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Gao J, Xiao Q, Lu Y, Guo J, Luan D, Jia C, Xu Q, Xu N. Higher percentage of CD34+ stem cells and elevated efficacy in androgenetic alopecia treatment observed in CGF prepared from 640 nm laser-pretreated blood: A preliminary study. J Cosmet Dermatol 2024; 23:2249-2255. [PMID: 38429917 DOI: 10.1111/jocd.16249] [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: 11/22/2023] [Revised: 01/31/2024] [Accepted: 02/15/2024] [Indexed: 03/03/2024]
Abstract
BACKGROUND Concentrated growth factor (CGF) injection has proven effective in treating androgenetic alopecia (AGA). The primary mechanism of CGF in treating AGA is thought to be the CD34+ stem cells and platelets-associated growth factors being injected into the scalp. CGF efficacy in treating AGA may rely on the activation level of these stem cells and platelets. The 640 nm laser is a United States Food and Drug Administration approved AGA treatment that activates follicle stem cells. Therefore, we hypothesize that pretreating CGF with a 640 nm laser may further activate CD34+ stem cells and platelets, thereby improving the efficacy of CGF in treating AGA. OBJECTIVE This study aims to investigate whether 640 nm laser pretreated CGF (640CGF) has a greater effect in treating AGA than 640 nm laser non-pretreated CGF (N640CGF) and evaluate whether 640 nm laser pretreatment changed CD34+ cell percentage. METHODS This study enrolled 10 patients (8 male, 2 female) with AGA aged 18-60 years who received CGF injections. The 640CGF group was pretreated with a 640 nm laser at an energy density of 4 J/cm2, with a 30 cm irradiation distance for 30 min. Half of the scalp was treated with 640CGF, whereas the other half was treated with N640CGF. The injection was prepared by a doctor who did not know which blood tube had been pretreated. The treatment efficacy was evaluated using a trichoscope 1 month after injection. RESULTS All 10 (100%) patients participated in the follow-up visit, and a higher quantity of new hairs was observed on the side injected with 640CGF than N640CGF (p = 0.019). Additionally, fewer malnourished hairs were observed on the 640CGF pretreated side (p = 0.015). No serious adverse events were reported. CONCLUSIONS A higher percentage of CD34+ stem cells and improved efficacy in AGA treatment could be observed with CGF prepared from 640 nm laser-pretreated blood.
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Affiliation(s)
- Jin Gao
- Department of Dermatology, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China
| | - Qin Xiao
- Department of Dermatology, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China
| | - Yongzhou Lu
- Department of Dermatology, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China
| | - Jing Guo
- Department of Dermatology, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China
| | - Dongdong Luan
- Department of Dermatology, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China
| | - Chuanlong Jia
- Department of Dermatology, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China
| | - Qiannan Xu
- Department of Dermatology, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China
- Department of Dermatology, Shanghai Ruijin Hospital, Jiaotong University School of Medicine, Shanghai, China
| | - Nan Xu
- Department of Dermatology, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China
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Zhi J, Li F, Jiang X, Bai R. Thyroid receptor β: A promising target for developing novel anti-androgenetic alopecia drugs. Drug Discov Today 2024; 29:104013. [PMID: 38705510 DOI: 10.1016/j.drudis.2024.104013] [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: 03/29/2024] [Revised: 04/22/2024] [Accepted: 04/29/2024] [Indexed: 05/07/2024]
Abstract
Androgenetic alopecia (AGA) significantly impacts the self-confidence and mental well-being of people. Recent research has revealed that thyroid receptor β (TRβ) agonists can activate hair follicles and effectively stimulate hair growth. This review aims to comprehensively elucidate the specific mechanism of action of TRβ in treating AGA from various perspectives, highlighting its potential as a drug target for combating AGA. Moreover, this review provides a thorough summary of the research advances in TRβ agonist candidates with anti-AGA efficacy and outlines the structure-activity relationships (SARs) of TRβ agonists. We hope that this review will provide practical information for the development of effective anti-alopecia drugs.
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Affiliation(s)
- Jia Zhi
- School of Pharmacy, Hangzhou Normal University, Hangzhou, 311121, P.R. China; Key Laboratory of Elemene Class Anti-tumor Chinese Medicines, Engineering Laboratory of Development and Application of Traditional Chinese Medicines, Collaborative Innovation Center of Traditional Chinese Medicines of Zhejiang Province, Hangzhou Normal University, Hangzhou 311121, PR China
| | - Feifan Li
- School of Pharmacy, Hangzhou Normal University, Hangzhou, 311121, P.R. China; Key Laboratory of Elemene Class Anti-tumor Chinese Medicines, Engineering Laboratory of Development and Application of Traditional Chinese Medicines, Collaborative Innovation Center of Traditional Chinese Medicines of Zhejiang Province, Hangzhou Normal University, Hangzhou 311121, PR China
| | - Xiaoying Jiang
- School of Pharmacy, Hangzhou Normal University, Hangzhou, 311121, P.R. China; Key Laboratory of Elemene Class Anti-tumor Chinese Medicines, Engineering Laboratory of Development and Application of Traditional Chinese Medicines, Collaborative Innovation Center of Traditional Chinese Medicines of Zhejiang Province, Hangzhou Normal University, Hangzhou 311121, PR China.
| | - Renren Bai
- School of Pharmacy, Hangzhou Normal University, Hangzhou, 311121, P.R. China; Key Laboratory of Elemene Class Anti-tumor Chinese Medicines, Engineering Laboratory of Development and Application of Traditional Chinese Medicines, Collaborative Innovation Center of Traditional Chinese Medicines of Zhejiang Province, Hangzhou Normal University, Hangzhou 311121, PR China.
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3
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Lee JY, Kim CH, Lee WS. Relationship between Illness Behavior and Hair Loss Pattern According to the Basic and Specific (BASP) Classification. Ann Dermatol 2023; 35:318-320. [PMID: 37550233 PMCID: PMC10407333 DOI: 10.5021/ad.21.085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 09/28/2021] [Accepted: 11/23/2021] [Indexed: 08/09/2023] Open
Affiliation(s)
- Ju Yeong Lee
- Department of Dermatology and Institute of Hair and Cosmetic Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Chunk Hyeok Kim
- Department of Dermatology and Institute of Hair and Cosmetic Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Won-Soo Lee
- Department of Dermatology and Institute of Hair and Cosmetic Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea.
