Androgenetic alopecia (male pattern hair loss) in the United States: What treatments should primary care providers recommend?
Chin EY.
Abstract
PURPOSE:
Androgenetic alopecia (AGA), or male pattern hair loss, affects up to 96% of Caucasian men. Characterized by gradual thinning and eventual loss of hair along frontotemporal, parietal, and vertex areas of the scalp, AGA is associated with low self-esteem, depression, and dissatisfaction with body appearance.
DATA SOURCES:
In this systematic review of the literature, six primary research studies conducted in the United States are evaluated for their clinical application to primary care provider practice.
CONCLUSIONS:
Topical minoxidil 2%-5% 1 mL twice daily or finasteride 1 mg daily are recommended as first line treatments, followed by the use of Food and Drug Administration-cleared HairMax LaserComb® in patients who do not respond to first line modalities.
IMPLICATIONS FOR PRACTICE:
Further research in novel and established treatments is recommended, along with an evidence-based clinical practice guideline for practitioners in the United States.
]]>Higher body mass index is associated with greater severity of alopecia in men with male-pattern androgenetic alopecia in Taiwan: A cross-sectional study.
Yang CC, Hsieh FN, Lin LY, Hsu CK, Sheu HM, Chen W.
Abstract
BACKGROUND:
Obesity is a risk factor for multiple health problems, but its association with hair loss in androgenetic alopecia (AGA) remains controversial.
OBJECTIVE:
We sought to determine the association between body mass index (BMI) and alopecia severity in men with androgenic alopecia and early-onset AGA.
METHODS:
A cross-sectional study was conducted. The medical charts and photographs of men with a clinical diagnosis of AGA were reviewed.
RESULTS:
In all, 189 men were enrolled with a mean age of 30.8 years. In male-pattern AGA, men with severe alopecia had higher BMI than those with mild to moderate alopecia. After multivariate adjustments, the risk for severe alopecia was higher in the overweight or obese subjects with male-pattern AGA. In early-onset male-pattern AGA, the risk for having severe alopecia was also higher in the overweight or obese subjects.
LIMITATIONS:
Parameters used to evaluate obesity were limited because of the retrospective nature of the study.
CONCLUSIONS:
Higher BMI was significantly associated with greater severity of hair loss in men with male-pattern AGA, especially in those with early-onset AGA.
]]>Abstract
Background: Analysis of relative importance of side effects of anticancer therapy is extremely useful in the process of clinical decision making. There is evidence that patients' perception of the side effects of anticancer treatments changes over time. Objectives: Aim of this study was to evaluate the cancer patients' perceptions of physical and non-physical side effects of contemporary anticancer therapy. Four hundred and sixty-four patients entered the study (153 men and 311 women). Participants were asked to rank their side effects in order of distress by using two sets of cards naming physical and non-physical effects, respectively. Influencing factors, including treatment and patient characteristics, were also analysed. Results: Patients ranked the non-physical side effect 'Affects my family or partner' first. 'Constantly tired' and 'Loss of hair' were ranked second and third, respectively. Significant differences from previous studies on this topic emerged. In particular, 'Vomiting', a predominant concern in previous studies, almost disappeared, whereas 'Nausea' and 'Loss of hair' remained important side effects in the patients' perception. Interestingly, marital status was predominant in driving patients' perception, being associated with several side effects ('Constantly tired', 'Loss of appetite', 'Affects my work/Home duties', 'Affects my social activities', 'Infertility'). Other significant factors influencing patient's perception of side effects included age, disease characteristics and ongoing anticancer therapy. Conclusions: This study provided information on current status of patients' perceptions of side effects of anticancer treatment. These results could be used in pre-treatment patient education and counselling.
