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Younis N, Puigmal N, Kurdi AE, Badaoui A, Zhang D, Morales-Garay C, Saad A, Cruz D, Rahy NA, Daccache A, Huerta T, Deban C, Halawi A, Choi J, Dosta P, Guo Lian C, Artzi N, Azzi JR. Microneedle-Mediated Delivery of Immunomodulators Restores Immune Privilege in Hair Follicles and Reverses Immune-Mediated Alopecia. ADVANCED MATERIALS (DEERFIELD BEACH, FLA.) 2024; 36:e2312088. [PMID: 38638030 DOI: 10.1002/adma.202312088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 04/05/2024] [Indexed: 04/20/2024]
Abstract
Disorders in the regulatory arm of the adaptive immune system result in autoimmune-mediated diseases. While systemic immunosuppression is the prevailing approach to manage them, it fails to achieve long-lasting remission due to concomitant suppression of the regulatory arm and carries the risk of heightened susceptibility to infections and malignancies. Alopecia areata is a condition characterized by localized hair loss due to autoimmunity. The accessibility of the skin allows local rather than systemic intervention to avoid broad immunosuppression. It is hypothesized that the expansion of endogenous regulatory T cells (Tregs) at the site of antigen encounter can restore the immune balance and generate a long-lasting tolerogenic response. A hydrogel microneedle (MN) patch is therefore utilized for delivery of CCL22, a Treg-chemoattractant, and IL-2, a Treg survival factor to amplify them. In an immune-mediated murine model of alopecia, local bolstering of Treg numbers is shown, leading to sustained hair regrowth and attenuation of inflammatory pathways. In a humanized skin transplant mouse model, expansion of Tregs within human skin is confirmed without engendering peripheral immunosuppression. The patch offers high-loading capacity and shelf-life stability for prospective clinical translation. By harmonizing immune responses locally, the aim is to reshape the landscape of autoimmune skin disease management.
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Affiliation(s)
- Nour Younis
- Brigham and Woman's Hospital, Department of Medicine, Renal Division, Harvard Medical School, Boston, MA, 02115, USA
| | - Núria Puigmal
- Brigham and Woman's Hospital, Department of Medicine, Division of Engineering in Medicine, Harvard Medical School, Boston, MA, 02115, USA
- Institute for Medical Engineering and Science, Massachusetts Institute of Technology, Cambridge, MA, 02138, USA
- Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, MA, 02215, USA
| | - Abdallah El Kurdi
- Department of Biochemistry and Molecular Genetics, Faculty of Medicine, American University of Beirut, Beirut, 11-0236, Lebanon
| | - Andrew Badaoui
- Brigham and Woman's Hospital, Department of Medicine, Renal Division, Harvard Medical School, Boston, MA, 02115, USA
| | - Dongliang Zhang
- Brigham and Woman's Hospital, Department of Medicine, Renal Division, Harvard Medical School, Boston, MA, 02115, USA
| | - Claudia Morales-Garay
- Brigham and Woman's Hospital, Department of Medicine, Division of Engineering in Medicine, Harvard Medical School, Boston, MA, 02115, USA
| | - Anis Saad
- Brigham and Woman's Hospital, Department of Medicine, Renal Division, Harvard Medical School, Boston, MA, 02115, USA
| | - Diane Cruz
- Brigham and Woman's Hospital, Department of Medicine, Division of Engineering in Medicine, Harvard Medical School, Boston, MA, 02115, USA
| | - Nadim Al Rahy
- Brigham and Woman's Hospital, Department of Medicine, Renal Division, Harvard Medical School, Boston, MA, 02115, USA
| | - Andrea Daccache
- Brigham and Woman's Hospital, Department of Medicine, Renal Division, Harvard Medical School, Boston, MA, 02115, USA
| | - Triana Huerta
- Brigham and Woman's Hospital, Department of Medicine, Division of Engineering in Medicine, Harvard Medical School, Boston, MA, 02115, USA
| | - Christa Deban
- Brigham and Woman's Hospital, Department of Medicine, Renal Division, Harvard Medical School, Boston, MA, 02115, USA
| | - Ahmad Halawi
- Brigham and Woman's Hospital, Department of Medicine, Renal Division, Harvard Medical School, Boston, MA, 02115, USA
| | - John Choi
- Brigham and Woman's Hospital, Department of Medicine, Renal Division, Harvard Medical School, Boston, MA, 02115, USA
| | - Pere Dosta
- Brigham and Woman's Hospital, Department of Medicine, Division of Engineering in Medicine, Harvard Medical School, Boston, MA, 02115, USA
- Institute for Medical Engineering and Science, Massachusetts Institute of Technology, Cambridge, MA, 02138, USA
- Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, MA, 02215, USA
| | - Christine Guo Lian
- Department of Pathology, Brigham and Women's Hospital, Boston, MA, 02115, USA
| | - Natalie Artzi
- Brigham and Woman's Hospital, Department of Medicine, Division of Engineering in Medicine, Harvard Medical School, Boston, MA, 02115, USA
- Institute for Medical Engineering and Science, Massachusetts Institute of Technology, Cambridge, MA, 02138, USA
- Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, MA, 02215, USA
| | - Jamil R Azzi
- Brigham and Woman's Hospital, Department of Medicine, Renal Division, Harvard Medical School, Boston, MA, 02115, USA
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Ertas YN, Ertas D, Erdem A, Segujja F, Dulchavsky S, Ashammakhi N. Diagnostic, Therapeutic, and Theranostic Multifunctional Microneedles. SMALL (WEINHEIM AN DER BERGSTRASSE, GERMANY) 2024; 20:e2308479. [PMID: 38385813 DOI: 10.1002/smll.202308479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/23/2023] [Revised: 01/04/2024] [Indexed: 02/23/2024]
Abstract
Microneedles (MNs) have maintained their popularity in therapeutic and diagnostic medical applications throughout the past decade. MNs are originally designed to gently puncture the stratum corneum layer of the skin and have lately evolved into intelligent devices with functions including bodily fluid extraction, biosensing, and drug administration. MNs offer limited invasiveness, ease of application, and minimal discomfort. Initially manufactured solely from metals, MNs are now available in polymer-based varieties. MNs can be used to create systems that deliver drugs and chemicals uniformly, collect bodily fluids, and are stimulus-sensitive. Although these advancements are favorable in terms of biocompatibility and production costs, they are insufficient for the therapeutic use of MNs. This is the first comprehensive review that discusses individual MN functions toward the evolution and development of smart and multifunctional MNs for a variety of novel and impactful future applications. The study examines fabrication techniques, application purposes, and experimental details of MN constructs that perform multiple functions concurrently, including sensing, drug-molecule release, sampling, and remote communication capabilities. It is highly likely that in the near future, MN-based smart devices will be a useful and important component of standard medical practice for different applications.
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Affiliation(s)
- Yavuz Nuri Ertas
- Department of Biomedical Engineering, Erciyes University, Kayseri, 38039, Türkiye
- ERNAM-Nanotechnology Research and Application Center, Erciyes University, Kayseri, 38039, Türkiye
- UNAM-National Nanotechnology Research Center, Bilkent University, Ankara, 06800, Türkiye
| | - Derya Ertas
- ERNAM-Nanotechnology Research and Application Center, Erciyes University, Kayseri, 38039, Türkiye
| | - Ahmet Erdem
- Department of Biomedical Engineering, Kocaeli University, Umuttepe Campus, Kocaeli, 41380, Türkiye
- Department of Chemistry, Kocaeli University, Umuttepe Campus, Kocaeli, 41380, Türkiye
| | - Farouk Segujja
- Department of Biomedical Engineering, Kocaeli University, Umuttepe Campus, Kocaeli, 41380, Türkiye
| | - Scott Dulchavsky
- Department of Surgery, Henry Ford Health, Detroit, MI, 48201, USA
| | - Nureddin Ashammakhi
- Institute for Quantitative Health Science and Engineering (IQ) and Department of Biomedical Engineering (BME), Colleges of Engineering and Human Medicine, Michigan State University, East Lansing, MI, 48824, USA
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Xiao C, Zhang GH, Li HQ, Yang PP, Zhang HB, Mu YX. Meta-Analysis of Efficacy of Platelet-Rich Plasma Combined with Minoxidil for Androgenetic Alopecia. Aesthetic Plast Surg 2024:10.1007/s00266-024-04054-6. [PMID: 38789807 DOI: 10.1007/s00266-024-04054-6] [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: 01/29/2024] [Accepted: 04/09/2024] [Indexed: 05/26/2024]
Abstract
BACKGROUND Androgenetic alopecia (AGA) is a prevalent type of hair loss that impacts individuals of both genders. Platelet-rich plasma (PRP) and minoxidil have been employed as therapeutic interventions for AGA, yet the efficacy of their concurrent use remains ambiguous. OBJECTIVE To perform a comprehensive review and meta-analysis aimed at evaluating the effectiveness of platelet-rich plasma (PRP) in combination with minoxidil for the treatment of androgenetic alopecia (AGA). METHODS We conducted a comprehensive search of the databases PubMed, Embase, Web of Science, and Cochrane Library, encompassing their complete records up until December 2023. Eligible studies were randomized controlled trials that compared the combination of PRP and minoxidil with minoxidil or PRP alone in patients with AGA. The primary outcome measure was the change in hair growth as assessed by the hair density or hair thickness. Secondary outcome measures included patient satisfaction, and global photographic assessment. RESULTS A total of 6 studies involving 343 participants were included in this meta-analysis. The results showed that PRP combined with minoxidil significantly improved hair growth compared to minoxidil or PRP alone. The pooled analysis demonstrated a significant increase in hair density (weighted mean difference [WMD] = 9.14; 95% confidence interval [CI]: 6.57-11.70) and hair diameter (WMD = 4.72; 95% CI 3.21-6.23) in the PRP combined with minoxidil group. Moreover, patients receiving PRP combined with minoxidil reported higher satisfaction rates compared to those using minoxidil or PRP alone. CONCLUSIONS This meta-analysis suggests that PRP combined with minoxidil is an effective treatment for AGA, providing significant improvement in hair growth and patient satisfaction. LEVEL OF EVIDENCE III This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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Affiliation(s)
- Chuan Xiao
- Binzhou Medical University Hospital, Binzhou City, Shandong Province, China
| | - Guo-Hui Zhang
- Department of Plastic Surgery, Binzhou Medical University Hospital, Binzhou City, Shandong Province, China.
| | - Hai-Qi Li
- Binzhou Medical University Hospital, Binzhou City, Shandong Province, China
| | - Peng-Peng Yang
- Department of Plastic Surgery, Binzhou Medical University Hospital, Binzhou City, Shandong Province, China
| | - Hai-Bo Zhang
- Department of Plastic Surgery, Binzhou Medical University Hospital, Binzhou City, Shandong Province, China
| | - Yue-Xiao Mu
- Department of Plastic Surgery, Binzhou Medical University Hospital, Binzhou City, Shandong Province, China
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Li J, Ge R, Lin K, Wang J, He Y, Lu H, Dong H. Advances in the Application of Microneedles in the Treatment of Local Organ Diseases. SMALL (WEINHEIM AN DER BERGSTRASSE, GERMANY) 2024; 20:e2306222. [PMID: 37786290 DOI: 10.1002/smll.202306222] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Revised: 09/07/2023] [Indexed: 10/04/2023]
Abstract
In recent years, microneedles (MNs) have attracted a lot of attention due to their microscale sizes and high surface area (500-1000 µm in length), allowing pain-free and efficient drug delivery through the skin. In addition to the great success of MNs based transdermal drug delivery, especially for skin diseases, increasing studies have indicated the expansion of MNs to diverse nontransdermal applications, including the delivery of therapeutics for hair loss, ocular diseases, and oral mucosal. Here, the current treatment of hair loss, eye diseases, and oral disease is discussed and an overview of recent advances in the application of MNs is provided for these three noncutaneous localized organ diseases. Particular emphasis is laid on the future trend of MNs technology development and future challenges of expanding the generalizability of MNs.
