.crd.york.ac.uk/PROSPERO/display_record.asp?ID=CRD42021268040, identifier CRD42021268040.
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Affiliation(s)
- Peter R. Feldman
- Arbor Life Labs, Toronto, ON, Canada,Norwich Medical School, University of East Anglia, Norwich, United Kingdom,*Correspondence: Peter R. Feldman,
| | - Pietro Gentile
- Surgical Science Department, University of Rome Tor Vergata, Rome, Italy
| | | | - Hendrik M. Motswaledi
- Department of Dermatology, Sefako Makgatho Health Sciences University, Pretoria, South Africa
| | - Samantha Gorun
- Faculty of Epidemiology and Biostatistics, Western University, London, ON, Canada,School or Mathematics and Statistics, University of Glasgow, Glasgow, United Kingdom
| | - Jacob Pesachov
- Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Michael Markel
- Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Maxwell I. Silver
- Faculty of Dentistry, University of Toronto, Toronto, ON, Canada,Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Megan Brenkel
- Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Oriel J. Feldman
- Arbor Life Labs, Toronto, ON, Canada,Faculty of Science, Wilfrid Laurier University, Waterloo, ON, Canada
| | - Corey L. Kamen
- Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | | | - Jaime Guevara-Aguirre
- College of Medicine, Universidad San Francisco De Quito (USFQ), Quito, Ecuador,Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, Netherlands,Institute of Endocrinology, Metabolism, and Reproduction (IEMYR), Quito, Ecuador,College of Medicine, University of Florida, Gainesville, FL, United States
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10
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Choi GS, Sim WY, Kang H, Huh CH, Lee YW, Shantakumar S, Ho YF, Oh EJ, Duh MS, Cheng WY, Bobbili P, Thompson-Leduc P, Ong G. Long-Term Effectiveness and Safety of Dutasteride versus Finasteride in Patients with Male Androgenic Alopecia in South Korea: A Multicentre Chart Review Study. Ann Dermatol 2022; 34:349-359. [PMID: 36198626 PMCID: PMC9561294 DOI: 10.5021/ad.22.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 04/27/2022] [Accepted: 05/17/2022] [Indexed: 11/16/2022] Open
Abstract
Background Dutasteride improves hair growth compared with finasteride in male androgenic alopecia (AGA) and is well tolerated. However, real-world evidence for long-term dutasteride use in AGA is lacking. Objective To describe baseline characteristics, treatment patterns and long-term safety and effectiveness of dutasteride versus finasteride. Methods This was a multicentre, retrospective medical chart review study conducted in South Korea. The index date was the first prescription of dutasteride or finasteride. Baseline characteristics were assessed 6 months prior to index. Safety and effectiveness (improvements in basic and specific [BASP] classification) data were collected from index throughout the observation period. Results Overall, 600 male adult patients were included (dutasteride, n=295; finasteride, n=305). Dutasteride-treated patients were older (p<0.001) and more likely to have moderate/severe BASP classification at baseline (p=0.010) compared with finasteride-treated patients. Among patients treated with recommended, on-label dosing exclusively (n=535: dutasteride, n=250; finasteride, n=285), dutasteride-treated patients showed greater improvement in hair growth than finasteride-treated patients, as measured by the BASP basic M classification (adjusted incidence rate ratio [95% confidence interval]: 2.06 [1.08, 3.95]; p=0.029). Among this same subset, overall occurrence of adverse events (AEs) during the observation period were not statistically equivalent between groups (dutasteride 7.6%, finasteride 10.5%; p=0.201), although reports of AEs of special interest were equivalent (p<0.001). Conclusion Dutasteride showed greater effectiveness than finasteride in improving BASP classification in treating male AGA and had a similar or possibly lower occurrence of overall AEs. Dutasteride may provide an effective and safe treatment option for male patients with AGA.