Abstract
Currently, efficacious treatments for chemotherapy-induced alopecia (hair loss) are lacking, and incidences of permanent hair loss following high-dose chemotherapy are on the increase. In this article, we describe mechanisms by which the pharmacological defense status of the hair follicle might be enhanced, thereby reducing the accumulation of cytotoxic cancer drugs and preventing or reducing hair loss and damage. We believe this could be achieved via the selective increase in ATP-binding cassette (ABC) transporter expression within the hair follicle epithelium, following application of topical agonists for regulatory nuclear receptors. Clinical application would require the development of hair follicle-targeted formulations, potentially utilizing nanoparticle technology. This novel approach has the potential to yield entirely new therapeutic options for the treatment and management of chemotherapy-induced alopecia, providing significant psychological and physical benefit to cancer patients.
]]>Progressive alopecia associated with hypoparathyroidism in a Jersey heifer.
Villarroel A, et al
Abstract
BACKGROUND:
Chronic progressive generalized alopecia in dairy cattle has been anecdotally discussed in veterinary forums.
OBJECTIVE:
To describe subclinical changes in an otherwise apparently healthy animal with chronic progressive generalized alopecia.
ANIMALS:
One 10-month-old Jersey heifer.
METHODS:
Case report.
RESULTS:
A heifer was presented for chronic progressive alopecia (hair loss). The skin was hyperpigmented and very thin (2.4 ± 0.0 mm, compared with 8.1 ± 0.3 mm measured in four contemporaneous Jersey heifers). Histopathological examination of the skin revealed severe epidermal hyperplasia, orthokeratotic hyperkeratosis and diffuse follicular atrophy. Clinicopathological changes included hypocalcaemia that did not respond to calcium therapy. Serum parathyroid hormone (PTH) was not detected, compared with 1.38 ± 0.78 pmol/L in four contemporaneous Jersey heifers. A diagnosis of hypoparathyroidism was made based on hypocalcaemia and low PTH in the presence of normal magnesium levels. The heifer was otherwise healthy and was allowed to continue normal life. A spontaneous abortion occurred at 5.5 months of pregnancy and this was likely due to the presence of twin fetuses. Despite targeted therapy of the ensuing retained placenta, the heifer declined in health and had to be euthanized. From the time of diagnosis with hypoparathyroidism until euthanasia (29 months of age), blood levels of calcium, phosphorus and PTH were regularly monitored. Calcium and phosphorus levels varied widely. Serum PTH was consistently undetectable. At postmortem examination, the parathyroid glands could not be located.
CONCLUSIONS AND CLINICAL IMPORTANCE:
To our knowledge, this is the first report of naturally occurring hypoparathyroidism in cattle and with a clinical presentation of hair loss.
Slightly modified for hair loss blog use
]]>Development and characterization of phyto-vesicles of â-sitosterol for the treatment of androgenetic alopecia.
Upadhyay K, et al
Abstract
Alopecia or hair loss is a psychologically distressing phenomenon. Androgenetic alopecia (AGA) is the most common form of hair loss, which affects millions of men and women worldwide, and is an androgen driven disorder. To study the effect of â-sitosterol phyto-vesicles on AGA, the testosterone-induced alopecia model was used. For the study, the albino rats were used and the period of study was 21 days. â-Sitosterol is a phytosterol which is chemically similar to cholesterol. This compound was found suitable for the preparation of phyto-vesicles by the process involving its complexation with phosphatidyl choline. Pharmacokinetic studies of â-sitosterol reveal its poor absorption through the intestine. The objective of the present study is to enhance the bioavailability of â-sitosterol by its complexation with phosphatidyl choline and then to formulate it as phyto-vesicles for the treatment of hair loss. The complex of â-sitosterol was prepared with phosphatidyl choline and characterized on the basis of solubility, melting point, TLC, UV, IR and NMR spectroscopy. This complex was then formulated as phyto-vesicles and then characterized. The results revealed that effect on alopecia is better in case of phyto-vesicles as compared to the complex, physical mixture and the â-sitosterol itself. Enhanced bioavailability of the â-sitosterol complex may be due to the amphiphilic nature of the complex, which greatly enhance the water and lipid solubility of the compound. The present study clearly indicates the superiority of phyto-vesicles over the complex and â-sitosterol, in terms of better absorption and improved activity for the treatment of hair loss.
