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Yin CS, Minh Nguyen TT, Yi EJ, Zheng S, Bellere AD, Zheng Q, Jin X, Kim M, Park S, Oh S, Yi TH. Efficacy of probiotics in hair growth and dandruff control: A systematic review and meta-analysis. Heliyon 2024; 10:e29539. [PMID: 38698995 PMCID: PMC11064082 DOI: 10.1016/j.heliyon.2024.e29539] [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: 09/24/2023] [Revised: 04/05/2024] [Accepted: 04/09/2024] [Indexed: 05/05/2024] Open
Abstract
Background Probiotics are intellectually rewarding for the discovery of their potential as a source of functional food. Investigating the economic and beauty sector dynamics, this study conducted a comprehensive review of scholarly articles to evaluate the capacity of probiotics to promote hair growth and manage dandruff. Methods We used the PRISMA 2020 with Embase, Pubmed, ClinicalTrials.gov, Scopus, and ICTRP databases to investigate studies till May 2023. Meta-analyses utilizing the random effects model were used with odds ratios (OR) and standardized mean differences (SMD). Result Meta-analysis comprised eight randomized clinical trials and preclinical studies. Hair growth analysis found a non-significant improvement in hair count (SMD = 0.32, 95 % CI -0.10 to 0.75) and a significant effect on thickness (SMD = 0.92, 95 % CI 0.47 to 1.36). In preclinical studies, probiotics significantly induced hair follicle count (SMD = 3.24, 95 % CI 0.65 to 5.82) and skin thickness (SMD = 2.32, 95 % CI 0.47 to 4.17). VEGF levels increased significantly (SMD = 2.97, 95 % CI 0.80 to 5.13), while IGF-1 showed a non-significant inducement (SMD = 0.53, 95 % CI -4.40 to 5.45). For dandruff control, two studies demonstrated non-significant improvement in adherent dandruff (OR = 1.31, 95 % CI 0.13-13.65) and a significant increase in free dandruff (OR = 5.39, 95 % CI 1.50-19.43). Hair follicle count, VEGF, IGF-1, and adherent dandruff parameters were recorded with high heterogeneity. For the systematic review, probiotics have shown potential in improving hair growth and controlling dandruff through modulation of the immune pathway and gut-hair axis. The Wnt/β-catenin pathway, IGF-1 pathway, and VEGF are key molecular pathways in regulating hair follicle growth and maintenance. Conclusions This review found significant aspects exemplified by the properties of probiotics related to promoting hair growth and anti-dandruff effect, which serve as a roadmap for further in-depth studies to make it into pilot scales.
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Affiliation(s)
- Chang-Shik Yin
- Acupuncture and Meridian Science Research Center, College of Oriental Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Trang Thi Minh Nguyen
- Graduate School of Biotechnology, Kyung Hee University, 1732 Deogyeong-daero, Giheung-gu, Yongin, Republic of Korea
| | - Eun-Ji Yi
- Graduate School of Biotechnology, Kyung Hee University, 1732 Deogyeong-daero, Giheung-gu, Yongin, Republic of Korea
- Snowwhitefactory Co, Ltd., 807 Nonhyeon-ro, Gangnam-gu, Seoul, 06032, Republic of Korea
| | - Shengdao Zheng
- Graduate School of Biotechnology, Kyung Hee University, 1732 Deogyeong-daero, Giheung-gu, Yongin, Republic of Korea
- Snowwhitefactory Co, Ltd., 807 Nonhyeon-ro, Gangnam-gu, Seoul, 06032, Republic of Korea
| | - Arce Defeo Bellere
- Graduate School of Biotechnology, Kyung Hee University, 1732 Deogyeong-daero, Giheung-gu, Yongin, Republic of Korea
| | - Qiwen Zheng
- Graduate School of Biotechnology, Kyung Hee University, 1732 Deogyeong-daero, Giheung-gu, Yongin, Republic of Korea
| | - Xiangji Jin
- Department of Pharmacology, School of Medicine, Kyung Hee University, 23 Kyungheedae-ro, Dong-daemun, Seoul, Republic of Korea
| | - Myeongju Kim
- Graduate School of Biotechnology, Kyung Hee University, 1732 Deogyeong-daero, Giheung-gu, Yongin, Republic of Korea
| | - Sejic Park
- Graduate School of Biotechnology, Kyung Hee University, 1732 Deogyeong-daero, Giheung-gu, Yongin, Republic of Korea
| | - Sarang Oh
- Graduate School of Biotechnology, Kyung Hee University, 1732 Deogyeong-daero, Giheung-gu, Yongin, Republic of Korea
- Snowwhitefactory Co, Ltd., 807 Nonhyeon-ro, Gangnam-gu, Seoul, 06032, Republic of Korea
| | - Tae-Hoo Yi
- Graduate School of Biotechnology, Kyung Hee University, 1732 Deogyeong-daero, Giheung-gu, Yongin, Republic of Korea
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Kamishima T, Hirabe C, Myint KZY, Taguchi J. Divergent progression pathways in male androgenetic alopecia and female pattern hair loss: Trichoscopic perspectives. J Cosmet Dermatol 2024; 23:1828-1839. [PMID: 38189587 DOI: 10.1111/jocd.16177] [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: 10/09/2023] [Revised: 11/22/2023] [Accepted: 12/28/2023] [Indexed: 01/09/2024]
Abstract
BACKGROUND Despite similarities in progressive miniaturization of hair follicles and transition of terminal hairs to vellus hairs, insufficient trichoscopic comparisons between male androgenetic alopecia (MAGA) and female pattern hair loss (FPHL) hinder our ability to select effective treatments. AIM Our study aimed to explore gender-specific trichoscopic characteristics of MAGA and FPHL, while formulating hypotheses regarding the progression of these conditions across clinical stages. METHODS We classified 126 male MAGA subjects using Hamilton-Norwood Classification and 57 FPHL subjects using adopted Sinclair Scale. Subsequently, we analyzed nine trichoscopic factors divided into three categories: hair-diameter related, hair-number per follicular unit related, and hair density related factors. RESULTS Of the nine quantitative trichoscopic factors, hair-diameter and hair-number per follicular unit showed strong correlations with clinical stages in both genders. Hair density, a common trichoscopic factor for hair loss evaluation, weakly correlated with clinical stages in FPHL, but not at all in MAGA. In addition, MAGA was characterized by a progressive reduction in hair-diameter, followed by a reduction in hair-number per follicular unit. FPHL, on the contrary, showed the opposite progression. CONCLUSIONS Trichoscopic factors vary with disease severity in a gender-specific manner. Our research highlights that MAGA and FPHL involve two distinct streams: hair-diameter decreasing by hair follicle miniaturization (Stream 1), and hair-number per follicular unit decreasing by hair follicle tri-lineage niche dysfunction (Stream 2). MAGA typically starts from Stream 1 to Stream 2, while FPHL starts from Stream 2. These diverse progression pathways underscore the importance of personalized treatment approaches.
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Affiliation(s)
- Tomoko Kamishima
- Department of Dermatology, Tokyo Midtown Skin/Aesthetic Clinic Noage, Tokyo, Japan
| | - Chie Hirabe
- Department of Dermatology, Tokyo Midtown Skin/Aesthetic Clinic Noage, Tokyo, Japan
| | - Khin Zay Yar Myint
- Tokyo Midtown Center for Advanced Medical Science and Technology, Tokyo, Japan
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Lee JH, Choi S. Deciphering the molecular mechanisms of stem cell dynamics in hair follicle regeneration. Exp Mol Med 2024; 56:110-117. [PMID: 38182654 PMCID: PMC10834421 DOI: 10.1038/s12276-023-01151-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Revised: 10/24/2023] [Accepted: 11/01/2023] [Indexed: 01/07/2024] Open
Abstract
Hair follicles, which are connected to sebaceous glands in the skin, undergo cyclic periods of regeneration, degeneration, and rest throughout adult life in mammals. The crucial function of hair follicle stem cells is to maintain these hair growth cycles. Another vital aspect is the activity of melanocyte stem cells, which differentiate into melanin-producing melanocytes, contributing to skin and hair pigmentation. Sebaceous gland stem cells also have a pivotal role in maintaining the skin barrier by regenerating mature sebocytes. These stem cells are maintained in a specialized microenvironment or niche and are regulated by internal and external signals, determining their dynamic behaviors in homeostasis and hair follicle regeneration. The activity of these stem cells is tightly controlled by various factors secreted by the niche components around the hair follicles, as well as immune-mediated damage signals, aging, metabolic status, and stress. In this study, we review these diverse stem cell regulatory and related molecular mechanisms of hair regeneration and disease conditions. Molecular insights would provide new perspectives on the disease mechanisms as well as hair and skin disorder treatment.
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Affiliation(s)
- Jung Hyun Lee
- Department of Dermatology, School of Medicine, University of Washington, Seattle, WA, 98109, USA
- Institute for Stem Cell and Regenerative Medicine, University of Washington, Seattle, WA, 98109, USA
| | - Sekyu Choi
- Department of Life Sciences, Pohang University of Science and Technology (POSTECH), Pohang, 37673, Republic of Korea.
- Medical Science and Engineering, School of Convergence Science and Technology, Pohang University of Science and Technology (POSTECH), Pohang, 37673, Republic of Korea.
- School of Interdisciplinary Bioscience and Bioengineering, Pohang University of Science and Technology (POSTECH), Pohang, 37673, Republic of Korea.
- Institute for Convergence Research and Education in Advanced Technology (I_CREATE), Yonsei University, Incheon, 21983, Republic of Korea.
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Li J, Ge R, Lin K, Wang J, He Y, Lu H, Dong H. Advances in the Application of Microneedles in the Treatment of Local Organ Diseases. SMALL (WEINHEIM AN DER BERGSTRASSE, GERMANY) 2024; 20:e2306222. [PMID: 37786290 DOI: 10.1002/smll.202306222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Revised: 09/07/2023] [Indexed: 10/04/2023]
Abstract
In recent years, microneedles (MNs) have attracted a lot of attention due to their microscale sizes and high surface area (500-1000 µm in length), allowing pain-free and efficient drug delivery through the skin. In addition to the great success of MNs based transdermal drug delivery, especially for skin diseases, increasing studies have indicated the expansion of MNs to diverse nontransdermal applications, including the delivery of therapeutics for hair loss, ocular diseases, and oral mucosal. Here, the current treatment of hair loss, eye diseases, and oral disease is discussed and an overview of recent advances in the application of MNs is provided for these three noncutaneous localized organ diseases. Particular emphasis is laid on the future trend of MNs technology development and future challenges of expanding the generalizability of MNs.