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Affiliation(s)
- Gwang-Seong Choi
- Department of Dermatology, Inha University College of Medicine, Incheon, Korea
| | - Woo-Young Sim
- Department of Dermatology, Kyung Hee University Hospital at Gangdong, Seoul, Korea
| | - Hoon Kang
- Department of Dermatology, Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Chang Hun Huh
- Department of Dermatology, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Yang Won Lee
- Department of Dermatology, Konkuk University School of Medicine, Seoul, Korea
| | | | - Yu-Fan Ho
- Vaccines R&D, Medical Affairs, GSK, Singapore
| | | | | | | | | | | | - Gary Ong
- Pharma Research and Development, Global Medical, GSK, Singapore.
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Hetz SP, Martin J, Pototschnig H. Patient Satisfaction and Clinical Effects of Platelet-Rich Plasma on Pattern Hair Loss in Male and Female Patients. Cureus 2022; 14:e28801. [PMID: 36225399 PMCID: PMC9534340 DOI: 10.7759/cureus.28801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/02/2022] [Indexed: 11/21/2022] Open
Abstract
Introduction Hair loss is a widespread condition in both genders. Over the past decade, platelet-rich plasma (PRP) has become a common treatment for hair loss. Our goal was to analyze patient satisfaction and the clinical effects of PRP on male and female pattern hair loss. Methods Over a period of 12 months, we treated a total of 56 patients for androgenetic alopecia with PRP. All of these patients were included in this study; 15 cc of whole blood was spun in an ACP double syringe (Arthrex Inc., Naples, Forida) for five minutes. The yielded 5 to 6 cc of PRP were then injected into the scalp. Forty-nine patients were treated with a series of three injections at monthly intervals, three patients with a series of four injections, two patients with a series of five injections, one patient was treated with a series of seven injections, and one patient with a series of eight injections. Follow-ups were conducted one month after the last treatment. A self-drawn questionnaire was used to assess the satisfaction and clinical results from the patient's and the clinician's perspectives. Results The average age was 41 years (20-68 years). Fifty-seven percent of all patients were male and 43% female. In total, the patients were satisfied with the treatment results. The average score was 7.29 on a scale from 0 to 10. The clinician's rating was similar (6.46). Moreover, with an average score of 8 on a scale from 0 to 10, it is very likely that the patients will recommend PRP treatments to friends. The probability of occurrence of clinical effects among the entire study population was reported as follows: improvement in hair density (patient‘s rating: 64%; clinician's rating: 46%), thickness (38%; 45%), quality (46%; 54%), sheen/lustre (27%; 21%), new hair growth (57%; 68%), less hair loss (48%; 20%), other positive effects (5%, 2%), no effects (4%; 4%), negative effects (0%; 0%). Conclusion Our study revealed encouraging results for the treatment of male and female pattern hair loss with PRP. The autologous treatment was rated with high satisfaction scores and can be considered a safe and effective treatment modality.
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12
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Gupta AK, Hall DC, Talukder M, Bamimore MA. There Is a Positive Dose-Dependent Association between Low-Dose Oral Minoxidil and Its Efficacy for Androgenetic Alopecia: Findings from a Systematic Review with Meta-Regression Analyses. Skin Appendage Disord 2022; 8:355-361. [PMID: 36161084 PMCID: PMC9485924 DOI: 10.1159/000525137] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Accepted: 04/28/2022] [Indexed: 12/24/2022] Open
Abstract
Background Recently, low-dose oral minoxidil (LDOM) has entered the landscape of therapies for androgenetic alopecia (AGA). We determined whether using LDOM is associated with improving AGA in a dose-dependent manner; secondarily, we examined whether a dose-dependent association also exists for safety. Methods Systematic searches were conducted in PubMed and Scopus to identify studies that would be eligible for our quantitative analyses; the logistics of our analyses was determined by the data we gathered. Results Six studies were eligible for quantitative analyses; we conducted meta-regressions. We found that, for persons with AGA, increasing the dosage of LDOM by 1 mg/day was − after six months − significantly associated with an expected sex-adjusted increase in hair diameter (mean difference = 1.4 μm, p = 0.01), total hair density (mean difference = 47.1 hairs/cm<sup>2</sup>, p = 0.007), terminal hair density (mean difference = 9.1 hairs/cm<sup>2</sup>, p = 0.001), risk of hypertrichosis (mean difference = 17.9%, p = 0.006), and cardiovascular adverse events (mean difference = 4.8%, p = 0.004). Conclusions Our study produced new evidence as our work is the first to show a positive dose-dependent association between the use of LDOM and change in hair diameter, hair density, risk of hypertrichosis, and cardiovascular adverse events for persons with AGA. Future randomized trials could produce causal evidence that would corroborate these dose-dependent associations.