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Wei W, Zhang Y, Long B, Zhang Y, Zhang C, Zhang S. Injections of platelet-rich plasma prepared by automatic blood cell separator combined with topical 5% minoxidil in the treatment of male androgenetic alopecia. Skin Res Technol 2023; 29:e13315. [PMID: 37522500 PMCID: PMC10280600 DOI: 10.1111/srt.13315] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 03/22/2023] [Indexed: 08/01/2023]
Abstract
BACKGROUND Platelet-rich plasma (PRP) has been increasingly accepted as a potential therapy in the treatment of androgenetic alopecia (AGA), However, there remains a dearth of data on the effectiveness of PRP prepared by automatic blood cell separator with a combination of topical minoxidil for the treatment of AGA. OBJECTIVE To evaluate the efficacy and safety of PRP prepared by automatic blood cell separator combined with topical 5% minoxidil therapy in male AGA. METHODS Thirty male patients with mild/moderate AGA were enrolled in a randomized double-blind controlled study. Patients were randomly divided into two treatment arms: (group A) PRP prepared by automatic blood cell separator combined with topical 5% minoxidil group; (group B) PRP prepared by automatic blood cell separator combined with a topical placebo group. Trichoscopic assessments regarding hair density/quantity and mean hair diameter were performed at baseline and follow-up. Clinical efficacy of global photography and patient satisfaction were conducted to verify the therapeutic efficacy of the treatment, and the occurrence of adverse reactions was recorded. RESULTS We detected a significant increase in all patients in hair density and quantity after PRP treatment (p < 0.05), and there was no significant difference in mean hair diameter. Although hair density/quantity was more pronounced in group A than in group B, the difference between groups was not statistically significant (p > 0.05). In terms of clinical efficacy and patient satisfaction, group A was superior to group B, and no serious adverse reactions occurred. CONCLUSION We hereby conclude that the injections of PRP prepared by an automated method are effective and safe in the treatment of mild-to-moderate male AGA patients, and its combination with topical 5% minoxidil therapy was superior to PRP monotherapy with better clinical efficacy and higher patient satisfaction.
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Affiliation(s)
- Wei Wei
- Department of DermatologyProvincial Hospital Affiliated to Anhui Medical UniversityHefeiChina
| | - Yuanjing Zhang
- Department of DermatologyThe First Affiliated Hospital of the University of Science and Technology of ChinaHefeiChina
| | - Binman Long
- Department of DermatologyThe First Affiliated Hospital of the University of Science and Technology of ChinaHefeiChina
| | - Yuanyuan Zhang
- Department of TransfusionThe First Affiliated Hospital of the University of Science and Technology of ChinaHefeiChina
| | - Chi Zhang
- Department of DermatologyThe First Affiliated Hospital of the University of Science and Technology of ChinaHefeiChina
| | - Siping Zhang
- Department of DermatologyProvincial Hospital Affiliated to Anhui Medical UniversityHefeiChina
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Priya S, Tomar Y, Desai VM, Singhvi G. Enhanced skin drug delivery using dissolving microneedles: a potential approach for the management of skin disorders. Expert Opin Drug Deliv 2023:1-18. [PMID: 36893450 DOI: 10.1080/17425247.2023.2190095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/11/2023]
Abstract
INTRODUCTION For decades, finding effective long-term or disease-modifying treatments for skin disorders has been a major focus of scientists. The conventional drug delivery systems showed poor efficacy with high doses and are associated with side effects, which lead to challenges in adherence to therapy. Therefore, to overcome the limitations of conventional drug delivery systems, drug delivery research has focused on topical, transdermal, and intradermal drug delivery systems. Among all, the dissolving microneedles have gained attention with a new range of advantages of drug delivery in skin disorders such as breaching skin barriers with minimal discomfort and its simplicity of application to the skin, which allows patients to administer it themselves. AREAS COVERED This review highlighted the insights into dissolving microneedles for different skin disorders in detail. Additionally, it also provides evidence for its effective utilization in the treatment of various skin disorders. The clinical trial status and patents for dissolving microneedles for the management of skin disorders are also covered. EXPERT OPINION The current review on dissolving microneedles for skin drug delivery is accentuating the breakthroughs achieved so far in the management of skin disorders. The output of the discussed case studies anticipated that dissolving microneedles can be a novel drug delivery strategy for the long-term treatment of skin disorders.
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Affiliation(s)
- Sakshi Priya
- Industrial Research Laboratory, Department of Pharmacy, Birla Institute of Technology and Science (BITS) Pilani, Pilani Campus, India
| | - Yashika Tomar
- Industrial Research Laboratory, Department of Pharmacy, Birla Institute of Technology and Science (BITS) Pilani, Pilani Campus, India
| | - Vaibhavi Meghraj Desai
- Industrial Research Laboratory, Department of Pharmacy, Birla Institute of Technology and Science (BITS) Pilani, Pilani Campus, India
| | - Gautam Singhvi
- Industrial Research Laboratory, Department of Pharmacy, Birla Institute of Technology and Science (BITS) Pilani, Pilani Campus, India
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Udare S, Baruah A, Mathur A, Dayananda TR, Jain K, Puhan MR, Bajaj P, Sharma R, Gamit SR, Ramesh V, Venugopal V, Karthik V, Neena Gala MY, Muchhala S, Mane A. Positioning of Low Alcohol or Alcohol-Free Minoxidil Formulation for the Management of Androgenetic Alopecia: Indian Perspective. Int J Trichology 2023; 15:13-17. [PMID: 37305189 PMCID: PMC10251296 DOI: 10.4103/ijt.ijt_54_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 08/31/2022] [Indexed: 06/13/2023] Open
Abstract
Topical minoxidil is used for treating different hair disorders. Even though it is an effective therapy, many patients show poor compliance due to the cost, side effects, and duration of treatment. Topical minoxidil is the mainstay treatment for androgenetic alopecia (AGA). Recently, low alcohol or alcohol-free topical minoxidil formulation has proven to be an alternative for patients suffering from AGA, including those with poor compliance with other therapies. Thus, the current article provides the positioning of low alcohol or alcohol-free topical minoxidil to manage AGA in Indian clinical practice.