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Affiliation(s)
- Jinze Li
- Marshall Laboratory of Biomedical Engineering, Shenzhen Key Laboratory for Nano-Biosensing Technology, School of Biomedical Engineering, Shenzhen University Medical School, Shenzhen University, Guangdong, 518060, China
| | - Rujiao Ge
- Beijing Key Laboratory for Bioengineering and Sensing Technology, Research Center for Bioengineering and Sensing Technology, School of Chemistry and Biological Engineering, University of Science and Technology Beijing, Beijing, 100083, China
| | - Kai Lin
- College of Chemistry and Environmental Engineering, Shenzhen University, Guangdong, 518060, China
| | - Junren Wang
- Marshall Laboratory of Biomedical Engineering, Shenzhen Key Laboratory for Nano-Biosensing Technology, School of Biomedical Engineering, Shenzhen University Medical School, Shenzhen University, Guangdong, 518060, China
| | - Yu He
- Department of Pharmacology, University of Oxford, Oxford, OX1 3QT, UK
| | - Huiting Lu
- Department of Chemistry, School of Chemistry and Biological Engineering, University of Science and Technology Beijing, Beijing, 100083, China
| | - Haifeng Dong
- Marshall Laboratory of Biomedical Engineering, Shenzhen Key Laboratory for Nano-Biosensing Technology, School of Biomedical Engineering, Shenzhen University Medical School, Shenzhen University, Guangdong, 518060, China
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Khutsishvili N, Rudnicka L, Ovcharenko Y, Starace M, Buchukuri I, Pataraia S, Lortkipanidze N. Trichoscopy - a valuable tool for identifying conditions mimicking androgenetic alopecia. Int J Dermatol 2024; 63:23-31. [PMID: 37950461 DOI: 10.1111/ijd.16895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 10/20/2023] [Accepted: 10/22/2023] [Indexed: 11/12/2023]
Abstract
Androgenetic alopecia (AGA) is the most prevalent type of hair loss in women and men. Recently, a European consensus group published guidelines for the diagnostic evaluation of AGA in men, women, and adolescents. This S1 guideline presents expert opinion-based recommendations for gender-dependent steps in the diagnostic procedure, which can easily be implemented in the daily clinical routine. For diagnosing AGA, detailed anamnesis and objective learning are not enough because there are several conditions mimicking this disease. Trichoscopy can be considered an important, non-invasive tool for diagnosing hair and scalp disorders that may have similar clinical signs to AGA.
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Affiliation(s)
| | | | | | | | - Irma Buchukuri
- Petre Shotadze Tbilisi Medical Academy, Tbilisi, Georgia
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de Oliveira AFQ, Arcanjo FPN, Rodrigues MRP, Rosa E Silva AA, Hall PR. Use of autologous platelet-rich plasma in androgenetic alopecia in women: a systematic review and meta-analysis. J DERMATOL TREAT 2023; 34:2138692. [PMID: 36264022 DOI: 10.1080/09546634.2022.2138692] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To conduct a systematic review and meta-analysis to verify the efficacy of using autologous platelet-rich plasma (PRP) in female pattern alopecia (FPA). BACKGROUND Androgenetic alopecia is the leading cause of hair loss in men andwomen and often impacts self-esteem and quality of life. DATA SOURCES MEDLINE/PubMed, Cochrane Library, ClinicalTrials.gov, and EMBASE up to May 2021. STUDY SELECTION AND DATA EXTRACTION We identified all studies evaluating the effect of PRP in FPA. A narrative synthesis was performed from data on the efficacy of PRP treatment and adverse effects; quantitative results of PRP use compared to control treatment for female androgenetic alopecia (AGA) were synthesized. The outcomes analyzed were terminal density and hair thickness. RESULTS Seven articles were selected for this review. Meta-analysis showed that PRP-based interventions were able to increase terminal hair density compared to control (standardized mean difference (SMD)=2.98, 95% confidence intervals (CIs)=1.10, 4.85), with no significant increase in hair thickness (SMD = 1.16, 95% CI= -0.96, 3.28). During and after treatment, no major side effects were reported by patients or researchers. CONCLUSIONS The use of autologous PRP injections in female AGA seems to be promising, with more consistent results on terminal hair density. However, caution is recommended in the interpretation of these results until they can be replicated in larger and more representative samples. PROSPERO registration number CRD42021257154.
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Abstract
Noninflammatory alopecia is common in dogs and is a frequent cause to consult a veterinarian. It is also a common reason to take biopsies. Noninflammatory alopecia can be attributed to a decreased formation or cytodifferentiation of the hair follicle or the hair shaft in utero, resulting in congenital alopecia. Congenital alopecia often has a hereditary cause, and examples of such disorders are ectodermal dysplasias associated with gene variants of the ectodysplasin A gene. Noninflammatory alopecia may also be caused by impaired postnatal regeneration of hair follicles or shafts. Such disorders may have a clear breed predilection, and alopecia starts early in life. A hereditary background is suspected in those cases but has not been proven. They are referred to as follicular dysplasia although some of these disorders present histologically like a hair cycle disturbance. Late-onset alopecia is usually acquired and may be associated with endocrinopathies. Other possible causes are impaired vascular perfusion or stress. As the hair follicle has limited possible responses to altered regulation, and histopathology may change during the course of a disease, a detailed clinical history, thorough clinical examination including blood work, appropriate biopsy site selection, and detailed histological findings need to be combined to achieve a final diagnosis. This review aims to provide an overview about the known noninflammatory alopecic disorders in dogs. As the pathogenesis of most disorders is unknown, some statements are based on comparative aspects or reflect the authors' opinion.
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Sakpuwadol N, Tejapira K, Kositkuljorn C, Pomsoong C, Suchonwanit P. Differences in Demographic and Clinical Characteristics Among Subtypes of Female Pattern Hair Loss. Clin Cosmet Investig Dermatol 2023; 16:2073-2082. [PMID: 37575151 PMCID: PMC10417682 DOI: 10.2147/ccid.s422335] [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: 05/21/2023] [Accepted: 07/30/2023] [Indexed: 08/15/2023]
Abstract
Background Female pattern hair loss (FPHL) is the most common hair loss disorder in women that can be classified into three patterns, including Ludwig, Olsen, and Hamilton-Norwood subtypes. Information regarding the comparison of demographics, clinical characteristics, and associated comorbidities among subtypes of FPHL is scarce and contradictory. Objective To evaluate and compare the epidemiology, clinical manifestations, and comorbid conditions of FPHL subtypes and determine their associated factors. Methods This retrospective study included patients who were diagnosed with FPHL between January 2000 and November 2021. Participants were classified into three subtypes, namely Ludwig, Olsen, and Hamilton-Norwood, and were statistically compared. Variables significantly associated with each FPHL subtype were identified using multivariable multinomial logistic regression analysis. Results Among the 519 patients with FPHL, the Ludwig subtype was the most prevalent (51.1%), followed by the Olsen (32.9%) and Hamilton-Norwood (16%) subtypes. The Hamilton-Norwood subtype revealed significantly higher frequencies of early disease onset (61.4%), menstrual irregularity (22.9%), polycystic ovary syndrome (PCOS, 18.1%), and seborrhea (30.1%) but lower frequencies of overweight (24.1%) and type 2 diabetes mellitus (DM, 2.4%). Multivariable multinomial regression analysis demonstrated that the Hamilton-Norwood subtype was a predictor for early disease onset and PCOS compared to Ludwig (early onset: odds ratio (OR) = 2.14, 95% confidence interval (CI) = 1.39-4.22, P = 0.02; PCOS: OR = 2.02, 95% CI = 1.55-4.84, P = 0.03), and Olsen (early onset: OR = 1.89, 95% CI = 1.03-3.92, P = 0.04; PCOS: OR = 2.24, 95% CI = 1.89-5.31, P = 0.01). In contrast, the Hamilton-Norwood pattern was at decreased risk for type 2 DM compared to Ludwig (OR = 0.51, 95% CI = 0.03-0.82, P = 0.02), and Olsen (OR = 0.68, 95% CI = 0.04-0.79, P = 0.03). Conclusion The Ludwig pattern was found to be the most prevalent FPHL subtype among Thai patients. Moreover, the Hamilton-Norwood subtype was associated with early disease onset and PCOS, whereas the Ludwig and Olsen subtypes were associated with type 2 DM.
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Affiliation(s)
- Nawara Sakpuwadol
- Division of Dermatology, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Kasama Tejapira
- Division of Dermatology, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Chaninan Kositkuljorn
- Division of Dermatology, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Cherrin Pomsoong
- Division of Dermatology, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Poonkiat Suchonwanit
- Division of Dermatology, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
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Redmond LC, Limbu S, Farjo B, Messenger AG, Higgins CA. Male pattern hair loss: Can developmental origins explain the pattern? Exp Dermatol 2023; 32:1174-1181. [PMID: 37237288 PMCID: PMC10946844 DOI: 10.1111/exd.14839] [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: 12/02/2022] [Revised: 05/04/2023] [Accepted: 05/09/2023] [Indexed: 05/28/2023]
Abstract
Male pattern hair loss (MPHL), also referred to as male androgenetic alopecia (AGA) is the most common type of non-scarring progressive hair loss, with 80% of men suffering from this condition in their lifetime. In MPHL, the hair line recedes to a specific part of the scalp which cannot be accurately predicted. Hair is lost from the front, vertex, and the crown, yet temporal and occipital follicles remain. The visual effect of hair loss is due to hair follicle miniaturisation, where terminal hair follicles become dimensionally smaller. Miniaturisation is also characterised by a shortening of the growth phase of the hair cycle (anagen), and a prolongation of the dormant phase (kenogen). Together, these changes result in the production of thinner and shorter hair fibres, referred to as miniaturised or vellus hairs. It remains unclear why miniaturisation occurs in this specific pattern, with frontal follicles being susceptible while occipital follicles remain in a terminal state. One main factor we believe to be at play, which will be discussed in this viewpoint, is the developmental origin of the skin and hair follicle dermis on different regions of the scalp.