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Affiliation(s)
- Aditya K. Gupta
- Mediprobe Research Inc., London, Ontario, Canada
- Division of Dermatology, Department of Medicine, University of Toronto School of Medicine, Toronto, Ontario, Canada
- *Aditya K. Gupta,
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13
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Nestor MS, Ablon G, Gade A, Han H, Fischer DL. Treatment options for androgenetic alopecia: Efficacy, side effects, compliance, financial considerations, and ethics. J Cosmet Dermatol 2021; 20:3759-3781. [PMID: 34741573 PMCID: PMC9298335 DOI: 10.1111/jocd.14537] [Citation(s) in RCA: 83] [Impact Index Per Article: 27.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Accepted: 10/08/2021] [Indexed: 01/05/2023]
Abstract
Background Androgenetic alopecia (AGA) is the most common form of hair loss consisting of a characteristic receding frontal hairline in men and diffuse hair thinning in women, with frontal hairline retention, and can impact an individual's quality of life. The condition is primarily mediated by 5‐alpha‐reductase and dihydrotestosterone (DHT) which causes hair follicles to undergo miniaturization and shortening of successive anagen cycles. Although a variety of medical, surgical, light‐based and nutraceutical treatment options are available to slow or reverse the progression of AGA, it can be challenging to select appropriate therapies for this chronic condition. Aims To highlight treatment options for androgenetic alopecia taking into consideration the efficacy, side effect profiles, practicality of treatment (compliance), and costs to help clinicians offer ethically appropriate treatment regimens to their patients. Materials and Methods A literature search was conducted using electronic databases (Medline, PubMed, Embase, CINAHL, EBSCO) and textbooks, in addition to the authors' and other practitioners' clinical experiences in treating androgenetic alopecia, and the findings are presented here. Results Although topical minoxidil, oral finasteride, and low‐level light therapy are the only FDA‐approved therapies to treat AGA, they are just a fraction of the treatment options available, including other oral and topical modalities, hormonal therapies, nutraceuticals, PRP and exosome treatments, and hair transplantation. Discussion Androgenetic alopecia therapy remains challenging as treatment selection involves ethical, evidence‐based decision‐making and consideration of each individual patient's needs, compliance, budget, extent of hair loss, and aesthetic goals, independent of potential financial benefits to the practitioners.
