More is Not Always Better in Hair Growth Factors. Epidermal Growth Factor: Hair Growth Factor Involved in Alopecia Areata Pathogenesis

Growth Factors and Microneedling in Alopecia Areata: A Narrative Review

Alopecia areata (AA) is an autoimmune condition that causes non-scarring hair loss on the scalp or other hair-bearing surfaces. Various signalling molecules regulate the hair cycle and hair follicle regeneration. These include genes, growth factors, nuclear receptors, cytokines, and subcellular signalling pathways. Growth factors can cause the vascular endothelium and dermal fibroblasts to proliferate, extend the anagen phase, and delay the initiation of catagen in the hair follicle, thereby promoting hair growth. Microneedling causes the release of growth factors and has been shown to help high-molecular-weight drugs penetrate the stratum corneum and hair follicles. These recent discoveries regarding the pathogenesis of AA have resulted in the development of promising therapies. Herein, this article reviews the use of growth factors and microneedling in the treatment of AA and explores their efficacy and safety. Treatment with growth factors and microneedling appears to be highly effective for AA, with no major adverse effects, and may provide a new option for hair regeneration therapy. To support the efficacy of growth factors and microneedling for AA treatment, additional large-scale studies of patients with AA are needed.

Efficacy of Adipocyte-Derived Stem Cells-Conditioned Media in Telogen Effluvium

Objectives

To assess the effectiveness of adipocyte-derived mesenchymal stem cells-conditioned media (ADSC-CM) formulation in telogen effluvium patients.

Methods

A retrospective cohort study was conducted at a dermatology clinic in Jeddah, Saudi Arabia. The study included 50 consecutive patients aged 20-70 years, who were diagnosed with telogen effluvium. All patients received five monthly sessions of the same commercial ADSC-CM formulation, using a standardized application protocol. Pre- and post-intervention changes in trichometry parameters were analyzed.

Results

There was a significant increase in mean hair density (up to 29.01 hair/cm2; effect size 0.7-1.0), cumulative hair thickness (up to 2.67 units; effect size 0.7-1.4), and the number of follicular hair units (up to 19.96%; effect size 1.0-1.3) in all scalp regions (p < 0.001), associated with a decrease in mean trichometry-derived Sinclair scale by 0.8-1.3 (p < 0.001). Positive outcomes were observed in 70%-92% of the patients depending on the parameter and scalp region. There was no impact of the patient's age on ADSC-CM efficacy.

Conclusion

ADSC-CM was successfully applied as a new treatment option for patients with telogen effluvium. These findings provide another therapeutic and research area for dermatologists to optimize the management of telogen effluvium and reduce its impact on patients.

The use of epidermal growth factor in dermatological practice

Epidermal growth factor (EGF) is a growth factor that plays a pivotal role in wound healing and maintaining tissue homeostasis by regulating cell survival, proliferation, migration, and differentiation. Exogenous administration of bioidentical human recombinant epidermal growth factor (rhEGF) has been known to promote skin wound healing, although rhEGF is increasingly being used in drug delivery systems and nanotechnology. However, despite considerable attention being focused on the potential clinical applications of rhEGF in several dermatological conditions beyond wound healing, the number of studies still remains relatively low. Herein, we conducted a literature search of PubMed/Medline and Google Scholar databases to retrieve published literature related to rhEGF and summarised the effects of rhEGF in the treatment of various wound types, radiotherapy or chemotherapy-related skin reactions, atopic dermatitis, skin aging, and post-inflammatory hyperpigmentation.

The potential role of fibroblast-derived multi-peptide factors in activation of growth factors and β-Catenin in hair follicle cells

BACKGROUND

Dermal fibroblasts play a pivotal role in hair follicle regeneration during wound repair. Recently, dermal fibroblast-conditioned medium (DFCM), which contains multi-peptide factors (MPFs), has been used to promote wound repair.

AIM

This study aimed to investigate the stimulatory effects of MPF-containing DFCM on hair growth.

METHODS

MPF-containing DFCM was prepared using human neonatal dermal fibroblasts. Outer root sheath (ORS) and dermal papilla (DP) cells were cultured in MPF-containing DFCM. We examined the expression and secretion of growth factors and cytokines using quantitative polymerase chain reaction and a growth factor array. In addition, the effect of MPFs on β-catenin activity was determined using the TOPflash assay. All experiments were repeated at least three times with separate batches of cells.

RESULTS

MPF-containing DFCM increased keratinocyte growth factor (KGF), vascular endothelial growth factor (VEGF), and epidermal growth factor (EGF) mRNA expression in ORS cells and KGF and VEGF mRNA expression in DP cells. When ORS cells were treated with MPF-containing DFCM, the secretion of several growth factors, including EGF, VEGF, insulin-like growth factor-binding protein (IGFBP)-4, IGFBP-6, and fibroblast growth factor-7, was increased in the cell-cultured medium compared with that in control. Additionally, MPF-containing DFCM increased the transcriptional activation of β-catenin in DP cells.

CONCLUSIONS

These results suggest that MPF-containing DFCM might stimulate hair growth by inducing growth factors in ORS and DP cells and regulating β-catenin in DP cells.

Low Level Laser versus Platelet-rich Plasma in Treatment of Alopecia Areata: A Randomized Controlled Intra-patient Comparative Study

Abstract                                                                                                           Background: Non-scarring alopecia areata (AA) is a disease that is mediated through autoimmunity. Recently, autologous platelet-rich plasma (PRP) and photobiomodulation (PBM), commonly known as low-level laser (or light, LLLT) have been suggested to provide a valuable role in stimulating the growth of hair follicles (HF) Aim: Compare between the significance and wellbeing of PRP and LLLT in the management of AA. Patients & methodology: Thirty patients, each having three patches of AA participated in the study. Patches were assigned randomly to have one of the two treatments: PRP or LLLT. The third patch served as a control and received placebo treatment. PRP was done once weekly whereas LLLT was done 3 sessions per week for a maximum of 6 weeks. Patients were followed up at one month and three months. The thickness and density of hair were evaluated by the folliscope. Results: A noteworthy higher improvement was detected in the thickness and the density of hair in the PRP treated patches as evaluated by the folliscope and patients satisfaction. The obtained outcomes were sustained during the 12 week follow-up period in most of patients. Conclusion: PRP and LLLT could be considered as efficacious alternatives for the treatments of  AA with the least morbidity in addition to a little cost profit ratio. KEYWORDS: Alopecia areata, platelet-rich plasma, folliscope, photobiomodulation, low level laser therapy.