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Zdilla MJ. Hundreds of body parts are named after hair: is anatomical terminology supercilious or simply super silly? Anat Sci Int 2024; 99:481-491. [PMID: 38587583 DOI: 10.1007/s12565-024-00765-7] [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: 12/18/2023] [Accepted: 03/01/2024] [Indexed: 04/09/2024]
Abstract
Relatively more-apparent body parts are often used to name relatively less-apparent body parts. To explore this etymological phenomenon, this report assesses anatomical terminology derived from some of the most apparent structures of the human body-hairs. Hair-related anatomical terminology involves varied etymons, roots, and derivatives: calvus "bald," cilia "eyelashes," glaber "hairless," pilus "hair," pubes (historically referring to the developing beard), pudendum "modesty" (referring to hair growth that covers genitalia), tempus "time" (referring to the location where hair commonly grays, thus showing a person's age), and tragus "goat" (referring to the tuft of hair that resembles the beard of a goat). Also including lanugo, vibrissae, hirci, flocculus, and cauda equina, a systematic review of Terminologia Anatomica and Terminologia Neuroanatomica revealed 285 unique non-duplicate hair-related terms. Several anatomical terms allude to particular age groups or sexes, but are used indiscriminately (e.g., tragus alludes to the older male ear, though may describe the fetal female ear). Likewise, human-centric anatomical terminology influences non-human anatomical terminology- a turtle has a "temporal bone" only because some humans develop gray hair on the sides of their heads as they age. Accordingly, etymological recursion is common: The human ear has a tragus, named after the goat, and the goat ear has a tragus, named after the human tragus, that was named after the goat. The use of Latin as the foundation of anatomical and medical terminology may appear seriously supercilious; however, it is often simply super silly. After all, hundreds of body parts are formally named after hair.
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Affiliation(s)
- Matthew J Zdilla
- Department of Pathology, Anatomy, and Laboratory Medicine (PALM), West Virginia University School of Medicine, Morgantown, WV, 26506, USA.
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2
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Özkoca D, Kazan D, Gencebay G, Caf N, Kara Esen B, Oba MÇ. A cross sectional study evaluating the relationship of acne to androgenetic alopecia subtype and severity. Arch Dermatol Res 2024; 316:533. [PMID: 39154095 DOI: 10.1007/s00403-024-03334-0] [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: 06/29/2024] [Revised: 07/18/2024] [Accepted: 08/05/2024] [Indexed: 08/19/2024]
Abstract
The circulating androgens have a role in the pathogenesis of both acne vulgaris and androgenetic alopecia; an association between these two have been found previously. The aim of this study is to investigate the relationship of the severity of acne vulgaris lesions to the subtype of AGA; and to validate the relationship between severities of acne vulgaris and AGA. This study was conducted cross-sectionally at five different dermatology clinics. Male and female androgenetic alopecia patients with comorbid acne vulgaris have been included. The age, gender, severity of acne lesions, subtype of androgenetic alopecia and the severity of androgenetic alopecia were noted. The severity of acne lesions were graded according to the Global Acne Severity Scale and androgenetic alopecia was graded according to the Hamilton and Ludwig Scales. SPSS v 21 was used for the statistical analysis. A total of 101 patients have been included (12 male and 89 female). The mean age of the patients with severe acne was statistically significantly lower (p = 0.020). The difference in terms of gender was statistically insignificant (p = 0.388). The severity of acne vulgaris was found to be independent of the severity and of the subtype of AGA; p = 0.623 and 0.870 respectively. Neither a relationship between the severity of androgenetic alopecia and severity of acne; nor a relationship between acne severity and androgenetic alopecia subtype were found in this study. Thus we report that, acne severity is independent of the subtype and stage of the co-existing androgenetic alopecia.
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Affiliation(s)
- Defne Özkoca
- Dermatology and Venerology Clinic, Zonguldak Atatürk State Hospital, Zonguldak, Turkey.
- Department of Dermatology and Venerology, Koç University Medical Faculty, Istanbul, Turkey.
- Topkapı, Koç Üniversitesi Hastanesi, Davutpaşa Cd. No: 4, 34010, Zeytinburnu/İstanbul, Turkey.
| | - Didem Kazan
- Dermatology and Venerology Clinic, Kütahya Evliya Çelebi Research Hospital, Kütahya, Turkey
| | - Güllü Gencebay
- Dermatology and Venerology Clinic, İzmir Medicana Hospital, İzmir, Turkey
| | - Nazlı Caf
- Dermatology and Venerology Clinic, Başakşehir Çam and Sakura State Hospital, Istanbul, Turkey
| | - Beril Kara Esen
- Esenler District Health Directorate, Republic of Türkiye Ministry of Health, Istanbul, Turkey
| | - Muazzez Çiğdem Oba
- Dermatology and Venerology Clinic, Sancaktepe Şehit Prof Dr İlhan Varank Research and Training Hospital, Istanbul, Turkey
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3
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Nguyen NH, Taylor JM, Huang KX, Lee JC. Estrogen hormone therapy stabilizes lateral hairline in transfeminine patients: Implications for facial feminization surgery. J Plast Reconstr Aesthet Surg 2024:S1748-6815(24)00415-7. [PMID: 39153870 DOI: 10.1016/j.bjps.2024.07.044] [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: 04/30/2024] [Revised: 06/12/2024] [Accepted: 07/08/2024] [Indexed: 08/19/2024]
Abstract
BACKGROUND Although several studies report on the suppressing effects of estrogen therapy on facial and body hair in transgender and nonbinary (TGNB) individuals, few studies have elucidated its effects on hairline stability on the scalp. In this study, we assessed the influence of estrogen therapy on forehead length. METHODS All TGNB patients, aged 30 years or older, assigned male at birth (AMAB) seeking facial feminization surgery were included in the study. Central and forehead lengths were collected at the initial consultation visits. Variables, including age, duration of hormone replacement therapy (HRT), presence of spironolactone, and presence of other hair treatments, such as finasteride, dutasteride, or minoxidil, that potentially influence hair growth were collected by chart review. Multivariable linear regressions were constructed with relevant predictor variables while also incorporating global health scores as a proxy for psychological effects on hair loss. RESULTS Overall, 171 patients were included in this study, with a median age of 36.0 (interquartile range (IQR) 32.0-46.0) years and median HRT duration of 2.0 (IQR 1.0-6.0) years. Multivariable linear regressions revealed no significant predictors for central forehead length. However, lateral forehead length was positively predicted by age (B=0.06, 95% confidence interval (CI) [0.03-0.08], p < 0.001) and hair treatment (B=0.66, 95% CI [0.14-1.18], p = 0.01), but negatively predicted by HRT duration (B=-0.07, 95% CI [-0.10 to -0.04], p < 0.001). CONCLUSIONS Although older age is a predictor of lateral hairline recession in TGNB AMAB individuals, lateral forehead length was also predicted to decrease by 0.07 cm with each year of feminizing hormone therapy in patients over 30 years of age.
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Affiliation(s)
- Nghiem H Nguyen
- Division of Plastic and Reconstructive Surgery, Department of Surgery, UCLA David Geffen School of Medicine, Los Angeles, CA 90095, USA
| | - Jeremiah M Taylor
- Division of Plastic and Reconstructive Surgery, Department of Surgery, UCLA David Geffen School of Medicine, Los Angeles, CA 90095, USA
| | - Kelly X Huang
- Division of Plastic and Reconstructive Surgery, Department of Surgery, UCLA David Geffen School of Medicine, Los Angeles, CA 90095, USA
| | - Justine C Lee
- Division of Plastic and Reconstructive Surgery, Department of Surgery, UCLA David Geffen School of Medicine, Los Angeles, CA 90095, USA.
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Rosenthal A, Conde G, Greco JF, Gharavi NM. Management of androgenic alopecia: a systematic review of the literature. J COSMET LASER THER 2024:1-16. [PMID: 38852607 DOI: 10.1080/14764172.2024.2362126] [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: 01/08/2024] [Accepted: 05/28/2024] [Indexed: 06/11/2024]
Abstract
We aimed to determine the efficacy of the various available oral, topical, and procedural treatment options for hair loss in individuals with androgenic alopecia. Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, a systematic review of the National Library of Medicine was performed. Overall, 141 unique studies met our inclusion criteria. We demonstrate that many over the counter (e.g. topical minoxidil, supplements, low-level light treatment), prescription (e.g. oral minoxidil, finasteride, dutasteride), and procedural (e.g. platelet-rich plasma, fractionated lasers, hair transplantation) treatments successfully promote hair growth, highlighting the superiority of a multifaceted and individualized approach to management.
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Affiliation(s)
- Amanda Rosenthal
- Department of Dermatology, Kaiser Permanente Los Angeles Medical Center, Los Angeles, CA, USA
| | - Geena Conde
- Department of Dermatology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Joseph F Greco
- Department of Research, Greco Hair Restoration, Sarasota, FL, USA
| | - Nima M Gharavi
- Department of Dermatology, Cedars-Sinai Medical Center, Los Angeles, CA, USA
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Francès MP, Vila-Vecilla L, Russo V, Caetano Polonini H, de Souza GT. Utilising SNP Association Analysis as a Prospective Approach for Personalising Androgenetic Alopecia Treatment. Dermatol Ther (Heidelb) 2024; 14:971-981. [PMID: 38555553 PMCID: PMC11052732 DOI: 10.1007/s13555-024-01142-y] [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: 02/07/2024] [Accepted: 03/14/2024] [Indexed: 04/02/2024] Open
Abstract
INTRODUCTION Androgenetic alopecia (AGA) is a prevalent, multifactorial form of hair loss involving complex aetiological factors, such as altered androgen regulation and energy metabolism. Existing treatments offer limited success, thus highlighting the need for advanced, personalised therapeutic strategies. This study focuses on correlating the genetic mechanisms of AGA with molecular targets involved in the response to current treatment modalities. METHODS An anonymised database including 26,607 patients was subjected to analysis. The dataset included information on patients' genotypes in 26 single nucleotide polymorphisms (SNPs), specifically, and diagnosed AGA grades, representing a broad range of ethnic backgrounds. RESULTS In our sample, 64.6% of males and 35.4% of females were diagnosed with female pattern hair loss. This distribution aligns well with prior studies, thus validating the representativeness of our dataset. AGA grading was classified using the Hamilton-Norwood and Ludwig scales, although no association was found to the grade of the disease. SNP association analysis revealed eight SNPs, namely rs13283456 (PTGES2), rs523349 (SRD5A2), rs1800012 (COL1A1), rs4343 (ACE), rs10782665 (PTGFR), rs533116 (PTGDR2), rs12724719 (CRABP2) and rs545659 (PTGDR2), to be statistically significant with a p-value below 0.05. CONCLUSIONS The study establishes a preliminary association between eight specific SNPs and AGA. These genetic markers offer insights into the variability of therapeutic responses, thus underlining the importance of personalised treatment approaches. Our findings show the potential for more targeted research to understand these SNPs' and further roles in AGA pathophysiology and in modulating treatment response.
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Sathyanarayanan H, Sundaram M. Study of Association of Dyslipidemia in Male Androgenetic Alopecia Patients in a Tertiary Care Hospital. Cureus 2024; 16:e51741. [PMID: 38318584 PMCID: PMC10840442 DOI: 10.7759/cureus.51741] [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: 01/03/2024] [Indexed: 02/07/2024] Open
Abstract
INTRODUCTION Androgenetic alopecia (AGA) is a hereditary and androgen-dependent progressive thinning of the scalp hair in a defined pattern. Several studies have reported an association between dyslipidemia and AGA. However, scarce data is available on association between severity of AGA and dyslipidemia. Hence, we performed a study to assess the clinical, epidemiological profile in male AGA patients and to compare lipid parameters among AGA cases and non-AGA controls to evaluate dyslipidemia association. MATERIALS AND METHODS This is a prospective case-control study included 108 age-matched AGA cases and non-AGA controls between 19-40 years. AGA was clinically diagnosed, and grading was done according to Norwood-Hamilton Classification. Fasting Lipid parameters for both cases and controls were determined using standard laboratory methods. RESULTS Among the cases and controls, the mean age was 26.20±5.353 years. There was a statistically significant association between AGA and mean total cholesterol (TC) (P<0.001), mean high-density lipoprotein (HDL) (P<0.001), mean low-density lipoprotein (LDL) (P<0.001) and mean cholesterol/HDL ratio (P<0.001), except for mean triglycerides (TG) (P=0.443). Grade 4 was the commonest grading (20.4%). As the severity of AGA increased, the lipid parameters were significantly deranged. It was evident Grade 4 onwards with statistically significant derangement in TC (P<0.001), TG (P=0.005), HDL (P=0.002), LDL (P <0.001) and cholesterol/HDL(P<0.001). CONCLUSIONS AGA was found to be significantly associated with dyslipidemia and more common among severe grades. AGA could be a cutaneous marker of underlying systemic illness. Early screening for dyslipidemia is beneficial in patients with AGA.