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Affiliation(s)
- Jinze Li
- Marshall Laboratory of Biomedical Engineering, Shenzhen Key Laboratory for Nano-Biosensing Technology, School of Biomedical Engineering, Shenzhen University Medical School, Shenzhen University, Guangdong, 518060, China
| | - Rujiao Ge
- Beijing Key Laboratory for Bioengineering and Sensing Technology, Research Center for Bioengineering and Sensing Technology, School of Chemistry and Biological Engineering, University of Science and Technology Beijing, Beijing, 100083, China
| | - Kai Lin
- College of Chemistry and Environmental Engineering, Shenzhen University, Guangdong, 518060, China
| | - Junren Wang
- Marshall Laboratory of Biomedical Engineering, Shenzhen Key Laboratory for Nano-Biosensing Technology, School of Biomedical Engineering, Shenzhen University Medical School, Shenzhen University, Guangdong, 518060, China
| | - Yu He
- Department of Pharmacology, University of Oxford, Oxford, OX1 3QT, UK
| | - Huiting Lu
- Department of Chemistry, School of Chemistry and Biological Engineering, University of Science and Technology Beijing, Beijing, 100083, China
| | - Haifeng Dong
- Marshall Laboratory of Biomedical Engineering, Shenzhen Key Laboratory for Nano-Biosensing Technology, School of Biomedical Engineering, Shenzhen University Medical School, Shenzhen University, Guangdong, 518060, China
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Liu D, Xu Q, Meng X, Liu X, Liu J. Status of research on the development and regeneration of hair follicles. Int J Med Sci 2024; 21:80-94. [PMID: 38164355 PMCID: PMC10750333 DOI: 10.7150/ijms.88508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 10/17/2023] [Indexed: 01/03/2024] Open
Abstract
Hair loss, or alopecia, is a prevalent condition in modern society that imposes substantial mental and psychological burden on individuals. The types of hair loss, include androgenetic alopecia, alopecia areata, and telogen effluvium; of them, androgenetic alopecia is the most common condition. Traditional treatment modalities mainly involve medical options, such as minoxidil, finasteride and surgical interventions, such as hair transplantation. However, these treatments still have many limitations. Therefore, exploring the pathogenesis of hair loss, specifically focusing on the development and regeneration of hair follicles (HFs), and developing new strategies for promoting hair regrowth are essential. Some emerging therapies for hair loss have gained prominence; these therapies include low-level laser therapy, micro needling, fractional radio frequency, platelet-rich plasma, and stem cell therapy. The aforementioned therapeutic strategies appear promising for hair loss management. In this review, we investigated the mechanisms underlying HF development and regeneration. For this, we studied the structure, development, cycle, and cellular function of HFs. In addition, we analyzed the symptoms, types, and causes of hair loss as well as its current conventional treatments. Our study provides an overview of the most effective regenerative medicine-based therapies for hair loss.
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Affiliation(s)
| | | | | | - Xiaomei Liu
- Department of Toxicology, School of Public Health, Jilin University, Changchun 130021, China
| | - Jinyu Liu
- Department of Toxicology, School of Public Health, Jilin University, Changchun 130021, China
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Abdi P, Awad C, Anthony MR, Farkouh C, Kenny B, Maibach HI, Ogunyemi B. Efficacy and safety of combinational therapy using topical minoxidil and microneedling for the treatment of androgenetic alopecia: a systematic review and meta-analysis. Arch Dermatol Res 2023; 315:2775-2785. [PMID: 37665358 DOI: 10.1007/s00403-023-02688-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 03/01/2023] [Accepted: 07/27/2023] [Indexed: 09/05/2023]
Abstract
Androgenetic alopecia is a widespread condition that is the most common type of hair loss affecting approximately 58% and 40% of men and women by the age of 50, respectively. Patients have been known to experience severe distress due to androgenetic alopecia, including anxiety, low self-esteem, and depression. The objective of this study was to conduct a systematic review and meta-analysis to determine the efficacy of combination therapy using topical minoxidil and microneedling compared to topical minoxidil alone. This systematic review of randomized controlled trials was carried out using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist. The literature search was performed using Scopus, Cochrane, Embase, and the National Institutes of Health's United States National Library of Medicine from inception through January 20, 2023. Randomized controlled trials examining the efficacy of combinational therapy and monotherapy using microneedling and minoxidil on patients with clinically diagnosed androgenetic alopecia were included after screening titles, abstracts, and full texts. Two independent reviewers selected studies, extracted data, and appraised the risk of bias using the Cochrane risk of bias assessment tool. Ten randomized controlled trials, including 466 patients, were selected for this review and eight studies were ultimately included in the meta-analysis. All eight studies displayed a statistically significant increase in total hair count [standard mean difference (SMD) 1.76; 95% CI 1.26-2.26; P < 0.00001]; however, the evidence did not support a statistically significant increase in hair diameter (SMD 0.82; 95% CI - 0.01 to 1.65; P = 0.05). No scarring nor serious adverse events were reported in any of the studies. The findings of this meta-analysis strongly support the utilization of a multimodal therapeutic approach of minoxidil and microneedling for hair growth in patients with androgenetic alopecia. However, variations in factors such as rating scale measurements, microneedling methods, and areas of treatment may have resulted in confounding. Further randomized controlled, large-sample trials employing rigorous methodologies are needed to gain a more comprehensive understanding regarding treatment efficacy, namely the impact of combinational therapy on hair diameter.Clinical trial registrations This study follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and is registered in the International Prospective Register of Systematic Reviews (PROSPERO) database (CRD42023391164) and the International Platform of Registered Systematic Review and Meta-analysis Protocols (INPLASY) database (INPLASY202310031).
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Affiliation(s)
- Parsa Abdi
- Memorial University of Newfoundland Faculty of Medicine, 300 Prince Philip Dr, St. John's, NL, A1B 3V6, Canada.
| | - Christian Awad
- Memorial University of Newfoundland Faculty of Medicine, 300 Prince Philip Dr, St. John's, NL, A1B 3V6, Canada
| | | | | | - Bret Kenny
- Department of Dermatology and Skin Science, University of British Columbia Faculty of Medicine, 835 West 10th Avenue, Vancouver, BC, V5Z 4E8, Canada
| | - Howard I Maibach
- Division of Dermatology, School of Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Boluwaji Ogunyemi
- Division of Dermatology, Memorial University of Newfoundland Faculty of Medicine, 300 Prince Philip Dr, St. John's, NL, A1B 3V6, Canada
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7
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Qian Y, Zhu L, Wu L, Chen J, Ding B, Li Y, Cao Y. Favorable effect of herbal extract on androgenic alopecia: A case report. Medicine (Baltimore) 2023; 102:e34524. [PMID: 37773795 PMCID: PMC10545014 DOI: 10.1097/md.0000000000034524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2023] [Accepted: 07/07/2023] [Indexed: 10/01/2023] Open
Abstract
RATIONALE Androgenic alopecia (AGA) is a prevalent condition with progressive miniaturization of hair follicles. Currently, reliable treatments have remained limited, and complementary medications for AGA are still being investigated. Traditional Chinese medicine formulas have conspicuous advantages in the treatment of AGA with good development prospects. Zimmer aqueous spray (ZAS) is a water spray containing Zimmer herbal extract powder (ZMWP), which consists of Ligustri lucidi Fructus, Ecliptae Herba, Fallopia multiflora (Thunb.) Harald. and Polygonatum sibiricum Delar. ex Redoute, etc. ZMWP is an active ingredient in the prevention of hair loss. Our aim is to provide evidence for the effectiveness of ZAS in the treatment of AGA. PATIENT CONCERNS A 41-year-old man had suffered from hair loss for 8 years. INTERVENTIONS The patient with moderate AGA received 3 to 4 mL ZAS daily or every other day for 3 months. OUTCOMES The hair density obviously increased after 3 months of therapy. The improvement of hair diameter, vellus hair rate, and 1 hair pilosebaceous unit rate were observed with a trichoscopy and quantitatively analyzed. Besides, honeycomb pigment pattern mitigated and arborized red lines. LESSONS The results suggested that ZMWP might have the capability of improving hair growth and attenuating AGA, which can be a promising alternative treatment of AGA.
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Affiliation(s)
- Yuxin Qian
- Zhejiang Chinese Medical University, Hangzhou, People’s Republic of China
| | - Lijian Zhu
- Zhejiang Chinese Medical University, Hangzhou, People’s Republic of China
| | - Lan Wu
- Zhejiang Chinese Medical University, Hangzhou, People’s Republic of China
| | - Jingya Chen
- Zhejiang Chinese Medical University, Hangzhou, People’s Republic of China
| | - Bin Ding
- Zhejiang Chinese Medical University, Hangzhou, People’s Republic of China
| | - Yuanyuan Li
- Department of Dermatology, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, People’s Republic of China
| | - Yi Cao
- The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, People’s Republic of China
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8
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Kaiser MA, Ferrari LM, Gaumond SI, Issa N, Jimenez JJ, Issa NT. Platelet Rich Plasma Combination Therapies for Treatment of Androgenetic Alopecia: A Systematic Review. J Cutan Aesthet Surg 2023; 16:169-177. [PMID: 38189076 PMCID: PMC10768946 DOI: 10.4103/jcas.jcas_206_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] [Indexed: 01/09/2024] Open
Abstract
Androgenetic alopecia (AGA) is the most common cause of alopecia in males and females. Minoxidil and finasteride are the only FDA-approved treatments for AGA. New treatments including Platelet Rich Plasma (PRP) and microneedling have shown promising results. The purpose of this literature review was to highlight recent studies examining the effects of topical minoxidil combined with PRP to minoxidil or PRP monotherapy. The method used for this paper includes a systematic review of the literature from 2010 to 2022 using the PubMed, EMBASE, and MEDLINE databases examining studies evaluating combination therapies for AGA. Three randomized control trials compared combination PRP + topical 5% minoxidil to either no treatment, 5% minoxidil, or PRP only. Two studies found increased hair growth at five months and at six months following combined therapy. Another study found an increase in hair density and improved patient satisfaction with combination therapy compared to monotherapy. A prospective study revealed that patients treated with combined 5% minoxidil, PRP, and microneedling reported the highest patient and physician satisfaction compared to minoxidil monotherapy. An observational study evaluating topical 5% minoxidil with PRP reported an increase in hair diameter after one year of combination treatment compared to minoxidil monotherapy. PRP therapy combined with minoxidil and microneedling in a retrospective study was shown to increase hair growth compared to PRP with minoxidil as well as PRP or minoxidil monotherapy. In conclusion, a variety of studies demonstrated superior treatment response with a combination of PRP and minoxidil therapy in patients with AGA. Limitations to this study include different PRP preparation protocols, few randomized control studies, and small sample sizes.
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Affiliation(s)
- Michael A Kaiser
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Lina M Ferrari
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Simonetta I Gaumond
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Najy Issa
- St. George’s University School of Medicine, West Indies, Grenada
| | - Joaquin J Jimenez
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Naiem T Issa
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
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9
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Kaiser M, Abdin R, Gaumond SI, Issa NT, Jimenez JJ. Treatment of Androgenetic Alopecia: Current Guidance and Unmet Needs. Clin Cosmet Investig Dermatol 2023; 16:1387-1406. [PMID: 37284568 PMCID: PMC10239632 DOI: 10.2147/ccid.s385861] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Accepted: 05/23/2023] [Indexed: 06/08/2023]
Abstract
Androgenetic alopecia (AGA) is the most common cause of hair loss in men and women. Traditionally, topical minoxidil and oral finasteride have been the standard of care yielding mixed results. New treatments such as Low-Level Laser Therapy (LLLT), microneedling, platelet-rich plasma (PRP), and others have been extensively studied in the literature, and the purpose of this review is to provide a comprehensive discussion of the latest treatment methods and their efficacy in treating AGA. Novel therapies such as oral minoxidil, topical finasteride, topical spironolactone, botulinum toxin, and stem cell therapy offer interesting alternatives to standard of care therapies for patients. In this review, we present data from recent studies on the clinical efficacy of these treatments. Furthermore, as new treatments have emerged, clinicians have tested combination therapies to assess whether there may be a synergistic relationship between multiple modalities. While there has been a great increase in the treatments available for AGA, the quality of evidence varies greatly and there is still a great need for randomized double blinded clinical trials to adequately assess the clinical efficacy of some treatments. While PRP and LLLT have demonstrated encouraging results, standardized treatment protocols are needed to adequately inform clinicians on how to use such therapies. Given the abundance of new therapeutic options, clinicians and patients must weigh the benefits and risks of each treatment option for AGA.