]]>Development and characterization of phyto-vesicles of â-sitosterol for the treatment of androgenetic alopecia.
Upadhyay K, et al
Abstract
Alopecia or hair loss is a psychologically distressing phenomenon. Androgenetic alopecia (AGA) is the most common form of hair loss, which affects millions of men and women worldwide, and is an androgen driven disorder. To study the effect of â-sitosterol phyto-vesicles on AGA, the testosterone-induced alopecia model was used. For the study, the albino rats were used and the period of study was 21 days. â-Sitosterol is a phytosterol which is chemically similar to cholesterol. This compound was found suitable for the preparation of phyto-vesicles by the process involving its complexation with phosphatidyl choline. Pharmacokinetic studies of â-sitosterol reveal its poor absorption through the intestine. The objective of the present study is to enhance the bioavailability of â-sitosterol by its complexation with phosphatidyl choline and then to formulate it as phyto-vesicles for the treatment of hair loss. The complex of â-sitosterol was prepared with phosphatidyl choline and characterized on the basis of solubility, melting point, TLC, UV, IR and NMR spectroscopy. This complex was then formulated as phyto-vesicles and then characterized. The results revealed that effect on alopecia is better in case of phyto-vesicles as compared to the complex, physical mixture and the â-sitosterol itself. Enhanced bioavailability of the â-sitosterol complex may be due to the amphiphilic nature of the complex, which greatly enhance the water and lipid solubility of the compound. The present study clearly indicates the superiority of phyto-vesicles over the complex and â-sitosterol, in terms of better absorption and improved activity for the treatment of hair loss.
]]>Ann Dermatol. 2011 Nov;23(4):455-62. Epub 2011 Nov 3.
Hair shaft damage from heat and drying time of hair dryer.
Lee Y,et al
Source
Department of Dermatology and Institute of Hair and Cosmetic Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea.
Abstract
BACKGROUND:
Hair dryers are commonly used and can cause hair damage such as roughness, dryness and loss of hair color. It is important to understand the best way to dry hair without causing damage.
OBJECTIVE:
The study assessed changes in the ultra-structure, morphology, moisture content, and color of hair after repeated shampooing and drying with a hair dryer at a range of temperatures.
METHODS:
A standardized drying time was used to completely dry each hair tress, and each tress was treated a total of 30 times. Air flow was set on the hair dryer. The tresses were divided into the following five test groups: (a) no treatment, (b) drying without using a hair dryer (room temperature, 20ž), (c) drying with a hair dryer for 60 seconds at a distance of 15 cm (47ž), (d) drying with a hair dryer for 30 seconds at a distance of 10 cm (61ž), (e) drying with a hair dryer for 15 seconds at a distance of 5 cm (95ž). Scanning and transmission electron microscopy (TEM) and lipid TEM were performed. Water content was analyzed by a halogen moisture analyzer and hair color was measured with a spectrophotometer.
RESULTS:
Hair surfaces tended to become more damaged as the temperature increased. No cortex damage was ever noted, suggesting that the surface of hair might play a role as a barrier to prevent cortex damage. Cell membrane complex was damaged only in the naturally dried group without hair dryer. Moisture content decreased in all treated groups compared to the untreated control group. However, the differences in moisture content among the groups were not statistically significant. Drying under the ambient and 95ž conditions appeared to change hair color, especially into lightness, after just 10 treatments.
CONCLUSION:
Although using a hair dryer causes more surface damage than natural drying, using a hair dryer at a distance of 15 cm with continuous motion causes less damage than drying hair naturally
]]>Ethinylestradiol/Chlormadinone acetate for use in dermatological disorders.