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Affiliation(s)
| | - Murugan Sundaram
- Dermatology, Sri Ramachandra Institute of Higher Education and Research, Chennai, IND
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Legiawati L, Yusharyahya SN, Bernadette I, Novianto E, Priyanto MH, Gliselda KC, Iriyanty S, Mutiara R. Comparing Single-spin Versus Double-spin Platelet-rich Plasma (PRP) Centrifugation Methods on Thrombocyte Count and Clinical Improvement of Androgenetic Alopecia: A Preliminary, Randomized, Double-blind Clinical Trial. THE JOURNAL OF CLINICAL AND AESTHETIC DERMATOLOGY 2023; 16:39-44. [PMID: 38125672 PMCID: PMC10729807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 12/23/2023]
Abstract
Objective Platelet-rich plasma (PRP) is widely known as an alternative therapy for androgenetic alopecia (AGA); however, there is no standardized method for its preparation and application. This study aims to compare the thrombocyte count elevation and clinical AGA improvements between single- and double-spin PRP preparation methods. Methods This preliminary, double-blind, randomized clinical trial included 30 male subjects with AGA aged 25 to 59 years with Hamilton-Norwood stages III to VI. Subjects were divided into a single-spin group (3,000rpm for 15 minutes) and a double-spin group (first spinning at 1,500rpm for 6 minutes, continuing at 2,500rpm for 15 minutes). The study was conducted for six weeks, with a two-week visit interval. Baseline and PRP thrombocyte counts were assessed on the initial appointment. A total of 1cc of PRP was intradermally injected into a 6×4cm predetermined area, administered at Weeks 0, 2, and 4. At every visit, clinical progress was assessed by overall hair appearance, photography, trichoscopy, and trichoscan. All subjects were instructed to use minoxidil twice daily during the study. This study has been registered at clinicaltrials.gov (ID No. NCT05681897). Results Both groups increased thrombocyte counts by 4 to 5 times from their initial levels; however, the increase in the single-spin group was more significant. Significant improvements were observed in both groups, including hair density, hair rate, and hair count of anagen, telogen, vellus, and terminal hair. Limitations Limitations include lack of placebo or vehicle control. Conclusion Both PRP preparation methods significantly raise thrombocyte counts, substantially improve nearly all hair parameters, and have tremendous therapeutic promise for treating AGA. Clinicians may designate one of the two techniques.
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Affiliation(s)
- Lili Legiawati
- All authors are with Department of Dermatology and Venereology, Faculty of Medicine, Universitas Indonesia, dr. Cipto Mangunkusumo National General Hospital in Jakarta, Indonesia
| | - Shannaz Nadia Yusharyahya
- All authors are with Department of Dermatology and Venereology, Faculty of Medicine, Universitas Indonesia, dr. Cipto Mangunkusumo National General Hospital in Jakarta, Indonesia
| | - Irma Bernadette
- All authors are with Department of Dermatology and Venereology, Faculty of Medicine, Universitas Indonesia, dr. Cipto Mangunkusumo National General Hospital in Jakarta, Indonesia
| | - Endi Novianto
- All authors are with Department of Dermatology and Venereology, Faculty of Medicine, Universitas Indonesia, dr. Cipto Mangunkusumo National General Hospital in Jakarta, Indonesia
| | - Mufqi Handaru Priyanto
- All authors are with Department of Dermatology and Venereology, Faculty of Medicine, Universitas Indonesia, dr. Cipto Mangunkusumo National General Hospital in Jakarta, Indonesia
| | - Keneyzia Carla Gliselda
- All authors are with Department of Dermatology and Venereology, Faculty of Medicine, Universitas Indonesia, dr. Cipto Mangunkusumo National General Hospital in Jakarta, Indonesia
| | - Septiana Iriyanty
- All authors are with Department of Dermatology and Venereology, Faculty of Medicine, Universitas Indonesia, dr. Cipto Mangunkusumo National General Hospital in Jakarta, Indonesia
| | - Rizka Mutiara
- All authors are with Department of Dermatology and Venereology, Faculty of Medicine, Universitas Indonesia, dr. Cipto Mangunkusumo National General Hospital in Jakarta, Indonesia
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Roets B. Potential application of PBM use in hair follicle organoid culture for the treatment of androgenic alopecia. Mater Today Bio 2023; 23:100851. [PMID: 38024838 PMCID: PMC10663892 DOI: 10.1016/j.mtbio.2023.100851] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 10/26/2023] [Accepted: 10/28/2023] [Indexed: 12/01/2023] Open
Abstract
Androgenic alopecia is a hereditary condition of pattern hair loss in genetically susceptible individuals. The condition has a significant impact on an individual's quality of life, with decreased self-esteem, body image issues and depression being the main effects. Various conventional treatment options, such as minoxidil, finasteride and herbal supplements, aim to slow down hair loss and promote hair growth. However, due to the chronic nature of the condition the financial cost of treatment for androgenic alopecia is very high and conventional treatment options are not universally effective and come with a host of side effects. Therefore, to address the limitations of current treatment options a novel regenerative treatment option is required. One promising approach is organoids, organoids are 3D cell aggregates with similar structures and functions to a target organ. Hair follicle organoids can be developed in vitro. However, the main challenges are to maintain the cell populations within the organoid in a proliferative and inductive state, as well as to promote the maturation of organoids. Photobiomodulation is a form of light therapy that stimulates endogenous chromophores. PBM has been shown to improve cell viability, proliferation, migration, differentiation and gene expression in dermal papilla cells and hair follicle stem cells. Therefore, photobiomodulation is a potential adjunct to hair follicle organoid culture to improve the proliferation and inductive capacity of cells.
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Affiliation(s)
- Brendon Roets
- Biomedical Science, Faculty of Health Science, University of Johannesburg, Johannesburg, 2028, South Africa
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Hu L, Zhang X, Luo F, Zhao H. Inverse androgenic alopecia. BMJ Case Rep 2023; 16:e254361. [PMID: 37907317 PMCID: PMC10619064 DOI: 10.1136/bcr-2022-254361] [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] [Indexed: 11/02/2023] Open
Abstract
A man in his 50s presented to our clinic with obvious progressive hair thinning in the occipital area below the creeping alopecia crown vertex accompanied by the typical Hamilton-Norwood pattern of male androgenetic alopecia (MAGA) hair loss. Based on his clinical features, trichoscopy findings and histological features, as well as his good response to conventional anti-MAGA therapeutic drugs, such as finasteride and minoxidil, a novel isotype of MAGA, named inverse-MAGA, was first identified, and this isotype should be widely evaluated in future studies.
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Affiliation(s)
- Li Hu
- Department of Dermatology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Xiaojiao Zhang
- Department of Dermatology, University-Town Hospital of Chongqing Medical University, Chongqing, China
| | - Fuling Luo
- Department of Pharmacy, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Hengguang Zhao
- Department of Dermatology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
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Al Najjar OA, Alkhars MA, Al Molhim SF, AlAjmi MS, Alhafith AA, Al Najjar MA, AlMaqhawi A. The Impact of Androgenic Alopecia on the Quality of Life of Male Individuals: A Cross-Sectional Study. Cureus 2023; 15:e47760. [PMID: 38021524 PMCID: PMC10676293 DOI: 10.7759/cureus.47760] [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] [Accepted: 10/26/2023] [Indexed: 12/01/2023] Open
Abstract
Background Hair plays a significant role in physical appearance and hair loss can profoundly affect self-esteem and mental health. Studies show that people with clinically obvious and undetectable hair loss may have dramatically decreased quality of life (QoL). This study investigated the impact of androgenic alopecia on the quality of life of male individuals in the Eastern Province of Saudi Arabia and their willingness to seek treatment. Methods In the eastern province of Saudi Arabia, a cross-sectional study was carried out among men identified with androgenic alopecia (AGA). A self-administered survey was disseminated among the patients through social media sites. The questionnaire includes fundamental demographic factors including age, place of residence, level of education, the severity of androgenic alopecia, treatment method, and Skindex-29 to assess the patient's quality of life. Results Four hundred-two male patients out of 717 participants were selected, and 158 (39.3%) were aged between 20 to 29 years old. Satisfaction with treatment medication was reported by 24 (19.5%) out of those who underwent treatment (n=123). Less effectiveness was the most common reason for treatment dissatisfaction (81, 81.8%). The overall mean Skindex-29 score was 23.2 (SD 19.6) out of 100 points. Younger age, suffering hair loss for a shorter duration, undergoing alopecia treatment, being diagnosed with alopecia by a medical doctor, and having a moderate level of AGA were the factors that greatly affected the patient's QoL. Conclusion Consistent with the literature, this study showed that AGA significantly impaired patients' QoL. Among QoL domains, the symptoms domain had a greater effect on patients than the emotions or functional domains. Younger males who were suffering recently from hair loss and were diagnosed with AGA by the medical doctor demonstrated greater QoL impairment than the rest of the patients. A multicenter study may result in a better representation of the impact of QoL in patients with AGA.
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Affiliation(s)
- Omar A Al Najjar
- Department of Family and Community Medicine, King Faisal University, Al-Ahsa, SAU
| | - Mohammed A Alkhars
- Department of Family and Community Medicine, King Faisal University, Al-Ahsa, SAU
| | - Saleh F Al Molhim
- Department of Family and Community Medicine, King Faisal University, Al-Ahsa, SAU
| | - Mohammed S AlAjmi
- Department of Family and Community Medicine, King Faisal University, Al-Ahsa, SAU
| | - Abdullah A Alhafith
- Department of Family and Community Medicine, King Faisal University, Al-Ahsa, SAU
| | - Maryam A Al Najjar
- Department of Family and Community Medicine, King Faisal University, Al-Ahsa, SAU
| | - Abdullah AlMaqhawi
- Department of Family and Community Medicine, King Faisal University, Al-Ahsa, SAU
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Legiawati L, Suseno LS, Sitohang IBS, Yusharyahya SN, Pawitan JA, Liem IK, Kurniawati T, Ardelia A, Paramastri K. Combination of adipose-derived stem cell conditioned media and minoxidil for hair regrowth in male androgenetic alopecia: a randomized, double-blind clinical trial. Stem Cell Res Ther 2023; 14:210. [PMID: 37605227 PMCID: PMC10441691 DOI: 10.1186/s13287-023-03440-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 08/02/2023] [Indexed: 08/23/2023] Open
Abstract
INTRODUCTION Treatments for AGA have yet to produce satisfactory outcomes and may cause intolerable side effects. Recent studies have reported that adipose tissue-derived stem cell conditioned media (ADSC-CM) could induce hair growth and regeneration. OBJECTIVE To investigate the efficacy of ADSC-CM combined with minoxidil for hair regeneration therapy in male AGA. METHODS This study lasted for 6 weeks. Subjects were divided into two groups: concentrated and non-concentrated ADSC-CM. Scalp was divided vertically in half before intradermal injection was administered from the frontal region of the scalp toward the vertex with a 30G needle, spaced about 1 cm apart. Treatment side received 2 ml of ADSC-CM; the other side was given 2 ml of NaCl 0.9% as placebo. Patients applied 5% minoxidil twice daily post-injection. Improvements were assessed using photographs and trichoscan every 2 weeks. RESULTS Hair count, hair density, and mean thickness increased significantly on both sides after 6 weeks, while vellus rate decreased proportionally with the increase of terminal rate. No statistically significant differences between treatment groups were found. Minimum side effects were reported, and subjects were satisfied with the results. CONCLUSION Combination of ADSC-CM and minoxidil could be a potential agent for hair regrowth. Follow-up research with extensive populations, longer duration, and different study design may be required to confirm the exact mechanisms of ADSC-CM on hair growth. TRIAL REGISTRATION Clinicaltrials.gov, NCT05296863. Registered 25 March 2022-Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT05296863 .