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Affiliation(s)
| | - Summik Limbu
- Department of BioengineeringImperial College LondonLondonUK
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Mohamed NE, Soltan MR, Galal SA, El Sayed HS, Hassan HM, Khatery BH. Female Pattern Hair Loss and Negative Psychological Impact: Possible Role of Brain-derived Neurotrophic Factor (BDNF). Dermatol Pract Concept 2023; 13:e2023139. [PMID: 37557155 PMCID: PMC10412050 DOI: 10.5826/dpc.1303a139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/02/2023] [Indexed: 08/11/2023] Open
Abstract
INTRODUCTION Female Pattern Hair Loss (FPHL) is considered the most common type of hair loss in females. Women with FPHL may suffer from psychological distress and defective social functioning. Patients with psychiatric and neurodegenerative disorders almost have a deficient brain and blood brain-derived neurotrophic factor levels (BDNF). This serum BDNF level may act as a diagnostic marker for negative psychological impact in FPHL patients. OBJECTIVES Evaluate the levels of serum BDNF in patients with FPHL and correlate its level to the severity of alopecia and the degree of psychological impact. METHODS Forty-six female patients with FPHL and 41 healthy age-matched female volunteers as a control were included in the study. Patients filled out a Dermatology Life Quality Index questionnaire. Both patients and controls filled Beck Depression Inventory, Beck Anxiety Inventory, and Perceived Stress Scale (PSS) questionnaires. Serum levels of BDNF were measured for all the participants using the ELISA technique. RESULTS Patients with FPHL had significantly lower levels of BDNF and significantly higher Beck depression inventory score and PSS questionnaire scores. There is a significant negative correlation between serum levels of BDNF and Beck Depression Inventory, Beck Anxiety Inventory, and PSS questionnaire scores. CONCLUSIONS Patients with FPHL are at a high risk to develop chronic stress and depression. The serum level of BDNF is a good predictor for the assessment of chronic stress and depression in FPHL patients.
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Affiliation(s)
- Noha E Mohamed
- Department of Dermatology, STDs, and Andrology, Faculty of Medicine Fayoum University, Faiyum, Egypt
| | | | - Sara A Galal
- Dermatology and Venereology Department, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt
| | - Hassan Salem El Sayed
- Medical Biochemistry and Molecular Biology, Faculty of Medicine Fayoum University, Egypt The research was conducted in the outpatient clinic of the Department of Dermatology, STDs, and Andrology, Faculty of Medicine, Fayoum University
| | - Hadir M Hassan
- Department of Dermatology, STDs, and Andrology, Faculty of Medicine Fayoum University, Faiyum, Egypt
| | - Basma Hm Khatery
- Department of Dermatology, STDs, and Andrology, Faculty of Medicine Fayoum University, Faiyum, Egypt
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Ho CY, Chen JYF, Hsu WL, Yu S, Chen WC, Chiu SH, Yang HR, Lin SY, Wu CY. Female Pattern Hair Loss: An Overview with Focus on the Genetics. Genes (Basel) 2023; 14:1326. [PMID: 37510231 PMCID: PMC10379895 DOI: 10.3390/genes14071326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Revised: 06/11/2023] [Accepted: 06/20/2023] [Indexed: 07/30/2023] Open
Abstract
Pattern hair loss can occur in both men and women, and the underlying molecular mechanisms have been continuously studied in recent years. Male androgenetic alopecia (M-AGA), also termed male pattern hair loss, is the most common type of hair loss in men. M-AGA is considered an androgen-dependent trait with a background of genetic predisposition. The interplay between genetic and non-genetic factors leads to the phenotype of follicular miniaturization. Although this similar pattern of phenotypic miniaturization can also be found in female pattern hair loss (FPHL), the corresponding genetic factors in M-AGA do not account for the phenotype in FPHL, indicating that there are different genes contributing to FPHL. Therefore, the role of genetic factors in FPHL is still uncertain. Understanding the genetic mechanism that causes FPHL is crucial for the future development of personalized treatment strategies. This review aims to highlight the differences in the ethnic prevalence and genetic background of FPHL, as well as the current genetic research progress in nutrition, Wnt signaling, and sex hormones related to FPHL.
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Affiliation(s)
- Chih-Yi Ho
- School of Post Baccalaureate Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan
| | - Jeff Yi-Fu Chen
- Department of Biotechnology, Kaohsiung Medical University, Kaohsiung 807, Taiwan
| | - Wen-Li Hsu
- Department of Dermatology, College of Medicine, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 801, Taiwan
| | - Sebastian Yu
- Department of Dermatology, College of Medicine, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 801, Taiwan
| | - Wei-Chiao Chen
- Department of Dermatology, College of Medicine, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 801, Taiwan
| | - Szu-Hao Chiu
- Department of Dermatology, College of Medicine, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 801, Taiwan
| | - Hui-Ru Yang
- Department of Laboratory Medicine, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung 801, Taiwan
| | - Sheng-Yao Lin
- Department of Dermatology, College of Medicine, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 801, Taiwan
| | - Ching-Ying Wu
- Department of Dermatology, College of Medicine, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 801, Taiwan
- Department of Cosmetic Science, Chang Gung University of Science and Technology, Taoyuan 333, Taiwan
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Deoghare S, Sadick NS. Combination therapy in female pattern hair loss. J COSMET LASER THER 2023; 25:1-6. [PMID: 37289953 DOI: 10.1080/14764172.2023.2222942] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 06/04/2023] [Indexed: 06/10/2023]
Abstract
Patterned hair loss is a common type of non-scarring alopecia, characterized by miniaturization of hair follicles. The etiology of female pattern hair loss (FPHL) is not clearly linked to androgens or other hormones thereby making it a challenging condition to treat. Various treatment modalities, like minoxidil (topical or oral), spironolactone, finasteride, have been tried alone or in combination with variable results. Combination therapy is superior to the monotherapy, since these multiple treatment modalities act by targeting different pathogenetic pathways, making the treatment aggressive and more effective.
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Affiliation(s)
- Shreya Deoghare
- AHRS Fellow, Sadick Dermatology, New York, USA and Senior Resident, Department of Dermatology, Dr. D. Y. Patil Medical College and Hospital, Pune, India
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Henne SK, Nöthen MM, Heilmann-Heimbach S. Male-pattern hair loss: Comprehensive identification of the associated genes as a basis for understanding pathophysiology. MED GENET-BERLIN 2023; 35:3-14. [PMID: 38835416 PMCID: PMC10842561 DOI: 10.1515/medgen-2023-2003] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2024]
Abstract
Male-pattern hair loss (MPHL) is a highly heritable and prevalent condition that is characterized by progressive hair loss from the frontotemporal and vertex scalp. This androgen-dependent hair loss may commence during puberty, and up to 80 % of European men experience some degree of MPHL during their lifetime. Current treatment options for MPHL have limited efficacy, and improved understanding of the underlying biological causes is required to facilitate novel therapeutic approaches. To date, molecular genetic studies have identified 389 associated genomic regions, have implicated numerous genes in these regions, and suggested pathways that are likely to contribute to key pathophysiological mechanisms in MPHL. This review provides an overview of the current status of MPHL genetic research. We discuss the most significant achievements, current challenges, and anticipated developments in the field, as well as their potential to advance our understanding of hair (loss) biology, and to improve hair loss prediction and treatment.
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Affiliation(s)
- Sabrina K Henne
- University Hospital of Bonn & University of Bonn Institute of Human Genetics Bonn Germany
| | - Markus M Nöthen
- University Hospital of Bonn & University of Bonn Institute of Human Genetics Bonn Germany
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Müller Ramos P, Melo DF, Radwanski H, de Almeida RFC, Miot HA. Female pattern hair loss: therapeutic update. An Bras Dermatol 2023:S0365-0596(23)00053-3. [PMID: 37003900 DOI: 10.1016/j.abd.2022.09.006] [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: 08/11/2022] [Revised: 09/22/2022] [Accepted: 09/23/2022] [Indexed: 04/03/2023] Open
Abstract
Female androgenetic alopecia or female-pattern hair loss (FPHL) is highly prevalent and has a great impact on the quality of life. The treatment is a routine challenge in dermatological practice, as many therapeutic options have a limited level of evidence and often do not meet patients expectations. Lack of knowledge of the pathogenesis of the hair miniaturization process and the factors that regulate follicular morphogenesis restricts the prospect of innovative therapies. There is also a lack of randomized, controlled studies with longitudinal follow-up, using objective outcomes and exploring the performance of the available treatments and their combinations. Topical minoxidil, which has been used to treat female pattern hair loss since the 1990s, is the only medication that has a high level of evidence and remains the first choice. However, about 40% of patients do not show improvement with this treatment. In this article, the authors critically discuss the main clinical and surgical therapeutic alternatives for FPHL, as well as present camouflage methods that can be used in more extensive or unresponsive cases.
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Affiliation(s)
- Paulo Müller Ramos
- Department of Dermatology, Faculty of Medicine, Universidade Estadual Paulista, Botucatu, SP, Brazil.
| | - Daniel Fernandes Melo
- Department of Dermatology, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | | | | | - Hélio Amante Miot
- Department of Dermatology, Faculty of Medicine, Universidade Estadual Paulista, Botucatu, SP, Brazil
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Yang X, Yu W, Qiao R, Sun J, Jiang Y. The Predictive Value of Midscalp Hair Density and Terminal Hair Percentage in the Severity Evaluation of FPHL Assessed by Trichoscan in a Sample of Chinese Population. Clin Cosmet Investig Dermatol 2022; 15:2675-2684. [PMID: 36536758 PMCID: PMC9758977 DOI: 10.2147/ccid.s390148] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2022] [Accepted: 12/07/2022] [Indexed: 09/26/2023]
Abstract
BACKGROUND Female pattern hair loss (FPHL) is the most common hair loss disorder in women, which may impair patient's self-identity. It presents as a diffuse reduction in hair density at the mid and frontal regions of the scalp with preservation of the frontal hairline. TrichoScan can be used as a diagnostic tool and for monitoring patients in male pattern hair loss, but little is known in FPHL with Chinese population. OBJECTIVE To explore the predictive value of various TrichoScan characteristics at different areas of the scalp in the diagnosis and evaluation of FPHL. MATERIALS AND METHODS A total of 261 FPHL subjects were divided into three groups according to Ludwig classification. Together with 108 healthy controls, they were evaluated by computer-assisted TrichoScan. Various hair parameters were analyzed in the frontal, midscalp, vertex, parietal, and occipital areas of the scalp. RESULTS Declining hair densities, terminal hair percentage, hair follicular unit density, mean hair diameter, and average hair/unit combined with increased intermediate hair percentage, and vellus hair percentage were observed across all areas of the scalp for FPHL subjects. Hair density and terminal hair percentage in the midscalp area were the factors most affecting Ludwig classification. The two parameters combined achieved 85.12% correct classification rate and an area under the ROC curve of 0.88 in the diagnosis of FPHL. Additionally, we reported a unique type of FPHL which mostly affected the parietal area, occurring with or without traditional midline changes. CONCLUSION FPHL in a Chinese population presented characteristics of reduced hair density and miniaturization of hair follicles in the midline scalp and to a lesser extent in the parietal area. Hair density and terminal hair percentage in the midscalp exhibited the greatest predictive value of Ludwig classification. Our results may further provide the basis for quantitative classification of FPHL.
