Aryl hydrocarbon receptor overexpression in miniaturized follicles in female pattern hair loss

Female pattern hair loss: therapeutic update

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.

Morphological Changes of Meibomian Glands in Men With Benign Prostate Hyperplasia

PURPOSE

Meibomian glands are subject to regulation by sex hormones. We have now investigated the possible relation between benign prostate hyperplasia (BPH) and meibomian gland dysfunction (MGD).

METHODS

Men diagnosed with BPH and receiving treatment with tamsulosin and age-matched male control subjects who attended Itoh Clinic, Saitama, Japan, were enrolled. An ocular symptom score, lid margin abnormality score, and superficial punctate keratopathy score as well as the meiboscore (0-6), meibum grade, breakup time of the tear film, and Schirmer test values were evaluated. Male pattern baldness was also graded according to the Hamilton-Norwood scale.

RESULTS

Forty-four eyes of 44 men with BPH (mean age ± SD, 76.1 ± 2.2 years) and 46 eyes of 46 control subjects (mean age ± SD, 75.3 ± 6.2 years) were enrolled. The meiboscore in the BPH group (4.5 ± 1.4) was significantly higher than that in the control group (1.8 ± 1.5, P < 0.0001). Breakup time of the tear film was significantly shorter (3.6 ± 1.7 vs. 5.6 ± 2.5 seconds, P < 0.0001), and Schirmer test value was significantly smaller (9.8 ± 4.8 vs. 13.3 ± 8.0 mm, P = 0.048) in the BPH group than that in the control group. Other ocular parameters did not differ significantly between the 2 groups. The proportion of men with androgenic alopecia was also higher in the BPH group than that in the control group.

CONCLUSIONS

BPH was associated with meibomian gland loss and instability of the tear film as well as with the presence of androgenic alopecia.

The Potential Application of Ecklonia cava Extract in Scalp Protection

The scalp is exposed to environmental hazards including airborne pollutants, which exert adverse effects on skin health. Therefore, compounds for defending skin from pollutants have attracted interest in the cosmeceutical community. We investigated whether Ecklonia cava exhibited prophylactic effects against urban pollutants by measuring cell viability and cell cycle distribution in human follicle dermal papilla cells (HFDPC). The effect of E. cava on pollutant-induced damage to skin barrier was determined by measuring filaggrin and MMP-1 expression in both keratinocytes and in a skin explant model. In a clinical trial, the effect of E. cava on scalp skin of patients with scalp scale was observed by evaluating hydration and redness after 4 weeks of daily treatment with a shampoo containing E. cava extract. E. cava extract recovered the loss of cell viability and abnormal cell cycle distribution induced by urban pollutants in HFDPCs. It also attenuated pollutant-induced damage to skin barrier by decreasing MMP-1 and increasing filaggrin expression in keratinocytes and the epidermis of skin explants. Moreover, E. cava showed soothing effects on human scalp by increasing hydration and decreasing redness in a clinical trial. Collectively, E. cava extract may be a good candidate for therapeutic applications designed to repair or protect hair scalp.

Translation into Portuguese language (Brazil), transcultural adaptation and validation of the quality of life questionnaire in female pattern hair loss (WAA-QoL-BP)

BACKGROUND

Female pattern hair loss (FPHL) is a common complaint in adult women and inflicts major impact in quality of life, however, there is no specific questionnaire available in Portuguese for such evaluation.

OBJECTIVES

Translation into Brazilian Portuguese, cultural adaptation and validation of the WAA-QoL (Women's Androgenetic Alopecia Quality of Life Questionnaire).

METHODS

Methodological study. After authorization by the author, cultural (linguistic) translation and adaptation to Portuguese of the WAA-QoL questionnaire were carried out. The translated version (WAA-QoL-BP) and DLQI (Dermatology Life Quality index) were submitted to patients with FPHL for concurrent validation. Twenty patients were reevaluated to assess temporal stability.

RESULTS

A total of 116 patients with APF were evaluated, the mean age (SD) was 47 (14) years, and 89 (76%) patients were classified as grades II and III (Sinclair). There was high internal consistency: Cronbach´s alpha was 0.97 for the WAA-QoL-BP and 0.87 for the DLQI. The correlation between WAA-QoL and DLQI resulted in (rho) 0.81 (p <0.01). The intraclass correlation coefficient for complete agreement of WAA-QoL-BP was 0.95 (p <0.01) in the test-retest comparison.

STUDY LIMITATIONS

Sampling of patients only from the State of São Paulo.

CONCLUSIONS

A Brazilian version for WAA-QoL was translated and adapted, which proved to be valid and consistent.