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Affiliation(s)
- Mark S Nestor
- Center for Clinical and Cosmetic Research, Aventura, Florida, USA.,Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, Miami, Florida, USA.,Department of Surgery, Division of Plastic Surgery, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Glynis Ablon
- Ablon Skin Institute & Research Center, Manhattan Beach, California, USA.,Department of Dermatology, University of California Los Angeles (UCLA), Los Angeles, California, USA
| | - Anita Gade
- Center for Clinical and Cosmetic Research, Aventura, Florida, USA
| | - Haowei Han
- Center for Clinical and Cosmetic Research, Aventura, Florida, USA
| | - Daniel L Fischer
- Center for Clinical and Cosmetic Research, Aventura, Florida, USA
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14
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Gupta AK, Quinlan EM, Venkataraman M, Bamimore MA. Microneedling for Hair Loss. J Cosmet Dermatol 2021; 21:108-117. [PMID: 34714971 DOI: 10.1111/jocd.14525] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 09/10/2021] [Accepted: 09/30/2021] [Indexed: 12/19/2022]
Abstract
BACKGROUND Microneedling is a relatively novel therapeutic modality introduced in the 1990s where small, fine needles are used to create micro punctures in the skin. It is a minimally invasive procedure used for various dermatological conditions, including androgenetic alopecia (AGA). OBJECTIVE AND METHODS We comprehensively summarize the literature regarding microneedling in dermatology. We performed linear multivariable regressions to synthesize evidence from the clinical trials that investigated the efficacy of microneedling for AGA. Studies eligible for quantitative analyses were assessed for evidence quality. RESULTS The exact mechanism of microneedling action is yet to be determined, with theories that include the wound-healing cascade. Microneedling monotherapy significantly increased total hair count more than topical minoxidil 5% (β = 12.29; p < 0.001). The combination treatment of microneedling with topical 5% minoxidil increased total hair count significantly compared to monotherapy with microneedling (β = 7.63, p < 0.05). Increasing the overall treatment duration of microneedling and reducing the frequency of microneedling sessions may positively influence an increase in total hair count. CONCLUSION There are limited studies that investigate microneedling as a monotherapy for hair loss since majority of the trials combine it with other therapies such as topical minoxidil or platelet-rich plasma. While preliminary results look promising, further investigation of microneedling as a monotherapy in larger, randomized controlled trials will help determine its safety and efficacy, and place in treating AGA.
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Affiliation(s)
- Aditya K Gupta
- Mediprobe Research Inc., London, ON, Canada.,Faculty of Medicine, University of Toronto, Toronto, ON, Canada
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15
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Feldman PR, Fiebig KM, Piwko C, Mints BM, Brown D, Cahan DJ, Guevara-Aguirre J. Safety and efficacy of ALRV5XR in men with androgenetic alopecia: A randomised, double-blinded, placebo-controlled clinical trial. EClinicalMedicine 2021; 40:101124. [PMID: 34541479 PMCID: PMC8435693 DOI: 10.1016/j.eclinm.2021.101124] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 08/13/2021] [Accepted: 08/18/2021] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Androgenetic alopecia (AGA) is the most common hair loss disorder seen in men. It can have an early onset but has also been associated with ageing and senescence. It often induces pronounced psychological impact. ALRV5XR, a new hair loss treatment herein evaluated, was designed to target multiple molecular pathways involved in hair growth and hair follicle stem cell biology. The main objectives of the study were the assessment of safety and efficacy profiles of ALRV5XR in men. METHODS This 24-week, parallel randomised, placebo-controlled, double-blinded clinical trial was performed in a USA community clinic. Healthy men (age 22-65) with AGA and belonging to the Hamilton-Norwood (HN) classification I-VII and Fitzpatrick skin type (FST) I-VI, were randomly allocated in a 1:1 ratio into ALRV5XR or placebo treatment groups. Dermatologist assessment, phototrichograms, and blood samples were obtained in a blinded fashion at baseline, 12 and 24 weeks. Subjects were given a masked treatment consisting of oral capsules, shampoo, conditioner, and follicle serum, which was intended for daily use. Efficacy was assessed via absolute and per cent changes in terminal hair (TH) density, and response rates. The trial was registered with clinicaltrials.gov (NCT04450589) and is completed. FINDINGS Forty-six subjects were enroled in the study, 23 allocated to the ALRV5XR treatment and 23 to the placebo group. Enrolment occurred from April 11 to October 23, 2018. Thirty-six subjects completed the trial (17 ALRV5XR, 19 placebo) and 11 subjects in each group were evaluable for TH outcomes. At 24 weeks, the absolute change in TH density improved by 21·0 THs/cm2 (95% CI: 9·2-32·8; p = 0·0014), and the relative density increased by 16·4% (95% CI: 7·4%-25·5%; p = 0·0012). The odds ratio for being a responder (≥ 0 change) was 87·4. TH density increased linearly and was not affected by HN, FST, ethnicity, age, or body mass index. All subjects in the ALRV5XR group responded to treatment while 81·8% of the placebo group decreased TH density. ALRV5XR induced statistically significant changes in both decrease in vellus hair (VH) density as well as in concomitant increase of the TH/VH ratio when compared to placebo. ALRV5XR was well tolerated, and no adverse events were observed. INTERPRETATION ALRV5XR treatment resulted in clinically significant TH regrowth in men with AGA. Furthermore, it appeared to reverse the characteristic hair miniaturisation seen in this condition. When compared to results of published trials of standard therapy, ALRV5XR showed a multi-fold increase both in efficacy and in response rates. In addition, the continuance of TH regrowth from 12 to 24 weeks suggests that the normal structure and function of non-productive telogen follicles is restored and that a normal hair phenotype may be attained by extended ALRV5XR treatment. FUNDING Arbor Life Labs.