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Affiliation(s)
- Xianhong Yang
- Department of Dermatopathology, Hospital for Skin Diseases, Institute of Dermatology, Chinese Academy of Medical Sciences & Peking Union Medical College, Nanjing, People’s Republic of China
| | - Wanting Yu
- Department of Dermatology, Hangzhou Third Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou, People’s Republic of China
| | - Rui Qiao
- Department of Dermatopathology, Hospital for Skin Diseases, Institute of Dermatology, Chinese Academy of Medical Sciences & Peking Union Medical College, Nanjing, People’s Republic of China
| | - Jianfang Sun
- Department of Dermatopathology, Hospital for Skin Diseases, Institute of Dermatology, Chinese Academy of Medical Sciences & Peking Union Medical College, Nanjing, People’s Republic of China
| | - Yiqun Jiang
- Department of Dermatopathology, Hospital for Skin Diseases, Institute of Dermatology, Chinese Academy of Medical Sciences & Peking Union Medical College, Nanjing, People’s Republic of China
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Piccini I, Sousa M, Altendorf S, Jimenez F, Rossi A, Funk W, Bíró T, Paus R, Seibel J, Jakobs M, Yesilkaya T, Edelkamp J, Bertolini M. Intermediate Hair Follicles from Patients with Female Pattern Hair Loss Are Associated with Nutrient Insufficiency and a Quiescent Metabolic Phenotype. Nutrients 2022; 14:nu14163357. [PMID: 36014862 PMCID: PMC9416027 DOI: 10.3390/nu14163357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 08/10/2022] [Accepted: 08/11/2022] [Indexed: 11/28/2022] Open
Abstract
Female pattern hair loss (FPHL) is a non-scarring alopecia resulting from the progressive conversion of the terminal (t) scalp hair follicles (HFs) into intermediate/miniaturized (i/m) HFs. Although data supporting nutrient deficiency in FPHL HFs are lacking, therapeutic strategies are often associated with nutritional supplementation. Here, we show by metabolic analysis that selected nutrients important for hair growth such as essential amino acids and vitamins are indeed decreased in affected iHFs compared to tHFs in FPHL scalp skin, confirming nutrient insufficiency. iHFs also displayed a more quiescent metabolic phenotype, as indicated by altered metabolite abundance in freshly collected HFs and release/consumption during organ culture of products/substrates of TCA cycle, aerobic glycolysis, and glutaminolysis. Yet, as assessed by exogenous nutrient supplementation ex vivo, nutrient uptake mechanisms are not impaired in affected FPHL iHFs. Moreover, blood vessel density is not diminished in iHFs versus tHFs, despite differences in tHFs from different FPHL scalp locations or versus healthy scalp or changes in the expression of angiogenesis-associated growth factors. Thus, our data reveal that affected iHFs in FPHL display a relative nutrient insufficiency and dormant metabolism, but are still capable of absorbing nutrients, supporting the potential of nutritional supplementation as an adjunct therapy for FPHL.
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Affiliation(s)
- Ilaria Piccini
- Monasterium Laboratory Skin & Hair Research Solutions GmbH, 48149 Münster, Germany
| | - Marta Sousa
- Monasterium Laboratory Skin & Hair Research Solutions GmbH, 48149 Münster, Germany
| | - Sabrina Altendorf
- Monasterium Laboratory Skin & Hair Research Solutions GmbH, 48149 Münster, Germany
| | - Francisco Jimenez
- Mediteknia Hair Transplant Clinic and Hair Lab, Universidad Fernando Pessoa Canarias, Gran Canaria, Canary Islands, 35450 Guía, Spain
| | - Alfredo Rossi
- Department of Clinical Internal Anesthesiological and Cardiovascular Sciences, “Sapienza” University of Rome, 00161 Rome, Italy
| | | | - Tamás Bíró
- Monasterium Laboratory Skin & Hair Research Solutions GmbH, 48149 Münster, Germany
| | - Ralf Paus
- Monasterium Laboratory Skin & Hair Research Solutions GmbH, 48149 Münster, Germany
- Dermatology & Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, FL 33136, USA
| | | | | | | | - Janin Edelkamp
- Monasterium Laboratory Skin & Hair Research Solutions GmbH, 48149 Münster, Germany
| | - Marta Bertolini
- Monasterium Laboratory Skin & Hair Research Solutions GmbH, 48149 Münster, Germany
- Correspondence: ; Tel.: +49-(0)251-93263-080
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Jung H, Jung DM, Lee SS, Kim EM, Yoon K, Kim KK. Mangifera Indica leaf extracts promote hair growth via activation of Wnt signaling pathway in human dermal papilla cells. Anim Cells Syst (Seoul) 2022; 26:129-136. [PMID: 35784391 PMCID: PMC9246026 DOI: 10.1080/19768354.2022.2085790] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
The crosstalk between androgens and Wnt signaling pathways is critical in the hair growth cycle. Therefore, natural products that target these two pathways for the inhibition of hair loss are sought after. In this study, we investigated the effect of water extracts of Mangifera indica leaves (WEML) on hair growth. WEML treatment significantly reduced the expression levels of both dickkopf-1 (DKK1) and type 2 5α-reductase (SRD5A2) involved in Wnt signal suppression activity and dihydrotestosterone (DHT) synthesis, respectively, in human follicle dermal papilla cells (HFDP). In addition, WEML treatment effectively upregulated Wnt target genes and downregulated DKK1 expression that was increased by DHT treatment. Degranulation analysis in rat basophilic leukemia mast cell line (RBL-2H3) using β-hexosaminidase release assay confirmed that WEML did not exhibit allergenic activity. Furthermore, hair growth was significantly enhanced in in vivo mice model treated with WEML. These results suggest that M. indica leave extract contains bioactive materials that can be used to treat hair loss.
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Affiliation(s)
- Haesoo Jung
- Department of Biochemistry, College of Natural Sciences, Chungnam National University, Daejeon, Republic of Korea
| | - Da-Min Jung
- Department of Biochemistry, College of Natural Sciences, Chungnam National University, Daejeon, Republic of Korea
| | - Sang-Soo Lee
- Department of Biochemistry, College of Natural Sciences, Chungnam National University, Daejeon, Republic of Korea
| | - Eun-Mi Kim
- Department of Predictive Toxicology, Korea Institute of Toxicology, Daejeon, Republic of Korea
| | - Kyungah Yoon
- Department of Clinical Laboratory Science, Daejeon Health Institute of Technology, Daejeon, Republic of Korea
| | - Kee K. Kim
- Department of Biochemistry, College of Natural Sciences, Chungnam National University, Daejeon, Republic of Korea
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Sasaki GH. Clinical Use of Extracellular Vesicles in the Management of Male and Female Pattern Hair Loss: A Preliminary Retrospective IRB Safety and Efficacy Study. Aesthet Surg J Open Forum 2022; 4:ojac045. [PMID: 35923863 PMCID: PMC9342625 DOI: 10.1093/asjof/ojac045] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
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.
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19
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Kim BH, Kim MG, Choi BY. Lagerstroemia indica extract regulates human hair dermal papilla cell growth and degeneration via modulation of β-catenin, Stat6 and TGF-β signaling pathway. J Cosmet Dermatol 2022; 21:2763-2773. [PMID: 35596731 DOI: 10.1111/jocd.15081] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Revised: 05/07/2022] [Accepted: 05/11/2022] [Indexed: 12/01/2022]
Abstract
BACKGROUND Lagerstroemia indica (L. indica) is reported to have diverse biological activities including anti-inflammatory, anti-cancer, neuro-regulatory, antidiabetic and antioxidant activity. AIMS The purpose of the present study is to examine the potential of hair growth promotion and/or hair loss prevention by L. indica extract. PATIENTS/METHODS The effects of L. indica on hair growth have been studied in human hair follicle dermal papillary (hHFDP) cells and follicular organ culture ex vivo by cell proliferation assay, PCR, western blot analysis and reporter gene activity assay. Moreover, a clinical trial was conducted in healthy volunteers. RESULTS L. indica significantly promoted the proliferation of hHFDP cells, which was associated with increased expression of TCF/LEF, VEGF and Gli1 mRNA, and inhibition of STAT6 and Smad2 mRNA. Treatment with L. indica also increased the TCF/LEF reporter gene activity but downregulated the SBE- and STAT6-luciferase activities. The expression of total β-catenin, CDK4 and CDK2 were elevated, while that of STAT6 and SMAD2/3 was suppressed upon treatment with L. indica. In human hair follicles organ culture, L. indica significantly inhibited hair follicular degeneration. The clinical trial showed a statistically significant rise in total hair count in test group (n=24) after 24 weeks of applying the hair tonic enriched with L. indica (141.46 ± 21.27 number/cm2 , p < 0.05). CONCLUSION We suggest that L. indica extract prevents hair loss as well as stimulate hair growth by regulating the Wnt-β-catenin, JAK3-STAT6 and TGF-β1-Smad signaling pathways, and may be further developed as a novel functional cosmetic for preventing hair loss.
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Affiliation(s)
- Byung Hyun Kim
- Department of Pharmaceutical Science & Engineering, Seowon University
| | - Myong Gi Kim
- Department of Food Science & Engineering, Seowon University, Cheongju, Chungbuk, South Korea
| | - Bu Young Choi
- Department of Pharmaceutical Science & Engineering, Seowon University
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20
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Chew S, Gajjar T, Sethi S. Safety and Efficacy of Trimax‐360 Serum in Healthy Adult Subjects with Mild to Moderate Alopecia of Scalp. J Cosmet Dermatol 2022; 21:4536-4544. [DOI: 10.1111/jocd.14998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 01/11/2022] [Accepted: 04/12/2022] [Indexed: 11/28/2022]
Affiliation(s)
- Soon‐Keong Chew
- Maxwell Pharma Sdn Bhd B23‐2 Block B, Zenith Corporate Park, Jalan SS7/26, Kelana Jaya 47301 Petaling Jaya Malaysia
| | - Trusha Gajjar
- Cliantha Research Limited Garden View, Corporate House no. 7, Sindhu Bhavan Road, Opposite Auda Garden Bodakdev Ahmedabad 380054 India
| | - Simran Sethi
- Cliantha Research Limited Garden View, Corporate House no. 7, Sindhu Bhavan Road, Opposite Auda Garden Bodakdev Ahmedabad 380054 India
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21
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He F, Shen M, Zhao Z, Liu Y, Zhang S, Tang Y, Xie H, Chen X, Li J. Epidemiology and disease burden of androgenetic alopecia in college freshmen in China: A population-based study. PLoS One 2022; 17:e0263912. [PMID: 35171966 PMCID: PMC8849549 DOI: 10.1371/journal.pone.0263912] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Accepted: 01/29/2022] [Indexed: 11/19/2022] Open
Abstract
Objective To evaluate the epidemiology and disease burden of androgenetic alopecia (AGA) in college freshmen in China. Methods This population-based cross-sectional survey was carried out among 9227 freshmen of two comprehensive universities in two cities of China (Changsha and Xiamen) from September 2018 to October 2018. Questionnaires covering basic issues, surrounding demographic information, history of diseases, living habits, comorbidities, etc. were completed online in a self-reported manner Dermatological examination was performed by certified dermatologists. The disease burden of AGA, which includes health-related quality of life, symptoms of anxiety, symptoms of depression and quality of sleep, was measured by EQ-5D-3L, PHQ-2, GAD-2 and PSQI, respectively. Results The prevalence of AGA in college freshmen in China was 5.3/1000. Male was significantly associated with higher prevalence of AGA (7.9/1000, P<0.01) while female with lower risk of AGA (OR = 0.29, P = 0.002). There was no significant association between BMI and AGA, nor predilection of AGA in the Han nationality or the other ethnic minorities. Annual household income or parental highest educational level exerted no significant influence on the prevalence of AGA. Rosacea (OR = 3.22, P = 0.019) was significantly associated with higher prevalence of AGA while acne seemed not to be related to AGA. The scores of EQ-5D, GAD-2, PHQ-2 and PSQI were not significantly different between students with and without AGA. Conclusion The onset of AGA in Chinese college freshmen differ between genders and was significantly associated with rosacea.