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Affiliation(s)
- Satish Udare
- Sparkle Skin and Aesthetic Centre, Navi Mumbai, Maharashtra, India
| | - Anita Baruah
- Department of Dermatology, New Era Hospital, Nagpur, Maharashtra, India
| | - Anurag Mathur
- Department of Dermatology, IADVL, IMA, Meerut, Uttar Pradesh, India
| | | | - Kapil Jain
- Skin Prayag - The Skin and Hair Clinic, Delhi, India
| | | | | | | | | | - V. Ramesh
- Skin Laser Clinic, Hanamkonda, Telangana, India
| | | | | | | | | | - Amey Mane
- Dr. Reddy's Laboratories, Hyderabad, Telangana, India
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7
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Sondagar DM, Mehta HH, Agharia RS, Jhavar MK. Efficacy of Low-Level Laser Therapy in Androgenetic Alopecia - A Randomized Controlled Trial. Int J Trichology 2023; 15:25-32. [PMID: 37305186 PMCID: PMC10251294 DOI: 10.4103/ijt.ijt_5_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Accepted: 03/09/2022] [Indexed: 06/13/2023] Open
Abstract
Background Androgenetic alopecia (AGA) is caused by the susceptibility of hair follicles to androgenic miniaturization, which leads to hair loss. The most common modalities for the treatment of AGA include the use of topical minoxidil and oral finasteride. Low-level laser therapy (LLLT) is a newer modality of treatment for AGA. We tried to evaluate the added benefit of LLLT in AGA compared with topical minoxidil 5% alone. Aim The aim of this study was to compare the efficacy of LLLT combined with topical 5% minoxidil in AGA versus topical 5% minoxidil used alone. Materials and Methods After ethics committee approval, 54 patients of AGA were randomly divided into two groups. Group A participants received LLLT therapy twice a week plus topical 5% minoxidil and Group B participants received only minoxidil 5% solution. Both the groups were followed up for 16 weeks and evaluated with gross photographs, TrichoScan analysis, and dermoscopy to look for any improvement in hair density. Results After 16 weeks, improvement in hair density of 14.78% ± 10.93% in Group A was recorded compared to 11.43% ± 6.43% in Group B. However, while comparing both means, P value was 0.45 which was not significant. The physician global assessment and patient satisfaction score revealed no significant difference between both the groups. Conclusion Although LLLT appears to be safe and effective in the treatment of male pattern hair loss, we did not observe any significant difference in terms of improvement in hair density between both the groups.
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Affiliation(s)
- Dharm Mansukh Sondagar
- Department of Dermatology, Venereology and Leprosy, Government Medical College, Bhavnagar, Gujarat, India
| | - Hita H. Mehta
- Department of Dermatology, Venereology and Leprosy, Government Medical College, Bhavnagar, Gujarat, India
| | | | - Milan K. Jhavar
- Department of Dermatology, Venereology and Leprosy, Government Medical College, Bhavnagar, Gujarat, India
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Abstract
Male baldness is physically benign though it is increasingly described as a "disease" based on claims that it is profoundly distressing. The medicalization of baldness was assessed using data extracted from a review of 37 male baldness psychosocial impact studies. Findings revealed most studies likely had commercial influences (78%), represented baldness as a disease (77%), were conducted on biased samples (68%), and advocated for baldness products/services (60%), omitting their limitations (68%). Health psychologists should challenge baldness medicalization so that men can make informed choices about what, if anything, they do with their baldness.
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9
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Qiu J, Yi Y, Jiang L, Miao Y, Jia J, Zou J, Hu Z. Efficacy assessment for low-level laser therapy in the treatment of androgenetic alopecia: a real-world study on 1383 patients. Lasers Med Sci 2022; 37:2589-2594. [PMID: 35133519 PMCID: PMC9343305 DOI: 10.1007/s10103-022-03520-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Accepted: 02/02/2022] [Indexed: 11/17/2022]
Abstract
Low-level laser therapy (LLLT) has been a treatment modality by many androgenetic alopecia (AGA) patients in recent years. It remained unclear as to how long the treatment regime should be maintained, and which characteristics of patients should this be recommended. A real-world study was carried out with an FDA-cleared low-level laser helmet for 1383 patients. Ordinal logistic regression analysis with propensity score matching (PSM) was used to investigate the factors related to efficacy assessment. More than 80% of users were between 18 and 40 years old. The median use times were 133 for mild AGA patients and 142 for moderate-to-severe AGA patients, which equated to 38 weeks and 40 weeks, respectively. The overall clinical effectiveness was nearly 80%. PSM analysis revealed that gender (P = 0.002), use period (P = 0.068), scalp conditions with dandruff, rash, and itchy symptoms were associated with the grading of efficacy assessment. Male users (ordinal OR: 1.35, CI: (1.01, 1.79)); use for more than 180 times or use period for 1 year (ordinal OR: 1.40, CI: (1.11, 1.96)); and those with scalp dandruff (ordinal OR: 1.34, CI: (1.01, 1.87)), rash (ordinal OR: 1.47, CI: (1.04, 2.07)), and itchy symptoms (ordinal OR: 1.51, CI: (1.12, 2.03)) had better efficacy assessments. The recommended treatment regime with low-level laser helmet was more than 1 year or 180 use times. Male patients with dandruff, rash, and itchy symptoms in scalps tended to have a better efficacy assessment.
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Affiliation(s)
- Jun Qiu
- Department of Plastic and Aesthetic Surgery, Nanfang Hospital of Southern Medical University, 1838 North Guangzhou AV, Guangzhou, 510515, Guangdong, China
| | - Yanhua Yi
- Department of Plastic and Aesthetic Surgery, Nanfang Hospital of Southern Medical University, 1838 North Guangzhou AV, Guangzhou, 510515, Guangdong, China.,Department of Burn, Would Repair Surgery and Plastic Surgery, Department of Aesthetic Surgery, Affiliated Hospital of Guilin Medical University, Guilin, 541001, Guangxi, China
| | - Linlang Jiang
- Department of Plastic and Aesthetic Surgery, Affiliated Hospital of Xiangnan University, Chenzhou, China
| | - Yong Miao
- Department of Plastic and Aesthetic Surgery, Nanfang Hospital of Southern Medical University, 1838 North Guangzhou AV, Guangzhou, 510515, Guangdong, China
| | - James Jia
- Department of Plastic and Aesthetic Surgery, Nanfang Hospital of Southern Medical University, 1838 North Guangzhou AV, Guangzhou, 510515, Guangdong, China
| | - Jian Zou
- Research Department, Slinph Technologies Co., Ltd, Room 1703, Block A, Bairuida Building, 4001 Ban Xue Gang Avenue, Long Gang District, Shenzhen, China.
| | - Zhiqi Hu
- Department of Plastic and Aesthetic Surgery, Nanfang Hospital of Southern Medical University, 1838 North Guangzhou AV, Guangzhou, 510515, Guangdong, China.