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Affiliation(s)
- Michael Kaiser
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Rama Abdin
- Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, FL, USA
| | - Simonetta I Gaumond
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Naiem T Issa
- Forefront Dermatology, Vienna, VA, USA
- Issa Research and Consulting, LLC, Springfield, VA, USA
| | - Joaquin J Jimenez
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
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10
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Devjani S, Ezemma O, Kelley KJ, Stratton E, Senna M. Androgenetic Alopecia: Therapy Update. Drugs 2023; 83:701-715. [PMID: 37166619 PMCID: PMC10173235 DOI: 10.1007/s40265-023-01880-x] [Citation(s) in RCA: 29] [Impact Index Per Article: 29.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/17/2023] [Indexed: 05/12/2023]
Abstract
Androgenetic alopecia (AGA), also known as male pattern hair loss (MPHL) or female pattern hair loss (FPHL), is the most common form of alopecia worldwide, and arises from an excessive response to androgens. AGA presents itself in a characteristic distribution unique to both sexes. Despite its prevalence, AGA can be quite challenging to treat. The condition is chronic in nature and stems from an interplay of genetic and environmental factors. There are only two US Food and Drug Administration (FDA)-approved drugs for the condition: topical minoxidil and oral finasteride. However, numerous non-FDA-approved treatments have been shown to be effective in treating AGA in various studies. Some of these treatments are relatively new and still to be explored, thus emphasizing the need for an updated review of the literature. In this comprehensive review, we discuss the evaluation of AGA and the mechanisms of action, costs, efficacies, and safety profiles of existing, alternative, and upcoming therapeutics for this widespread condition.
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Affiliation(s)
- Shivali Devjani
- Department of Dermatology, Lahey Hospital and Medical Center, 67 South Bedford St, #100, Burlington, MA, 01803, USA
| | - Ogechi Ezemma
- Department of Dermatology, Lahey Hospital and Medical Center, 67 South Bedford St, #100, Burlington, MA, 01803, USA
| | - Kristen J Kelley
- Department of Dermatology, Lahey Hospital and Medical Center, 67 South Bedford St, #100, Burlington, MA, 01803, USA
| | - Emma Stratton
- Department of Dermatology, Lahey Hospital and Medical Center, 67 South Bedford St, #100, Burlington, MA, 01803, USA
| | - Maryanne Senna
- Department of Dermatology, Lahey Hospital and Medical Center, 67 South Bedford St, #100, Burlington, MA, 01803, USA.
- Harvard Medical School, Boston, MA, USA.
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Elshall AA, Ghoneim AM, Abd-Elmonsif NM, Osman R, Shaker DS. Boosting hair growth through follicular delivery of Melatonin through lecithin-enhanced Pickering emulsion stabilized by chitosan-dextran nanoparticles in testosterone induced androgenic alopecia rat model. Int J Pharm 2023; 639:122972. [PMID: 37084830 DOI: 10.1016/j.ijpharm.2023.122972] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 04/12/2023] [Accepted: 04/15/2023] [Indexed: 04/23/2023]
Abstract
The strategy in this work was loading Melatonin (MEL), the powerful antioxidant photosensitive molecule, in novel Pickering emulsions (PEs) stabilized by chitosan-dextran sulphate nanoparticles (CS-DS NPs) and enhanced by lecithin, for treatment of androgenic alopecia (AGA). Biodegradable CS-DS NPs dispersion was prepared by polyelectrolyte complexation and optimized for PEs stabilization. PEs were characterized for droplet size, zeta potential, morphology, photostability and antioxidant activity. Ex-vivo permeation study through rat full thickness skin was conducted with optimized formula. Differential tape stripping trailed by cyanoacrylate skin surface biopsy was executed, for quantifying MEL in skin compartments and hair follicles. In-vivo evaluation of MEL PE hair growth activity was performed on testosterone induced AGA rat model. Visual inspection followed by anagen to telogen phase ratio (A/T) and histopathological examinations were conducted and compared with marketed 5% minoxidil spray "Rogaine ®". Data showed that PE improved MEL antioxidant activity and photostability. Ex-vivo results displayed MEL PE high follicular deposition. In-vivo study demonstrated that MEL PE treated testosterone induced AGA rat group, restored hair loss and produced maximum hair regeneration along with prolonged anagen phase amongst tested groups. The histopathological examination revealed that MEL PE prolonged anagen stage, increased follicular density and A/T ratio by 1.5-fold. The results suggested that lecithin-enhanced PE stabilized by CS-DS NPs was found to be an effective approach to enhance photostability, antioxidant activity and follicular delivery of MEL. Thus, MEL-loaded PE could be a promising competitor to commercially marketed Minoxidil for treatment of AGA.
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Affiliation(s)
- Asmaa A Elshall
- Department of Applied Biotechnology, Biotechnology School, Nile University, Sheikh Zayed, Giza, Egypt.
| | - Amira M Ghoneim
- Department of Pharmaceutics &Pharmaceutical Technology, Faculty of Pharmacy, Future University in Egypt (FUE), Cairo, Egypt.
| | - Nehad M Abd-Elmonsif
- Department of Oral Biology, Faculty of oral and dental medicine, Future University in Egypt (FUE), Cairo, Egypt
| | - Rihab Osman
- Department of Pharmaceutics & Industrial Pharmacy, Faculty of Pharmacy, Ain Shams University, Cairo, Egypt
| | - Dalia S Shaker
- Department of Pharmaceutics &Pharmaceutical Technology, Faculty of Pharmacy, Future University in Egypt (FUE), Cairo, Egypt
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Sultana N, Waheed A, Ali A, Jahan S, Aqil M, Sultana Y, Mujeeb M. Exploring new frontiers in drug delivery with minimally invasive microneedles: fabrication techniques, biomedical applications and regulatory aspects. Expert Opin Drug Deliv 2023:1-17. [PMID: 37038271 DOI: 10.1080/17425247.2023.2201494] [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: 04/12/2023]
Abstract
INTRODUCTION Transdermal drug delivery is limited by the stratum corneum, inhibiting the therapeutic potential of the permeants. Microneedles (MN) have opened new frontiers in transdermal drug delivery systems. These micro-sized needles offer painless and accentuated delivery of drugs even with high molecular weights. AREAS COVERED The review embodies drug delivery strategies with microneedles with a description of MN types and fabrication techniques using various materials. The application of MN is not limited to drug delivery, but it also encompasses in vaccine delivery, diagnosis, phlebotomy and even in the cosmetic industry. The review also tabulates microneedle-based marketed formulations. In a nutshell, we aim to present a panoramic view of microneedles including the design, applications, and regulatory aspects of MN. EXPERT OPINION With the availability of numerous materials at the disposal of pharmaceutical scientists; the microneedle-based drug delivery technology has offered significant interventions towards the management of chronic maladies including cardiovascular disorders, diabetes, asthma, mental depression, etc. As happens with any new technology there are concerns with MN also such as biocompatibility issues with the material used for the fabrication. Nevertheless, the pharmaceutical industry must strive for preparing harmless, efficient, and cost-effective MN based delivery systems for wider acceptance and patient compliance.
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Affiliation(s)
- Niha Sultana
- School of Pharmaceutical Education & Research, Jamia Hamdard, New Delhi, India-110062
| | - Ayesha Waheed
- School of Pharmaceutical Education & Research, Jamia Hamdard, New Delhi, India-110062
| | - Asad Ali
- School of Pharmaceutical Education & Research, Jamia Hamdard, New Delhi, India-110062
| | - Samreen Jahan
- School of Pharmaceutical Education & Research, Jamia Hamdard, New Delhi, India-110062
| | - Mohd Aqil
- School of Pharmaceutical Education & Research, Jamia Hamdard, New Delhi, India-110062
| | - Yasmin Sultana
- School of Pharmaceutical Education & Research, Jamia Hamdard, New Delhi, India-110062
| | - Mohd Mujeeb
- School of Pharmaceutical Education & Research, Jamia Hamdard, New Delhi, India-110062
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Kakizaki P, Contin LA, Barletta M, Machado CJ, Michalany NS, Valente NYS, Donati A. Efficacy and Safety of Scalp Microneedling in Male Pattern Hair Loss. Skin Appendage Disord 2023; 9:18-26. [PMID: 36636456 PMCID: PMC9830423 DOI: 10.1159/000526215] [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: 02/06/2022] [Accepted: 06/29/2022] [Indexed: 01/16/2023] Open
Abstract
Introduction There are few reports involving scalp microneedling in MPHL patients, and in most of them, physical stimulus is associated with other therapeutic agents. The aim of this study was to evaluate the efficacy and risks of isolated scalp microneedling in MPHL patients. Methods Thirty patients were included in this randomized single-blinded study and submitted to 4 monthly scalp microneedling sessions. Two different microneedling devices were used: roller (n = 15) and tattoo cartridge (n = 15). Scalp coverage and hair density changes were measured 4 and 16 weeks after the last session. Adverse events were observed throughout the study, and scalp biopsies were performed before and after to investigate scarring changes. Results Four of 12 participants in the roller group and 2 of 14 participants in the tattoo cartridge group showed an improvement in clinical pictures at the first follow-up visit. Only half of these patients sustained an improvement until the last follow-up visit. No benefit in hair density was observed in either group. No reports of adverse events were made. Neocollagenesis and elastolysis were noted in scalp biopsies. Discussion/Conclusion Isolated scalp microneedling did not show improvement in scalp coverage or hair density of MPHL participants in this study.
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Affiliation(s)
| | | | | | | | | | | | - Aline Donati
- Hospital do Servidor Público Municipal-São Paulo, São Paulo, Brazil
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14
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Zhang Y, Sheng Y, Zeng Y, Hu R, Zhao J, Wang W, Yang Q. Randomized trial of microneedling combined with 2% minoxidil topical solution for the treatment of female pattern hair loss in a Chinese population. J Cosmet Dermatol 2022; 21:6985-6991. [PMID: 36214061 DOI: 10.1111/jocd.15424] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 09/13/2022] [Accepted: 09/27/2022] [Indexed: 01/06/2023]
Abstract
OBJECTIVE To evaluate the efficacy and safety of 2% minoxidil combined with microneedling in the treatment of female pattern hair loss. METHODS Forty female patients with female pattern hair loss were randomly divided into two groups with 20 patients each. The control group was treated with 2% minoxidil. The combined treatment group was treated with weekly microneedling in addition to daily minoxidil. The treatment period of both groups was 24 weeks. RESULTS There were no significant differences in age or duration of disease between the two groups of patients. The effective rate in the combined treatment group was 85%, which was significantly higher than that of the control group (45%). The hair counts were also higher in the combined treatment group. All of the adverse reactions observed during the treatment period were mild. No severe adverse event was observed in either group. CONCLUSION Microneedling combined with minoxidil had better efficacy for female pattern hair loss during the treatment period and follow-up. Microneedling combined with minoxidil therapy was safe and effective.