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Affiliation(s)
- Lili Legiawati
- Department of Dermatology and Venereology, Faculty of Medicine, Dr. Cipto Mangunkusumo Hospital, Universitas Indonesia, Diponegoro No. 71, Central Jakarta, DKI Jakarta, 10430, Indonesia.
- Stem Cell Medical Technology, Integrated Service Unit, Faculty of Medicine, Dr. Cipto Mangunkusumo Hospital, Universitas Indonesia, Jakarta, Indonesia.
| | - Lis Surachmiati Suseno
- Department of Dermatology and Venereology, Faculty of Medicine, Dr. Cipto Mangunkusumo Hospital, Universitas Indonesia, Diponegoro No. 71, Central Jakarta, DKI Jakarta, 10430, Indonesia
- Stem Cell Medical Technology, Integrated Service Unit, Faculty of Medicine, Dr. Cipto Mangunkusumo Hospital, Universitas Indonesia, Jakarta, Indonesia
| | - Irma Bernadette S Sitohang
- Department of Dermatology and Venereology, Faculty of Medicine, Dr. Cipto Mangunkusumo Hospital, Universitas Indonesia, Diponegoro No. 71, Central Jakarta, DKI Jakarta, 10430, Indonesia
- Stem Cell Medical Technology, Integrated Service Unit, Faculty of Medicine, Dr. Cipto Mangunkusumo Hospital, Universitas Indonesia, Jakarta, Indonesia
| | - Shannaz Nadia Yusharyahya
- Department of Dermatology and Venereology, Faculty of Medicine, Dr. Cipto Mangunkusumo Hospital, Universitas Indonesia, Diponegoro No. 71, Central Jakarta, DKI Jakarta, 10430, Indonesia
- Stem Cell Medical Technology, Integrated Service Unit, Faculty of Medicine, Dr. Cipto Mangunkusumo Hospital, Universitas Indonesia, Jakarta, Indonesia
| | - Jeanne Adiwinata Pawitan
- Stem Cell Medical Technology, Integrated Service Unit, Faculty of Medicine, Dr. Cipto Mangunkusumo Hospital, Universitas Indonesia, Jakarta, Indonesia
- Department of Histology, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
- Faculty of Medicine, Stem Cell and Tissue Engineering Research Center, Indonesia Medical Education and Research Institute (IMERI), Universitas Indonesia, Jakarta, Indonesia
| | - Isabella Kurnia Liem
- Stem Cell Medical Technology, Integrated Service Unit, Faculty of Medicine, Dr. Cipto Mangunkusumo Hospital, Universitas Indonesia, Jakarta, Indonesia
| | - Trie Kurniawati
- Stem Cell Medical Technology, Integrated Service Unit, Faculty of Medicine, Dr. Cipto Mangunkusumo Hospital, Universitas Indonesia, Jakarta, Indonesia
| | - Athaya Ardelia
- Department of Dermatology and Venereology, Faculty of Medicine, Dr. Cipto Mangunkusumo Hospital, Universitas Indonesia, Diponegoro No. 71, Central Jakarta, DKI Jakarta, 10430, Indonesia
- Stem Cell Medical Technology, Integrated Service Unit, Faculty of Medicine, Dr. Cipto Mangunkusumo Hospital, Universitas Indonesia, Jakarta, Indonesia
| | - Kanya Paramastri
- Department of Dermatology and Venereology, Faculty of Medicine, Dr. Cipto Mangunkusumo Hospital, Universitas Indonesia, Diponegoro No. 71, Central Jakarta, DKI Jakarta, 10430, Indonesia
- Stem Cell Medical Technology, Integrated Service Unit, Faculty of Medicine, Dr. Cipto Mangunkusumo Hospital, Universitas Indonesia, Jakarta, Indonesia
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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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Somenek M, Romero NJ. Facial Analysis for Gender Affirmation/Gender-Related Facial Analysis. Facial Plast Surg Clin North Am 2023; 31:341-348. [PMID: 37348975 DOI: 10.1016/j.fsc.2023.03.002] [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: 06/24/2023]
Abstract
There are anthropometric differences between the bony and integumentary facial features of male and female individuals. When compared to males, female faces in general are more heart-shaped, with a shorter and smoother forehead, a smaller more defined nose, and a tapered chin.
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Affiliation(s)
- Michael Somenek
- Facial Plastic Surgery, Somenek+PittmanMD Advanced Plastic Surgery, 2440 M Street Northwest Suite 507, Washington, DC 20037, USA.
| | - Nahir J Romero
- Somenek +Pittman MD, 2440 M Street Northwest Suite 507, Washington, DC 20037, USA
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Kohli M, Ganjoo A, Sharma A, Patil CY, Sethi S, Patel B. Prospective Efficacy and Safety Study of an Innovative Kerascalp Hair Growth Serum in Mild-to-Moderate Alopecia in India: Regrowth Study. Cureus 2023; 15:e38742. [PMID: 37303414 PMCID: PMC10247907 DOI: 10.7759/cureus.38742] [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] [Accepted: 05/08/2023] [Indexed: 06/13/2023] Open
Abstract
BACKGROUND AND AIM Male and female pattern baldness, commonly known as androgenetic alopecia is the most common type of alopecia, often predetermined genetically, which generally affects the scalp and is characterized by progressive terminal hair loss, known as miniaturization. This study aimed to assess the safety and efficacy of Kerascalp hair serum, a unique combination of esculin, ximenynic acid, and lauric acid, extracted from natural sources in subjects with mild to moderate androgenetic alopecia. METHODS An open-label, single-arm clinical study was conducted on healthy males and females aged 18-60 years. Each subject applied the hair serum once daily for 90 days. The efficacy of hair serum was evaluated in terms of the following outcome variables: anagen and telogen ratio (A:T ratio), hair thickness, hair density, hair fall, and hair strength assessment. Subjects were assessed on day 0, day 30, day 60, day 90, and on follow-up day 120. RESULTS Thirty subjects completed all assessment visits. After using the hair serum for 90 days, statistically significant (p<0.0001) improvement was observed in A:T ratio, hair density, hair thickness, and hair strength; a statistically significant reduction (p<0.0001) in hair fall was also observed. Moreover, improvement in general appearance of hair (in terms of hair volume and density) and scalp (in terms of itchiness, redness, roughness, and dryness) was recorded through dermatological assessment at each treatment visit and at follow-up visit compared to baseline. No adverse event was recorded during the study period, and on follow-up. CONCLUSIONS The results of this clinical study suggest that a 90 days treatment with a phyto-ingredient-based Kerascalp hair serum is safe and effective in significantly improving A:T ratio, hair density, hair thickness, and hair strength, while reducing hair shedding. The improvement in the test parameters persists, even 30 days after stopping the usage of the serum.
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Affiliation(s)
| | - Anil Ganjoo
- Dermatology and Laser Surgery, Skinnovation Clinics, New Delhi, IND
| | - Aseem Sharma
- Dermatology, Skin Saga Centre for Dermatology, Mumbai, IND
| | | | - Simran Sethi
- General Practice, Cliantha Research, Ahmedabad, IND
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15
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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 BonnInstitute of Human GeneticsBonnGermany
| | - Markus M. Nöthen
- University Hospital of Bonn & University of BonnInstitute of Human GeneticsBonnGermany
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Oiwoh SO, Akinboro AO, Olayemi O, Salawu AA, Olasode OA, Onayemi EO. Androgenetic alopecia: Traditional cardiovascular risk factors, metabolic syndrome, and component traits among Nigerian adults. Niger J Clin Pract 2023; 26:463-469. [PMID: 37203111 DOI: 10.4103/njcp.njcp_530_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] [Indexed: 05/20/2023]
Abstract
Background Androgenetic alopecia (AGA) has been linked to cardiovascular diseases (CVDs) and metabolic syndrome (MetS). Works on AGA, cardiovascular risk factors (CVRFs) and MetS are rare among Nigerians. Aim This study set out to determine the relationship among CVRFs, MetS, and AGA. Subjects and Methods This is a cross-sectional study done among adults who were 18 years and above in selected communities in Ogbomoso on 260 consenting AGA participants as well as 260 age controls without AGA. They were matched for age and sex using a multistage sampling method. Anthropometric measurements, fasting blood glucose, and lipid profile samples were collected. MetS was diagnosed using International Diabetes Federation criteria. Data were analyzed using IBM SPSS version 20. Ethical approval was gotten before commencement of the study (LTH/OGB/EC/2017/162). Result Metabolic syndrome in AGA was higher than in controls (8.08% vs. 7.69%, p = 0.742). AGA was significantly associated with elevated mean systolic blood pressure (SBP) (p = 0.008), low High Density Lipoprotein (HDL-c) (p < 0.001), alcohol intake (p < 0.001), dyslipidaemia (p = 0.002), and sedentary lifestyle (p = 0.010). The correlates of AGA severity in male and female gender are age (p < 0.001 and 0.009 respectively), SBP (p = 0.024) and abdominal obesity (p = 0.027) in male gender. Conclusion AGA in Nigerians is associated with dyslipidaemia, alcohol intake, and sedentary lifestyle. AGA severity is related to age, higher mean SBP, abdominal obesity and low HDL-c in male and age, and Body mass index in females. Nigerians with AGA should be screened for dyslipidaemia and counseled against the use of alcohol and sedentary lifestyle.
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Affiliation(s)
- S O Oiwoh
- Department of Internal Medicine, Dermatology and Venereology Unit, Irrua Specialist Teaching Hospital, Irrua, Edo State, Nigeria
| | - A O Akinboro
- Department of Medicine, Dermatology and Venereology Unit, Ladoke Akintola University of Technology, Ogbomoso, Oyo State, Nigeria
| | - O Olayemi
- Department of Internal Medicine, UniOsun Teaching Hospital, Osogbo, Osun State, Nigeria
| | - A A Salawu
- Department of Chemical Pathology, Ladoke Akintola University of Technology, Ogbomoso, Oyo State, Nigeria
| | - O A Olasode
- Department of Dermatology and Venereology, Obafemi Awolowo University, Ile Ife, Osun State, Nigeria
| | - E O Onayemi
- Department of Dermatology and Venereology, Obafemi Awolowo University, Ile Ife, Osun State, Nigeria
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17
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Smith GL. Hair Regrowth with Novel Hemp Extract: A Case Series. Int J Trichology 2023; 15:18-24. [PMID: 37305187 PMCID: PMC10251293 DOI: 10.4103/ijt.ijt_34_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: 03/10/2022] [Accepted: 06/14/2022] [Indexed: 06/13/2023] Open
Abstract
Introduction The endocannabinoid system (ECS), discovered in the 1990s, is a system involved with maintaining cellular homeostasis by down-regulating the damaging inflammatory responses and upregulating regenerative processes. Cannabidiol (CBD), tetrahydrocannabivarin (THCV), and cannabidivarin (CBDV) are all phytocannabinoids found in varying quantities in hemp extract. These three cannabinoids have novel therapeutic effects on hair regrowth through the ECS. The method of action is different from and synergistic with current hair regrowth therapies. The three cannabinoids are fat-soluble and poorly absorbed past the epidermis, but topical application easily reaches hair follicles where they act as partial or full CB1 antagonist and agonist of transient receptor potential vanilloid-1 (TRPV1) and vanilloid receptor-4 (TRPV4). All these ECS receptors relate to hair follicle function. Blocking the CB1 receptor on the hair follicle has been shown to result in hair shaft elongation; in addition, the hair follicle cycle (anagen, catagen, and telogen phases) is controlled by TRPV1. The effects of CBD on hair growth are dose dependent and higher doses may result in premature entry into the catagen phase through a different receptor known as TRPV4. CBD has also been shown to increase Wnt signaling, which causes dermal progenitor cells to differentiate into new hair follicles and maintains anagen phase of the hair cycle. Objective This study was conducted on subjects with androgenetic alopecia (AGA), as follow-up to a prior published study using hemp extract high in CBD without CBDV or THCV. That study showed an average 93.5% increase in hair numbers after 6 months of use. This subsequent study is being done to determine if daily topical application of a hemp-oil high in CBD, THCV, and CBDV concentrations would result in improved hair regrowth in the area of the scalp most affected by AGA. Materials and Methods A case series study was done of 31 (15 men and 16 women, 27 Caucasian, 2 Asian, and 1 mixed race) subjects with AGA. They used a once-daily topical hemp extract formulation, averaging about 33 mg/day for 6 months. A hair count of the greatest area of alopecia was carried out before treatment was started and again after 6 months of treatment. To facilitate consistent hair count analysis, a permanent tattoo was placed at the point for maximum hair loss on the scalp. The subjects were also asked to qualitatively rate their psychosocial perception of "scalp coverage" improvement after the study was completed. The qualitative scale included "very unhappy," "unhappy," "neutral," "happy," and "very happy." The subjects were photographed in a standard manner before and after the study. The photographs were compared for improvements in "scalp coverage" by an independent physician. The qualitative scale included "none," "mild," "moderate," and "extensive" improvement of scalp coverage. Results The results revealed that all subjects had some regrowth. This ranged from 31.25% (from 16 to 21 hairs) to 2000% (from 1 to 21 hairs). The average increase was statistically significant 246% (15.07 hairs/cm2 increase) in men and 127% (16.06 hairs/cm2) in women. There were no reported adverse effects. All subjects rated their psychosocial perception of the effects of the hair loss, as "happy" or "very happy." Independent review of the photographs revealed evidence of "mild" to "extensive" scalp coverage improvements for all of the subjects. Conclusion Although the exact mechanism of therapeutic effects is not known, THCV and CBDV are most likely functioning as full CB1 receptor neutral antagonists and CBD is most likely functioning as a partial CB1 receptor antagonist and potentially through Wnt messaging. All three cannabinoids were functioning as TRPV1 agonists. The addition of menthol through the peppermint extract is probably acting through promoting a rapid onset of anagen phase. This topical hemp formulation was superior to oral finasteride, 5% minoxidil once daily foam and CBD topical extract alone. Since this hemp extract works through novel mechanisms entirely different from both finasteride and minoxidil, it can be used in conjunction with these current drugs and would be expected to have synergistic effects. However, safety and efficacy of this combination would be to be evaluated.