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Huang Y, Yu H, Wang L, Shen D, Ni Z, Ren S, Lu Y, Chen X, Yang J, Hong Y. Research progress on cosmetic microneedle systems: Preparation, property and application. Eur Polym J 2022. [DOI: 10.1016/j.eurpolymj.2021.110942] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Microneedles mediated bioinspired lipid nanocarriers for targeted treatment of alopecia. J Control Release 2020; 329:1-15. [PMID: 33227337 DOI: 10.1016/j.jconrel.2020.11.038] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Revised: 11/18/2020] [Accepted: 11/19/2020] [Indexed: 02/08/2023]
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12
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Tan PC, Zhang PQ, Xie Y, Gao YM, Li QF, Zhou SB, Liu Q, Liu K. Autologous Concentrated Growth Factors Combined with Topical Minoxidil for the Treatment of Male Androgenetic Alopecia: A Randomized Controlled Clinical Trial. Facial Plast Surg Aesthet Med 2020; 23:255-262. [PMID: 32833539 DOI: 10.1089/fpsam.2020.0288] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
Background: Minoxidil (MXD) is an U.S. Food and Drug Administration-approved drug for the topical treatment of androgenetic alopecia (AGA) with minor side effects, but its hair growth (HG) effect is unsatisfactory. Methods: A double-blinded within-subjects randomized clinical trial was conducted on 16 male AGA patients who showed limited improvement after MXD treatment. Eligible participants received three concentrated growth factor (CGF) injections on half of the scalp and the placebo on the other side at 4-week intervals, and MXD was applied twice daily on both sides throughout the follow-up period. The primary endpoint was the HG ratio at V4. The secondary endpoints included the HG ratios at V2, V3, and V5; hair density and T/V ratio at V2, V3, V4, and V5; Global Aesthetic Improvement Scale (GAIS) scores at V4 and V5; and participant satisfaction at V4. Results: Each group included 16 subjects; each half of the scalp was randomly assigned to the MXD+CGF or MXD group. The HG ratio at V4 was higher in the MXD+CGF group than in the MXD group. The MXD+CGF group had significant improvements in hair density, HG ratio, and T/V ratio compared with the MXD group over the follow-up period. The GAIS scores and participant satisfaction were higher in the MXD+CGF group than in the MXD group. Unexpectedly, the MXD+CGF treatment hastened HG, which was sustained for 3 months after discontinuation. No severe adverse events occurred. Conclusions: The combined treatment of MXD and CGF is safe and more efficient for AGA patients. Combining CGF can expedite the potency of MXD and provide patients with fast and lasting HG.
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Affiliation(s)
- Poh-Ching Tan
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, P.R. China
| | - Pei-Qi Zhang
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, P.R. China
| | - Yun Xie
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, P.R. China
| | - Yi-Ming Gao
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, P.R. China
| | - Qing-Feng Li
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, P.R. China
| | - Shuang-Bai Zhou
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, P.R. China
| | - Qing Liu
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, P.R. China
| | - Kai Liu
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, P.R. China
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Kim D, Park S. Pharmacological therapeutics in androgenetic alopecia. JOURNAL OF THE KOREAN MEDICAL ASSOCIATION 2020. [DOI: 10.5124/jkma.2020.63.5.277] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Androgenetic alopecia (AGA) is the most common type of hair loss and affects both men and women. Male pattern hair loss shows characteristic frontal recession and vertex baldness, whereas female pattern hair loss produces diffuse alopecia over the mid-frontal scalp. AGA is mediated by increased androgen susceptibility in affected scalp hairs. 5α-Reductase converts testosterone into dihydrotestosterone, a potent androgen, in the scalp. Both androgen receptors and 5α-reductase have higher expression levels in the balding scalp than in non-affected regions. Increased androgen susceptibility induces hair follicle miniaturization, which leads to the progressive loss of thicker terminal hairs in the balding scalp. Currently, topical minoxidil and oral 5α-reductase inhibitors, such as finasteride and dutasteride, are approved options for the pharmacological treatment of AGA. Topical minoxidil remains the mainstay of therapy for mild to moderate AGA in both men and women. The daily intake of 1-mg finasteride or 0.5-mg dutasteride shows better efficacy than topical minoxidil in regard to hair regrowth in male AGA. Anti-androgens can be used in female AGA wit clinical and biochemical evidence of hyperandrogenism. Patients may be overwhelmed and confused by the variety of treatment options for AGA management, including over-the-count drugs with low evidence quality. Therefore, physicians must be aware of the current guidelines for the management of AGA based on evidence-based approaches to select better options for patients.
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14
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Sun B, Zhang S, Pradhan S, Zhao W, Xu Y, Zhang X, Diao Y, Jiang X. Investigation of optimum transplant and extraction density based on the data from the donor area of Chinese androgenetic alopecia patients: a multicenter, retrospective study. J COSMET LASER THER 2020; 22:137-140. [PMID: 32375571 DOI: 10.1080/14764172.2020.1761550] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
The rise in the incidence of androgenetic alopecia (AGA) in China has increased the inclination toward hair transplantation. To calculate the optimum density of hair follicles needed covering both the hairless area and the safe donor area (SDA), 119 male patients with AGA were recruited into this multicenter investigation. We evaluated the mean diameter and the number of hair follicles (HFs) and follicular units (FUs) in the SDA of AGA. The mean density of HFs was 137.45 ± 30.11 hair/cm2 and the FUs was 76.82 ± 12.09 FUs/cm2. The mean diameter of the hair was 0.97 ± 0.01 mm in the SDA. We obtained the decisive factors in the restoration of the scalp by building a geometric model and summarizing it in a new formula. This study showed that the length and direction of the hair play a vital role in restoring the bald area with hair transplantation. The density of 55.00 ± 10.00 hair/cm2 (30.00 ± 5.00 FUs/cm2) for the transplanted area and no less than 106.88 hair/cm2 (60.00 FUs/cm2) for SDA is regarded as an optimum parameter for hair transplantation of AGA.