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Affiliation(s)
- Yao Zhang
- Department of Dermatology, Minhang Hospital, Fudan University, Shanghai, China
| | - Youyu Sheng
- Department of Dermatology, Huashan Hospital, Fudan University, Shanghai, China
| | - Yibin Zeng
- Department of Dermatology, Minhang Hospital, Fudan University, Shanghai, China
| | - Ruiming Hu
- Department of Dermatology, Huashan Hospital, Fudan University, Shanghai, China
| | - Jun Zhao
- Department of Dermatology, Huashan Hospital, Fudan University, Shanghai, China
| | - Wuqing Wang
- Department of Dermatology, Minhang Hospital, Fudan University, Shanghai, China
| | - Qinping Yang
- Department of Dermatology, Huashan Hospital, Fudan University, Shanghai, China
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Microneedle arrays for cutaneous and transcutaneous drug delivery, disease diagnosis, and cosmetic aid. J Drug Deliv Sci Technol 2022. [DOI: 10.1016/j.jddst.2022.104058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/07/2022]
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Jia L, Xiong J, Guo R, Li Y, Jiang H. A Comprehensive Review of Microneedling as a Potential Treatment Option for Androgenetic Alopecia. Aesthetic Plast Surg 2022; 46:2979-2994. [PMID: 35930041 DOI: 10.1007/s00266-022-03042-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Accepted: 07/21/2022] [Indexed: 12/13/2022]
Abstract
BACKGROUND Microneedling refers to a minimally invasive technique that uses multiple fine needles targeted skin epidermis for mechanical stimulation to obtain therapeutic or cosmetic effects. It is suitable for the treatment of a variety of dermatological conditions, including androgenetic alopecia (AGA). OBJECTIVE This article aims to make a comprehensive review of the relevant studies on microneedling for the management of AGA. METHODS Extensive literature search was performed using PubMed, Web of Science, and EBSCO databases. 4 in vivo studies and 25 clinical trials were included according to the inclusion and exclusion criteria. RESULTS The effects of microneedling on AGA was investigated in animal experiments. Several clinical trials, including randomized controlled trials, strengthen the validity of the findings. Microneedling therapy showed some encouraging results with minor complications when used alone or in combination with topical products. CONCLUSIONS Microneedling appears to be a safe and effective therapeutic option for AGA. Larger and more randomized controlled trials regarding the role of microneedling in AGA are strongly recommended to provide more definitive evidence. LEVEL OF EVIDENCE IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.
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Affiliation(s)
- Lingling Jia
- Department of Plastic Surgery, Shanghai East Hospital, Tongji University School of Medicine, 150 Jimo Road, Shanghai, 200120, China
| | - Jiachao Xiong
- Department of Plastic Surgery, Shanghai East Hospital, Tongji University School of Medicine, 150 Jimo Road, Shanghai, 200120, China
| | - Rong Guo
- Department of Plastic Surgery, Shanghai East Hospital, Tongji University School of Medicine, 150 Jimo Road, Shanghai, 200120, China
| | - Yufei Li
- Department of Plastic Surgery, Shanghai East Hospital, Tongji University School of Medicine, 150 Jimo Road, Shanghai, 200120, China.
| | - Hua Jiang
- Department of Plastic Surgery, Shanghai East Hospital, Tongji University School of Medicine, 150 Jimo Road, Shanghai, 200120, China.
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Zhang F, Yang YN, Feng JD, Zhao JH, Wan L, Che J, Yan Y, Guo NN, Zhang JY. Observation on the Efficacy of a Combined Treatment for Moderate and Severe Androgenetic Alopecia Incorporating Electric Microneedles. Clin Cosmet Investig Dermatol 2022; 15:2573-2581. [PMID: 36471758 PMCID: PMC9719273 DOI: 10.2147/ccid.s383289] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 11/10/2022] [Indexed: 11/07/2023]
Abstract
Objective To evaluate the effectiveness and safety of a combined treatment for moderate and severe androgenetic alopecia (AGA) involving the use of electric microneedles. Methods A total of 83 patients with moderate to severe AGA in the Department of Dermatology at Beijing Jishuitan Hospital were included in this study. The male patients were administered finasteride orally and 5% minoxidil for external use, while the female patients were given spironolactone orally or Diane-35 and 2% minoxidil for external use. All the patients were then treated via electric microneedle therapy alongside the YUFA ®medical care package (Foshan, China) once a week for 1-28 weeks. The seven-point method and root hair measurement using a hair mirror were adopted to evaluate the efficacy and any adverse reactions of the combined treatment. Results Eleven patients were treated for 1-3 weeks, 60 for 4-12 weeks, and 12 for more than 12 weeks. The efficacy evaluation using the seven-point method for 12 weeks of treatment indicated a 100% response rate, specifically, a 42.1% mild improvement rate, a 38.6% moderate improvement rate, and a 19.3% marked improvement rate. Besides, the efficacy assessment was also completed with root hair count method and the number of hair roots measured at fixed points were 148.67±11.15, 158.13±5.11 and 169.75±2.06 after treatment time at 16, 20 and 24 weeks, respectively. Of note, a statistical difference in the number of hair roots could be observed during the period of week 20-week 24 (P < 0.01). Conclusion The combined treatment of moderate to severe AGA using the electric microneedle technique has a clear effect and can effectively increase the hair density. With a simple operation and mild side effects, the technique has wide application prospects.
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Affiliation(s)
- Fan Zhang
- Hair Medical Research Center, Department of Dermatology and Venereology, Beijing Jishuitan Hospital, Beijing, People’s Republic of China
| | - Yi-Nuo Yang
- School of Clinical Medicine, Peking University School of Medicine, Beijing, People’s Republic of China
| | - Jin-Di Feng
- School of Clinical Medicine, Peking University School of Medicine, Beijing, People’s Republic of China
| | - Jing-Hui Zhao
- Hair Medical Research Center, Department of Dermatology and Venereology, Beijing Jishuitan Hospital, Beijing, People’s Republic of China
| | - Li Wan
- Hair Medical Research Center, Department of Dermatology and Venereology, Beijing Jishuitan Hospital, Beijing, People’s Republic of China
| | - Jing Che
- Hair Medical Research Center, Department of Dermatology and Venereology, Beijing Jishuitan Hospital, Beijing, People’s Republic of China
| | - Ying Yan
- Hair Medical Research Center, Department of Dermatology and Venereology, Beijing Jishuitan Hospital, Beijing, People’s Republic of China
| | - Ning-Ning Guo
- Hair Medical Research Center, Department of Dermatology and Venereology, Beijing Jishuitan Hospital, Beijing, People’s Republic of China
| | - Jia-Yu Zhang
- Hair Medical Research Center, Department of Dermatology and Venereology, Beijing Jishuitan Hospital, Beijing, People’s Republic of China
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18
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Cheng H, Zhang R, Zhuo F. Synergistic effect of microneedle-delivered extracellular matrix compound and radiofrequency on rejuvenation of periorbital wrinkles. Front Med (Lausanne) 2022; 9:900784. [PMID: 35935789 PMCID: PMC9355126 DOI: 10.3389/fmed.2022.900784] [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: 03/21/2022] [Accepted: 06/28/2022] [Indexed: 11/13/2022] Open
Abstract
Background A combination of minimally invasive modalities can induce collagen regeneration more quickly and promote the penetration of topical agents, thus promoting skin rejuvenation. In this study, we aimed to investigate the synergistic efficacy of extracellular matrix compound (ECM-C) via microneedle (MN) and radiofrequency (RF) on periorbital wrinkles. Method A total of 25 participants with periorbital wrinkles were selected for this study. The left and right side of the periorbital area was randomly given ECM-C via MN or ECM-C via MN combined with RF. MN combined with ECM-C treatment was given 5 times at 2 weeks intervals, whereas RF treatment was given 3 times at 4-week intervals. The following items were assessed: wrinkles by VISIA® system; biophysical parameters such as skin hydration, transepidermal water loss (TEWL), erythema index, and melanin index by CK multiple probe adapter; and skin elasticity and skin thickness by DermaLab Combo® photographs were taken at the baseline and 2 weeks after the last treatment. Subjective assessments, such as Crow's Feet Grading Scale (CFGS) and Global Aesthetic International Scale (GAIS), were also recorded. Result A total of 25 participants with an average age of 43 years participated in this trial. Periorbital wrinkles on both sides decreased after the treatment, and the side treated with ECM via MN and RF showed better improvement than the other side with ECM-C via MN alone. Skin hydration increased after the treatment on both sides. TEWL, skin erythema, and skin melanin indexes were not changed. Skin elasticity and skin thickness increased more on the side of ECM-C via MN and RF than on the other side of ECM-C via MN alone. The evaluation scores for CFGS improved on either side; however, no difference was found for CFGS and GAIS between intergroup comparisons after the treatment. Conclusion The objective assessment of wrinkles, elasticity, and thickness of periorbital skin improved more on the side with ECM-C treatment via MN combined with RF than on the other side of ECM-C treatment via MN only. However, no statistically significant difference was found between the subjective CFGS and GAIS evaluation of the two sides.
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Liang X, Chang Y, Wu H, Liu Y, Zhao J, Wang L, Zhuo F. Efficacy and Safety of 5% Minoxidil Alone, Minoxidil Plus Oral Spironolactone, and Minoxidil Plus Microneedling on Female Pattern Hair Loss: A Prospective, Single-Center, Parallel-Group, Evaluator Blinded, Randomized Trial. Front Med (Lausanne) 2022; 9:905140. [PMID: 35899211 PMCID: PMC9309533 DOI: 10.3389/fmed.2022.905140] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2022] [Accepted: 06/03/2022] [Indexed: 11/18/2022] Open
Abstract
Background The efficacy of topical minoxidil (MX) alone on female pattern hair loss (FPHL) is limited. Combination therapy based on topical MX is currently expected to provide better outcomes. Objectives This study aimed to assess whether the combined therapies including MX plus oral spironolactone (SPT) and MX plus microneedling (MN) have advantages in efficacy and safety over topical MX alone on mild-to-moderate FPHL with normal hormone levels in the blood and regular menstrual cycle. Methods A prospective, single-center, parallel-group, evaluator blinded, randomized trial including 120 non-menopause women with proven FPHL (Sinclair class II-III) was performed in China. Patients were randomly assigned to three groups, namely, the MX group (5% topical MX alone, once daily), the MX + SPT group (MX plus SPT 80–100 mg daily), and the MX+MN group (MX plus MN every 2 weeks, 12 sessions). The change from the baseline to week 24 was assessed in hair growth (hair density and diameter under dermoscope), scalp tissue structure (epidermal thickness, dermis thickness, and average hair follicle diameter under ultrasound biomicroscopy), physician's global assessment (using a 7-point global-assessment scale and Sinclair's stage change), patient evaluation (Women's Androgenetic Alopecia Quality of Life Questionnaire and Sinclair's hair-shedding score) and side effects. Results In total, 115 participants completed the trial. At week 24, the hair density increased most in MX + MN group and increased least in MX group (p < 0.001 for MX + MN group vs. MX + SPT group; p = 0.009 for MX + SPT group vs. MX group). The hair shaft diameter significantly increased in all groups (p < 0.001, respectively), but there were no significant differences among the three groups (p = 0.905). The epidermal thickness and average hair follicle diameter only increased in MX + MN group. Dermis thickness increased in all groups, but there were no significant differences among the three groups. Both physician's and patient assessments showed improvement in all three groups. Scalp pruritus was the most common side effect. The MX + SPT group had the most reported adverse effects. Limitations The main limitations of this study are the relatively small sample size, the exclusion of severe FPHL patients, and the potential bias from unblinded treatments among the 3 groups. Conclusion Topical MX combined with MN is a better choice than either MX plus oral SPT or MX alone for the treatment of mild-to-moderate FPHL patients.