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Association of androgenetic alopecia with a more severe form of COVID-19 infection. Ir J Med Sci 2023; 192:187-192. [PMID: 35320487 PMCID: PMC8942051 DOI: 10.1007/s11845-022-02981-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2021] [Accepted: 03/13/2022] [Indexed: 02/04/2023]
Abstract
BACKGROUND Individual susceptibility to develop acute respiratory distress syndrome is related to age and most frequent comorbidities. So far, it is known that severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) primarily infects the type II pneumocytes in humans, with the help of transmembrane serine protease type 2 (TMPRSS2). Up to now, the only known transcriptional promoters of genes coding TMPRSS2 are androgenic. Theoretically, the elevated level of androgens or androgen receptors would lead to a higher expression of TMPRSS2 and a higher level of viremia as a consequence. AIM The aim of our research was to indirectly investigate if the severity of SARS-CoV-2 infection is dependent on the expression of androgen receptors. METHODS This observational study analysed male patients hospitalized for SARS-CoV-2 infection with respect to the length of hospitalisation, the outcome of the disease, the type of necessary oxygen support and the presence of comorbidities and hairiness. In hairiness estimation, we used an adapted version of the Hamilton-Norwood scale and the presence of the Gabrin sign. RESULTS In total, 208 patients were enrolled in the study. There were statistically significant differences comparing the average age of patients with the different types of alopecia when groups were divided according to the presence of the Gabrin sign (t = 4.958, p > 0.01). The outcomes and the type of needed minimal oxygen support, compared with the type of alopecia in the case of Gabrin + / - classification showed a statistically significant difference in the outcome of the disease (p = 0.027). There were no statistically significant differences in the distribution of comorbidities among alopecia groups, but hypertension was related to poor COVID-19 prognosis. CONCLUSION Our findings suggest that the Gabrin sign and hypertension are related to a poor COVID-19 prognosis.
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19
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Lyakhovitsky A, Tzanani I, Gilboa S, Segal O, Galili E, Baum S, Barzilai A. Changing spectrum of hair and scalp disorders over the last decade in a tertiary medical centre. J Eur Acad Dermatol Venereol 2023; 37:184-193. [PMID: 36066315 DOI: 10.1111/jdv.18570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Accepted: 07/27/2022] [Indexed: 12/15/2022]
Abstract
BACKGROUND Hair- and scalp-related disorders (HSRDs) encompass a wide range of conditions that affect people of all ages. OBJECTIVE To evaluate the workload and trends in HSRDs at an outpatient dermatological clinic in a tertiary medical centre over a 10-year period. METHODS Medical records for HSRD visits to the outpatient dermatology clinic at the Sheba Medical Center, an Israeli tertiary care center, were reviewed between 1 January, 2010 and 31 December, 2020. RESULTS There were 10,396 HSRD visits with a new-to-follow-up visit ratio of 1:1.9. The annual number of HSRD visits, as well as their proportion out of all dermatological outpatient visits, have increased from 295 (1.24%) in 2010 to 1726 (9.44%) in 2020. The patients' mean age was 35.3 years (women 39.5 years, men 28.8 years), age range 1-87 years. Over the decade, there was a growing predominance of women with an average female-to-male ratio of 2:1. The winter season accounted for 28.7% of annual visits, followed by the autumn (25.6%), summer (24.3%) and spring (21.4%). The most prevalent HSRDs included androgenetic alopecia (30.6%), alopecia areata (19.3%), telogen effluvium (15.4%), non-scarring folliculitis (15.4%), seborrheic dermatitis (14.9%), lichen planopilaris (7.1%) and folliculitis decalvans (6.6%). Androgenetic alopecia demonstrated the highest increase over the decade examined (from 17% to 32%). CONCLUSION HSRDs account for a significant percentage of visits at a tertiary dermatology outpatient clinic. The number of HSRD visits has increased annually over the past decade. The recent advancement in diagnosis and treatment may account, at least in part, for the growing burden of HSRDs within dermatological ambulatory care.
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Affiliation(s)
| | - Ido Tzanani
- Department of Dermatology, Sheba Medical Center, Ramat-Gan, Israel
| | - Sarit Gilboa
- Department of Dermatology, Sheba Medical Center, Ramat-Gan, Israel
| | - Oz Segal
- Department of Dermatology, Sheba Medical Center, Ramat-Gan, Israel
| | - Eran Galili
- Department of Dermatology, Sheba Medical Center, Ramat-Gan, Israel
| | - Sharon Baum
- Department of Dermatology, Sheba Medical Center, Ramat-Gan, Israel
| | - Aviv Barzilai
- Department of Dermatology, Sheba Medical Center, Ramat-Gan, Israel.,Institute of Pathology, Sheba Medical Center, Ramat-Gan, Israel
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Jung DR, Yoo HY, Kim MJ, Singh V, Park SH, Jeong M, Park BJ, Shin JH. Comparative analysis of scalp and gut microbiome in androgenetic alopecia: A Korean cross-sectional study. Front Microbiol 2022; 13:1076242. [PMID: 36578576 PMCID: PMC9791053 DOI: 10.3389/fmicb.2022.1076242] [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: 10/21/2022] [Accepted: 11/21/2022] [Indexed: 12/14/2022] Open
Abstract
Androgenetic alopecia (AGA) is a non-scarring and progressive form of hair loss occurring in both men and women. Although genetic predisposition and sex steroid hormones are the main causes, many factors remain unknown, and various extrinsic factors can negatively affect the lifespan of hair. We investigated skin-gut axis microorganisms as potential exogenous factors causing AGA, through comparative analyses of the scalp and gut microbiome in individuals with and without AGA in a Korean cohort. Using 16S rRNA gene sequencing, we characterized the scalp and gut microbiomes of 141 individuals divided into groups by sex and presence of AGA. Alpha diversity indices in the scalp microbiome were generally higher in individuals with AGA than in healthy controls. These indices showed a strong negative correlation with scalp-inhabitant bacteria (Cutibacterium and Staphylococcus), indicating that the appearance of non-inhabitant bacteria increases as hair loss progresses. No significant differences in diversity were observed between the gut microbiomes. However, bacterial functional differences, such as bile acid synthesis and bacterial invasion of epithelial cells, which are related to intestinal homeostasis, were observed. The networks of the scalp and gut microbiome were more complex and denser with higher values of the network topology statistic coefficient values (i.e., transitivity, density, and degree centrality) and more unique associations in individuals with AGA than in healthy controls. Our findings reveal a link between skin-gut microorganisms and AGA, indicating the former's potential involvement in the latter's development. Additionally, these results provide evidence for the development of cosmetics and therapeutics using microorganisms and metabolites involved in AGA.
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Affiliation(s)
- Da-Ryung Jung
- Department of Applied Biosciences, Kyungpook National University, Daegu, South Korea
| | - Hye-Young Yoo
- Skin and Natural Products Lab, Kolmar Korea Co., Ltd., Seoul, South Korea
| | - Min-Ji Kim
- Department of Applied Biosciences, Kyungpook National University, Daegu, South Korea
| | - Vineet Singh
- Department of Applied Biosciences, Kyungpook National University, Daegu, South Korea
| | - Sung-Ha Park
- Skin and Natural Products Lab, Kolmar Korea Co., Ltd., Seoul, South Korea
| | - Minsoo Jeong
- Department of Applied Biosciences, Kyungpook National University, Daegu, South Korea
| | - Byoung-Jun Park
- Skin and Natural Products Lab, Kolmar Korea Co., Ltd., Seoul, South Korea,*Correspondence: Byoung-Jun Park,
| | - Jae-Ho Shin
- Department of Applied Biosciences, Kyungpook National University, Daegu, South Korea,Department of Integrative Biotechnology, Kyungpook National University, Daegu, South Korea,NGS Core Facility, Kyungpook National University, Daegu, South Korea,Jae-Ho Shin,
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21
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Ammar AM, Elshahid AR, Abdel-Dayem HA, Mohamed AA, Elsaie ML. Dermoscopic evaluation of the efficacy of combination of topical spironolactone 5% and minoxidil 5% solutions in the treatment of androgenetic alopecia: A cross sectional-comparative study. J Cosmet Dermatol 2022; 21:5790-5799. [PMID: 36039391 DOI: 10.1111/jocd.15328] [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: 06/29/2022] [Revised: 07/25/2022] [Accepted: 08/22/2022] [Indexed: 12/27/2022]
Abstract
BACKGROUND Androgenetic alopecia (AGA) is a common chronic dermatological illness that affects both men and women. AIM To assess and compare dermoscopically the impact of a combination of topical minoxidil solution (5%) and topical spironolactone solution (5%) in treating AGA in both sexes. PATIENTS AND METHODS One hundred and twenty patients diagnosed with AGA were divided into three groups; each group is composed of 40 patients. Group A (n = 40) were treated with a 5% topical minoxidil solution, group B (n = 40) were treated with a 5% topical spironolactone solution, and group C (n = 40) were treated with a 5% topical minoxidil and spironolactone combination. RESULTS Following the initiation of treatment and at 6 weeks (midterm), reduction in all dermoscopic features was observed in all groups; however, it was not statistically significant except for vellus hair reduction (p = 0.033). On the contrary, upright regrowing hairs were insignificantly increased in all groups (p = 1.088). The pattern of dermoscopic features remained to insignificantly decrease toward the end of 12 weeks treatment (full term) in all studied groups except for vellus hair that showed further significant reduction toward the end of the study (p = 0.011). CONCLUSION Both spironolactone as a 5% topical solution and minoxidil as a 5% topical solution might be used safely in a twice-daily dosage to treat AGA in both genders. Furthermore, combining them in a single topical dose form can boost efficacy and yield greater advantages.