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Affiliation(s)
- Bensen Sun
- The Department of Dermatology, West China Hospital of Sichuan University , Chengdu, China
| | - Shu Zhang
- The Department of Dermatology, West China Hospital of Sichuan University , Chengdu, China
| | - Sushmita Pradhan
- The Department of Dermatology, West China Hospital of Sichuan University , Chengdu, China
| | - Wenbin Zhao
- The Department of Dermatology, West China Hospital of Sichuan University , Chengdu, China
| | - Yuxian Xu
- Chengdu Hengmei Hair Medical Beauty Hospital , Chengdu, China
| | - Xinyi Zhang
- Chengdu Siyuan Hair-transplant Hospital , Chengdu, China
| | - Yongfeng Diao
- Sichuan Huamei Zixin Medical Beauty Hospital , Chengdu, China
| | - Xian Jiang
- The Department of Dermatology, West China Hospital of Sichuan University , Chengdu, China
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Kim BJ, Choi J, Choe SJ, Lee S, Lee WS. Modified basic and specific (BASP) classification for pattern hair loss. Int J Dermatol 2020; 59:60-65. [PMID: 31231799 DOI: 10.1111/ijd.14553] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2018] [Revised: 03/05/2019] [Accepted: 05/20/2019] [Indexed: 01/24/2023]
Abstract
BACKGROUND In 2007, Lee et al. introduced a basic and specific (BASP) classification for pattern hair loss that was comprehensive and applicable regardless of race or gender. However, this BASP classification has several limitations. Frontal type hair loss classification is relatively crude, and a specific hair loss pattern cannot be ascertained when hair loss is associated with the temporal and occipital areas. METHODS In our modified BASP classification, frontal type classification was subdivided into five instead of three grades. Basic type classification remained the same as in the previous method. In addition, information regarding the involvement of the temporal or occipital scalp was recorded. Accuracy and ease of use were evaluated and compared with the existing BASP classification in 138 patients with pattern hair loss. RESULTS Temporal or occipital involvement was observed in 14 patients, accounting for 11.1% of subjects. Final type accuracy was 82.5% in the existing BASP classification and 71.4% in the modified classification. Ease of use for two practitioners was 70.2 and 72.1% for the existing BASP classification, and 48.9 and 52.2% for the modified method. CONCLUSION We expect that the modified BASP classification will overcome the limitations of the existing BASP classification. We believe this modified classification will be a valuable tool for pattern hair loss classification because of its classification of previously unclassified types.
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Affiliation(s)
- Beom Jun Kim
- Department of Dermatology and Institute of Hair and Cosmetic Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Jaewoong Choi
- Department of Dermatology and Institute of Hair and Cosmetic Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Sung Jay Choe
- Department of Dermatology and Institute of Hair and Cosmetic Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Solam Lee
- Department of Dermatology and Institute of Hair and Cosmetic Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Won-Soo Lee
- Department of Dermatology and Institute of Hair and Cosmetic Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
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Motofei IG, Rowland DL, Tampa M, Sarbu MI, Mitran MI, Mitran CI, Stoian AP, Diaconu CC, Paunica S, Georgescu SR. Finasteride and androgenic alopecia; from therapeutic options to medical implications. J DERMATOL TREAT 2019; 31:415-421. [DOI: 10.1080/09546634.2019.1595507] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
- Ion G. Motofei
- Department of Dermatology, Carol Davila University, Bucharest, Romania
- Department of Surgery, St. Pantelimon Hospital, Bucharest, Romania
| | - David L. Rowland
- Department of Psychology, Valparaiso University, Valparaiso, IN, USA
| | - Mircea Tampa
- Department of Dermatology, Carol Davila University, Bucharest, Romania
| | | | | | | | - Anca Pantea Stoian
- Faculty of General Medicine, Carol Davila University, Bucharest, Romania
| | - Camelia C. Diaconu
- Faculty of General Medicine, Carol Davila University, Bucharest, Romania
| | - Stana Paunica
- Dan Theodorescu Hospital, Carol Davila University, Bucharest, Romania
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Gajjar PC, Mehta HH, Barvaliya M, Sonagra B. Comparative Study between Mesotherapy and Topical 5% Minoxidil by Dermoscopic Evaluation for Androgenic Alopecia in Male: A Randomized Controlled Trial. Int J Trichology 2019; 11:58-67. [PMID: 31007474 PMCID: PMC6463458 DOI: 10.4103/ijt.ijt_89_18] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Aim: This study aims to compare efficacy and safety between mesotherapy (intralesional injection) and 5% topical minoxidil solution in male androgenic alopecia (AGA) by dermoscopic evaluation. Methodology: In a randomized active controlled trial, we enrolled 49 clinically diagnosed males of AGA and randomly allotted them into two groups – mesotherapy (A) (25) and minoxidil (B) (24). Males in Group A were given total 8 sessions of intralesional mesosolution with microneedling procedure while Group B males were prescribed topical solution of minoxidil 5% twice daily for 4 months. Results were evaluated at baseline and then monthly for 4 months with clinical photographs, dermoscopy, trichoscan, 7-point standard assessment tool, and patient-self assessment scores. Results: Grade II was the most common presentation in our study. All dermoscopic parameters such as variation of hair shaft diameter, follicular units with single and multiple hairs, yellow dots, and perifollicular halo did not show any significant difference between the groups at all time points except at 1st month where the difference in variation of hair shaft diameter between the two group was 0.04. We observed a significant increase (P = 0.01) in the variation of hair shaft diameter between pre- and post-treatment in mesotherapy group compared to minoxidil group. The rest of parameters failed to show any significant difference within the group in mesotherapy and minoxidil. Conclusion: In our study, we observed a significant increase in the variation of hair shaft diameter between pre- and post-treatment in Group A compared to B. Other dermoscopic, trichoscan, and subjective measurement tool failed to show significant difference between two groups. Our observation suggests that there is no significant improvement of mesotherapy in male AGA over minoxidil.