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Kim MJ, Seong KY, Kim DS, Jeong JS, Kim SY, Lee S, Yang SY, An BS. Minoxidil-loaded hyaluronic acid dissolving microneedles to alleviate hair loss in an alopecia animal model. Acta Biomater 2022; 143:189-202. [PMID: 35202857 DOI: 10.1016/j.actbio.2022.02.011] [Citation(s) in RCA: 37] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 02/09/2022] [Accepted: 02/10/2022] [Indexed: 12/18/2022]
Abstract
Alopecia is defined as hair loss in a part of the head due to various causes, such as drugs, stress and autoimmune disorders. Various therapeutic agents have been suggested depending on the cause of the condition and patient sex, and age. Minoxidil (MXD) is commonly used topically to treat alopecia, but its low absorption rate limits widespread use. To overcome the low absorption, we suggest microneedles (MNs) as controlled drug delivery systems that release MXD. We used hyaluronic acid (HA) to construct MN, as it is biocompatible and safe. We examined the effect of HA on the hair dermal papilla (HDP) cells that control the development of hair follicles. HA enhanced proliferation, migration, and aggregation of HDP cell by increasing cell-cell adhesion and decreasing cell substratum. These effects were mediated by the cluster of differentiation (CD)-44 and phosphorylation of serine‑threonine kinase (Akt). In chemotherapy-induced alopecia mice, topical application of HA tended to decrease chemotherapy-induced hair loss. Although the amount of MXD administered by HA-MNs was 10% of topical treatment, the MXD-containing HA-MNs (MXD-HA-MNs) showed better effects on the growth of hair than topical application of MXD. In summary, our results demonstrated that HA reduces hair loss in alopecia mice, and that delivery of MXD and HA using MXD-HA-MNs maximizes therapeutic effects and minimize the side effects of MXD for the treatment of alopecia. STATEMENT OF SIGNIFICANCE: (1) Significance, This work reports a new approach for treatment of alopecia using a dissolving microneedle (MN) prepared with hyaluronic acid (HA). The HA provided a better environment for cellular functions in the hair dermal papilla cells. The HA-MNs containing minoxidil (MXD) exhibited a significant reduction of hair loss, although amount of MXD contained in them was only 10% of topically applied MXD., (2) Scientific impact, This is the first report demonstrating the direct anti-alopecia effects of HA administrated in a transdermal route and the feasibility of novel therapeutics using MXD-containing HA-MNs. We believe that our work will excite interdisciplinary readers of Acta Biomaterialia, those who are interested in the natural polymers, drug delivery, and alopecia.
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A study to assess the efficacy of fractional carbon dioxide laser with topical platelet-rich plasma in the treatment of androgenetic alopecia. Lasers Med Sci 2022; 37:2279-2286. [PMID: 34981272 DOI: 10.1007/s10103-021-03496-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2021] [Accepted: 12/10/2021] [Indexed: 10/19/2022]
Abstract
Owing to the inadequate response to and limitations of the approved medications for androgenetic alopecia, novel therapies are warranted to enhance outcomes. The objective of this paper is to ascertain the effectiveness of fractional carbon dioxide laser followed by platelet-rich plasma application on hair regrowth and to compare the two laser settings. Seven participants were enrolled in this half-head pilot study based on different laser pulse energy and density values (12 mJ, 800 spots/cm2 and 22 mJ, 400 spots/cm2). Ten treatment sessions were performed every 2 weeks with 12-week follow-up. The evaluation methods were based on hair density from standardized phototrichograms, global photographic assessment, and patient satisfaction. Significantly increased total and terminal hair densities were observed during treatment in both groups as compared with baselines. The mean total hair density has weekly increased significantly with high pulse energy (1.42 hair/cm2) as compared to low pulse energy (1.04 hair/cm2) throughout the study period (p = 0.023; 4.89 hair/cm2). Global photographs and patient satisfaction scores demonstrated improvement, but only the latter showed statistical significance (p = 0.029). The average pain intensity scores were not different between the groups (p = 0.760) all over the procedure. The adverse events were minor and well tolerated. This synergistic treatment remarkably leads to hair restoration and high patient satisfaction. The parameters of 22-mJ beam energy with 400 spots/cm2 density are appropriate and superior to 12-mJ beam energy with 800 spots/cm2. Albeit higher energy, no more pain is indicated in the high pulse energy group. Trial registration number (TRN): TCTR20180619004, Thai Clinical Trials Registry (TCTR) since 2018-05-15 13:39:48.
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Nestor MS, Ablon G, Gade A, Han H, Fischer DL. Treatment options for androgenetic alopecia: Efficacy, side effects, compliance, financial considerations, and ethics. J Cosmet Dermatol 2021; 20:3759-3781. [PMID: 34741573 PMCID: PMC9298335 DOI: 10.1111/jocd.14537] [Citation(s) in RCA: 98] [Impact Index Per Article: 32.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Accepted: 10/08/2021] [Indexed: 01/05/2023]
Abstract
Background Androgenetic alopecia (AGA) is the most common form of hair loss consisting of a characteristic receding frontal hairline in men and diffuse hair thinning in women, with frontal hairline retention, and can impact an individual's quality of life. The condition is primarily mediated by 5‐alpha‐reductase and dihydrotestosterone (DHT) which causes hair follicles to undergo miniaturization and shortening of successive anagen cycles. Although a variety of medical, surgical, light‐based and nutraceutical treatment options are available to slow or reverse the progression of AGA, it can be challenging to select appropriate therapies for this chronic condition. Aims To highlight treatment options for androgenetic alopecia taking into consideration the efficacy, side effect profiles, practicality of treatment (compliance), and costs to help clinicians offer ethically appropriate treatment regimens to their patients. Materials and Methods A literature search was conducted using electronic databases (Medline, PubMed, Embase, CINAHL, EBSCO) and textbooks, in addition to the authors' and other practitioners' clinical experiences in treating androgenetic alopecia, and the findings are presented here. Results Although topical minoxidil, oral finasteride, and low‐level light therapy are the only FDA‐approved therapies to treat AGA, they are just a fraction of the treatment options available, including other oral and topical modalities, hormonal therapies, nutraceuticals, PRP and exosome treatments, and hair transplantation. Discussion Androgenetic alopecia therapy remains challenging as treatment selection involves ethical, evidence‐based decision‐making and consideration of each individual patient's needs, compliance, budget, extent of hair loss, and aesthetic goals, independent of potential financial benefits to the practitioners.
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Affiliation(s)
- Mark S Nestor
- Center for Clinical and Cosmetic Research, Aventura, Florida, USA.,Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, Miami, Florida, USA.,Department of Surgery, Division of Plastic Surgery, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Glynis Ablon
- Ablon Skin Institute & Research Center, Manhattan Beach, California, USA.,Department of Dermatology, University of California Los Angeles (UCLA), Los Angeles, California, USA
| | - Anita Gade
- Center for Clinical and Cosmetic Research, Aventura, Florida, USA
| | - Haowei Han
- Center for Clinical and Cosmetic Research, Aventura, Florida, USA
| | - Daniel L Fischer
- Center for Clinical and Cosmetic Research, Aventura, Florida, USA
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Ziaeifar E, Ziaeifar F, Mozafarpoor S, Goodarzi A. Applications of microneedling for various dermatologic indications with a special focus on pigmentary disorders: A comprehensive review study. Dermatol Ther 2021; 34:e15159. [PMID: 34657363 DOI: 10.1111/dth.15159] [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: 08/04/2021] [Revised: 10/09/2021] [Accepted: 10/13/2021] [Indexed: 11/30/2022]
Abstract
Microneedling can accelerate skin repair through numerous complex processes triggered by micro-injuries it produces on the skin surface with very thin needles. The current growth in the application of microneedling in the treatment of cutaneous diseases can be explained by its numerous effects on the skin as reported in the literature. Despite the numerous studies conducted on the application of microneedling in the treatment of skin lesions, its effects on pigmented skin lesions have remained relatively unexplored. The present review comprises an examination of the evidence for the application of microneedling in skin diseases in general and a comprehensive review of the applications of microneedling in pigmentation disorders. The review involved a search of all clinical studies, including trials, case reports, and case series, in the databases MEDLINE/PubMed and Google Scholar using the following keywords: "microneedling," "dermal needling," "percutaneous collagen induction," "skin needling," "dermaroller," and "dermatology disorder." Pertinent data were extracted from all relevant articles published from 1990 to April 2021, and focused on the application of microneedling in the treatment of pigmented skin lesions. Despite the limited number of available studies, evidence suggests the effectiveness and safety of microneedling in treating vitiligo, melasma, and periorbital hypermelanosis. It is noteworthy that the combination of any type of non-aggressive needing technique with other effective therapies (especially topical agents and mesotherapy) yields more promising therapeutic results than single therapy for melasma, dark cycles, and vitiligo as the prototype of pigmentary disorders. However, single needling therapy is significantly effective, too.
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Affiliation(s)
- Elham Ziaeifar
- Department of Dermatology, Rasool Akram Medical Complex Clinical Research Development Center (RCRDC), School of Medicine، Iran University of Medical Sciences (IUMS), Tehran, Iran
| | - Fatemeh Ziaeifar
- Department of General Medicine, Iran University of Medical Sciences (IUMS), Tehran, Iran
| | - Samaneh Mozafarpoor
- Department of Dermatology, Skin Disease and Leishmaniasis Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Azadeh Goodarzi
- Department of Dermatology, Rasool Akram Medical Complex Clinical Research Development Center (RCRDC), School of Medicine، Iran University of Medical Sciences (IUMS), Tehran, Iran
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Yepuri V, Venkataram M. Platelet-Rich Plasma with Microneedling in Androgenetic Alopecia: Study of Efficacy of the Treatment and the Number of Sessions Required. J Cutan Aesthet Surg 2021; 14:184-190. [PMID: 34566361 PMCID: PMC8423195 DOI: 10.4103/jcas.jcas_33_20] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Background Platelet-rich plasma (PRP) is a simple and safe procedure, which has been used for soft tissue and wound healing. PRP has been used in dermatology for skin rejuvenation and alopecia. Objective The objective of our study was to study efficacy of PRP with microneedling in patients with androgenetic alopecia (AGA) and to assess number of sessions required for a patient. Materials and Methods Sixty patients diagnosed with AGA were studied between August 2016 and October 2018 who did not respond to minoxidil and finasteride. PRP was prepared by centrifugation of patients' blood. PRP with microneedling was done for all patients under aseptic conditions. Four to six sessions were done at an interval of 4 weeks. Subjective and objective scores were assessed based on a visual analog global score. Assessment was done at the first session, every next sitting, and 4 weeks after the last sitting. Follow-up was done at 3rd and 6th month after the last sitting. Results According to subjective scores, two patients (3.33%) had excellent results, 24 (40%) very good, 22 (36.6%) good, 6 (10%) fair results, and 6 (10%) did not have any response. Objective assessment scores showed that two patients (3.33%) had excellent results, 26 (43.3%) very good, 21 (35%) good, 7 (11.6%) had fair results, and 4 (6.7%) did not have any response. Fifty patients underwent four sessions out of which 40 (i.e. 66%) patients had very good results. Only 10 patients required more than four sessions to achieve good results. Patients were happy with four sessions. There were no side effects noted either during or after the treatment. Conclusion This study shows PRP with microneedling as an efficacious treatment for AGA and augments the effects of conventional treatment. This study sets example for assessing the number of PRP sessions. A minimum of four sessions is required to achieve very good results.
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Affiliation(s)
- Vani Yepuri
- Venkat Center for Skin and Plastic Surgery, Bengaluru, Karnataka, India
| | - Mysore Venkataram
- Venkat Center for Skin and Plastic Surgery, Bengaluru, Karnataka, India
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Pathoulas JT, Bellefeuille G, Raymond O, Khalid B, Farah RS. Energy-based Devices for Hair Loss. Dermatol Clin 2021; 39:447-461. [PMID: 34053597 DOI: 10.1016/j.det.2021.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Treatment options for hair loss have traditionally been limited to topical and systemic therapies. Systemic therapies for inflammatory hair disorders are often immunosuppressive, and systemic treatment of androgenetic hair loss can cause undesired effects on sexual and reproductive health. Topical agents have a favorable side effect profile compared with systemic therapies, but many topicals have poor transcutaneous absorption, limiting their concentration and action at follicular targets in the dermis.
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Affiliation(s)
- James T Pathoulas
- Department of Dermatology, University of Minnesota, 516 Delaware Street Southeast Mail Code 98, Phillips-Wangensteen Building, Suite 4- 420, Minneapolis, MN 55455, USA
| | - Gretchen Bellefeuille
- Department of Dermatology, University of Minnesota, 516 Delaware Street Southeast Mail Code 98, Phillips-Wangensteen Building, Suite 4- 420, Minneapolis, MN 55455, USA
| | - Ora Raymond
- Department of Dermatology, University of Minnesota, 516 Delaware Street Southeast Mail Code 98, Phillips-Wangensteen Building, Suite 4- 420, Minneapolis, MN 55455, USA
| | - Bisma Khalid
- University of Minnesota, 420 Delaware St SE, Minneapolis, MN 55455, USA
| | - Ronda S Farah
- Department of Dermatology, University of Minnesota, 516 Delaware Street Southeast Mail Code 98, Phillips-Wangensteen Building, Suite 4- 420, Minneapolis, MN 55455, USA.