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Affiliation(s)
- Fanping He
- Department of Dermatology, Xiangya Hospital of Central South University, Changsha, Hunan, China
- Hunan Key Laboratory of Aging Biology, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Minxue Shen
- Department of Dermatology, Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Zhixiang Zhao
- Department of Dermatology, Xiangya Hospital of Central South University, Changsha, Hunan, China
- Hunan Key Laboratory of Aging Biology, Xiangya Hospital, Central South University, Changsha, China
| | - Yicong Liu
- Department of Dermatology, Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Shuping Zhang
- Department of Dermatology, Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Yan Tang
- Department of Dermatology, Xiangya Hospital of Central South University, Changsha, Hunan, China
- Hunan Key Laboratory of Aging Biology, Xiangya Hospital, Central South University, Changsha, China
| | - Hongfu Xie
- Department of Dermatology, Xiangya Hospital of Central South University, Changsha, Hunan, China
- Hunan Key Laboratory of Aging Biology, Xiangya Hospital, Central South University, Changsha, China
| | - Xiang Chen
- Department of Dermatology, Xiangya Hospital of Central South University, Changsha, Hunan, China
- * E-mail: (XC); (JL)
| | - Ji Li
- Department of Dermatology, Xiangya Hospital of Central South University, Changsha, Hunan, China
- Hunan Key Laboratory of Aging Biology, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital of Central South University, Changsha, Hunan, China
- * E-mail: (XC); (JL)
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22
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Ohn J, Son HY, Yu DA, Kim MS, Kwon S, Park WS, Kim JI, Kwon O. Early onset female pattern hair loss: a case–control study for analyzing clinical features and genetic variants. J Dermatol Sci 2022; 106:21-28. [DOI: 10.1016/j.jdermsci.2022.02.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 02/13/2022] [Accepted: 02/27/2022] [Indexed: 11/26/2022]
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Mohammadzadeh M, Mirzaei N, Mostafaii G, Atoof F, Miranzadeh MB, Dehghani R. Determination of potentially toxic metals in depilatory products in the Iranian markets: human health risk assessment. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2022; 29:13756-13765. [PMID: 34599443 DOI: 10.1007/s11356-021-16608-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Accepted: 09/14/2021] [Indexed: 06/13/2023]
Abstract
This study aimed to investigate the concentrations of heavy metals, including lead (Pb), cadmium (Cd), chromium (Cr), zinc (Zn), cobalt (Co), and arsenic metalloid (As), to assess their health risks in the popular depilatory products of the Iranian markets. Twenty-one samples of 7 popular brands of depilatory products, inclusive of cream and powder, were examined. Selected elements were measured by inductively coupled plasma optical emission spectrometry (ICP-OES) using the appropriate procedure for acid digestion and the measurement of heavy metal contents. The differences in heavy metal concentrations were investigated according to the type of product, brand, country of production, and product price using t test and one-way analysis of variance and post hoc Tukey test. Finally, carcinogenic and non-carcinogenic risk assessments were calculated for the studied elements. The results showed that Pb (5.46±2.30 mg/kg) and Co (0.16±0.69 mg/kg) had the highest and lowest concentrations in these products, respectively. In general, the concentration of heavy metals in depilatory creams was less than the concentration of elements in depilatory powders and less than the maximum allowable limits as defined by the Institute of Standards and Industrial Research of Iran (ISIRI). There was a direct and significant relationship between the concentration of heavy metals in depilatory powders and the product's price. Moreover, the amount of As in one of the brands of depilatory powder was determined to exceed the standard value (2 mg/kg). Also, hazard index (HI) and lifetime cancer risk (LCR) were below 1 and 10-6, respectively, which indicated that this mentioned heavy metal had no probable non-carcinogenic and carcinogenic risks for consumers. According to this study, it was evident that the chances of cancer and non-cancer risk using depilatory products were unlikely, but continuous use can be harmful due to the excessive accumulation of these heavy metals.
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Affiliation(s)
- Mahdiyeh Mohammadzadeh
- Social Determinants of Health (SDH) Research Center, Department of Environment Health, Kashan University of Medical Sciences, Kashan, Iran
- Student Research Committee, Kashan University of Medical Sciences, Kashan, Iran
| | - Nezam Mirzaei
- Social Determinants of Health (SDH) Research Center, Department of Environment Health, Kashan University of Medical Sciences, Kashan, Iran
| | - Gholamreza Mostafaii
- Social Determinants of Health (SDH) Research Center, Department of Environment Health, Kashan University of Medical Sciences, Kashan, Iran
| | - Fatemeh Atoof
- Departments of Biostatistics & Epidemiology, Faculty of Health, Kashan University of Medical Sciences, Kashan, Iran
| | - Mohammad Bagher Miranzadeh
- Social Determinants of Health (SDH) Research Center, Department of Environment Health, Kashan University of Medical Sciences, Kashan, Iran
| | - Rouhullah Dehghani
- Social Determinants of Health (SDH) Research Center, Department of Environment Health, Kashan University of Medical Sciences, Kashan, Iran.
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Tampucci S, Paganini V, Burgalassi S, Chetoni P, Monti D. Nanostructured Drug Delivery Systems for Targeting 5-α-Reductase Inhibitors to the Hair Follicle. Pharmaceutics 2022; 14:pharmaceutics14020286. [PMID: 35214018 PMCID: PMC8876829 DOI: 10.3390/pharmaceutics14020286] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Revised: 01/17/2022] [Accepted: 01/19/2022] [Indexed: 02/01/2023] Open
Abstract
Androgenetic alopecia is a multifactorial condition characterized by noticeable hair loss, affecting both men and women and representing a debilitating and chronic disorder that considerably affects the quality of life. Available topical treatments based on minoxidil or finasteride require repeated applications and are associated with a certain number of adverse effects. The challenges associated with current treatments pave the way for the research of new therapeutic strategies, more precise and selective, and capable of providing long-term results. In this context, the present review examines the new proposed formulation strategies to deliver 5-α-reductase inhibitors in order to obtain a targeted drug delivery, for improving drug retention at the site of action in the hair follicle, contemporaneously reducing drug systemic absorption, which is the cause of important adverse effects. In particular, the research will be focused on the several aspects that influence the performance of nanostructured drug delivery systems in creating a depot in the hair follicles, such as particle size, surface charge, excipients, and combined application with external stimuli (infrared radiation, mechanical massage, ultrasounds application).
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25
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The comparison of demographics and comorbidities of female pattern hair loss according to the clinical subtype and stage. J Am Acad Dermatol 2021; 87:779-783. [PMID: 34838685 DOI: 10.1016/j.jaad.2021.11.027] [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: 11/02/2021] [Accepted: 11/17/2021] [Indexed: 11/23/2022]
Abstract
BACKGROUND Previous literature regarding the frequencies of each subtype of female pattern hair loss is contradictory and the subtypes have not been compared to each other in terms of their epidemiologic characteristics and relationships with comorbid diseases. OBJECTIVES The aims of this study are to determine the frequency and the relationship with comorbidities for each subtype, and to determine the relationship of clinical stage with age and comorbid diseases. METHODS This is a prospective cross-sectional study involving patients with a definitive diagnosis of female pattern hair loss. The age, age at the time of diagnosis, family history for androgenetic alopecia, clinical subtype, clinical stage, and comorbid conditions were noted for each patient. SPSS version 21 (IBM SPSS) was used for statistical analysis. RESULTS Advanced stages of female pattern hair loss are related to increased age, menopausal state, and hypertension. Acne vulgaris is more prevalent in earlier stages. Hirsutism and acne vulgaris are more commonly encountered in the Ludwig and Hamilton subtypes. Hypertension is more frequent in Ludwig subtype. LIMITATIONS The confounding effect of age on the relationship between clinical subtype and comorbid diseases. CONCLUSION The relationship between comorbid diseases and stage in specific subtypes can guide us to the diagnosis of undiagnosed comorbid diseases.
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Treister-Goltzman Y, Yarza S, Peleg R. Iron Deficiency and Nonscarring Alopecia in Women: Systematic Review and Meta-Analysis. Skin Appendage Disord 2021; 8:83-92. [DOI: 10.1159/000519952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Accepted: 09/26/2021] [Indexed: 11/19/2022] Open
Abstract
Background: There is no clear-cut evidence in the existing medical literature of an association between iron deficiency and nonscarring alopecia. Objective: The objective of the study was to conduct a systematic review of the medical literature on the prevalence of iron deficiency in women with nonscarring alopecia and compare their ferritin levels with those of women without this condition. Methods: The electronic databases PubMed, Scopus, and Web of Science were searched between June 15, 2019, and July 24, 2019. Studies that evaluated the prevalence of iron deficiency in women with nonscarring alopecia and/or compared ferritin levels in women with and without this condition were entered into the meta-analysis. Thirty-six of 928 identified studies entered the systematic meta-analysis. The meta-analysis was performed using the random-effects method. Results: The overall number of participants was 10,029. The prevalence of ferritin levels from 10 to 15 ng/dL and below was 21% (12; 29). Women with nonscarring alopecia had lower ferritin values at MD = −18.51 ng/dL (−25.85; −11.16, p < 0.01). Conclusion: Women with hair loss can benefit from higher ferritin levels.