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Affiliation(s)
| | - Hita Hemant Mehta
- Department of Dermatology, Government Medical College, Bhavnagar, Gujarat, India
| | - Manish Barvaliya
- Department of Pharmacology, Government Medical College, Bhavnagar, Gujarat, India
| | - Bhavesh Sonagra
- Department of Dermatology, Government Medical College, Bhavnagar, Gujarat, India
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18
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Park J, Kim DW, Park SK, Yun SK, Kim HU. Role of Hair Prostheses (Wigs) in Patients with Severe Alopecia Areata. Ann Dermatol 2018; 30:505-507. [PMID: 30065604 PMCID: PMC6029960 DOI: 10.5021/ad.2018.30.4.505] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2017] [Revised: 08/16/2017] [Accepted: 09/21/2017] [Indexed: 11/08/2022] Open
Affiliation(s)
- Jin Park
- Department of Dermatology, Chonbuk National University Medical School, Jeonju, Korea.,Research Institute of Clinical Medicine of Chonbuk National University-Biomedical Research Institute of Chonbuk National University Hospital, Jeonju, Korea
| | - Dae-Woo Kim
- Department of Dermatology, Chonbuk National University Medical School, Jeonju, Korea
| | - Su-Kyung Park
- Department of Dermatology, Chonbuk National University Medical School, Jeonju, Korea
| | - Seok-Kweon Yun
- Department of Dermatology, Chonbuk National University Medical School, Jeonju, Korea.,Research Institute of Clinical Medicine of Chonbuk National University-Biomedical Research Institute of Chonbuk National University Hospital, Jeonju, Korea
| | - Han-Uk Kim
- Department of Dermatology, Chonbuk National University Medical School, Jeonju, Korea.,Research Institute of Clinical Medicine of Chonbuk National University-Biomedical Research Institute of Chonbuk National University Hospital, Jeonju, Korea
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19
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Manabe M, Tsuboi R, Itami S, Osada SI, Amoh Y, Ito T, Inui S, Ueki R, Ohyama M, Kurata S, Kono T, Saito N, Sato A, Shimomura Y, Nakamura M, Narusawa H, Yamazaki M. Guidelines for the diagnosis and treatment of male-pattern and female-pattern hair loss, 2017 version. J Dermatol 2018; 45:1031-1043. [DOI: 10.1111/1346-8138.14470] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Accepted: 04/11/2018] [Indexed: 11/26/2022]
Affiliation(s)
- Motomu Manabe
- Department of Dermatology and Plastic Surgery; Akita University Graduate School of Medicine; Akita Japan
| | - Ryoji Tsuboi
- Department of Dermatology; Tokyo Medical University; Tokyo Japan
| | - Satoshi Itami
- Department of Regenerative Dermatology; Graduate School of Medicine; Osaka University; Osaka Japan
| | - Shin-Ichi Osada
- Department of Dermatology and Plastic Surgery; Akita University Graduate School of Medicine; Akita Japan
| | - Yasuyuki Amoh
- Department of Dermatology; Kitasato University School of Medicine; Sagamihara Japan
| | - Taisuke Ito
- Department of Dermatology; Hamamatsu University School of Medicine; Hamamatsu Japan
| | - Shigeki Inui
- Shinsaibashi Inui Dermatologic Clinic; Osaka Japan
| | - Rie Ueki
- Juntendo Tokyo Koto Geriatric Medical Center; Tokyo Japan
| | - Manabu Ohyama
- Department of Dermatology; Kyorin University School of Medicine; Tokyo Japan
| | | | - Takeshi Kono
- Department of Dermatology; Nippon Medical School Chiba Hokusoh Hospital; Chiba Japan
| | - Norimitsu Saito
- Department of Dermatology; Yokohama Rosai Hospital; Yokohama Japan
| | - Akio Sato
- Tokyo Memorial Clinic Hirayama; Tokyo Japan
| | - Yutaka Shimomura
- Department of Dermatology; Yamaguchi University Graduate School of Medicine; Yamaguchi Japan
| | - Motonobu Nakamura
- Department of Dermatology; University of Occupational and Environmental Health; Kitakyushu Japan
| | - Hiroshi Narusawa
- Department of Dermatology; Faculty of Medicine; Saga University; Saga Japan
| | - Masashi Yamazaki
- Department of Dermatology; Tokyo Medical University; Tokyo Japan
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20
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Motofei IG, Rowland DL, Baconi DL, Tampa M, Sârbu MI, Păunică S, Constantin VD, Bălălău C, Păunică I, Georgescu SR. Androgenetic alopecia; drug safety and therapeutic strategies. Expert Opin Drug Saf 2018; 17:407-412. [PMID: 29363345 DOI: 10.1080/14740338.2018.1430765] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
INTRODUCTION Androgenetic alopecia (AGA) is a benign condition with variable psychosocial impact, with some individuals adapting well while others needing therapeutic support. Although 5α-reductase inhibitors like finasteride and dutasteride have proven effective in ameliorating AGA, their use/selection is currently a subject of debate. AREAS COVERED Treatment of AGA with 5α-reductase inhibitors lead to variable adverse effects and relatively unstable results (therapeutic efficacy ending with treatment cessation), so the choice of optimal therapy is not straightforward. This paper presents a general perspective regarding AGA based on studies listed in PubMed, to better understand/appreciate the opportunity for long term use of medication for a biological condition having non-life threatening implications. Studies focussed on adverse effects suggest that finasteride should be used with caution in AGA, due to considerable and persistent side effects induced in some men. In contrast, efficacy data indicate that dutasteride (a stronger inhibitor) presents superior therapeutic results compared to finasteride. EXPERT OPINION This paper argues that finasteride should be preferred to dutasteride in the treatment of AGA. Thus, finasteride preserves important physiological roles of dihydrotestosterone (unrelated to AGA) and, in addition, its adverse effects seem to be (at least in part) predictable.
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Affiliation(s)
- Ion G Motofei
- a Faculty of General Medicine , Carol Davila University, St. Pantelimon Hospital , Bucharest , Romania
| | - David L Rowland
- b Department of Psychology , Valparaiso University , Valparaiso , IN , USA
| | - Daniela L Baconi
- c Department of Toxicology , Carol Davila University , Bucharest , Romania
| | - Mircea Tampa
- d Department of Dermatology , Carol Davila University , Bucharest , Romania
| | | | - Stana Păunică
- e Dan Teodorescu Hospital , Carol Davila University , Bucharest , Romania
| | - Vlad D Constantin
- a Faculty of General Medicine , Carol Davila University, St. Pantelimon Hospital , Bucharest , Romania
| | - Cristian Bălălău
- a Faculty of General Medicine , Carol Davila University, St. Pantelimon Hospital , Bucharest , Romania
| | - Ioana Păunică
- a Faculty of General Medicine , Carol Davila University, St. Pantelimon Hospital , Bucharest , Romania
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21
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Lulic Z, Inui S, Sim WY, Kang H, Choi GS, Hong W, Hatanaka T, Wilson T, Manyak M. Understanding patient and physician perceptions of male androgenetic alopecia treatments in Asia-Pacific and Latin America. J Dermatol 2017; 44:892-902. [PMID: 28370105 PMCID: PMC5573944 DOI: 10.1111/1346-8138.13832] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2016] [Accepted: 02/06/2017] [Indexed: 11/29/2022]
Abstract
This survey aimed to explore patient and physician attitudes towards male androgenetic alopecia (AGA), satisfaction with currently available male AGA treatments and investigate the factors affecting treatment choice. The survey was carried out in five countries (Japan, South Korea, Taiwan, Mexico and Brazil) between November and December 2015 using a standard market research methodology. Questionnaires were completed by patients with male AGA or hair loss/thinning and practicing physicians who were responsible for prescribing AGA treatment. In total, 835 patients and 338 physicians completed the questionnaire. Overall, 37.6% of patients reported satisfaction with the treatments they had used. The highest patient satisfaction was reported for 5‐alpha‐reductase inhibitors (53.9% of patients satisfied). In all countries, physicians were more likely than patients to think that male AGA has a major impact on patient confidence (89.3% vs 70.4%, respectively). There was agreement by physicians and patients that male AGA patients who are involved in their treatment decisions have better outcomes. Patients who were satisfied with AGA treatments were more likely to have the level of involvement they desired in treatment decisions (69.1% of satisfied patients) than dissatisfied patients (56.4% of dissatisfied patients). This survey provides valuable insights into the attitudes of patients and physicians in Asia and Latin America about male AGA and its treatments. The survey identified areas of disconnect between physicians and patients regarding the impact of male AGA, treatment consultations and the importance of treatment attributes. It also highlights the need for physicians to spend sufficient time with patients discussing AGA treatment approaches.