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Abstract
Significant androgenetic hair loss occurs in men older than 50 years, and in women it occurs in many who are perimenopausal, menopausal, and postmenopausal. By age 60 years, it is estimated that 80% of women experience hair loss. Other nonandrogenetic forms of hair loss occur due to various dermatologic disorders as well as systemic disorders. Children may also experience significant hair loss, often due to genetic abnormalities and incidences of trauma. In this article the author discusses a combination approach to hair loss for men, women, and children.
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27
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Hair Transplantation Surgery Versus Other Modalities of Treatment in Androgenetic Alopecia: A Narrative Review. COSMETICS 2021. [DOI: 10.3390/cosmetics8010025] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Androgenetic alopecia (AGA) is the most common type of baldness and its incidence has increased over the past few years with an earlier age of onset being widely reported all over the world. Although it is reported more often in men, it affects women as well. With the growing cosmetic concern of patients, emphasis has shifted from the more traditional treatment options such as finasteride and minoxidil to surgical options such as hair transplantation. This review briefly highlights all of the treatment options available for AGA so far. A special focus is on current data available on hair transplantation surgeries and the various methods, merits and demerits and limitations of surgery. The literature research considered published journal articles (scientific reviews) from 1990 to date. Studies were identified by searching electronic databases (MEDLINE and PubMed) and the reference lists of respective articles. Only articles available in English were considered for this review.
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Aggarwal K, Gupta S, Jangra RS, Mahendra A, Yadav A, Sharma A. Dermoscopic Assessment of Microneedling Alone versus Microneedling with Platelet-Rich Plasma in Cases of Male Pattern Alopecia: A Split-Head Comparative Study. Int J Trichology 2020; 12:156-163. [PMID: 33376284 PMCID: PMC7759059 DOI: 10.4103/ijt.ijt_64_20] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 05/26/2020] [Accepted: 07/20/2020] [Indexed: 12/21/2022] Open
Abstract
Introduction Male pattern alopecia (MPA) is a common disorder hugely impacting the quality of life of affected individuals. The meager number of options available for treatment has their own limitations. Novel therapies are continuously being researched for. Materials and Methods The present study included thirty male patients with Hamilton Grade II to Grade V. All patients received four sequential treatments with microneedling (MN) on one half of the scalp and platelet-rich plasma (PRP) with MN (MN + PRP) on the other half for 4 months. Three months following the last session, evaluation was done from the vertex and temporal sites in both the groups by dermoscopic microphotographs by a blinded evaluator. In addition, the patients were asked about their satisfaction score on the basis of treatment outcome. Results Overall hair thickness showed significant increase in both MN and MN + PRP group. Furthermore, the increase in thickness was almost double in the MN group as compared to MN + PRP group (0.006 and 0.003 mm, respectively). Overall hair density also increased significantly in both the study groups but more in MN + PRP group (14.6 hair/cm2) than the MN group (10.8 hair/cm2). However, the difference between the results of both the groups was not statistically significant. Conclusion To the best of our knowledge, this is the first split scalp study for MPA. We conclude that MN and PRP are both effective in treatment of androgenetic alopecia and improve the hair parameters and patient satisfaction. However, no additional effect of PRP over MN was observed. Both these therapies are safe and well tolerated without any major side effects. Limitations of our study were small sample size and lack of long-term follow-up.
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Affiliation(s)
- Kartikay Aggarwal
- Department of Dermatology and Venereology, Maharishi Markandeshwar Institute of Medical Sciences and Research, Ambala, Haryana, India
| | - Sanjeev Gupta
- Department of Dermatology and Venereology, Maharishi Markandeshwar Institute of Medical Sciences and Research, Ambala, Haryana, India
| | | | - Aneet Mahendra
- Department of Dermatology and Venereology, Maharishi Markandeshwar Institute of Medical Sciences and Research, Ambala, Haryana, India
| | - Anuradha Yadav
- Department of Dermatology and Venereology, Maharishi Markandeshwar Institute of Medical Sciences and Research, Ambala, Haryana, India
| | - Aastha Sharma
- Department of Dermatology and Venereology, Maharishi Markandeshwar Institute of Medical Sciences and Research, Ambala, Haryana, India
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29
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A Literature Review of the Microneedle Therapy System for Hair Loss. JOURNAL OF ACUPUNCTURE RESEARCH 2020. [DOI: 10.13045/jar.2020.00234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
This literature review was designed to investigate the effects of the microneedle therapy system (MTS) on alopecia in experimental, and clinical studies. The MTS is acupuncture needling therapy delivered by a roller. A literature review of studies published before May 2020 was conducted using 9 online databases, and a total of 13 studies (4 in vivo studies and 9 clinical trials) were included. Most studies showed that the MTS was effective when used in combination with other treatments. In vivo studies reported an increased level of hair growth factors following treatment. Typically, 1.5 mm needles were used in the MTS treatment and photographic evaluation (by either camera or microscope) was reported in most studies. Oriental medicine research included 2 in vivo studies, which reported positive effects when combined with the MTS. There were no reported severe side effects. the MTS might be safe and has a drug delivery effect. Further studies need to be conducted regarding the frequency and needle length depending on the type of alopecia using Oriental and Western medicine.
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30
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Dsouza L, Ghate VM, Lewis SA. Derma rollers in therapy: the transition from cosmetics to transdermal drug delivery. Biomed Microdevices 2020; 22:77. [PMID: 33104926 PMCID: PMC7588378 DOI: 10.1007/s10544-020-00530-3] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/13/2020] [Indexed: 12/11/2022]
Abstract
Derma roller, a device rolled onto the skin to form micropores, is extensively used for cosmetic purposes. The pores thus created are utilized to either result in the induction of collagen production, leading to glowing and wrinkle-free skin or for permeating the applied formulations to the site of action within the skin. Recent studies have shown the benefits of using derma rollers for transdermal delivery of drugs. In the nascent stage, this approach paves a way to successfully breach the stratum corneum and aid in the movement of medications directed towards the dermis and the hair follicles. The review essentially summarizes the evidence of the use of derma rollers in cosmetic setup, their designing, and the preclinical and clinical reports of efficacy, safety, and concerns when translated for pharmaceutical purposes and transdermal drug delivery.
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Affiliation(s)
- Leonna Dsouza
- Department of Pharmaceutics, Manipal College of Pharmaceutical Sciences, Manipal Academy of Higher Education (MAHE), Manipal, Karnataka, 576104, India
| | - Vivek M Ghate
- Department of Pharmaceutics, Manipal College of Pharmaceutical Sciences, Manipal Academy of Higher Education (MAHE), Manipal, Karnataka, 576104, India
| | - Shaila A Lewis
- Department of Pharmaceutics, Manipal College of Pharmaceutical Sciences, Manipal Academy of Higher Education (MAHE), Manipal, Karnataka, 576104, India.
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Faghihi G, Nabavinejad S, Mokhtari F, Fatemi Naeini F, Iraji F. Microneedling in androgenetic alopecia; comparing two different depths of microneedles. J Cosmet Dermatol 2020; 20:1241-1247. [PMID: 32897622 DOI: 10.1111/jocd.13714] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Accepted: 08/27/2020] [Indexed: 12/20/2022]
Abstract
BACKGROUND Microneedling has shown to have positive therapeutic effects in treatment of androgenetic alopecia (AGA); however, the best microneedling protocol is still controversial. AIMS Investigating effect of microneedling with 2 different depths of penetration on promoting hair growth in patients with AGA. METHODS Sixty patients, in the age of 18-45 years old with moderate and severe AGA, were allocated into 3 groups of control: treatment with minoxidil 5% lotion; group A: treatment with minoxidil 5% lotion and biweekly microneedling with a depth of 1.2 mm and group B: treatment with minoxidil 5% lotion and biweekly microneedling with a depth of 0.6 mm during 12 weeks. Efficacy parameters including change of hair count and hair thickness from baseline and assessment of hair growth by patient and investigator were evaluated. RESULTS Compared with the baseline, a significant increase in hair count and hair thickness was observed in all three groups after completion of the treatment course (P < .05). The mean rise in hair count (P = .017) and hair thickness (P = .007) was significantly greater in group B compared with control group. Investigator's evaluation of hair regrowth was significantly greater in group A (P = .04) and group B (P = .007) compared with control group. CONCLUSION Microneedling with a depth of 0.6 mm in combination with minoxidil is more effective than minoxidil monotherapy in patients with AGA in terms of hair count and hair thickness. This depth of penetration tended to be more beneficial than depth of 1.2 mm.
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Affiliation(s)
- Gita Faghihi
- Department of Dermatology, Skin Diseases and Leishmaniasis Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Samin Nabavinejad
- Department of Dermatology, Skin Diseases and Leishmaniasis Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Fatemeh Mokhtari
- Department of Dermatology, Skin Diseases and Leishmaniasis Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Farahnaz Fatemi Naeini
- Department of Dermatology, Skin Diseases and Leishmaniasis Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Fariba Iraji
- Department of Dermatology, Skin Diseases and Leishmaniasis Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
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32
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Ocampo‐Garza SS, Fabbrocini G, Ocampo‐Candiani J, Cinelli E, Villani A. Micro needling: A novel therapeutic approach for androgenetic alopecia, A Review of Literature. Dermatol Ther 2020; 33:e14267. [DOI: 10.1111/dth.14267] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 08/23/2020] [Accepted: 08/30/2020] [Indexed: 01/06/2023]
Affiliation(s)
- Sonia Sofia Ocampo‐Garza
- Dermatology Department Univeristy Hospital ¨Dr. José Eleuterio González¨, Universidad Autónoma de Nuevo León Monterrey Mexico
| | - Gabriella Fabbrocini
- Dermatology Unit, Department of Clinical Medicine and Surgery University of Naples Federico II Naples Italy
| | - Jorge Ocampo‐Candiani
- Dermatology Department Univeristy Hospital ¨Dr. José Eleuterio González¨, Universidad Autónoma de Nuevo León Monterrey Mexico
| | - Eleonora Cinelli
- Dermatology Unit, Department of Clinical Medicine and Surgery University of Naples Federico II Naples Italy
| | - Alessia Villani
- Dermatology Unit, Department of Clinical Medicine and Surgery University of Naples Federico II Naples Italy
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33
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Kapoor R, Shome D, Doshi K, Patel G, Vadera S. Evaluation of efficacy of QR 678 and QR678 neo hair growth factor formulation for the treatment of female pattern alopecia in patients with PCOS-A prospective study. J Cosmet Dermatol 2020; 19:2637-2646. [PMID: 33460214 DOI: 10.1111/jocd.13673] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 08/07/2020] [Accepted: 08/10/2020] [Indexed: 12/01/2022]
Abstract
BACKGROUND Hair is an essential identity of women. Femininity, sexuality, attractiveness, and personality are symbolically linked to a woman's hair. Female pattern hair loss is found in 20%-30% of patients with polycystic ovary syndrome (PCOS). AIM The aim of the present study was to evaluate the efficacy of QR678® and QR678 Neo® therapy in the treatment of female alopecia with PCOS. METHOD A total of 20 females diagnosed with PCOS in the age 25-50 years, with complaints of female pattern alopecia with Ludwig, grades I, and II were selected for the study. At each visit, 1.5 ml solution of QR678® was injected in the scalp skin of patients. A total of eight sessions were performed at an interval of 3 week each. All the patients were evaluated with standard global photography at baseline, 4th and 8th session, and 2 months after 8th session. RESULT Marked improvement was seen in the global photographic assessment score (mean = 8) which was maintained for over 1 year. In videomicroscopic assessment, after four sessions the patients had 8.07 fewer vellus hair, 6.07 more terminal hair, and average hair shaft diameter was 0.82 μm wider. After eight sessions, they had 11.66 fewer vellus hair, 13.77 more terminal hair, and hair shaft diameter was 2.86 μm wider than at baseline. CONCLUSION Intra-dermal injections of QR 678® hair growth factor formulation is an effective option for female pattern alopecia with PCOS. This is the first of its kind study using QR678® and QR678 Neo® in PCOS patients.