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Affiliation(s)
- Peter R Feldman
- Arbor Life Labs, Toronto, Ontario, Canada
- Corresponding author.
| | - Klaus M Fiebig
- Arbor Life Labs, Toronto, Ontario, Canada
- Corresponding author.
| | | | | | - Dennis Brown
- Valent Technologies, Menlo Park, California, USA
| | | | - Jaime Guevara-Aguirre
- Universidad San Francisco de Quito (USFQ), Quito, Ecuador
- Institute of Endocrinology, Metabolism, and Reproduction (IEMYR), Quito, Ecuador
- Maastricht University, Maastricht, the Netherlands
- College of Medicine, University of Florida, Gainesville, Florida, USA
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16
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Pathoulas JT, Bellefeuille G, Raymond O, Khalid B, Farah RS. Energy-based Devices for Hair Loss. Dermatol Clin 2021; 39:447-461. [PMID: 34053597 DOI: 10.1016/j.det.2021.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Treatment options for hair loss have traditionally been limited to topical and systemic therapies. Systemic therapies for inflammatory hair disorders are often immunosuppressive, and systemic treatment of androgenetic hair loss can cause undesired effects on sexual and reproductive health. Topical agents have a favorable side effect profile compared with systemic therapies, but many topicals have poor transcutaneous absorption, limiting their concentration and action at follicular targets in the dermis.
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Affiliation(s)
- James T Pathoulas
- Department of Dermatology, University of Minnesota, 516 Delaware Street Southeast Mail Code 98, Phillips-Wangensteen Building, Suite 4- 420, Minneapolis, MN 55455, USA
| | - Gretchen Bellefeuille
- Department of Dermatology, University of Minnesota, 516 Delaware Street Southeast Mail Code 98, Phillips-Wangensteen Building, Suite 4- 420, Minneapolis, MN 55455, USA
| | - Ora Raymond
- Department of Dermatology, University of Minnesota, 516 Delaware Street Southeast Mail Code 98, Phillips-Wangensteen Building, Suite 4- 420, Minneapolis, MN 55455, USA
| | - Bisma Khalid
- University of Minnesota, 420 Delaware St SE, Minneapolis, MN 55455, USA
| | - Ronda S Farah
- Department of Dermatology, University of Minnesota, 516 Delaware Street Southeast Mail Code 98, Phillips-Wangensteen Building, Suite 4- 420, Minneapolis, MN 55455, USA.