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Affiliation(s)
| | - Shigeki Inui
- Shinsaibashi Inui Dermatology Clinic, Osaka, Japan.,Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Woo-Young Sim
- College of Medicine, Kyung Hee University, Seoul, Korea
| | - Hoon Kang
- St Paul's Hospital, College of Medicine, Catholic University of Korea, Seoul, Korea
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22
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Barrón-Hernández YL, Tosti A. Bimatoprost for the treatment of eyelash, eyebrow and scalp alopecia. Expert Opin Investig Drugs 2017; 26:515-522. [DOI: 10.1080/13543784.2017.1303480] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Affiliation(s)
| | - Antonella Tosti
- Department of Dermatology and Cutaneous Surgery, University of Miami, Miller School of Medicine, Miami, FL, USA
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23
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Abstract
Male-pattern hair loss (MPHL) is a condition that affects the majority of men during adulthood. This condition is not life threatening but needs constant treatment and monitoring, especially in recent years where male appearance is gaining significant importance in society. An ideal classification with high amount of detail, practicality, and reproducibility is required to accurately diagnose and monitor this condition regularly and to assess the outcome of treatment. Numerous classifications have been invented, but many variants with different levels of detail, practicality, and reproducibility may cause confusion among clinicians. One clinician may not accurately able to convey accurate clinical description if different classifications are used. To avoid confusion, a new classification that can balance detail, practicality, and reproducibility is required. We hope that this will translate to better treatment and monitoring for patients. This review article aims to review different existing MPHL classifications and how it compares to each other in terms of detail, practicality, and reproducibility.
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Affiliation(s)
| | - Wenyu Wu
- Department of Dermatology, Huashan Hospital affiliated with Fudan University, Shanghai, China
| | - Kejia Wu
- Department of Dermatology, Huashan Hospital affiliated with Fudan University, Shanghai, China
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24
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25
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Abstract
BACKGROUND Female pattern hair loss (FPHL), or androgenic alopecia, is the most common type of hair loss affecting women. It is characterised by progressive shortening of the duration of the growth phase of the hair with successive hair cycles, and progressive follicular miniaturisation with conversion of terminal to vellus hair follicles (terminal hairs are thicker and longer, while vellus hairs are soft, fine, and short). The frontal hair line may or may not be preserved. Hair loss can have a serious psychological impact on women. OBJECTIVES To determine the efficacy and safety of the available options for the treatment of female pattern hair loss in women. SEARCH METHODS We updated our searches of the following databases to July 2015: the Cochrane Skin Group Specialised Register, CENTRAL in the Cochrane Library (2015, Issue 6), MEDLINE (from 1946), EMBASE (from 1974), PsycINFO (from 1872), AMED (from 1985), LILACS (from 1982), PubMed (from 1947), and Web of Science (from 1945). We also searched five trial registries and checked the reference lists of included and excluded studies. SELECTION CRITERIA We included randomised controlled trials that assessed the efficacy of interventions for FPHL in women. DATA COLLECTION AND ANALYSIS Two review authors independently assessed trial quality, extracted data and carried out analyses. MAIN RESULTS We included 47 trials, with 5290 participants, of which 25 trials were new to this update. Only five trials were at 'low risk of bias', 26 were at 'unclear risk', and 16 were at 'high risk of bias'.The included trials evaluated a wide range of interventions, and 17 studies evaluated minoxidil. Pooled data from six studies indicated that a greater proportion of participants (157/593) treated with minoxidil (2% and one study with 1%) reported a moderate to marked increase in their hair regrowth when compared with placebo (77/555) (risk ratio (RR) = 1.93, 95% confidence interval (CI) 1.51 to 2.47; moderate quality evidence). These results were confirmed by the investigator-rated assessments in seven studies with 1181 participants (RR 2.35, 95% CI 1.68 to 3.28; moderate quality evidence). Only one study reported on quality of life (QoL) (260 participants), albeit inadequately (low quality evidence). There was an important increase of 13.18 in total hair count per cm² in the minoxidil group compared to the placebo group (95% CI 10.92 to 15.44; low quality evidence) in eight studies (1242 participants). There were 40/407 adverse events in the twice daily minoxidil 2% group versus 28/320 in the placebo group (RR 1.24, 95% CI 0.82 to 1.87; low quality evidence). There was also no statistically significant difference in adverse events between any of the individual concentrations against placebo.Four studies (1006 participants) evaluated minoxidil 2% versus 5%. In one study, 25/57 participants in the minoxidil 2% group experienced moderate to greatly increased hair regrowth versus 22/56 in the 5% group (RR 1.12, 95% CI 0.72 to 1.73). In another study, 209 participants experienced no difference based on a visual analogue scale (P = 0.062; low quality evidence). The assessments of the investigators based on three studies (586 participants) were in agreement with these findings (moderate quality evidence). One study assessed QoL (209 participants) and reported limited data (low quality evidence). Four trials (1006 participants) did not show a difference in number of adverse events between the two concentrations (RR 1.02, 95% CI 0.91 to 1.20; low quality evidence). Both concentrations did not show a difference in increase in total hair count at end of study in three trials with 631 participants (mean difference (MD) -2.12, 95% CI -5.47 to 1.23; low quality evidence).Three studies investigated finasteride 1 mg compared to placebo. In the finasteride group 30/67 participants experienced improvement compared to 33/70 in the placebo group (RR 0.95, 95% CI 0.66 to 1.37; low quality evidence). This was consistent with the investigators' assessments (RR 0.77, 95% CI 0.31 to 1.90; low quality evidence). QoL was not assessed. Only one study addressed adverse events (137 participants) (RR 1.03, 95% CI 0.45 to 2.34; low quality evidence). In two studies (219 participants) there was no clinically meaningful difference in change of hair count, whilst one study (12 participants) favoured finasteride (low quality evidence).Two studies (141 participants) evaluated low-level laser comb therapy compared to a sham device. According to the participants, the low-level laser comb was not more effective than the sham device (RR 1.54, 95% CI 0.96 to 2.49; and RR 1.18, 95% CI 0.74 to 1.89; moderate quality evidence). However, there was a difference in favour of low-level laser comb for change from baseline in hair count (MD 17.40, 95% CI 9.74 to 25.06; and MD 17.60, 95% CI 11.97 to 23.23; low quality evidence). These studies did not assess QoL and did not report adverse events per treatment arm and only in a generic way (low quality evidence). Low-level laser therapy against sham comparisons in two separate studies also showed an increase in total hair count but with limited further data.Single studies addressed the other comparisons and provided limited evidence of either the efficacy or safety of these interventions, or were unlikely to be examined in future trials. AUTHORS' CONCLUSIONS Although there was a predominance of included studies at unclear to high risk of bias, there was evidence to support the efficacy and safety of topical minoxidil in the treatment of FPHL (mainly moderate to low quality evidence). Furthermore, there was no difference in effect between the minoxidil 2% and 5% with the quality of evidence rated moderate to low for most outcomes. Finasteride was no more effective than placebo (low quality evidence). There were inconsistent results in the studies that evaluated laser devices (moderate to low quality evidence), but there was an improvement in total hair count measured from baseline.Further randomised controlled trials of other widely-used treatments, such as spironolactone, finasteride (different dosages), dutasteride, cyproterone acetate, and laser-based therapy are needed.