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Affiliation(s)
- Rinky Kapoor
- Department of Dermatology, Cosmetic Dermatology & Dermato-Surgery & Director, The Esthetic Clinics, Mumbai, India
| | - Debraj Shome
- Department of Facial Plastic Surgery & Facial Cosmetic Surgery & Director, The Esthetic Clinics, Mumbai, India
| | - Komal Doshi
- Fellow in Facial Plastic Surgery and Facial Cosmetic Surgery, The Esthetic Clinics, Mumbai, India
| | | | - Sapna Vadera
- Fellow Facial Plastic Surgery and Facial Cosmetic Surgery, The Esthetic Clinics, Mumbai, India
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Lee WJ, Sohng C, Kim JY, Park KD, Jang YH, Lee S. Effect of a sphingolipid‐mimetic compound on the promotion of hair growth: A randomized, double‐blind, placebo‐controlled clinical trial. J Cosmet Dermatol 2020; 19:1715-1722. [DOI: 10.1111/jocd.13220] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2019] [Accepted: 10/25/2019] [Indexed: 01/19/2023]
Affiliation(s)
- Weon Ju Lee
- Department of Dermatology School of Medicine Kyungpook National University Kyungpook National University Hospital Daegu Korea
| | - Chihyeon Sohng
- Department of Dermatology School of Medicine Kyungpook National University Kyungpook National University Hospital Daegu Korea
| | - Jun Young Kim
- Department of Dermatology School of Medicine Kyungpook National University Kyungpook National University Hospital Daegu Korea
| | - Kyung Duck Park
- Department of Dermatology School of Medicine Kyungpook National University Kyungpook National University Hospital Daegu Korea
| | - Yong Hyun Jang
- Department of Dermatology School of Medicine Kyungpook National University Kyungpook National University Hospital Daegu Korea
| | - Seok‐Jong Lee
- Department of Dermatology School of Medicine Kyungpook National University Kyungpook National University Hospital Daegu Korea
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35
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Fujita J. Favorable effects of microneedling on long-standing androgenetic alopecia in an elderly man: A case report. J Cosmet Dermatol 2020; 20:588-590. [PMID: 32500595 DOI: 10.1111/jocd.13526] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Revised: 05/24/2020] [Accepted: 05/28/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND Androgenetic alopecia (AGA) is the most common type of alopecia. Currently, various methods have been tried to treat male AGA, but the outcomes are often unsatisfactory, especially for elderly persons. AIMS We report a case of an elderly man with a severe long-standing AGA, which was successfully managed with microneedling and minoxidil. PATIENTS/METHODS The patient was a 70-year-old Japanese man with family history of AGA, showed no abnormality in physical and laboratory examinations, and had received no treatment. We did monotherapy with 5% minoxidil twice daily to the right half of the scalp, while on the left half topical minoxidil was combined with weekly microneedling using an automated microneedling pen. RESULTS After 14 weeks of treatment, negligible hair growth was observed on the monotherapy side. On the combined-therapy side, however, hair growth was obvious and the density of hairs determined under trichoscope was significantly increased compared with the monotherapy side (P < .001). Only transient pain, erythema, and pinpoint bleeding were observed as adverse effects. CONCLUSION Although we need further clinical trials to assess the efficacy and safety and to standardize the method, microneedling combined with topical minoxidil could be a treatment option for severe AGA in elderly patients.
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Affiliation(s)
- Jun Fujita
- CL Clinic, Himeji, Japan.,Graduate School of Medicine, Kyoto University, Kyoto, Japan
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36
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Low-level laser therapy and narrative review of other treatment modalities in androgenetic alopecia. Lasers Med Sci 2020; 35:1239-1244. [PMID: 32162134 DOI: 10.1007/s10103-020-02994-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2019] [Accepted: 03/04/2020] [Indexed: 02/05/2023]
Abstract
Androgenetic alopecia (AGA), also termed as androgenic alopecia or common baldness, is a condition where there is androgen mediated conversion of susceptible terminal hair into vellus hair. Although it is reported more commonly in males, it also affects females but the incidence is relatively unknown. AGA tremendously affects the psychology of the patient due to its chronicity of treatment and cosmetic implications. There are numerous treatment options available for AGA but the choice of treatment has to often be tailored according to the patient's needs, affordability, and compliance. This review focusses on the various treatment options available, with special emphasis on the role of low-level laser therapy (LLLT) in the management of AGA. The literature research considered published journal articles (clinical trials or scientific reviews). Studies were identified by searching electronic databases (MEDLINE and PubMed) and reference lists of respective articles. Only articles available in English were considered for this review.
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Siah TW, Guo H, Chu T, Santos L, Nakamura H, Leung G, Shapiro J, McElwee KJ. Growth factor concentrations in platelet‐rich plasma for androgenetic alopecia: An intra‐subject, randomized, blinded, placebo‐controlled, pilot study. Exp Dermatol 2020; 29:334-340. [DOI: 10.1111/exd.14074] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Revised: 11/21/2019] [Accepted: 01/21/2020] [Indexed: 12/16/2022]
Affiliation(s)
- Tee Wei Siah
- Watford General Hospital Watford Hertfordshire UK
| | - Hongwei Guo
- Department of Dermatology and Skin Science University of British Columbia Vancouver BC Canada
| | - Thomas Chu
- Department of Dermatology Wayne State University School of Medicine Dearborn MI USA
- Department of Dermatology Far Eastern Memorial Hospital New Taipei Taiwan
| | - Leopoldo Santos
- Department of Medicine Santa Casa of São Paulo School of Medicine São Paulo SP Brazil
- Department of Dermatology and Alergology Municipal Public Servant Hospital of São Paulo São Paulo SP Brazil
- Department of Medicine University of Taubaté Taubaté SP Brazil
| | | | - Gigi Leung
- Department of Dermatology and Skin Science University of British Columbia Vancouver BC Canada
| | - Jerry Shapiro
- Department of Dermatology and Skin Science University of British Columbia Vancouver BC Canada
- The Ronald O. Perelman Department of Dermatology New York University School of Medicine New York NY USA
| | - Kevin J. McElwee
- Department of Dermatology and Skin Science University of British Columbia Vancouver BC Canada
- Centre for Skin Sciences University of Bradford Bradford West Yorkshire UK
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38
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Bao L, Gong L, Guo M, Liu T, Shi A, Zong H, Xu X, Chen H, Gao X, Li Y. Randomized trial of electrodynamic microneedle combined with 5% minoxidil topical solution for the treatment of Chinese male Androgenetic alopecia. J COSMET LASER THER 2020; 22:1-7. [PMID: 29028377 DOI: 10.1080/14764172.2017.1376094] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Background: In treating androgenetic alopecia, 5% minoxidil is a commonly used topical drug. By using electrodynamic microneedle at the same time may increase absorption of minoxidil and further stimulate hair growth.Objective: A 24-week, randomized, evaluator blinded, comparative study was performed to evaluate the efficacy of treating Chinese male androgenetic alopecia using microneedle combined with 5% minoxidil topical solution. Methods: Randomized subjects received topical 5% minoxidil (group 1, n = 20), local electrodynamic microneedle treatments (group 2, n = 20), or local electrodynamic microneedle treatments plus topical 5% minoxidil (group 3, n = 20). A total of 12 microneedle treatments were performed every 2 weeks with 2ml 5% minoxidil delivery in group three during each microneedle treatment. Patient receiving topical 5% minoxidil applied 1 ml of the solution twice daily over the course of the study. A total of 60 Chinese male subjects with Norwood-Hamilton type III-VI androgenetic alopecia were treated.Results: The mean improvement in total hair density from baseline to 24 weeks was 18.8/cm2 in group 1, 23.4/cm2 in group 2, and 38.3/cm2 in group 3. The hair growth in the three groups was significantly different (P = 0.002), but there were no significant differences in toxicity found between the three groups.Conclusions: Treatment with microneedle plus topical 5% minoxidil was associated with the best hair growth.
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Affiliation(s)
- Linlin Bao
- Department of Dermatology, The First Affiliated Hospital of China Medical University, Shenyang, China.,Department of Dermatology, Shenzhen People's Hospital, Shenzhen, China
| | - Lin Gong
- Department of Dermatology, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Menger Guo
- Department of Dermatology, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Taoming Liu
- Department of Dermatology, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Anyu Shi
- Department of Dermatology, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Haifeng Zong
- Department of Neonatology, Shenzhen Maternity and Child Care Hospital, Shenzhen, China
| | - Xuegang Xu
- Department of Dermatology, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Hongduo Chen
- Department of Dermatology, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Xinghua Gao
- Department of Dermatology, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Yuanhong Li
- Department of Dermatology, The First Affiliated Hospital of China Medical University, Shenyang, China
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Kim S, Eum J, Yang H, Jung H. Transdermal finasteride delivery via powder-carrying microneedles with a diffusion enhancer to treat androgenetic alopecia. J Control Release 2019; 316:1-11. [DOI: 10.1016/j.jconrel.2019.11.002] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Revised: 10/27/2019] [Accepted: 11/01/2019] [Indexed: 12/15/2022]
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Shetty VH, Goel S. Dermoscopic pre- and posttreatment evaluation in patients with androgenetic alopecia on platelet-rich plasma-A prospective study. J Cosmet Dermatol 2019; 18:1380-1388. [PMID: 30556270 DOI: 10.1111/jocd.12845] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Revised: 09/26/2018] [Accepted: 11/13/2018] [Indexed: 01/24/2023]
Abstract
BACKGROUND Platelet-rich plasma is rich in growth factors that promote differentiation and growth of dermal papilla cells by various signaling pathways. Dermoscopy is handy, bedside tool that helps to improve diagnostic accuracy in various hair disorders. OBJECTIVES To evaluate and study the role of dermoscopy in patients with androgenetic alopecia (AGA) pre- and posttreatment with platelet-rich plasma (PRP). METHODS It is a prospective comparative study. Twenty male patients with AGA, aged 18-45 years with modified Norwood-Hamilton classification grade II-VI were included in this study. Patients were given platelet-rich plasma injections every 3 week for a period of 3 months. Dermoscopy was performed with 10 x magnifications in polarized mode at baseline and at 3 months from the baseline and photographs were taken. Patients were evaluated based on following dermoscopic findings (a) hair count, (b) hair density, (c) hair diameter diversity, perifollicular pigmentation, yellow dots, multi-hair follicular units, honeycomb pigment pattern and white dots, (d) patient's hair growth assessment score. RESULTS Posttherapy, patients showed significant improvement in hair count (27.4%), hair diversity (84.2%), increase in number of thick, terminals hairs, reduction in yellow dots (60%), perifollicular pigmentation (92.3%) was appreciated. Hair pull test negative after treatment in 10 patients (50%). Patient's hair growth assessment score showed 50%-75% improvement in 7 (35%) patients. CONCLUSION Dermoscopy helps to easily evaluate and compare the therapeutic response pre- and posttreatment which can be easily documented and visualized at every visit.