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Liang B, Ding Y, Zhou Y, Yang C, Cheng Z. Evaluation of Susceptibility Genes/Loci Associated with Male Androgenetic Alopecia (MAGA) for Female-Pattern Hair Loss in a Chinese Han Population and a Brief Literature Review. Med Sci Monit 2021; 27:e933424. [PMID: 34753897 PMCID: PMC8591919 DOI: 10.12659/msm.933424] [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] [Indexed: 11/12/2022] Open
Abstract
Background Female-pattern hair loss (FPHL) is a common disorder affecting women, and FPHL can cause psychological dysfunction and affect the social activities of patients. The disease-causing mechanisms are believed to be similar to those of male androgenetic alopecia (MAGA). Although genome-wide association studies (GWAS) have confirmed susceptibility genes/loci for MAGA, the associations between these genetic loci and FPHL are largely unknown. We investigated the associations between susceptibility loci for MAGA and FPHL in a Chinese Han population; a literature review of susceptibility loci associated with MAGA for FPHL was also performed. Material/Methods Twenty-two previously reported sites were analyzed with the Sequenom iPlex platform, and the genotype statistical analysis consisted of a trend test and conservative accounting. The samples comprised 82 patients diagnosed with FPHL by dermatoscopy and 381 healthy controls from the Chinese Han population. Results No significantly associated variants were found in this FPHL study. The examined 22 tag SNPs in MAGA may not be associated with FPHL. The results of the current study in a Chinese Han population support the previous negative association obtained for a European population. Conclusions This was the first study exploring whether identified MAGA-associated loci confer susceptibility to FPHL in a Chinese Han population, and dermatoscopy was used to improve the diagnostic accuracy. However, there was no evidence of a relationship between susceptibility genes for MAGA and FPHL, and the results indicated that FPHL and MAGA are etiologically separate entities. Therefore, a systematic GWAS approach to FPHL may be required to clarify associated pathophysiological uncertainties.
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Affiliation(s)
- Bo Liang
- Department of Dermatology and Venereology, The First Affiliated Hospital, Anhui Medical University, Hefei, Anhui, China (mainland).,Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, Anhui, China (mainland).,Key Laboratory of Dermatology, Anhui Medical University, Ministry of Education, Hefei, Anhui, China (mainland)
| | - Yantao Ding
- Department of Dermatology and Venereology, The First Affiliated Hospital, Anhui Medical University, Hefei, Anhui, China (mainland).,Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, Anhui, China (mainland).,Key Laboratory of Dermatology, Anhui Medical University, Ministry of Education, Hefei, Anhui, China (mainland)
| | - Yi Zhou
- Department of Dermatology and Venereology, The First Affiliated Hospital, Anhui Medical University, Hefei, Anhui, China (mainland).,Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, Anhui, China (mainland).,Key Laboratory of Dermatology, Anhui Medical University, Ministry of Education, Hefei, Anhui, China (mainland)
| | - Chunjun Yang
- Department of Dermatology and Venereology, The Second Affiliated Hospital, Anhui Medical University, Hefei, Anhui, China (mainland)
| | - Zhixiang Cheng
- Department of Blood Transfusion, The Fourth Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China (mainland)
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Sasaki GH. 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. Aesthet Surg J 2021; 41:NP1659-NP1672. [PMID: 34050738 DOI: 10.1093/asj/sjab236] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
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
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Female Pattern Hair Loss: Why the Follicular Unit Transplantation Surgical Technique Remains a Good Option. Plast Reconstr Surg 2021; 147:839-849. [PMID: 33710162 DOI: 10.1097/prs.0000000000007760] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Female pattern hair loss is a common nonscarring alopecia that can present with several patterns of decreased hair density. The condition is very bothersome to affected women, and although there are multiple nonsurgical options, surgical follicular unit transplantation remains one of the most effective options. METHODS A retrospective chart review was performed of the senior author's (C.O.U.) experience and technique of follicular unit transplantation for treatment of female pattern hair loss. RESULTS A total of 751 patients with female pattern hair loss underwent follicular unit transplantation over the past 31 years. Average patient age was 48 years. Patients with small areas of hair loss made up 40 percent of the group (Ludwig stage I), those with medium-sized areas constituted 45 percent (Ludwig stage II), and those with large areas constituted 15 percent (Ludwig stage III). The average operative time was 3 hours 21 minutes. One hundred thirty-five patients (18 percent) underwent a second replacement, at an average period of 4 years after the procedure, because of the progressive nature of female pattern hair loss. Complications included donor-site scar widening in six patients and folliculitis in 17 patients. CONCLUSION Follicular unit transplantation is an excellent option for treatment of female pattern hair loss patients, as there is no need to shave the recipient sites, operative times are shorter than for follicular unit excision techniques, and the incidence of complications is very low. CLINICAL QUESTION/LEVEL OF EVIDENCE Therapeutic, IV.
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30
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Kiyat P, Palamar M, Gerceker Turk B, Yagci A. Evaluation of dry eye and Meibomian gland dysfunction in female androgenetic alopecia patients. Int Ophthalmol 2021; 41:3749-3757. [PMID: 34241758 DOI: 10.1007/s10792-021-01946-3] [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: 09/28/2020] [Accepted: 07/04/2021] [Indexed: 11/26/2022]
Abstract
PURPOSE To evaluate dry eye tests and Meibomian gland functions in female androgenetic alopecia patients. MATERIALS AND METHODS Twenty left eyes of 20 female androgenetic alopecia patients (Group 1) and 20 left eyes of 20 healthy female volunteers (Group 2) were enrolled in the study. The presence of dry eye was evaluated with Schirmer 1 test, invasive tear film break-up time (T-BUT), Oxford scale scoring and Ocular Surface Disease Index (OSDI) score assessments. Evaluation of upper and lower eyelid Meibomian glands was performed using infrared filter of a slit-lamp biomicroscope, and the drop out ratio was scored for each eyelid. RESULTS The mean ages of Group 1 and Group 2 were 48.3 ± 6.6 (range, 38-58) and 49.8 ± 5.4 (range, 38-59) years, respectively (P = 0.437). Mean T-BUT was statistically significantly lower in Group 1 (P = 0.013); mean OSDI score was significantly higher in Group 1 (P = 0.049). Mean Schirmer 1 score was lower and mean Oxford score was higher in Group 1, but the differences were not statistically significant (P = 0.291, P = 0.088, respectively). In addition, upper, lower and total meiboscores were significantly higher in Group 1 (P = 0.007, P = 0.003, P = 0.002, respectively). CONCLUSION Alterations in sex hormones play a role in the pathogenesis of both female androgenetic alopecia and Meibomian gland dysfunction. Significant differences were detected in the results of dry eye tests and Meibomian gland dropout ratios between subjects with female androgenetic alopecia and healthy control subjects. For this reason, female androgenetic alopecia patients should be examined for dry eye and Meibomian gland dysfunction and should be treated to prevent serious consequences.
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Affiliation(s)
- Pelin Kiyat
- Department of Ophthalmology, Ege University Faculty of Medicine, Goz Hastaliklari AD, 35040, Izmir, Turkey
| | - Melis Palamar
- Department of Ophthalmology, Ege University Faculty of Medicine, Goz Hastaliklari AD, 35040, Izmir, Turkey.
| | - Bengu Gerceker Turk
- Department of Dermatology, Ege University Faculty of Medicine, Izmir, Turkey
| | - Ayse Yagci
- Department of Ophthalmology, Ege University Faculty of Medicine, Goz Hastaliklari AD, 35040, Izmir, Turkey
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Stone RC, Aviv A, Paus R. Telomere Dynamics and Telomerase in the Biology of Hair Follicles and their Stem Cells as a Model for Aging Research. J Invest Dermatol 2021; 141:1031-1040. [PMID: 33509633 DOI: 10.1016/j.jid.2020.12.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Revised: 11/28/2020] [Accepted: 12/01/2020] [Indexed: 02/06/2023]
Abstract
In this review, we propose that telomere length dynamics play an important but underinvestigated role in the biology of the hair follicle (HF), a prototypic, cyclically remodeled miniorgan that shows an intriguing aging pattern in humans. Whereas the HF pigmentary unit ages quickly, its epithelial stem cell (ESC) component and regenerative capacity are surprisingly aging resistant. Telomerase-deficient mice with short telomeres display an aging phenotype of hair graying and hair loss that is attributed to impaired HF ESC mobilization. Yet, it remains unclear whether the function of telomerase and telomeres in murine HF biology translate to the human system. Therefore, we propose new directions for future telomere research of the human HF. Such research may guide the development of novel treatments for selected disorders of human hair growth or pigmentation (e.g., chemotherapy-induced alopecia, telogen effluvium, androgenetic alopecia, cicatricial alopecia, graying). It might also increase the understanding of the global role of telomeres in aging-related human disease.
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Affiliation(s)
- Rivka C Stone
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, Florida, USA.
| | - Abraham Aviv
- The Center of Human Development and Aging, Rutgers New Jersey Medical School, Newark, New Jersey, USA
| | - Ralf Paus
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, Florida, USA; Centre for Dermatology Research, University of Manchester, Manchester, United Kingdom; Monasterium Laboratory, Münster, Germany
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32
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Chen X, Li X, Chen B, Yin Y, Zhang J, Zhou C. Female Pattern Hair Loss in Female and Male: A Quantitative Trichoscopic Analysis in Chinese Han Patients. Front Med (Lausanne) 2021; 8:649392. [PMID: 33842510 PMCID: PMC8032947 DOI: 10.3389/fmed.2021.649392] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Accepted: 03/01/2021] [Indexed: 11/20/2022] Open
Abstract
Objectives: To investigate the trichoscopic features of female pattern hair loss (FPHL) in Chinese Han patients and analyze the difference between male and female patients with FPHL. Materials and Methods: Trichoscopic images were taken in four different scalp areas, including right frontal hairline, vertex, right parietal and occipital areas. Hair density, hair shaft diameter, vellus hair ratio and single hair follicle unit ratio were counted manually and analyzed. Results: Seventy-three subjects were enrolled in this study, including 38 patients with FPHL (28 females and 10 males) and 35 normal controls without hair loss. The hair density and hair shaft diameter of FPHL patients reduced in the whole scalp. Vellus hair ratio and single hair follicle unit ratio were both increased in FPHL compared to normal controls. The vertex was the most affected area and the hair shaft diameter showed the most significant difference. Parietal and occipital area were also affected in FPHL. The reduction or increase was correlated with the severity of Ludwig staging. Very few gender differences were detected in male and female FPHL patients. Conclusion: FPHL patients showed decreased hair density and hair shaft diameter, accompanied by increased vellus hair ratio and single hair follicle unit ratio. Parietal and occipital area can be also affected in FPHL, though not as severe as in vertex area. FPHL in male basically has the same characteristic as those in female patients. Limitation: The main limitation of the study is the small sample size which only enrolled 10 male FPHL patients, in comparison to the female cases. The findings could not be representative of the normal population with the limited sample size.