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Affiliation(s)
- Amr M Ammar
- Department of Dermatology, Venereology and Andrology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
| | - Ahmed R Elshahid
- Department of Dermatology, Venereology and Andrology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
| | - Hamdy A Abdel-Dayem
- Department of Pharmacology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
| | - Ahmed A Mohamed
- Department of Dermatology, Venereology and Andrology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
| | - Mohamed L Elsaie
- Department of Dermatology, Medical and Clinical Research Institute, National Research Centre, Cairo, Egypt
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22
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Porwal MH, Salter A, Patel D, Obeidat AZ. Alopecia in Multiple Sclerosis Patients Treated with Disease Modifying Therapies. J Cent Nerv Syst Dis 2022; 14:11795735221109674. [PMID: 35769950 PMCID: PMC9234852 DOI: 10.1177/11795735221109674] [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: 01/23/2022] [Accepted: 06/06/2022] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND There is currently limited literature addressing the reporting of alopecia in
multiple sclerosis (MS) patients treated with disease-modifying therapies
(DMTs). Anecdotal reports of hair thinning from patients on various DMTs
prompted further investigation of a large database. OBJECTIVE To analyze total reports, source of reporting, age distribution, and sex
distribution of alopecia associated with DMTs. METHODS FDA Adverse Event Reporting System (FAERS) public dashboard and OpenFDA
database were analyzed for alopecia reports between January 1, 2009, and
June 30, 2020, attributed to usage in MS of FDA approved DMTs. The main
outcomes included total reports for each drug, age, sex distribution, and
reporting source. OpenFDA data was used for statistical analyses including
reporting odds ratios (ROR) and information components. RESULTS 8759 alopecia reports were identified among 44 114 adverse events in skin and
subcutaneous tissue disorders (19.9%). 3701 (42.3%) with teriflunomide, 1675
(19.1%) with dimethyl fumarate, 985 (11.2%) with natalizumab, 926 (10.6%)
with fingolimod, 659 (7.5%) with interferon beta-1a, 257 (2.9%) with
glatiramer acetate, 243 (2.8%) with ocrelizumab, 124 (1.4%) with interferon
beta-1b, 117 (1.3%) with alemtuzumab, 36 (.4%) with siponimod, 24 (.3%) with
cladribine, and 12 (.1%) with rituximab. Reports were mostly made by
patients (78.3%) and highest in fifth and sixth decades of life. OpenFDA
analyses showed increased ROR (ROR 95% confidence interval) of alopecia in
females with teriflunomide (18.00, 17.12-18.93), alemtuzumab (1.43,
1.16-1.76), dimethyl fumarate (1.26, 1.18-1.34), and ocrelizumab (1.28,
1.11-1.49). Increased ROR in males was associated with teriflunomide (24.65,
20.72-29.31). CONCLUSION We identified many reports of alopecia for DMTs in addition to teriflunomide.
Within the limitations of the database, increased RORs of alopecia were
observed for females treated with alemtuzumab, dimethyl fumarate, and
ocrelizumab. The source of reporting was largely driven by female patients.
Possible alopecia, even if transient, should be considered during patient
education when starting DMTs.
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Affiliation(s)
- Mokshal H Porwal
- Department of neurology, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Amber Salter
- Department of Neurology, The University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Dhruvkumar Patel
- Midwestern University Arizona College of Osteopathic Medicine, Glendale, AZ, USA
| | - Ahmed Z Obeidat
- Department of neurology, Medical College of Wisconsin, Milwaukee, WI, USA
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23
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Roohaninasab M, Yavari SF, Babazadeh M, Hagh RA, Pazoki M, Amrovani M. Evaluating the Role of lncRNAs in the Incidence of Cardiovascular Diseases in Androgenetic Alopecia Patients. Cardiovasc Toxicol 2022; 22:603-619. [PMID: 35507254 DOI: 10.1007/s12012-022-09742-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 04/11/2022] [Indexed: 11/28/2022]
Abstract
Hair loss occurs in patients with Androgenetic Alopecia (AGA). The pattern of hair loss is different between men and women. The main cause of hair loss is increased cell apoptosis and decreased regeneration, proliferation and differentiation processes in hair follicles. Long Non-Coding RNAs (lncRNAs) are one of the most important molecules that regulate the processes of apoptosis, regeneration, proliferation and differentiation in hair follicles. Since studies have shown that lncRNAs can be effective in the development of cardiotoxicity and induction of cardiovascular disease (CVD); so effective lncRNAs in the regulation of regeneration, proliferation, differentiation and apoptosis of hair follicles can be involved in the development of CVD in AGA patients with. Therefore, this study investigated the lncRNAs involved in increasing apoptosis and reducing the processes of regeneration, proliferation and differentiation of hair follicles. The aim of the current study was to evaluate the role of lncRNAs as a risk factor in the incidence of CVD in AGA patients; it will help to design treatment strategies by targeting signaling pathways without any cardiotoxicity complications.
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Affiliation(s)
- Masoumeh Roohaninasab
- Department of Dermatology, Rasool Akram Medical Complex, Iran University of Medical Sciences, Sattarkhan St, Tehran, 1445613131, Iran
| | - Shadnaz Fakhteh Yavari
- Department of Tissue Engineering and Applied Cell Science, School of Advanced Technologies in Medicine, Shahid Beheshti University of Medical Science, Tehran, Iran.,Parvaz Research Ideas Supporter Institute, Tehran, Iran
| | - Motahareh Babazadeh
- Department of Dermatology, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | | | - Mahboubeh Pazoki
- Department of Cardiology, Rasoul Akram General Hospital, Iran University of Medical Sciences, Tehran, Iran.
| | - Mehran Amrovani
- High Institute for Education and Research in Transfusion Medicine, Tehran, Iran.
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24
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Association between Androgenetic Alopecia and Psychosocial Disease Burden: A Cross-Sectional Survey among Polish Men. Dermatol Res Pract 2022; 2022:1845044. [PMID: 35340914 PMCID: PMC8947924 DOI: 10.1155/2022/1845044] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 02/25/2022] [Indexed: 11/17/2022] Open
Abstract
A decline in quality of life in men with androgenetic alopecia (AGA) is frequently reported, so we aimed to evaluate the psychosocial burden related to AGA in Polish male patients with AGA. We enrolled 75 adult patients with AGA. The study was conducted in an outpatient dermatology clinic in Poland. Each participant answered 23 dedicated questions about demographic data, history of the disease, and a psychosocial condition. Overall, 38.7% of patients did not notice any impact of AGA on their contact with other people or activity in their free time; 50.7% of patients observed little or no effect on their relationship with their partner; 60% of patients often or sometimes felt embarrassed by their baldness (mainly those aged 18–25 years; p=0.002); 66.7% of patients reported a rather large negative impact on their self-esteem; and 81.3% of patients sometimes experienced stress in everyday life. We conclude that AGA impairs the emotional condition and social functioning of men of all ages, but particularly of younger men. Broader interventions should be planned to allow access to a psychological and psychosocial support, starting treatment at an early stage of the disease, and involving family physicians in the treatment of AGA.
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25
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Mysore V, Kavadya Y. Role of smoking in androgenetic alopecia: A systematic review. Int J Trichology 2022; 14:41-48. [PMID: 35531482 PMCID: PMC9069908 DOI: 10.4103/ijt.ijt_59_21] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Accepted: 11/13/2021] [Indexed: 11/17/2022] Open
Abstract
Smoking and its role in Androgenetic Alopecia has long been debated. Smoking may lead to hair loss by vasoconstriction, by forming DNA adducts, free radical damage to hair follicle, by enhancing senescence and hormonal effects. We have reviewed the available literature on AGA and smoking. Data available show that there is a significant association between smoking and AGA. However, studies demonstrating the benefit of avoidance of smoking in improving hair loss are lacking. Furthermore, large controlled studies with histological documentation are still unavailable to affirm the findings.
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26
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Alomaish AR, Gosadi IM, Dallak FH, Durayb AA, Dallak AH, Hakami JA, Hakami AM, Alshamakhy AE, Mleeh NT. Prevalence of alopecia and its contributing factors among primary healthcare attendees in the Jazan region, Saudi Arabia. J Family Med Prim Care 2021; 10:3851-3856. [PMID: 34934691 PMCID: PMC8653465 DOI: 10.4103/jfmpc.jfmpc_1070_21] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2021] [Revised: 07/14/2021] [Accepted: 07/30/2021] [Indexed: 01/18/2023] Open
Abstract
Background Alopecia is a common health condition that can be associated with social and psychological consequences. Aims This study aims to estimate the prevalence of hair loss and its associated risk factors among primary healthcare center (PHC) attendees in the Jazan region. Methods This investigation was a cross-sectional study conducted in the Jazan region of southwest Saudi Arabia. A total of 23 PHCs were randomly selected from five governorates in the region. Data were collected via interviewing PHCs attendees and were asked about their demographic characteristics, presence of hair loss, and among attendees who confirmed having hair loss, they were further asked about associated clinical features, healthcare-seeking behavior, and factors that might contribute to the development of their condition. Results A total of 729 participants consented to be involved in this study. The number of respondents who reported having hair loss was 483, representing 66.3% of the whole sample. Gender appears to have the highest level of variability, with the majority of participants reporting hair loss being female (P < 0.001). The most frequently reported type of hair loss was telogen effluvium, followed by androgenic alopecia. A total of 185 respondents reported taking medications to treat their hair loss, of whom 108 (58.3%) did not seek any medical advice to identify the cause of their condition. Limitations The main weakness of this investigation is related to relying on a reported presence of hair loss without having it confirmed with a clinical diagnosis. Conclusion A minority of participants who reported suffering from hair loss were further evaluated by healthcare professionals to learn the cause of their hair loss. This may indicate the presence of poor hair care and the probability of a higher risk of hair loss requiring the development of suitable preventive strategies.
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Affiliation(s)
| | - Ibrahim M Gosadi
- Department of Family and Community Medicine, Faculty of Medicine, Jazan University, Jazan, Saudi Arabia
| | | | - Amjad A Durayb
- Faculty of Medicine, Jazan University, Jazan, Saudi Arabia
| | - Ali H Dallak
- Intensive Care Unit, Aseer Central Hospital, Aseer, Saudi Arabia
| | | | - Ayman M Hakami
- Faculty of Medicine, Jazan University, Jazan, Saudi Arabia
| | - Arar E Alshamakhy
- Department of Dermatology, Prince Muhammad Bin Nassir Hospital, Jazan, Saudi Arabia
| | - Nouf T Mleeh
- Department of Dermatology, Faculty of Medicine, King Abdul-Aziz University, Jeddah, Saudi Arabia
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27
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Baghani M, Pourani MR, Nekooghadam SM, Ommi D, Fatemi A, Abdollahimajd F, Moravvej H. Androgenetic alopecia and COVID-19: Is there a clinical connection? J Cosmet Dermatol 2021; 21:420-425. [PMID: 34910352 DOI: 10.1111/jocd.14670] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 11/05/2021] [Accepted: 12/02/2021] [Indexed: 01/08/2023]
Abstract
BACKGROUND During the coronavirus disease 2019 (COVID-19) outbreak, multiple studies showed higher rates of severe infection in adults and specifically in male patients, which may be related to differences in androgen receptor (AR) expression. Androgenetic alopecia (AGA) is one of the AR expression manifestations. AIM To explore AGA severity as a possible risk factor for COVID-19 severity in hospitalized patients. METHODS A total of 164 subjects (116 men and 48 females) with confirmed COVID-19 in need of hospitalization were included in this study. An experienced dermatologist examined the correlation of clinical signs of COVID-19 severity with AGA types. For evaluation of the association between categorical variables and comparison of the mean age in three groups of COVID-19 patients, the Fisher's exact test and the analysis of variance were used. RESULTS Our cross-sectional study included 116 male patients (70.7%) with a median age of 65.5 (age range: 22-97) years. Among them, 13.8% required intubation, 15.5% needed intensive care unit (ICU) care, and 70.7% required inward hospitalization. The Hamilton-Norwood Scale (HNS) was as follows: HNS I 14.7%, HNS II 12.1%, HNS III 20.7%, HNS IV 19.8%, HNS IV 29.8%, HNS V 17.2%, HNS VI 13.8%, and HNS VII 1.7%. Also, 29.3% of the patients were female, possessing a median age of 72 (age range: 23-98) years. In this group, 8.3% required intubation, 6.3% required ICU care, and 85.4% needed inpatient ward admission care. The Ludwig Scale (LS) was as follows: LS I 52.1%, LS II 35.4%, and LS III 12.5%. CONCLUSION The severity of AGA type did not correlate with the severity of COVID-19 among hospitalized patients. Our results were in contrast with other research that suggested AGA severity as a marker of unfavorable outcomes of COVID-19.
