Traction alopecia: how to translate study data for public education--closing the KAP gap?

Traction alopecia (TA) affects up to 32% of women and 22% of high school girls with Afro-textured hair but can start in the preschool years. Traction induces inflammation and follicle damage. The risk of TA increases with symptomatic traction and combined hairstyles. To influence the practice of hairdressers and at risk individuals and help narrow the knowledge, attitudes, and practices (KAP) gap, scientific data should be translated into simple messages like "tolerate pain from a hairstyle and risk hair loss" and "no braids or weaves on relaxed hair". With appropriate education and public awareness, TA could potentially be eradicated.

Hairy tale of signaling in hair follicle development and cycling

Hair follicles (HFs) is an appendage from the vertebrate skin epithelium, and is critical for environmental sensing, animal appearance, and body heat maintenance. HFs arise from the embryonic ectoderm and regenerate cyclically during adult life. Distinct morphological and functional stages from development through homeostasis have been extensively studied for the past decades to dissect the critical molecular mechanisms. Accumulating work suggests that different signaling cascades, such as Wnt, Bmp, Shh, and Notch, together with specific combinations of transcription factors are at work at different stages. Here we provide a comprehensive review of mouse genetics studies, which include lineage tracing along with knockout and over-expression of core genes from key signaling pathways, to paint an updated view of the molecular regulatory network that govern each stage of hair follicle development and adult cycling.

Effect of liposomes containing antioxidant, phospholipid, and amino acid on skin regeneration after chemical burn

Liposomes containing natural flavonoid dihydroquercetin, phospholipid lecithin, and zwitterionic amino acid glycine were used for the therapy of glacial acetic acid-induced chemical burn. No inflammatory reaction was observed in the region of wound. The area of postburn injury did not increase in time. Planimetry and histological studies showed that improved skin regeneration was accompanied by repair of hair follicles and sebaceous glands.

New Methodology and Instrumentation for Follicular Unit Extraction: Lower Follicle Transection Rates and Expanded Patient Candidacy

BACKGROUND

Follicular unit extraction (FUE), as described in the literature for harvesting follicular units, is technically demanding, has limited patient candidacy, and can potentially result in high rates of follicle transection. Although FUE has potential advantages, such as faster surgical recovery, less postoperative pain, less noticeable scarring, and possible expansion of the donor area, the acceptance of the technique is limited by the problems noted above. The proposed methodology and instrumentation may allow widespread adoption of FUE.

OBJECTIVE

To present the SAFE (Surgically Advanced Follicular Extraction) System, a new methodology and novel instrumentation for FUE. This article presents the efficacy of this methodology and addresses patient candidacy.

METHODS

Twenty-two patients undergoing standard strip excision were enrolled in a pilot study to assess follicle transection rates using the SAFE System. Based on the success of the pilot study, an additional 37 patients receiving a total of 6,947 grafts were examined. Transection rates were recorded, and patients were examined for complications or adverse reactions.

RESULTS

The average follicle transection rate was 6.14%, with a range of 1.7 to 15%. The only adverse reaction was the occurrence of two buried grafts, resulting in inflammatory subcutaneous cysts requiring excision.

CONCLUSION

It appears that the SAFE System provides the methodology and instrumentation to enhance current FUE techniques and expand patient candidacy. The transection rate of this method compares favorably with traditional microscope graft dissection. Physicians with a modicum of technical skills can use the technique, and there does not appear to be a significant adverse reaction rate.