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Affiliation(s)
- Esther J van Zuuren
- Leiden University Medical CenterDepartment of DermatologyPO Box 9600B1‐QLeidenNetherlands2300 RC
| | | | - Jan Schoones
- Leiden University Medical CenterWalaeus LibraryPO Box 9600LeidenNetherlands2300 RC
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Abstract
Female Pattern Hair Loss or female androgenetic alopecia is the main cause of hair loss in adult women and has a major impact on patients' quality of life. It evolves from the progressive miniaturization of follicles that lead to a subsequent decrease of the hair density, leading to a non-scarring diffuse alopecia, with characteristic clinical, dermoscopic and histological patterns. In spite of the high frequency of the disease and the relevance of its psychological impact, its pathogenesis is not yet fully understood, being influenced by genetic, hormonal and environmental factors. In addition, response to treatment is variable. In this article, authors discuss the main clinical, epidemiological and pathophysiological aspects of female pattern hair loss.
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27
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Huang M, Zhou X. Appraisal of guidelines for androgenetic alopecia using the Appraisal of Guidelines for Research and Evaluation II instrument. J Eval Clin Pract 2015; 21:1089-94. [PMID: 26507460 DOI: 10.1111/jep.12474] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/25/2015] [Indexed: 11/26/2022]
Abstract
RATIONALE, AIMS AND OBJECTIVES The purpose of this study is to systematically evaluate the quality of methodological guidelines for androgenetic alopecia (AGA) using the Appraisal of Guidelines for Research and Evaluation (AGREE) II instrument by searching and analysing the available worldwide guidelines. This could provide a reference for selecting clinical guidelines and for developing new guidelines in the future. METHODS We searched PubMed and other electronic databases for any AGA guidelines published until 2014. The AGREE II instrument was used by two researchers to create a systematic appraisal in six domains to determine the guidelines fulfilling the inclusion and exclusion criteria. RESULTS Five guidelines associated with the therapy of AGA were identified. The mean scores for the six AGREE II domains were as follows: 89.45% for 'scope and purpose', 53.88% for 'stakeholder involvement', 53.96% for 'rigour of development', 87.22% for 'clarity of presentation', 42.92% for 'applicability' and 59.16% for 'editorial independence'. The European guideline ranked the highest, whereas the American guideline of 1996 ranked the lowest. The Asian, European and Japanese guidelines were strongly recommended, and the two from America were recommended with modifications. CONCLUSIONS Guidelines should provide accurate and evidence-based recommendations. The AGREE II instrument is a useful tool to improve the quality of guidelines, and high-quality guidelines for clinical practice can be provided by using it.
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Affiliation(s)
- Mengya Huang
- Department of Dermatology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Xun Zhou
- Department of Dermatology and Cosmetology, Chongqing Hospital of Traditional Chinese Medicine, Chongqing, China
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28
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Agarwal S, Godse K, Mahajan A, Patil S, Nadkarni N. Application of the basic and specific classification on patterned hair loss in indians. Int J Trichology 2013; 5:126-31. [PMID: 24574690 PMCID: PMC3927169 DOI: 10.4103/0974-7753.125606] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
CONTEXT Several classifications for pattern hair loss (PHL) have been used over the years. The Norwood-Hamilton classification for men and Ludwig's classification for women is used commonly, but they have their limitations. AIMS The objective of the following study is to evaluate the efficacy of the basic and specific (BASP) classification in Indian populations. SUBJECTS AND METHODS We used the BASP classification to classify the PHL in the patients visiting our out-patient department in the period from June 2012 to May 2013. 763 patients were classified out of which 313 were females and 450 were males. RESULTS The majority of the female patients were in the 3-5(th) decade of life and in males were in 4-6(th) decade. CONCLUSIONS The BASP classification is, easily remembered, reproducible classification for the diagnosis and treatment for both male and female pattern alopecia.
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Affiliation(s)
- Shweta Agarwal
- Department of Dermatology, Venereology and Leprosy, Dr. D. Y. Patil Hospital, Nerul, Navi Mumbai, Maharashtra, India
| | - Kiran Godse
- Department of Dermatology, Venereology and Leprosy, Dr. D. Y. Patil Hospital, Nerul, Navi Mumbai, Maharashtra, India
| | - Aditya Mahajan
- Department of Dermatology, Venereology and Leprosy, Dr. D. Y. Patil Hospital, Nerul, Navi Mumbai, Maharashtra, India
| | - Sharmila Patil
- Department of Dermatology, Venereology and Leprosy, Dr. D. Y. Patil Hospital, Nerul, Navi Mumbai, Maharashtra, India
| | - Nitin Nadkarni
- Department of Dermatology, Venereology and Leprosy, Dr. D. Y. Patil Hospital, Nerul, Navi Mumbai, Maharashtra, India
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