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Affiliation(s)
- Moein Baghani
- Skin Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Sayyed Mojtaba Nekooghadam
- Clinical Research Development Unit of Shohada-e Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Internal Department of Shohada-e Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Davood Ommi
- Clinical Research Development Unit of Shohada-e Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Functional Neurosurgery Research Center, Shahid Behehsti University of Medical Sciences, Tehran, Iran
| | - Alireza Fatemi
- Clinical Research Development Unit of Shohada-e Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Men's Health and Reproductive Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fahimeh Abdollahimajd
- Skin Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Clinical Research Development Unit of Shohada-e Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hamideh Moravvej
- Skin Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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28
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Zubair Z, Kantamaneni K, Jalla K, Renzu M, Jena R, Jain R, Muralidharan S, Yanamala VL, Alfonso M. Prevalence of Low Serum Vitamin D Levels in Patients Presenting With Androgenetic Alopecia: A Review. Cureus 2021; 13:e20431. [PMID: 35047268 PMCID: PMC8759975 DOI: 10.7759/cureus.20431] [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] [Received: 09/07/2021] [Accepted: 12/15/2021] [Indexed: 11/18/2022] Open
Abstract
The role of vitamin D receptor (VDR) has been well established and extensively studied in the hair cycle. Its deficiency is also closely linked to several types of alopecia, including alopecia areata, telogen effluvium, and androgenetic alopecia (AGA). Since there is limited research on the correlation between androgenetic alopecia and low serum vitamin D levels, our review aims to find relevant articles and comprehensively present them. A review of the literature was performed to gain insight into AGA. Specifically, PubMed and Google Scholar databases were searched to identify any relevant articles with a focus on androgenetic alopecia, male pattern baldness, and serum vitamin D levels. References within the included articles were also reviewed and taken into the study if found appropriate. All articles that met the inclusion criteria were analyzed for demographics, clinical, laboratory, radiographic, treatment, and outcomes data. We found 13 relevant studies that elucidated the relationship between low serum vitamin D levels and androgenetic alopecia and included them in the review. We concluded that serum vitamin D might be a possible parameter for diagnosing the onset and severity of AGA. Vitamin D supplementation has proven to be useful in the regrowth of hair in non-human subjects. Vitamin D could be a valid therapeutic approach, such as topical vitamin D (calcipotriol) seems to be a good treatment option to regrow hair follicles and prevent miniaturization of follicles due to androgenetic alopecia.
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29
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The role of family history and its influence on the onset time in female pattern hair loss. Postepy Dermatol Alergol 2021; 38:815-818. [PMID: 34849129 PMCID: PMC8610059 DOI: 10.5114/ada.2020.100745] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Accepted: 08/18/2020] [Indexed: 11/17/2022] Open
Abstract
Introduction Female pattern hair loss (FPHL) is one of the most common causes of hair loss in women. Genetics plays an important role in the development of the disease, but the etiopathogenesis and the inheritance pattern in women remain unexplained. Aim To determine the extent to which FPHL is of genetic origin in women from the Polish population and whether a positive family history is a risk factor for its earlier onset. Material and methods Family histories of 111 unrelated female patients with FPHL and 129 female patients without hair thinning were analysed. FPHL was diagnosed based on a detailed medical history, the clinical picture and trichoscopic features. Results A positive family history was noted in 69 (62.2%) patients with FPHL. In 32 (28.8%) patients from that group, more than one person in the family suffered from hair loss, whereas in the healthy group, the same was true of only 4 patients (3.1%) (p < 0.0001). A positive family history on the mother’s side proved statistically significant for FPHL patients. In the case of 20 (18%), hair loss had been identified in their grandparents, while the healthy group had a negative history in that respect. A positive family history of hair loss in grandparents was three times more frequent in the group of patients with the disease onset before 40. Conclusions A positive history on the mother’s side may be of great significance for FPHL development. Hair loss in more than one family member and in one’s grandparents may also indicate a higher risk of disease development.
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30
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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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31
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Wade TJ, Fisher ML, Burch RL. Toupee or Not Toupee?: Cranial Hair and Perceptions of Men’s Attractiveness, Personality, and Other Evolutionary Relevant Traits. EVOLUTIONARY PSYCHOLOGICAL SCIENCE 2021. [DOI: 10.1007/s40806-021-00303-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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32
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Mu Z, Gao Y, Li K, Liu H, Zhang J. Androgenetic Alopecia Among Hospital Staff: A Study of Prevalence, Types and a Comparison with General Population in a Secondary Hospital in China. Clin Cosmet Investig Dermatol 2021; 14:1387-1392. [PMID: 34616167 PMCID: PMC8487794 DOI: 10.2147/ccid.s333789] [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: 08/16/2021] [Accepted: 09/14/2021] [Indexed: 11/23/2022]
Abstract
Purpose The aim of this study is to analyze the prevalence and types of androgenetic alopecia (AGA) among hospital staff and compare it with the general population in dermatology. Subjects and Methods We carried out the study in a secondary hospital in China. We conducted face-to-face interviews with hospital staff and the outpatients and their accompanying persons (general population) visiting the dermatology clinic of the hospital. The severity of AGA was evaluated using the Hamilton–Norwood and Ludwig classifications. Results There were 297 subjects in the hospital staff (105 men and 192 women) and 318 subjects in the general population (109 men and 209 women). The prevalence of AGA among male and female staff was 42.9% and 13.0%, respectively, and the corresponding rates among general male and female population were 27.5% and 8.1%, respectively. However, there was no statistical difference in the prevalence of AGA between female staff and general female population. Among male staff, type IV was the most common type of hair loss (17.1%), and type IVa and type Va were the least common (1.0%). Among female staff, type I (6.3%) was the most common type of hair loss, and type III and male pattern hair loss were the least common (1.0%). A positive family history was found in 53.3% of male and 44.0% of female staff with AGA. Conclusion The prevalence of AGA in the male staff was higher than that in the general male population.
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Affiliation(s)
- Zhanglei Mu
- Department of Dermatology, Peking University People's Hospital, Beijing, People's Republic of China
| | - Yanjun Gao
- Department of Dermatology, Fuping Hospital Affiliated to The Second Hospital of Hebei Medical University, Hebei, People's Republic of China
| | - Kun Li
- Department of Dermatology, Peking University People's Hospital, Beijing, People's Republic of China
| | - Hualong Liu
- Department of Internal Medicine, Fuping Hospital Affiliated to The Second Hospital of Hebei Medical University, Hebei, People's Republic of China
| | - Jianzhong Zhang
- Department of Dermatology, Peking University People's Hospital, Beijing, People's Republic of China
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33
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Kash N, Leavitt M, Leavitt A, Hawkins SD, Roopani RB. Clinical Patterns of Hair Loss in Men: Is Dihydrotestosterone the Only Culprit? Dermatol Clin 2021; 39:361-370. [PMID: 34053589 DOI: 10.1016/j.det.2021.03.001] [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: 11/30/2022]
Abstract
A number of pathways and factors including oxidative stress, inflammation, prostaglandins, vasculogenesis, Wnt/β-catenin, and transforming growth factor-β have been shown to be important in male androgenetic alopecia. There is limited but increasing evidence of the potential usefulness of antioxidants, anti-inflammatory agents, prostaglandins, and growth factors for treating of androgenetic alopecia. Lifestyle factors and comorbidities including cardiovascular risk factors have been shown to be associated with male androgenetic alopecia. Further study of these pathways, factors, and comorbidities is needed to better understand the pathophysiology, find potentially useful therapeutic targets, and ensure a comprehensive approach to the management of androgenetic alopecia in men.
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Affiliation(s)
- Natalie Kash
- Department of Dermatology, Kansas City University-Graduate Medical Education Consortium/Advanced Dermatology and Cosmetic Surgery Orlando Dermatology Program, 260 Lookout Place, Suite 103, Maitland, FL 32751, USA
| | - Matt Leavitt
- Department of Dermatology, Kansas City University-Graduate Medical Education Consortium/Advanced Dermatology and Cosmetic Surgery Orlando Dermatology Program, 260 Lookout Place, Suite 103, Maitland, FL 32751, USA; Advanced Dermatology and Cosmetic Surgery, Maitland, FL, USA; University of Central Florida, College of Medicine, Orlando, FL, USA; Bosley Medical Group, Maitland, FL, USA.
| | - Adam Leavitt
- Department of Dermatology, The University of Michigan, Ann Arbor, MI, USA
| | - Spencer D Hawkins
- Department of Dermatology, The University of Michigan, Ann Arbor, MI, USA
| | - Rahil B Roopani
- Hair Restoration Surgery Program, Leavitt Medical Associates, 260 Lookout Place, Suite 103, Maitland, FL 32751, USA
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34
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Smith GL, Satino J. Hair Regrowth with Cannabidiol (CBD)-rich Hemp Extract - A Case Series. CANNABIS (ALBUQUERQUE, N.M.) 2021; 4:53-59. [PMID: 37287996 PMCID: PMC10212262 DOI: 10.26828/cannabis/2021.01.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/26/2023]
Abstract
Androgenetic alopecia (AGA) is the most common cause of hair loss. Several FDA approved medications are available but offer limited results. Studies have shown that the endocannabinoid system (ECS) is a key player in hair follicle cell growth. The ECS cannabinoid type one (CB1) receptors are well expressed in the hair follicle cells. Cannabidiol CBD is a negative allosteric modulator of the CB1 receptor and has been shown to result in hair shaft elongation. In addition, the hair follicle cycle phases are controlled by the ECS vanilloid receptor-1 (TRPV1). CBD has also been shown to increase Wnt signaling pathways that are involved in the differentiation of dermal progenitor cells into new hair follicles and maintaining the anagen phase of the hair cycle. The effects of CBD on hair growth are dose dependent and higher doses may result in premature entry into the catagen phase via a receptor known as vanilloid receptor-4 (TRPV4). Topical application of CBD reaches hair follicles where it is a CB1 negative modulator, and TRPV1, and TRPV4 agonist. A study was done of 35 subjects with AGA using a once daily topical hemp oil formulation, averaging about 3-4 mg per day of CBD and minimal amounts of other cannabinoids for six months. A hair count of the greatest area of alopecia was carried out before treatment and again after six months. The results revealed that men did slightly better than women, and the vertex area did better than the temporal areas. On average there was statistically significant 93.5% increase in hair after 6 months. All subjects had some regrowth. There were no reported adverse effects. Since the CBD works through novel mechanisms different from finasteride and minoxidil it can be used in conjunction with these current drugs and would be expected to have synergistic effects.
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Affiliation(s)
- Gregory L Smith
- Medical Director, Medical Life Care Planners, St. Petersburg, FL, USA
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35
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Babadjouni A, Pouldar Foulad D, Hedayati B, Evron E, Mesinkovska N. The Effects of Smoking on Hair Health: A Systematic Review. Skin Appendage Disord 2021; 7:251-264. [PMID: 34307472 DOI: 10.1159/000512865] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2020] [Accepted: 11/05/2020] [Indexed: 01/06/2023] Open
Abstract
Smoking is not only a preventable cause of significant systemic disease but also affects the follicular growth cycle and fiber pigmentation. Ambient tobacco smoke exposure results in nicotine accumulation in hair follicles and the hair shaft. This review summarizes the evidence on the association between smoking and hair health, as denoted by alopecia and premature hair graying (PHG). In July 2020, a review of the literature using PubMed/MEDLINE and CINAHL databases identified 32 studies investigating the relationship between smoking, PHG, and alopecia (androgenetic alopecia and frontal fibrosing alopecia). The prevalence of hair loss and PHG is more prevalent in smokers than nonsmokers. Smoking is associated with negative effects on hair health as evidenced in PHG and alopecia. Smoking status should be assessed in patients who are presenting to their dermatologist for evaluation of alopecia and PHG.