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Affiliation(s)
- Xi Chen
- Department of Dermatology, Peking University People's Hospital, Beijing, China.,Department of Dermatology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Xiangqian Li
- Department of Dermatology, Peking University People's Hospital, Beijing, China
| | - Baifu Chen
- Department of Dermatology, Peking University People's Hospital, Beijing, China
| | - Yue Yin
- Department of Dermatology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Jianzhong Zhang
- Department of Dermatology, Peking University People's Hospital, Beijing, China
| | - Cheng Zhou
- Department of Dermatology, Peking University People's Hospital, Beijing, China
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Investigating the Safety and Efficacy of Platelet-Rich Plasma (PRP) Treatment for Female Androgenetic Alopecia: Review of the Literature. ACTA ACUST UNITED AC 2021; 57:medicina57040311. [PMID: 33806169 PMCID: PMC8066895 DOI: 10.3390/medicina57040311] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Revised: 03/15/2021] [Accepted: 03/22/2021] [Indexed: 12/18/2022]
Abstract
Background: female androgenetic alopecia (FAGA) is a common cause of non-scarring alopecia in women, affecting approximately 40% of women by age 50, bearing a significant psychosocial burden on affected patients. Platelet-rich plasma (PRP) has been widely investigated as a potential effective treatment for several dermatological conditions, including male androgenetic alopecia (MAGA). However, few studies have been conducted focusing on the use of PRP in FAGA. The aim of this review was to identify reports that investigated the use of PRP for the treatment of FAGA. Methods: Electronic databases of MEDLINE, EMBASE, and Cochrane Central Register of Controlled Trials (CENTRAL) from inception to September 2020 have been searched using different combinations of the following terms: “androgenetic alopecia,” “FAGA,” “female pattern hair loss,” “platelet-rich fibrin,” “platelet-rich plasma,” and “PRP”. Results and conclusions: Eight (n = 8) clinical studies consistent with our research were identified. A total of 197 subjects has been enrolled in the included studies. All of them were adult female patients (mean age: 38.9) affected by female pattern hair loss. PRP is a well-tolerated procedure which showed promising results in males-only and mixed populations of AGA patients. PRP showed to produce high levels of satisfaction and improvement in the quality of life in patients affected by FAGA. In the light of this evidence, PRP may be proposed in patients who did not respond or did not tolerate topical minoxidil, as well as in combination with topical and oral treatments.
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34
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Chovarda E, Sotiriou E, Lazaridou E, Vakirlis E, Ioannides D. The role of prostaglandins in androgenetic alopecia. Int J Dermatol 2021; 60:730-735. [PMID: 33528035 DOI: 10.1111/ijd.15378] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Revised: 10/06/2020] [Accepted: 12/01/2020] [Indexed: 01/01/2023]
Abstract
BACKGROUND Though androgenetic alopecia (AGA) is one of the most common diseases affecting both sexes and all races, its pathogenesis is not completely clarified. The aim of this study was to investigate the role of the four major prostaglandins (PGs) (PGE2 , PGD2 , PGF2α , and PI2 or prostacyclin) in the pathogenesis of AGA in males and females. METHODS Human scalp biopsies were obtained from 30 adults (17 males and 13 females) suffering from AGA and from 30 healthy adults (18 males and 12 females). In each subject, two skin biopsies were performed, one from the frontal bald area and another one from the occipital area with normal hair growth. In the healthy group, biopsies were taken from both areas too. In each sample, all four PGs were measured. RESULTS In the patient group, PGD2 and prostacyclin or PGI2 levels were increased in bald compared to haired scalp. On the contrary, measurements of PGE2 and PGF2α showed that they were diminished in bald areas compared to haired areas. PG levels in healthy samples were comparable to the haired areas. CONCLUSION These results support that there is a fine balance between these four proteins in scalp hair follicles, and its maintenance may be crucial for hair growth. Furthermore, their receptors could be potential targets for treatment of AGA.
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Affiliation(s)
- Eleni Chovarda
- First Department of Dermatology-Venereology, Aristotle University, State Hospital of Skin and Venereal Diseases, Thessaloniki, Greece
| | - Eleni Sotiriou
- First Department of Dermatology-Venereology, Aristotle University, State Hospital of Skin and Venereal Diseases, Thessaloniki, Greece
| | - Elizabeth Lazaridou
- First Department of Dermatology-Venereology, Aristotle University, State Hospital of Skin and Venereal Diseases, Thessaloniki, Greece
| | - Efstratios Vakirlis
- First Department of Dermatology-Venereology, Aristotle University, State Hospital of Skin and Venereal Diseases, Thessaloniki, Greece
| | - Demetrios Ioannides
- First Department of Dermatology-Venereology, Aristotle University, State Hospital of Skin and Venereal Diseases, Thessaloniki, Greece
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Kutlu Ö, Metin A. Systemic dexpanthenol as a novel treatment for female pattern hair loss. J Cosmet Dermatol 2020; 20:1325-1330. [PMID: 32960484 DOI: 10.1111/jocd.13729] [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: 08/29/2020] [Accepted: 09/08/2020] [Indexed: 01/21/2023]
Abstract
BACKGROUND There are only a few drugs that have been used for the treatment of female pattern hair loss (FPHL). AIMS Through use of the Dermatologic Life Quality Index (DLQI) and a modified hair growth questionnaire, we aimed to evaluate the effect of dexpanthenol (DXP) as a new option for FPHL. METHODS Women who received 500 mg intramuscular DXP weekly for FPHL were included in this study. They were evaluated in terms of DLQI and laboratory characteristics, before and after DXP treatment, and were examined with a modified hair growth questionnaire. RESULTS Overall satisfaction with the appearance of the hair was described by the patients as 57.1% " I am satisfied," 28.6% "I am very satisfied," and 14.3% "I am neutral (neither satisfied nor dissatisfied)." There was a statistical difference between the mean DLQI scores before and after DXP treatment (P < .001). No statistical difference was found in the laboratory characteristics of the patients before and after DXP treatment (P > 0.05). No side effect was reported during DXP treatment. CONCLUSION Dexpanthenol is a safe and novel drug that may increase the quality of life in patients with FPHL.
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Affiliation(s)
- Ömer Kutlu
- Department of Dermatology and Venereology, School of Medicine, Uşak University, Uşak, Turkey
| | - Ahmet Metin
- Department of Dermatology and Venereology I School of Medicine, Yildirim Beyazit University, Ankara, Turkey
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Ahn JH, Park YE, Kim B, Park CW, Sim TH, Lee TK, Lee JC, Park JH, Kim JD, Lee HS, Won MH. Hair Growth is Promoted in Mouse Dorsal Skin by a Mixture of Platycladus orientalis (L.) Franco Leaf Extract and Alpha-Terpineol by Increasing Growth Factors and wnt3/β-Catenin. Nat Prod Commun 2020. [DOI: 10.1177/1934578x20951433] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
In this study, we investigated the effect of a mixture of Platycladus orientalis (L.) Franco leaf extract and α-terpineol, a natural monoterpene alcohol (PEaT), on hair growth and its mechanisms. C57/BL6 mice (total n = 14) in the telogen phase of hair growth were used. Either distilled water as vehicle or PEaT was topically applied to the dorsal skin for 17 days. Chronological hair growth change was examined by hair growth-promoting scores. In addition, to find out mechanisms of PEaT on hair growth, insulin-like growth factor-1 (IGF-1), vascular endothelial growth factor (VEGF), Ki-67, wnt3, and β-catenin expressions were investigated by using immunohistochemistry. We found that PEaT remarkably promoted hair growth by inducing early anagen transition compared with the control group. In addition, treatment with PEaT significantly increased numbers of Ki-67-positive cells and expressions of IGF-1, VEGF, wnt3, and β-catenin in the outer root sheath. These results indicate that PEaT used in this study might be a good hair growth promoter, showing that PEaT treatment increased growth factors and cell proliferation through upregulation of wnt3 and β-catenin expressions.
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Affiliation(s)
- Ji Hyeon Ahn
- Department of Biomedical Science and Research Institute for Bioscience and Biotechnology, Hallym University, Chuncheon, Gangwon, Republic of Korea
- Department of Neurobiology, School of Medicine, Kangwon National University, Chuncheon, Gangwon, Republic of Korea
| | - Young Eun Park
- Department of Neurobiology, School of Medicine, Kangwon National University, Chuncheon, Gangwon, Republic of Korea
| | - Bora Kim
- Department of Neurobiology, School of Medicine, Kangwon National University, Chuncheon, Gangwon, Republic of Korea
| | - Cheol Woo Park
- Department of Neurobiology, School of Medicine, Kangwon National University, Chuncheon, Gangwon, Republic of Korea
| | - Tae Heung Sim
- Leefarm Co. Ltd., Hongcheon, Gangwon, Republic of Korea
| | - Tae-Kyeong Lee
- Department of Biomedical Science and Research Institute for Bioscience and Biotechnology, Hallym University, Chuncheon, Gangwon, Republic of Korea
| | - Jae-Chul Lee
- Department of Neurobiology, School of Medicine, Kangwon National University, Chuncheon, Gangwon, Republic of Korea
| | - Joon Ha Park
- Department of Anatomy, College of Korean Medicine, Dongguk University, Gyeongju, Gyeongbuk, Republic of Korea
| | - Jong-Dai Kim
- Division of Food Biotechnology, School of Biotechnology, Kangwon National University, Chuncheon, Gangwon, Republic of Korea
| | - Hyun Sam Lee
- Leefarm Co. Ltd., Hongcheon, Gangwon, Republic of Korea
| | - Moo-Ho Won
- Department of Neurobiology, School of Medicine, Kangwon National University, Chuncheon, Gangwon, Republic of Korea
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Abstract
Androgenetic alopecia (AGA) is the most common hair loss disorder in men and women. The characteristic and reproducible balding pattern in AGA negatively affects self-image and the external perceptions of the balding patient. The phenotypical changes are driven by dihydrotestosterone (DHT) and its precursor testosterone. DHT induces follicle miniaturization and hair cycle changes until resulting hairs no longer extrude through the skin surface. AGA is inherited in a polygenetic pattern and is susceptible to epigenetic and environmental factors. Currently, minoxidil, finasteride, and photolaser therapy are the only Food and Drug Administration-approved medical treatments for AGA.
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Affiliation(s)
- Tymon Tai
- Tina and Rick Caruso Department of Otolaryngology Head and Neck Surgery, Keck School of Medicine of USC, CHP 204M 1540 Alcazar Street, Los Angeles, CA 90033, USA
| | - Amit Kochhar
- Tina and Rick Caruso Department of Otolaryngology Head and Neck Surgery, Keck School of Medicine of USC, CHP 204M 1540 Alcazar Street, Los Angeles, CA 90033, USA.