Whisker plucking alters responses of rat trigeminal ganglion neurons

Whisker plucking in developing and adult rats provides a convenient method of temporarily altering tactile input for the purposes of studying experience-dependent plasticity in the somatosensory cortex. Yet, a comprehensive examination of the effect of whisker plucking on the response properties of whisker follicle-innervating trigeminal ganglion (NVg) neurons is lacking. We used extracellular single unit recordings to examine responses of NVg neurons to controlled whisker stimuli in three groups of animals: (1) rats whose whiskers were plucked from birth for 21 days; (2) rats whose whiskers were plucked once at 21 days of age; and (3) control animals. After at least 3 weeks of whisker re-growth, NVg neurons in plucked rats displayed normal, single whisker receptive fields and could be characterized as slowly (SA) or rapidly adapting (RA). The proportion of SA and RA neurons was unaffected by whisker plucking. Both SA and RA NVg neurons in plucked rats displayed normal response latencies and angular tuning but abnormally large responses to whisker movement onsets and offsets. SA neurons were affected to a greater extent than RA neurons. The effect of whisker plucking was more pronounced in animals whose whiskers were plucked repeatedly during development than in rats whose whiskers were plucked once. Individual neurons in plucked animals displayed abnormal periods of prolonged rhythmic firing following deflection onsets and aberrant bursts of activity during the plateau phase of the stimulus. These results indicate that whisker plucking exerts a long-term effect on responses of trigeminal ganglion neurons to peripheral stimulation.

Proptosis after hair pulling

We describe proptosis due to a subperiosteal orbital hematoma that originated from a subgaleal bleed caused by hair pulling. A 13-year-old boy presented with a one-week history of progressive proptosis after his older sister pulled his hair during an argument. Computerized tomography showed a subgaleal hematoma and a right superior subperiosteal orbital hematoma. Progressive proptosis and compressive optic neuropathy developed, necessitating surgical evacuation with a favorable outcome.Hair pulling can result in a subgaleal bleed with extension to the orbital subperiosteal space. When managing patients with a subgaleal hematoma, this vision-threatening complication should be considered and treated accordingly.

An ultrastuctural study of hair fiber damage and restoration following treatment with permanent hair dye

INTRODUCTION

Hair fibers are comprised of non-nucleated keratinocytes and are biologically dead. Clinical damage to the hair shaft occurs with the application of hair dye. Whether this damage can be repaired and the time frame involved is of interest and may help to determine the optimal interval between repeat applications.

AIMS AND METHODS

Ultrastructural changes of hair shafts after application of permanent hair dye were observed sequentially in a 26-year-old woman. The dye contained p-phenylenediamine, m-aminophenol, resorcin and hydrogen peroxide as an oxidizer. Scanning and transmission electron microscopy was performed immediately before application of the hair dye and again at 30 min, 1 h, 3 h, 6 h, 1 day, 3 days, 1 week, 2 weeks, 4 weeks, 6 weeks and 8 weeks.

RESULTS

The hair showed cuticular swelling with focal degeneration. In some places there was exposure of the hair cortex due to extensive cuticular detachment. There were many holes of various size in the endocuticle, small focal lacunae along the intercellular space and an ill-defined A-layer especially beneath the area of cuticular detachment. The exocuticle appeared normal. The findings were most dramatic in the 6 h and 1 day specimens and tended to improve gradually thereafter. The 8 week specimen showed near complete restoration of the hair cuticle and return to the precoloring state.

CONCLUSION

Hair returns to its precoloring state and this requires 8 weeks.

Histologic study of the regeneration process of human hair follicles grafted onto SCID mice after bulb amputation

This study examines histologically the degeneration and subsequent regeneration processes of human hair follicles whose bulb is severely damaged. Human scalp hair follicles were isolated and grafted onto immunodeficient mice after their bulb was amputated. On day 14, thickening and corrugation of the vitreous membrane, apoptosis of follicular keratinocytes, and regression of the lower portion of the follicles were observed. By day 20, mesenchymal cells had accumulated around the lower end of the follicles. From day 14 through 50, the follicular regression and apoptosis continued, and between days 30 and 40 the follicles became maximally shortened, and the vitreous membrane disappeared. By day 50 the lower end of the follicles had become cup-shaped, and the cup surrounded an aggregate of mesenchymal cells that corresponded to the dermal papilla. By day 60, all the grafted follicles had developed into anagen VI follicles, and the apoptosis had ceased. These results indicate that human scalp hair follicles whose bulb is completely destroyed enter into dystrophic telogen after restoration of the dermal papilla, then into anagen, and that the duration of the dystrophic telogen is shorter than that of the normal hair cycle.