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Affiliation(s)
- Arash Babadjouni
- Department of Dermatology, University of California Irvine, Irvine, California, USA.,Midwestern University - Arizona College of Osteopathic Medicine, Glendale, Arizona, USA
| | | | - Bobak Hedayati
- Department of Dermatology, University of California Irvine, Irvine, California, USA
| | - Evyatar Evron
- Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Natasha Mesinkovska
- Department of Dermatology, University of California Irvine, Irvine, California, USA
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36
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Oiwoh S, Akinboro A, Olasode O, Onayemi E. Androgenetic alopecia: Prevalence and clinical characteristics in a South-West Nigerian spopulation. NIGERIAN JOURNAL OF MEDICINE 2021. [DOI: 10.4103/njm.njm_102_21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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37
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Zohdy M, Tantawy M, Khabir A, Mahsoub N. Serum paroxonase 1 level may be an indicator and predictor of the severity of androgenetic alopecia. Int J Trichology 2021; 13:26-31. [PMID: 34934297 PMCID: PMC8647709 DOI: 10.4103/ijt.ijt_128_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Revised: 11/05/2021] [Accepted: 10/13/2021] [Indexed: 11/04/2022] Open
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38
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Odhaib SA, Al Hamdi K, Mansour AA. Is There Any Association Between Clinical and Biochemical Hyperandrogenism in Women With Female Pattern Hair Loss? Cureus 2020; 12:e11732. [PMID: 33403164 PMCID: PMC7773309 DOI: 10.7759/cureus.11732] [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: 11/05/2022] Open
Abstract
Background The exact association between clinical and biochemical hyperandrogenism (HA) is heterogeneous and cannot be ascertained, especially in normoandrogenic women. Objectives Evaluate any association between clinical phenotypes and biochemical parameters of HA in premenopausal women with female pattern hair loss (FPHL). Materials and methods A cross-sectional observational study on 362 women, who were assessed for general characteristics, the different FPHL severities by Sinclair's score, hirsutism by modified Ferriman-Gallwey (mFG) score. Evaluation for biochemical HA included total, calculated free and bioavailable testosterone (TT), free testosterone (FT), and bioavailable testosterone (BT), respectively, and dehydroepiandrosterone sulfate. The variables of clinical HA were FPHL, hirsutism, and acne. Results The enrolled young premenopausal women's age range was (14-47 years). Around 78% were overweight or obese women. Eighty-percent of women had a mild FPHL, with a median of three years, where 2/3 of women had a duration <3 years with no significant relationship to FPHL severity. About 73% of women had either a mild to moderate hirsutism, and around 16% had acne. The biochemical HA was confirmed in around 52% of women (n=188), who show high levels of calculated FT. The calculated BT is high in 78.5% of women (n=284). The means of HA's biochemical indicators were in their reference ranges or slightly above, with no specific change pattern with the corresponding FPHL severity. None of these parameters had a significant relationship with the severity of FPHL. The FPHL duration was not affected by any presumed variable of clinical or biochemical HA. Conclusions FPHL severity was associated with other clinical HA signs like hirsutism and acne, but not to HA's biochemical parameter. Other parameters, like sex hormone-binding globulin (SHBG), and BMI, had no significant relation to the FPHL severity.
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Mancilla GA, Restrepo R, Sanclemente G. Accuracy of clinical diagnosis and videodermoscopy in female pattern hair loss. Skin Res Technol 2020; 27:537-543. [PMID: 33141980 DOI: 10.1111/srt.12981] [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: 05/05/2020] [Revised: 07/13/2020] [Accepted: 09/07/2020] [Indexed: 12/01/2022]
Abstract
BACKGROUND Female pattern hair loss (FPHL) is a non-scarring hair disease characterized by progressive hair diminishment and decrease of its density. Although typical cases of FPHL are usually straightforward to diagnose, its initial forms can be unrecognized and often need the use of other diagnostic methods. OBJECTIVE To describe the accuracy of a diagnosis of FPHL based on clinical grounds and videodermoscopy compared with scalp biopsy. METHODS An observational diagnostic test study was performed. Scalp biopsies were read by the same dermatopathologist and processed horizontally to allow follicle's number and size evaluation. Digital videodermoscopy was also performed. RESULTS A total of 202 patients were enrolled, but only 35 women were assessed with digital videodermoscopy. When clinical diagnosis was compared to scalp biopsy, a sensitivity, specificity, positive predictive value (PPV), and a negative predictive value (NPV), of 77% %, 72.4%, 82.2%; and 65.5%, were respectively obtained. Videodermoscopy showed a sensitivity, specificity, PPV and NPV of 88.9%, 100%, 100%, and 72.7%, respectively. CONCLUSIONS This study provided valuable information on the accuracy of clinical examination of FPHL, showed the usefulness of videodermoscopy as a method that in the future may replace scalp biopsy for its diagnosis, or also could aid patient´s follow-up.
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Affiliation(s)
| | | | - Gloria Sanclemente
- Group of Investigative Dermatology (GRID), University of Antioquia, Medellín, Colombia.,Hospital Universitario de San Vicente Fundacion, Medellin, Colombia.,IPS Universitaria, Medellin, Colombia
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Salem AS, Ibrahim HS, Abdelaziz HH, Elsaie ML. Implications of cigarette smoking on early-onset androgenetic alopecia: A cross-sectional Study. J Cosmet Dermatol 2020; 20:1318-1324. [PMID: 32946667 DOI: 10.1111/jocd.13727] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Revised: 08/31/2020] [Accepted: 09/09/2020] [Indexed: 12/14/2022]
Abstract
BACKGROUND Androgenetic alopecia (AGA) is a condition affecting both males and females. Aims We aimed to assess the demographic and clinical features of early-onset AGA among smokers and nonsmokers and to evaluate whether prevalence of AGA was affected by smoking. PAATIENTS/METHODS One thousand (1000) healthy males aged between 20 and 35 years not complaining of any local scalp condition and free of any mental illness were recruited for this study and divided into two groups of 500 each based on their smoking attitudes. Androgenetic alopecia was classified according to the Hamilton baldness scale, and trichoscopy was used to confirm the diagnosis of AGA. A designed questionnaire to determine basic physical and smoking habits completed and results was interpreted and analyzed. RESULTS The majority of smokers (425) had a form of AGA, while only (200) nonsmokers had a degree of AGA (P < .01). Of the smokers group, 235 (47%) had grade III AGA and 120 subjects (24%) had grade IV AGA. In the nonsmokers group, 100 subjects (20%) had grade II AGA and 50 subjects (10%) had either grade III or IV AGA. CONCLUSION The prevalence of AGA among smokers was statistically higher than among nonsmokers, while severity of AGA was not associated with the intensity of smoking. Nicotine and its derivative cotinine might be responsible for accelerating AGA progress pending further validation.
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Affiliation(s)
- Ahmed S Salem
- Department of Dermatology, Al Azhar University, Cairo, Egypt
| | - Hany S Ibrahim
- Department of Dermatology, Al Azhar University, Cairo, Egypt
| | | | - Mohamed L Elsaie
- Department of Dermatology, National Research Centre, Cairo, Egypt
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Elsaie LT, Elshahid AR, Hasan HM, Soultan FAZM, Jafferany M, Elsaie ML. Cross sectional quality of life assessment in patients with androgenetic alopecia. Dermatol Ther 2020; 33:e13799. [PMID: 32520416 DOI: 10.1111/dth.13799] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2020] [Accepted: 06/05/2020] [Indexed: 10/16/2023]
Abstract
Assessment of quality of life (QOL) of patients with androgenetic alopecia (AGA) has become increasingly important, both in order to evaluate the influence of the disease on patients and the therapy they require. We aimed to assess QOL in subjects complaining from AGA and evaluated the effects of various sociodemographic factors affecting their QOL. QOL was assessed in 400 patients with AGA and 100 controls using the World Health Organization Quality of life (WHOQOL-BREF) questionnaire. Four domains (physical, psychological, social, and environmental) and two items (overall perception of QOL and health) of the WHOQOL-BREF were the primary end points of this study. Patients had a lower QoL and less general satisfaction in all four domains of assessment than controls. The social impact was significantly higher in patients < 30 years of age (P = .003). Patients with severer form of AGA significantly had higher scores in all domains compared to those with less severe forms. Disease severity negatively impacted all the four domains significantly (P = .021). AGA harmfully affected the patient's QOL which warns the physicians to pay more attention to QOL impairment in patients of AGA for the better understanding of the disease burden on individual patients.
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Affiliation(s)
- Lotfy T Elsaie
- Department of Dermatology, Al Azhar University, Cairo, Egypt
| | | | - Hitham M Hasan
- Department of Public Health, Al Azhar university, Cairo, Egypt
| | | | | | - Mohamed L Elsaie
- Department of Dermatology, National Research Centre, Cairo, Egypt
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Abstract
A health paradox exists in the United States. Men have worse health outcomes than women, but national offices exist for promoting women's but not men's health. Two factors that might contribute to this paradox are: underappreciation for the number of health issues that affect men more than women and unawareness that men's health receives less attention than women's health. Therefore, the aim of this article was to summarize the data related to these two factors. First, using mostly government data, an inventory of health issues that are more common in males than females was generated, with prevalence rates listed. Second, results from two new scientometric analyses are presented: (a) number of times "men's health" and "women's health" appeared in titles or abstracts of papers in PubMed from 1970 to 2018; and (b) number of journals currently indexed in MEDLINE that specialize in men's or women's health. The epidemiological data illustrate numerous health issues are more prevalent in men than women, and scientometric data reveal men's health has been given less attention as a distinct field of biomedical research than women's health. This information can help to educate legislators, health officials, journalists, and the general public about the current paradox surrounding men's health in the United States.
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Affiliation(s)
- James L Nuzzo
- Neuroscience Research Australia, Randwick, Australia
- School of Medical Sciences, University of New South Wales, Sydney, Australia
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Danesh-Shakiba M, Poorolajal J, Alirezaei P. Androgenetic Alopecia: Relationship to Anthropometric Indices, Blood Pressure and Life-Style Habits. Clin Cosmet Investig Dermatol 2020; 13:137-143. [PMID: 32104040 PMCID: PMC7008189 DOI: 10.2147/ccid.s231940] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2019] [Accepted: 01/20/2020] [Indexed: 11/30/2022]
Abstract
Purpose The association of androgenetic alopecia (AGA) with cardiovascular risk factors including hypertension, smoking and high body mass index (BMI) has been investigated in several studies. However, the results are discrepant. The aim of the present study was to evaluate the association of AGA with anthropometrics, blood pressure and lifestyle habits. Patients and Methods In this case-control study, 256 men with AGA and 256 age-matched healthy controls were evaluated. Systolic and diastolic blood pressures, as well as anthropometric indices were measured. Data on lifestyle habits including smoking, hookah use and alcohol consumption were also collected. Results Patients with AGA had significantly lower BMI and lower waist to hip ratio as compared to controls (p = 0.012 and p = 0.002, respectively). Other anthropometrics as well as mean systolic and diastolic blood pressures were not significantly different between the two groups. There was no significant difference between patients and controls in terms of lifestyle habits. Patients with severe AGA (Norwood-Hamilton classification type IV-VII) had significantly higher systolic and diastolic blood pressures as compared to those with mild to moderate AGA (Norwood-Hamilton classification type II, III), but the mean age of the former group was also significantly higher (p < 0.001). Conclusion In contrast to some previous studies, our findings did not show a significant association between certain cardiovascular risk factors (such as hypertension and smoking) and AGA. Although lower BMI and lower waist to hip ratio were observed in the patient group, these values were within normal limits and therefore not biologically significant.
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Affiliation(s)
| | - Jalal Poorolajal
- Department of Epidemiology, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran.,Modeling of Noncommunicable Diseases Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Pedram Alirezaei
- Psoriasis Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
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Wortsman X, Carreño L, Ferreira-Wortsman C, Poniachik R, Pizarro K, Morales C, Calderon P, Castro A. Ultrasound Characteristics of the Hair Follicles and Tracts, Sebaceous Glands, Montgomery Glands, Apocrine Glands, and Arrector Pili Muscles. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2019; 38:1995-2004. [PMID: 30570163 DOI: 10.1002/jum.14888] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/26/2018] [Revised: 11/02/2018] [Accepted: 11/11/2018] [Indexed: 06/09/2023]
Abstract
OBJECTIVES To explore the capability of very high-frequency ultrasound (US; 50-71 MHz) to detect the normal morphologic characteristics of the hair follicles and tracts, sebaceous glands, Montgomery glands, apocrine glands, and arrector pili muscles. METHODS A retrospective study, approved by the Institutional Review Board, evaluated the normal US morphologic characteristics of the hair and adnexal structures in a database of very high-frequency US images extracted from the perilesional or contralateral healthy skin of 1117 consecutive patients who underwent US examinations for localized lesions of the skin and 10 healthy individuals from December 2017 to June 2018. These images were matched with their counterparts from the database of normal histologic images according to the corporal region. The Cohen concordance test and regional mean diameters of the hair follicles and adnexal structures were analyzed. RESULTS The normal hair follicles and tracts, sebaceous glands, Montgomery glands, apocrine glands, and arrector pili muscles were observed on US images and matched their histological counterparts in all the corporal regions. There was significant US concordance (κ = 0.82; P = .0001) among observers. Regional mean diameters (millimeters) of the hair follicles, sebaceous glands, and apocrine glands are provided. CONCLUSIONS The hair follicles and tracts, sebaceous glands, Montgomery glands, apocrine glands, and arrector pili muscles are detectable with very high-frequency US, including some regional and anatomic variants. Knowledge of their normal US appearances is a requisite for detecting subclinical changes, understanding the physiopathologic characteristics, and supporting the early diagnosis and management of common dermatologic diseases.