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39
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Evaluation of Hair Density and Hair Diameter in the Adult Thai Population Using Quantitative Trichoscopic Analysis. BIOMED RESEARCH INTERNATIONAL 2020; 2020:2476890. [PMID: 32104683 PMCID: PMC7035527 DOI: 10.1155/2020/2476890] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Accepted: 01/06/2020] [Indexed: 11/29/2022]
Abstract
The data of hair density and hair diameter in the Asian population, especially in Thais, are limited. We aimed to evaluate hair density and hair diameter of members of the Thai population at different scalp sites and to determine the effect of sex and aging as well as to compare the results with those in groups of other ethnicities. Healthy Thais whose hair examination findings were normal were evaluated. Two hundred and thirty-nine subjects participated in this study, of whom 79 were male and 160 were female. Hair density and hair diameter were analyzed at four different scalp sites using quantitative trichoscopic analysis. The highest hair density in Thais was observed in the vertex area. Hair densities at four different scalp sites were significantly different from one another; only hair density at the vertex site showed no significant difference from that in the occipital area. In contrast, hair diameter did not show any statistically significant differences for the different sites. We observed decreased mean hair density with increasing age and found statistically significant differences between participants in their 20s and those in their 60s, while hair diameter remained consistent. Comparing our results with a previous study in other ethnicities, the hair densities in Asians are generally lower. In conclusion, hair density in the Thai population varies at different scalp sites. Aging is a factor in declining hair density. Asians have a lower hair density compared to Caucasian and African populations.
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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: 50] [Impact Index Per Article: 12.5] [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.
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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.
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Heo JH, Yeom SD, Byun JW, Shin J, Choi GS. Significant relationship between temporal hair loss and other scalp areas in female pattern hair loss. J Dermatol 2020; 47:334-341. [PMID: 31919884 DOI: 10.1111/1346-8138.15220] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Accepted: 12/10/2019] [Indexed: 11/27/2022]
Abstract
Female pattern hair loss affects the central scalp, sparing the frontal hairline. The temporal area can also be affected by hair loss. We investigated the degree of temporal hair loss and correlation of other sites of scalp hair loss in Korean female pattern hair loss patients. A total of 109 women with female pattern hair loss were enrolled in this retrospective analysis. We measured hair density and thickness in five scalp sites including the frontal, vertex, occipital and bilateral temporal areas by phototrichogram. Frontal and vertex area hair loss were classified according to the Basic and Specific (BASP) classification, and temporal scalp and occiput areas were also assessed. Eighty-nine patients showed temporal hair loss. The mean of the hair density was lowest in the temporal area among all scalp areas. Total and thick hair densities of the frontal scalp were correlated with those of the vertex, temporal scalp and occiput in descending order, and hair thickness of the frontal scalp was more related with that of the temporal scalp than the vertex. In this study, temporal involvement is evident in female pattern hair loss. We suggest that temporal involvement should be added to pattern hair loss classification, especially BASP classification.
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Affiliation(s)
- Ji Hye Heo
- Department of Dermatology, Inha University School of Medicine, Incheon, Korea
| | - Seung Dohn Yeom
- Department of Dermatology, Inha University School of Medicine, Incheon, Korea
| | - Ji Won Byun
- Department of Dermatology, Inha University School of Medicine, Incheon, Korea
| | - Jeonghyun Shin
- Department of Dermatology, Inha University School of Medicine, Incheon, Korea
| | - Gwang Seong Choi
- Department of Dermatology, Inha University School of Medicine, Incheon, Korea
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Yi Y, Li X, Jia J, Guy Didier DN, Qiu J, Fu J, Mao X, Miao Y, Hu Z. Effect of Behavioral Factors on Severity of Female Pattern Hair Loss: An Ordinal Logistic Regression Analysis. Int J Med Sci 2020; 17:1584-1588. [PMID: 32669961 PMCID: PMC7359394 DOI: 10.7150/ijms.45979] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Accepted: 06/12/2020] [Indexed: 11/16/2022] Open
Abstract
Background: Female pattern hair loss (FPHL) is one of the most common types of hair loss with complex genetic predisposition. A frontal pattern hair loss with ponytail hairstyle is pervasively seen among young Chinese women. The purpose of this study is to investigate the association between the severity of FPHL and behavioral factors which include dietary, and sleep habits, and to test the hypothesis on whether ponytail hairstyle is an independent factor that increases the risks of being more severe on the FPHL scale. Methods: A cross-sectional survey was performed with a structured questionnaire in this study. The severity of FPHL was graded according to basic and specific (BASP) classifications. Ordinal logistic regression analysis was performed to investigate the factors related to the severity of FPHL. Results: 1,825 participants with different severities of FPHL completed the questionnaire. Ordinal logistic regression analysis revealed that the age group between thirty and forty years (OR:2.03, 95% CI: 1.56,2. 65), insufficient time with poor quality (OR:1.30, 95% CI: 1.05,1.62), presence of alcohol consumption (OR:2.15, 95% CI: 1.14,4.42), ponytail hairstyles (OR:2.03, 95% CI: 1.40,2.96), and oily scalps (OR:2.00, 95% CI: 1.65,2.43) were risk factors which increased the odds of being in the more severe type of FPHL, compared to the age group that ranged from eighteen to thirty years, sufficient sleep with good quality, without alcohol consumption, ponytail hairstyles, and oily scalps. Conclusion: Avoiding alcohol consumption and ponytail hairstyles, in combination with proper control of scalp oil, improve sleep quality with sufficient time may help prevent FPHL from deteriorating to the more severe type.
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Affiliation(s)
- Yanhua Yi
- Department of Plastic and Aesthetic Surgery, Nanfang Hospital of Southern Medical University, Guangzhou, Guangdong 510515, China
| | - Xiaoqiang Li
- Department of Plastic and Aesthetic Surgery, Nanfang Hospital of Southern Medical University, Guangzhou, Guangdong 510515, China
| | - James Jia
- Department of Plastic and Aesthetic Surgery, Nanfang Hospital of Southern Medical University, Guangzhou, Guangdong 510515, China
| | - Djakaya Ngondi Guy Didier
- Department of Plastic and Aesthetic Surgery, Nanfang Hospital of Southern Medical University, Guangzhou, Guangdong 510515, China
| | - Jun Qiu
- Department of Plastic and Aesthetic Surgery, Nanfang Hospital of Southern Medical University, Guangzhou, Guangdong 510515, China
| | - Jile Fu
- Department of Plastic and Aesthetic Surgery, Nanfang Hospital of Southern Medical University, Guangzhou, Guangdong 510515, China
| | - Xiaoyan Mao
- 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
| | - Zhiqi Hu
- Department of Plastic and Aesthetic Surgery, Nanfang Hospital of Southern Medical University, Guangzhou, Guangdong 510515, China
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Ghassemi M, Ghaffarpour GH, Ghods S. The effect of GGC and CAG repeat polymorphisms on the androgen receptor gene in response to finasteride therapy in men with androgenetic alopecia. JOURNAL OF RESEARCH IN MEDICAL SCIENCES 2019; 24:104. [PMID: 31949455 PMCID: PMC6950337 DOI: 10.4103/jrms.jrms_27_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Revised: 05/28/2019] [Accepted: 09/27/2019] [Indexed: 11/04/2022]
Abstract
Background: It should be assessed whether the polymorphisms on androgen receptor gene can affect therapeutic response to androgenetic alopecia (AGA) medications. We aimed to find a link between polymorphisms on the androgen receptor gene (including the number of triple sequences of cytosine, adenine, and guanine [CAG] and guanine-guanine-cytosine [GGC]) and response to treatment with finasteride in male patients. Materials and Methods: This case–control study was performed on 25 consecutive male patients with hereditary AGA and 25 sex-matched healthy individuals without AGA. The complete sequence of the gene was extracted from the NCBI database. To replicate the samples, real-time polymerase chain reaction technique was used for the pointed gene and the results were confirmed by the sequencing technique. Results: The mean number of CAG sequences in two groups with and without baldness, was 23.16 ± 0.47 and 23.04 ± 0.67. For GGC sequencing with and without baldness, mean count was 22.22 ± 1.45 and 19.92 ± 81.2, respectively, which was significantly higher in the group with baldness. There was no association between number of CAG sequence and improvement in hair loss or the level of patients' satisfaction, but lower number of GGC sequences was associated with higher rate of stopping hair loss, more new hair growth, higher level of satisfaction, and more clinical response to finasteride and clinical improvement in AGA patients. Conclusion: Counting of GGC sequence in the gene encoding the androgen receptor is associated with an increase in odds of baldness and a decrease in the response rate to finasteride in AGA patients.
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Affiliation(s)
- Mohammadreza Ghassemi
- Department of Dermatology, Rasoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| | | | - Shiva Ghods
- Department of Dermatology, Rasoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
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Daniels G, Akram S, Westgate GE, Tamburic S. Can plant-derived phytochemicals provide symptom relief for hair loss? A critical review. Int J Cosmet Sci 2019; 41:332-345. [DOI: 10.1111/ics.12554] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2019] [Revised: 05/23/2019] [Accepted: 06/22/2019] [Indexed: 12/16/2022]
Affiliation(s)
- G. Daniels
- Cosmetic Science Research Group; University of the Arts, London; 20 John Princes Street London U.K
| | - S. Akram
- Cosmetic Science Research Group; University of the Arts, London; 20 John Princes Street London U.K
| | - G. E. Westgate
- Gill Westgate Consultancy Ltd; Stevington Bedfordshire U.K
| | - S. Tamburic
- Cosmetic Science Research Group; University of the Arts, London; 20 John Princes Street London U.K
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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.
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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
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Female pattern hair loss: A clinical, pathophysiologic, and therapeutic review. Int J Womens Dermatol 2018; 4:203-211. [PMID: 30627618 PMCID: PMC6322157 DOI: 10.1016/j.ijwd.2018.05.001] [Citation(s) in RCA: 53] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2017] [Revised: 04/30/2018] [Accepted: 05/05/2018] [Indexed: 12/16/2022] Open
Abstract
Female pattern hair loss (FPHL) is the most common form of alopecia in women. Affected women may experience psychological distress and impaired social functioning. Early diagnosis and initiation of treatment are desirable because treatments are more effective to avoid the progression of hair loss than stimulating regrowth. Typically, a diagnosis of FPHL can be confirmed by review of a patient's medical history and a physical examination alone. Testing a scalp biopsy is diagnostic but usually not required. In women with signs of hyperandrogenism, an investigation for ovarian or adrenal disorders should be performed. Treatment for FPHL is obscured by myths. The aim of FPHL treatment could be two-fold: Reverse or stabilize the process of hair follicle miniaturization. Mild-to-moderate FPHL in women can be treated with oral antiandrogen therapies (cyproterone acetate and spironolactone) and/or topical minoxidil with good results in many cases. If used correctly, available medical treatments arrest the progression of the disease and reverse miniaturization in most patients with mild-to-moderate FPHL. Hair systems and surgery may be considered for selected cases of severe FPHL.
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