Gómez Vázquez M,et al
Edited for hair loss blog
Abstract
The diagnosis and management of four cases of dermatological disorders, most of which are related to the endocrine disorder of androgen excess, are presented. Combined oral contraceptives (COCs) may be useful when well-tolerated hormonal therapy and/or when contraception is required. A female patient with androgenetic alopecia or female pattern balding, without underlying hyperandrogenism, was treated with ethinylestradiol/chlormadinone acetate (EE/CMA) 0.03 mg/2 mg for 6 months and experienced stabilization of pattern hair loss (case report 1). A patient who had previously received a COC for an irregular menstrual pattern but again experienced irregular menses and also acne after stopping treatment was diagnosed with acne associated with polycystic ovary syndrome (PCOS) [case report 2]. After 6 month's treatment with EE/CMA 0.03 mg/2 mg, this patient had fewer acne lesions and became eumenorrheic. A third patient who had excess hair since childhood was diagnosed with idiopathic hirsutism (no underlying gynecological or endocrinological disorder was found) and was treated with EE/CMA 0.03 mg/2 mg (case report 3). Less hair growth was reported after 6 months' treatment. Case report 4 describes a patient who presented with oligomenorrhea and acne. She was diagnosed with PCOS with acne, seborrhea and mild hirsutism. Treatment with EE/CMA 0.03 mg/2 mg for 6 months resulted in improvements in her facial acne, seborrhea and hirsutism; she also became eumenorrheic. These four cases illustrate that EE/CMA may be a useful and well tolerated treatment option in the management of patients with dermatological disorders with or without hyperandrogenization.
Hair loss and hair regrowth hair loss treatment
]]>Balding blog
]]>[Diagnostic defects and treatment set-backs in hair disorders]
[Article in French]
Piérard-Franchimont C, Quatresooz P, Piérard GE.
CHU du Sart Tilman et Sauvenière, Service de Dermatopathologie, Belgique.
Abstract
Hair loss, also called hair effluvium is often considered as an ancillary complaint. However, this situation is quite common in both genders. It is part of numerous clinical presentations in internal medicine and dermatology. Obviously, any correlation between a biologic abnormality and hair loss does not prove a relationship of causality. In absence of pathogenic diagnosis and causality criteria, chances are low to control adequately hair effluvium by a treatment given by the whims of fate. In addition, the risk and frequency of therapeutic inertia are increased. When the hair loss is not controlled and/or compensated by growth of new hairs, several types of alopecia inexorably develop.
modified for hair loss treatment blog
]]>N-acetylcysteine, a glutamate modulator, in the treatment of trichotillomania: a double-blind, placebo-controlled study.
Grant JE,et al
CONTEXT: Trichotillomania is characterized by repetitive hair pulling that causes noticeable hair loss.. OBJECTIVE: To determine the efficacy and tolerability of N-acetylcysteine in adults with trichotillomania. DESIGN: Twelve-week, double-blind, placebo-controlled trial. SETTING: Ambulatory care center. PATIENTS: Fifty individuals with trichotillomania INTERVENTIONS: N-acetylcysteine (dosing range, 1200-2400 mg/d) or placebo was administered for 12 weeks. MAIN OUTCOME MEASURES: Patients were assessed using the Massachusetts General Hospital Hair Pulling Scale, the Clinical Global Impression scale, the Psychiatric Institute Trichotillomania Scale, and measures of depression, anxiety, and psychosocial functioning...snip... RESULTS: Patients assigned to receive N-acetylcysteine had significantly greater reductions in hair-pulling symptoms as measured using the Massachusetts General Hospital Hair Pulling Scale and the Psychiatric Institute Trichotillomania Scale. Fifty-six percent of patients "much or very much improved" with N-acetylcysteine use compared with 16% taking placebo. Significant improvement was initially noted after 9 weeks of treatment. CONCLUSIONS: This study, the first to our knowledge that examines the efficacy of a glutamatergic agent in the treatment of trichotillomania, found that N-acetylcysteine demonstrated statistically significant reductions in trichotillomania symptoms.
edited for hair loss and hair regrowth blog.
:
ACETYLCYSTEINE - HSDB