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Affiliation(s)
- Ximena Wortsman
- Institute for Diagnostic Imaging and Research for the Skin and Soft Tissues, Santiago, Chile
- Departments of Dermatology, University of Chile, Santiago, Chile
| | - Laura Carreño
- Departments of Pathology, Dermopathology Section, University of Chile, Santiago, Chile
| | | | | | - Kharla Pizarro
- Departments of Pathology, Dermopathology Section, University of Chile, Santiago, Chile
| | - Claudia Morales
- Departments of Pathology, Dermopathology Section, University of Chile, Santiago, Chile
| | - Perla Calderon
- Departments of Dermatology, University of Chile, Santiago, Chile
| | - Ariel Castro
- Office for Clinical Research Support, Hospital Clínico Universidad de Chile, University of Chile, Santiago, Chile
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Vañó-Galván S, Saceda-Corralo D, Blume-Peytavi U, Cucchía J, Dlova NC, Gavazzoni Dias MFR, Grimalt R, Guzmán-Sánchez D, Harries M, Ho A, Holmes S, Larrondo J, Mosam A, Oliveira-Soares R, Pinto GM, Piraccini BM, Pirmez R, De la Rosa Carrillo D, Rudnicka L, Shapiro J, Sinclair R, Tosti A, Trüeb RM, Vogt A, Miteva M. Frequency of the Types of Alopecia at Twenty-Two Specialist Hair Clinics: A Multicenter Study. Skin Appendage Disord 2019; 5:309-315. [PMID: 31559256 DOI: 10.1159/000496708] [Citation(s) in RCA: 47] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2018] [Accepted: 01/03/2019] [Indexed: 12/11/2022] Open
Abstract
Background The frequency of different types of alopecia is not clearly reported in recent studies. Objective To analyze the frequency of the types of alopecia in patients consulting at specialist hair clinics (SHC) and to assess for global variations. Methods Multicenter retrospective study including data from patients evaluated at referral SHC in Europe, America, Africa and Australia. Results A total of 2,835 patients (72.7% females and 27.3% males) with 3,133 diagnoses of alopecia were included (73% were non-cicatricial and 27% were cicatricial alopecias). In all, 57 different types of alopecia were characterized. The most frequent type was androgenetic alopecia (AGA) (37.7%), followed by alopecia areata (AA) (18.2%), telogen effluvium (TE) (11.3%), frontal fibrosing alopecia (FFA) (10.8%), lichen planopilaris (LPP) (7.6%), folliculitis decalvans (FD) (2.8%), discoid lupus (1.9%) and fibrosing alopecia in a pattern distribution (FAPD) (1.8%). There was a male predominance in patients with acne keloidalis nuchae, dissecting cellulitis and FD, and female predominance in traction alopecia, central centrifugal cicatricial alopecia, FFA, TE, FAPD and LPP. Conclusion AGA followed by AA and TE were the most frequent cause of non-cicatricial alopecia, while FFA was the most frequent cause of cicatricial alopecia in all studied geographical areas.
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Affiliation(s)
- Sergio Vañó-Galván
- Dermatology Department, Ramon y Cajal Hospital, University of Alcala, IRYCIS, Trichology Unit, Grupo Pedro Jaen Clinic, Madrid, Spain
| | - David Saceda-Corralo
- Dermatology Department, Ramon y Cajal Hospital, University of Alcala, IRYCIS, Trichology Unit, Grupo Pedro Jaen Clinic, Madrid, Spain
| | - Ulrike Blume-Peytavi
- Department of Dermatology and Allergy, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Jose Cucchía
- Private Trichology Practice, Santa Ana Medical Center, Bogotá, Colombia
| | - Ncoza C Dlova
- Department of Dermatology, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa
| | | | - Ramon Grimalt
- Dermatology Department, Universitat Internacional de Catalunya, Barcelona, Spain
| | | | - Matthew Harries
- The Dermatology Centre, University of Manchester, Salford Royal NHS Foundation Trust, Salford, United Kingdom
| | - Anthony Ho
- The Ronald O. Perelman Department of Dermatology, New York University School of Medicine, New York, New York, USA
| | - Susan Holmes
- Alan Lyell Centre for Dermatology, Queen Elizabeth University Hospital, Glasgow, United Kingdom
| | - Jorge Larrondo
- Department of Dermatology, Clínica Alemana de Santiago, Facultad de Medicina Clínica Alemana, Universidad del Desarrollo, Santiago, Chile
| | - Anisa Mosam
- Department of Dermatology, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa
| | - Rui Oliveira-Soares
- Department of Dermatology, Hospital Cuf Descobertas, Lisbon, Portugal.,Department of Dermatology, Hospital Cuf Torres Vedras, Torres Vedras, Portugal
| | - Giselle M Pinto
- Hair and Scalp Diseases, Outpatient Clinic, Division of Dermatology, Santa Casa de Misericórdia, Porto Alegre, Brazil
| | - Bianca M Piraccini
- Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | - Rodrigo Pirmez
- Department of Dermatology, Instituto de Dermatologia Professor Rubem David Azulay, Santa Casa da Misericórdia do Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - Lidia Rudnicka
- Department of Dermatology, Medical University of Warsaw, Warsaw, Poland
| | - Jerry Shapiro
- The Ronald O. Perelman Department of Dermatology, New York University School of Medicine, New York, New York, USA
| | - Rodney Sinclair
- Sinclair Dermatology, East Melbourne, Victoria, Australia.,Department of Medicine, University of Melbourne, Parkville, Victoria, Australia
| | | | - Ralph M Trüeb
- Center for Dermatology and Hair Diseases Professor Trüeb, Wallisellen, Switzerland
| | - Annika Vogt
- Department of Dermatology and Allergy, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Mariya Miteva
- Department of Dermatology and Cutaneous Surgery, University of Miami L. Miller School of Medicine, Miami, Florida, USA
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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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Qu Q, Miao Y, Guo ZH, Feng CB, Chen Q, Liu Y, Liu F, Shi PL, Cao DX, Hu ZQ. Types of hairline recession in androgenetic alopecia and perceptions of aging in Asian males. Int J Dermatol 2019; 58:1191-1196. [PMID: 30888056 DOI: 10.1111/ijd.14423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Revised: 02/12/2019] [Accepted: 02/12/2019] [Indexed: 11/27/2022]
Abstract
BACKGROUND Cranial hair loss is one of the characteristics of age. Hairline recession has been confirmed adversely to affect the perceptions of age in Western males. However, comparatively little is known about the effect of frontal recession on the perceived facial age (PFA) of East Asian males. Moreover, specific roles of different types of hairline recession in PFA of different age groups still remain a mystery. OBJECTIVE To investigate and quantify the effect of different types of hairline recession on PFA in East Asian young males of different age groups. METHODS Thirty non-bald males were selected and divided equally into three groups (20s, 30s, and 40s). With the aid of modern software, the frontoparietal area of facial images from 30 experimenters was modified into three basic types of hair loss (M2 , C2 , and U2 ) according to the basic and specific classification of androgenic alopecia. In a web-based survey, approximately 900 naive participants were asked to estimate the PFA of males from their original and modified facial images. RESULTS Perceived facial age increased to 1.58 ± 0.79, 4.19 ± 1.27, and 5.90 ± 1.00 years when the original facial images were modified to have hair loss types M2 , C2 , or U2 , respectively. In addition, the PFA of males with hair loss type C2 or U2 appeared significantly older than the original facial images in the 30s group. CONCLUSION Different types of hairline recession can increase the PFA to different degrees in East Asian males of different age groups.
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Affiliation(s)
- Qian Qu
- Department of Plastic and Aesthetic Surgery, NanFang Hospital of Southern Medical University, Guangzhou, 510515, China
| | - Yong Miao
- Department of Plastic and Aesthetic Surgery, NanFang Hospital of Southern Medical University, Guangzhou, 510515, China
| | - Zhen-He Guo
- Department of Plastic and Aesthetic Surgery, NanFang Hospital of Southern Medical University, Guangzhou, 510515, China
| | - Chuan-Bo Feng
- Department of Plastic and Aesthetic Surgery, NanFang Hospital of Southern Medical University, Guangzhou, 510515, China
| | - Qian Chen
- Department of Plastic and Aesthetic Surgery, NanFang Hospital of Southern Medical University, Guangzhou, 510515, China
| | - Yang Liu
- Department of Plastic and Aesthetic Surgery, NanFang Hospital of Southern Medical University, Guangzhou, 510515, China
| | - Fang Liu
- Department of Plastic and Aesthetic Surgery, NanFang Hospital of Southern Medical University, Guangzhou, 510515, China
| | - Pan-Li Shi
- Department of Plastic and Aesthetic Surgery, NanFang Hospital of Southern Medical University, Guangzhou, 510515, China
| | - Dan-Xia Cao
- Department of Plastic and Aesthetic Surgery, NanFang Hospital of Southern Medical University, Guangzhou, 510515, China
| | - Zhi-Qi Hu
- Department of Plastic and Aesthetic Surgery, NanFang Hospital of Southern Medical University, Guangzhou, 510515, China
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Dhaher SA, Yacoub AA, Jacob AA. Estimation of Zinc and Iron Levels in the Serum and Hair of Women with Androgenetic Alopecia: Case-control Study. Indian J Dermatol 2018; 63:369-374. [PMID: 30210156 PMCID: PMC6124235 DOI: 10.4103/ijd.ijd_624_16] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
Background: Although female androgenetic alopecia (FAGA) occurs in genetically susceptible women, some trace elements may play an important role. Aim of the Study: This study aimed to evaluate serum and hair zinc and iron levels in patients with FAGA and to compare the findings with normal controls. Patients and Methods: A case–control study that was conducted at Dermatology Clinic in Basra General Hospital, Basra, Iraq. The participants were divided into two groups: The first group consisted of 27 women with FAGA and the second was age-matched 28 healthy women control group. The serum and hair zinc and iron assays were done for all participants. Results: Both hair and serum zinc levels in FAGA group were significantly lower than that in the control (103.4±25.5 ppm vs. 143.5±33.1 ppm for hair and 65.6±14.2 μg/dl vs. 128.4±41.4 μg/dl for serum). Hair iron level in FAGA was significantly lower than in control (17.9±3.8 ppm vs. 26.9±7.4 ppm, P>0.05). Serum iron level in FAGA group was lower than in the control, but it was not significant statistically (88.9±22.3 μg/dl vs. 100.9±18.9 μg/dl). Except for the hair iron, there was no significant correlation between zinc and iron concentrations in hair and serum with severity of alopecia. Conclusions: Zinc and iron levels in serum and hair were lower in FAGA compared to that of normal individuals indicating that trace elements might play an important role in the etiopathogenesis of FAGA.
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Affiliation(s)
- Samer A Dhaher
- Department of Dermatology, College of Medicine, Basra University, Basra, Iraq
| | | | - Ausama Ayob Jacob
- Department of Pharmacology and Toxicology, College of Pharmacy, Basra, Iraq
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49
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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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Abstract
Hair loss is a common condition that affects most people at some point in their lives. It can exist as an isolated problem or with other diseases and conditions. Androgenetic alopecia (AGA) and its association with the metabolic syndrome (MetS) have received increasing interest since 1972, when the first link between cardiovascular risk factors and hair loss was raised. We have reviewed studies concerning the relationship between alopecia and MetS. Many studies have investigated the relationship among AGA and MetS and its individual components, particularly in men, where a disproportionately large number of these studies supports this association. AGA has also been associated with other metabolic-related conditions, including coronary artery disease, polycystic ovary syndrome, and Cushing syndrome, as well as several nutritional deficiencies, all of which have led to many clinicians advocating for the screening of MetS and cardiovascular risk factors in patients who present with AGA.
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