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Affiliation(s)
- Vinma H Shetty
- Dermatology, Venereology and Leprosy, A. J. Institute of Medical Sciences, Mangalore, India
| | - Saumya Goel
- Dermatology, Venereology and Leprosy, A. J. Institute of Medical Sciences, Mangalore, India
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Katzer T, Leite Junior A, Beck R, da Silva C. Physiopathology and current treatments of androgenetic alopecia: Going beyond androgens and anti-androgens. Dermatol Ther 2019; 32:e13059. [PMID: 31400254 DOI: 10.1111/dth.13059] [Citation(s) in RCA: 51] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2018] [Revised: 07/31/2019] [Accepted: 08/02/2019] [Indexed: 01/29/2023]
Abstract
Androgenetic alopecia (AGA) is the most diagnosed hair loss dysfunction. Its physiopathology comprises a genetic predisposition affording an exacerbated response of the hair follicles cells to androgens aggravated by scalp inflammation and extrinsic factors. This paper presents a review of the mechanisms and extrinsic factors involved in the AGA physiopathology as well as its conventional and emerging treatments. The research focused on reports regarding AGA physiopathology and treatments published between January 2001 and July 2019 in medical and related journals. The most used medical treatments for AGA-minoxidil and finasteride-present non satisfactory results in some cases. Currently, the low-level laser therapy is recognized as a safe and effective treatment for AGA. Some minimally invasive techniques-mesotherapy, microneedling, carboxytherapy, and platelet-rich plasma-are also used to stimulate hair growth. Pharmaceutical substances with mechanisms differing from the anti-androgen activity are under current investigation and many of them have botanical origins; however, formulations with higher performance are required, and the hair follicles ability of being a drug and nanoparticle reservoir has been researched. The association of different strategies, that is, substances with synergic mechanisms and the use of advantageous technologies associated with lifestyle changes could improve the treatment outcomes.
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Affiliation(s)
- Tatiele Katzer
- Pharmaceutical Nanotechnology Post Graduate Program, Federal University of Santa Maria, Santa Maria, Brazil
| | - Ademir Leite Junior
- Clinical Psychology Post Graduate Program, Pontifícia Universidade Católica, São Paulo, Brazil
| | - Ruy Beck
- Pharmaceutical Science Post Graduate Program, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Cristiane da Silva
- Pharmaceutical Nanotechnology Post Graduate Program, Federal University of Santa Maria, Santa Maria, Brazil
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Dhingra N, Bonati LM, Wang EB, Chou M, Jagdeo J. Medical and aesthetic procedural dermatology recommendations for transgender patients undergoing transition. J Am Acad Dermatol 2019; 80:1712-1721. [DOI: 10.1016/j.jaad.2018.05.1259] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2018] [Revised: 05/22/2018] [Accepted: 05/28/2018] [Indexed: 11/28/2022]
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Geizhals S, Grunfeld J, Kwon H, Fox J. Cervical lymphadenopathy from PRP treatment with microneedling therapy. J Cosmet Dermatol 2019; 18:910-911. [DOI: 10.1111/jocd.12772] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Revised: 04/27/2018] [Accepted: 07/26/2018] [Indexed: 11/29/2022]
Affiliation(s)
| | | | | | - Joshua Fox
- Advanced Dermatology, PC New Hyde Park New York
- Department of Dermatology Mt. Sinai Medical Center New York New York
- Department of Dermatology Hofstra Northwell School of Medicine Hempstead New York
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Sharma S, Hatware K, Bhadane P, Sindhikar S, Mishra DK. Recent advances in microneedle composites for biomedical applications: Advanced drug delivery technologies. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2019; 103:109717. [PMID: 31349403 DOI: 10.1016/j.msec.2019.05.002] [Citation(s) in RCA: 63] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/02/2019] [Revised: 04/13/2019] [Accepted: 05/02/2019] [Indexed: 02/06/2023]
Abstract
In the twenty-first century, microneedles based drug delivery is drawing attention worldwide in the research due to current signs of progress in the controlled release drug delivery through microneedles. The microneedles represent a promising technology to deliver therapeutic compounds into the skin for chronic complications like osteoporosis, diabetes, cancer and induction of immune responses from protein and DNA vaccines. However, the delivery of hydrophilic drugs and macromolecular agents are challenging. In this write up authors included the meticulous illustration of the chronological development of fabrication of microneedles with respect to an assortment of techniques, their modifications, clinical trials and regulatory perspectives period of 2000-2019. This review summarizes characterization, fabrications, biological applications and challenges. Additionally, relevant patents based on microneedle from USPTO) database are also highlighted.
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Affiliation(s)
- Sanjay Sharma
- NMIMS, School of Pharmacy and Technology Management, Shirpur, Maharashtra, India
| | - Ketan Hatware
- NMIMS, School of Pharmacy and Technology Management, Shirpur, Maharashtra, India
| | - Prashant Bhadane
- NMIMS, School of Pharmacy and Technology Management, Shirpur, Maharashtra, India
| | - Sainath Sindhikar
- NMIMS, School of Pharmacy and Technology Management, Shirpur, Maharashtra, India
| | - Dinesh K Mishra
- NMIMS, School of Pharmacy and Technology Management, Shirpur, Maharashtra, India.
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Wipf A, Boysen N, Hordinsky MK, Dando EE, Sadick N, Farah RS. The rise of transcutaneous drug delivery for the management of alopecia: a review of existing literature and an eye towards the future. J COSMET LASER THER 2018; 21:247-254. [PMID: 30300013 DOI: 10.1080/14764172.2018.1525743] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Introduction: Fractional lasers and microneedling devices are increasingly used with topical drugs to treat various conditions, including alopecia, as they grant access to dermal structures such as hair follicles and cutaneous vasculature. Objective: To perform a comprehensive review on transcutaneous drug delivery for the management of alopecia. Methods: PubMed, Embase, and Ovid Medline databases were searched using terms including: alopecia, microneedling, lasers, androgenetic alopecia (AGA), alopecia areata (AA), drug delivery. Articles were examined for inclusion criteria: diagnosis of alopecia regardless of type, use of fractional laser or microneedling devices, and subsequent administration of topical medication. Results: 8 studies, 6 prospective clinical trials and 2 case series, examining either AA or AGA were identified. For AA, five studies examined microneedling together with topical triamcinolone in three of these, while two studies used photodynamic therapy. Regarding AGA, two studies used topical minoxidil plus microneedling, and one examined topical finasteride with fractional erbium glass laser. Improvement was seen in 6 of the 8 studies. Discussion: Transcutaneous drug delivery via fractional laser and microneedling is a promising modality with preliminary evidence for increased hair regrowth over topical therapy alone. Further studies are needed to elucidate treatment parameters and appropriate device selection for drug delivery.
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Affiliation(s)
- Angela Wipf
- a Department of Dermatology , University of Minnesota , Minneapolis , Minnesota , United States
| | - Nicholas Boysen
- a Department of Dermatology , University of Minnesota , Minneapolis , Minnesota , United States
| | - Maria K Hordinsky
- a Department of Dermatology , University of Minnesota , Minneapolis , Minnesota , United States
| | - Emily E Dando
- b University of Pittsburgh School of Medicine , Pittsburgh , PA , United States
| | - Neil Sadick
- c Sadick Dermatology , New York , NY , United States
| | - Ronda S Farah
- a Department of Dermatology , University of Minnesota , Minneapolis , Minnesota , United States
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Zduńska K, Kołodziejczak A, Rotsztejn H. Is skin microneedling a good alternative method of various skin defects removal. Dermatol Ther 2018; 31:e12714. [DOI: 10.1111/dth.12714] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Revised: 08/03/2018] [Accepted: 08/12/2018] [Indexed: 12/24/2022]
Affiliation(s)
- Kamila Zduńska
- Chair of Cosmetology, Department of Cosmetology and Aesthetic Dermatology, Faculty of Pharmacy; Medical University of Łódź; Łódź Poland
| | - Anna Kołodziejczak
- Chair of Cosmetology, Department of Cosmetology and Aesthetic Dermatology, Faculty of Pharmacy; Medical University of Łódź; Łódź Poland
| | - Helena Rotsztejn
- Chair of Cosmetology, Department of Cosmetology and Aesthetic Dermatology, Faculty of Pharmacy; Medical University of Łódź; Łódź Poland
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Yu AJ, Luo YJ, Xu XG, Bao LL, Tian T, Li ZX, Dong YX, Li YH. A pilot split-scalp study of combined fractional radiofrequency microneedling and 5% topical minoxidil in treating male pattern hair loss. Clin Exp Dermatol 2018; 43:775-781. [PMID: 29952106 DOI: 10.1111/ced.13551] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/06/2017] [Indexed: 02/03/2023]
Affiliation(s)
- A.-J. Yu
- Department of Dermatology; No. 1 Hospital of China Medical University; Shenyang China
| | - Y.-J. Luo
- Department of Dermatology; No. 1 Hospital of China Medical University; Shenyang China
| | - X.-G. Xu
- Department of Dermatology; No. 1 Hospital of China Medical University; Shenyang China
| | - L.-L. Bao
- Department of Dermatology; No. 1 Hospital of China Medical University; Shenyang China
| | - T. Tian
- Department of Dermatology; No. 1 Hospital of China Medical University; Shenyang China
| | - Z.-X. Li
- Department of Dermatology; No. 1 Hospital of China Medical University; Shenyang China
| | - Y.-X. Dong
- Department of Dermatology; No. 1 Hospital of China Medical University; Shenyang China
| | - Y.-H. Li
- Department of Dermatology; No. 1 Hospital of China Medical University; Shenyang China
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Ramaut L, Hoeksema H, Pirayesh A, Stillaert F, Monstrey S. Microneedling: Where do we stand now? A systematic review of the literature. J Plast Reconstr Aesthet Surg 2018; 71:1-14. [DOI: 10.1016/j.bjps.2017.06.006] [Citation(s) in RCA: 77] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2017] [Revised: 05/14/2017] [Accepted: 06/06/2017] [Indexed: 02/07/2023]
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Kumar MK, Inamadar AC, Palit A. A Randomized Controlled, Single-Observer Blinded Study to Determine the Efficacy of Topical Minoxidil plus Microneedling versus Topical Minoxidil Alone in the Treatment of Androgenetic Alopecia. J Cutan Aesthet Surg 2018; 11:211-216. [PMID: 30886475 PMCID: PMC6371730 DOI: 10.4103/jcas.jcas_130_17] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Background: Androgenetic alopecia (AGA) is the most common form of hair loss in adults, which is generally progressive in the absence of treatment. As a head full of healthy hair adds to the cosmetic appeal of the individual, the consequences of AGA are predominantly psychological. Currently, topical minoxidil is the first-line treatment for AGA. Many adjuvant treatment modalities have been used synergistically with minoxidil. Microneedling is one among such adjuvant treatments, which works by various mechanisms to stimulate the dermal papillary cells that play a key role in hair growth. Aim: To compare the efficacy of microneedling along with topical minoxidil and topical minoxidil alone in the treatment of AGA in men. Materials and Methods: Sixty-eight men with Norwood–Hamilton grade III and IV AGA were recruited for the study. After randomization, one group was treated with weekly microneedling and twice daily application of 5% minoxidil solution and the other group was treated with twice daily application of 5% minoxidil solution alone. Global photographs were taken at baseline (pretreatment) and at end of the study duration. Trichoscopic images were taken from a targeted fixed area before treatment (baseline) and at end of the therapy from where hair count was also carried out. The two primary efficacy parameters were assessed: increase in the hair count from that of the baseline and patient self-assessment of hair growth at the end of the study. Results: The mean increase in hair count in the targeted area of one square inch at the end of the treatment was significantly greater for the combination treatment group (12.52/inch2) compared to that for the minoxidil alone group (1.89/inch2). Four patients in the “microneedling plus topical minoxidil” group reported a 50% improvement versus none in the “minoxidil alone” group. Conclusion: Our study showed that the combination of microneedling and topical minoxidil treatment was superior compared to topical minoxidil alone with regard to increase in the hair count and patient satisfaction, although the response achieved was not cosmetically significant.
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Affiliation(s)
- Muriki K Kumar
- Department of Dermatology, Venereology and Leprosy, Shri B. M. Patil Medical College, Hospital and Research Centre, BLDE (Deemed to be University), Vijayapur 586104, India
| | - Arun C Inamadar
- Department of Dermatology, Venereology and Leprosy, Shri B. M. Patil Medical College, Hospital and Research Centre, BLDE (Deemed to be University), Vijayapur 586104, India
| | - Aparna Palit
- Department of Dermatology, Venereology and Leprosy, Shri B. M. Patil Medical College, Hospital and Research Centre, BLDE (Deemed to be University), Vijayapur 586104, India
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