Impaired skin wound healing in peroxisome proliferator-activated receptor (PPAR)alpha and PPARbeta mutant mice

We show here that the alpha, beta, and gamma isotypes of peroxisome proliferator-activated receptor (PPAR) are expressed in the mouse epidermis during fetal development and that they disappear progressively from the interfollicular epithelium after birth. Interestingly, PPARalpha and beta expression is reactivated in the adult epidermis after various stimuli, resulting in keratinocyte proliferation and differentiation such as tetradecanoylphorbol acetate topical application, hair plucking, or skin wound healing. Using PPARalpha, beta, and gamma mutant mice, we demonstrate that PPARalpha and beta are important for the rapid epithelialization of a skin wound and that each of them plays a specific role in this process. PPARalpha is mainly involved in the early inflammation phase of the healing, whereas PPARbeta is implicated in the control of keratinocyte proliferation. In addition and very interestingly, PPARbeta mutant primary keratinocytes show impaired adhesion and migration properties. Thus, the findings presented here reveal unpredicted roles for PPARalpha and beta in adult mouse epidermal repair.

[Study of microinjuries to hair cuticle of human head by scanning electron microscopy]

The author presents the data on microclues in the free edges of hair cuticles of human head: microinjuries, microdefects (cracks, breaks, clefts, large and small waves) in representatives of Asia, Africa, Latin America, and Eastern Europe. The studies were carried out by scanning electron microscopy. Microinjuries of cuticle cells forming during hair combing by different types of combs and as a result of "permanent" curling are described. Scanning electron microscopy at the optimal magnification of x 3000 is a highly informative method for investigating microinjuries to the hair cuticle as additional signs in expert evaluation of the hair.

Follicle trauma and the role of the dissecting microscope in hair transplantation. A multicenter study

Use of the dissecting stereomicroscope during hair transplant graft dissection has been advocated as a means of reducing hair follicle transection and improving graft growth. The study evaluated the prevalence of hair follicle transection in grafts prepared with and without the dissecting stereomicroscope. Approximately half as much transection (10% vs 20%, p < 0.05) was noted in grafts prepared with microscopes, suggesting their use may be associated with less hair follicle trauma and improved hair growth.

The nature of cuticular "ruffles" on slowly plucked anagen hair roots

When an anagen hair is slowly plucked, the root's surface near the distal end of the keratogenous zone shows rings of 'ruffles' which are cuticular scales rolled back towards the root tip in a tight curl. During extraction, the rachet-like cuticle of the inner root sheath tears apart the almost differentiated cuticular scales on the root's cortex. Further extraction rolls up the cuticle because of the friction with the inner root sheath cuticle and because the torn intercellular cement reconstitutes so that the ruffle's curl is stabilized by cohesion (self-gluing). No evidence was found for pretensioning in the root's cuticle as an explanation for the curling.

The RBE for skin tumors and hair follicle damage in the rat following irradiation with alpha particles and electrons

Rat skin was irradiated with cyclotron-accelerated alpha particles with doses ranging from 210 rads to 6850 rads and monoenergetic electrons with doses ranging from 810 rads to 12,300 rads. The beams were modified so that the depth-dose curves were approximately identical with penetrations of about 1.0 mm. Tumors were counted every 4 weeks for 80 weeks, and at death or sacrifice the hair follicle damage was assessed by using "whole mounts" of separated epithelium. The RBE values determined from a comparison of the dose response curves were: acute skin injury, RBE = 3.0+/-1.0; hair follicle survival, RBE = 2.1 +/- 0.7; hair follicle damage, RBE = 2.6 = 0.4; tumor induction, RBE = 2.9+/- 0.5. Within the experimental error, these values were independent of the dose. For both types of radiation, the tumor incidence increased approximately as the square of time and at low doses approximately as the 4th power of dose. The histological characteristics of the tumors and the correlation between the incidence of tumors and damaged hair follicles were independent of the type of radiation. The results were consistent with the hypothesis that structural damage to the hair follicles is a factor in the tumor induction process.