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Gupta AK, Renaud HJ, Bamimore M. Platelet‐rich plasma for androgenetic alopecia: Efficacy differences between men and women. Dermatol Ther 2020; 33:e14143. [DOI: 10.1111/dth.14143] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Revised: 07/27/2020] [Accepted: 07/28/2020] [Indexed: 12/16/2022]
Affiliation(s)
- Aditya K. Gupta
- Mediprobe Research Inc. London Canada
- Division of Dermatology, Department of Medicine University of Toronto School of Medicine Toronto Canada
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18
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Gupta AK, Quinlan EM, Williams KL. The shifting preferences of patients and physicians in nonsurgical hair loss treatment. J Cosmet Dermatol 2020; 20:929-936. [PMID: 32892459 DOI: 10.1111/jocd.13681] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 08/10/2020] [Accepted: 08/12/2020] [Indexed: 12/18/2022]
Abstract
BACKGROUND There are multiple etiologies for hair thinning and loss, including genetic, hormonal, immune, scaring, and infectious. Hair loss treatment involves both surgical intervention and nonsurgical therapies such as pharmaceuticals, haircare products, vitamins, and low-level laser therapy (LLLT). While pharmaceuticals have been extensively researched, the efficacy of other therapies remains inconclusive. With so many available treatments, consumers often research their options using search engines such as Google and/or seek help from hair restoration physicians. AIMS To identify and analyze changing trends in international consumer and physician interest in nonsurgical hair loss therapies. METHODS Worldwide trends in Google searches of hair loss products (2004-2020) were compared with product prescription frequency surveys from members of the International Society of Hair Restoration Surgery (2004-2019, ~29% response rate). RESULTS Minoxidil and finasteride were the most prescribed hair loss treatments, while "minoxidil" was the most "Googled" term. Generic products were searched more often than their brand counterparts. Nutritionals and haircare prescriptions increased over time. LLLT was also increasingly prescribed, with Internet searches increasing following government regulation announcements. The COVID-19 pandemic initially negatively affected hair loss treatment searches, which have since returned to, and surpassed, pre-pandemic levels. CONCLUSION Regulations and social media have influence on consumer interest in hair loss products. A weak economy and coronavirus fears may persuade consumers to turn to cheaper hair loss treatment alternatives. Hair restoration specialists need to keep abreast of online trends to communicate effectively with their patients. Patients should be cognizant of the safety and efficacy of hair restoration treatments.
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Affiliation(s)
- Aditya K Gupta
- Mediprobe Research Inc., London, ON, Canada.,Department of Dermatology, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
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19
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Gupta AK, Bamimore MA. Factors influencing the effect of photobiomodulation in the treatment of androgenetic alopecia: A systematic review and analyses of summary-level data. Dermatol Ther 2020; 33:e14191. [PMID: 32790116 DOI: 10.1111/dth.14191] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Revised: 08/07/2020] [Accepted: 08/08/2020] [Indexed: 11/30/2022]
Abstract
Low-level laser therapy (LLLT) is used to treat androgenetic alopecia (AGA). The therapeutic effect of LLLT on AGA has been evaluated; however, there is a paucity of studies that investigated device- and usage-related factors that may influence the effect of LLLT on hair regrowth. The literature was systematically searched to identify eligible studies; PubMed, Scopus, EMBASE and clinicaltrials.gov databases were searched on 30 April 2020. Eligible studies were randomized trials that investigated the effect of LLLT on hair density in AGA. Robust linear regressions were used to make comparisons. An increase in the per-session energy fluence by 1 J/cm2 is significantly associated with an increase in hair density by 0.23 hairs/cm2 (95% CI: 0.21 hairs/cm2 , 0.25 hairs/cm2 ). The number of laser or light-emitting diodes is not significantly associated with change in hair density. Increasing the total duration of exposure to treatment is associated with a significant increase in hair density (β = .53, P < .05). Switching from continuous to pulse irradiation was associated with a significant increase in hair density (β = 10.11, P < .01). Energy fluence, irradiation session duration, and light pulsing have a significant therapeutic effect on AGA, while the number of diodes does not.
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Affiliation(s)
- Aditya K Gupta
- Mediprobe Research Inc., London, Ontario, Canada.,Division of Dermatology, Department of Medicine, University of Toronto School of Medicine, Toronto, Ontario, Canada
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