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Background: The aim of this study was to study new therapeutic options for the treatment of female and male androgenetic alopecia (AGA) and to assess the efficacy of a possible new coadjuvant oral and topical therapy, containing a complex of natural substances., Methods: Sixty individuals affected by mild-to-moderate female and male AGA were enrolled in the study and underwent the oral and topical treatment with a microemulsion formulation for 6 months. At baseline and at 3- and 6-month follow-up, global photographs were taken and three expert operators evaluated photographs using the 7-point scale. On a subgroup of our sample, non-invasive phototrichograms with TrichoScan ® HD at baseline and follow-ups were performed to collect the trichological parameters of total number of hairs, hair density/cm 2 , vellus hair density/cm 2 , terminal hair density/cm 2 and hair thickness. One-way ANOVA and Unpaired Student t-test were performed to analyze the data., Results: Using the 7-point scale, a clinically visible improvement of hair loss was observed after three and six months of treatment. A statistically significant increase of all TrichoScan ® trichological parameters was observed at both 3- and 6 month-follow-up., Conclusions: The complex of natural and active substances tested in this work showed good efficacy in improving both male and female hair loss. These new products could represent a valid alternative or coadjuvant therapy of AGA, increasing the efficacy of conventional treatments such as minoxidil or finasteride.

Introduction: Recently CDK4/6 inhibitors have been introduced for the treatment of hormone positive breast cancer resistant to endocrine therapy. Among their side effects, alopecia is often reported being associated to patients' distress and depressive symptoms., Case Report: We report the case of a 70-year-old woman affected by breast cancer in treatment with Palbociclib, who developed alopecia.Management and Outcome: We prescribed a topical solution with cetirizine. Global photography, trichoscopy and trichogram were assessed. All evaluations demonstrated alopecia improvement., Discussion: Currently, no treatment options for CDK 4/6 inhibitors induced alopecia have been proposed. Herein, we report the use of topical cetirizine.

Background: Chemotherapy-induced alopecia (CIA) affects 65% of patients receiving chemotherapy regimens and is often identified with the massive hair loss stage. Reflectance confocal microscopy (RCM) is a noninvasive technique used in alopecia assessment for disease characterization and state of activity., Objective: To describe RCM features of CIA in different timing and identify specific phases of alopecia development., Methods: A total of 16 patients treated with chemotherapy underwent dermoscopy and RCM evaluations four times during the observation: 2 and 4-6 weeks after starting and 3 and 6 months after the end of chemotherapy. Ten examinations for each stage were performed., Results: Four phases of CIA have been identified. Initial hair loss showed specific dots not previously described, named CIA dots. massive hair loss phase was characterized by black dots (10/10 pt), CIA dots (8/10 pt) and hair shaft abnormalities. Three months after the end of chemotherapy, during the partial regrowth phase, 10/10 patients showed thin hair in regrowth and 8/10 presented black and yellow dots. At 6 months, normal hair in regrowth appears in all patients (total regrowth phase)., Conclusions: Chemotherapy-induced alopecia has to be considered as a dynamic process with specific phases characterized by distinctive dermoscopic and confocal features., (© 2019 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Androgenetic alopecia (AGA), one of the most common causes of hair loss in men and women, is an infrequent cause of alopecia in children. In AGA, patients generally start noticing hair thinning after the onset of puberty due to progressive miniaturisation of the hair follicle which leads to vellus transformation of terminal hair. However, the occurrence of prepubertal AGA has rarely been reported in the literature. The pathophysiology of AGA is tightly linked to androgen hormones; prepubertal children do not usually produce significant amounts of adrenal or gonadal androgens. When it does occur, an underlying abnormality should be suspected. Secondary causes of AGA must be excluded when evaluating a patient before the appearance of puberty. Premature puberty, polycystic ovarian syndrome and other causes of hyperandrogenism can present with hair loss in an androgenetic pattern. This article reviews the normal physiology of androgen hormones and their role in the pathophysiology of childhood AGA., (© 2019 The Australasian College of Dermatologists.)

Background: Chemotherapy-induced alopecia (CIA) ranks among the psychologically most devastating effects of cancer treatment for oncological patients, with an overall incidence of 65%. Nowadays trichoscopy is largely employed in the diagnosis of alopecia, but no description of CIA trichoscopic pattern is present in literature., Aims: We want to create an organic description of CIA trichoscopic aspects., Methods: Oncological patients candidate to chemotherapy drugs, afferent to our trichological outpatient were studied. Anamnesis, clinical exam, clinical global photography, pull test, trichogram, and trichoscopy were conducted at the different moments of therapeutic treatment., Results: A definite trichoscopic pattern in the different phases of treatment was observed. After the first 3 weeks of chemotherapy rare and scattered black dots, broken hairs, flame hairs and pohl pinkus appeared. At the end of chemotherapy besides the features described above, numerous thin hair in regrowth were detected, together to rare terminal hair, scattered black dots and circle hair. Three months after chemotherapy a progressive increase of follicular units and elongation of the existing hair were visible., Conclusions: We propose an description of CIA trichoscopic pattern and its evolution during the different phases of chemotherapy., (© 2018 Wiley Periodicals, Inc.)

Background: Chemotherapy-induced alopecia (CIA) is probably one of the most shocking aspects for oncological patients and underestimated by physicians. Among hair loss risk factors, there are treatment-related aspects such as drug dose, administration regimen, and exposure to X-rays, but also patient-related characteristics. To the best of our knowledge, no guidelines are available about CIA management., Aims and Methods: With this study, based on literature background and our clinical experience, we would like to propose a list of actions in order to estimate the risk of hair loss before starting chemotherapy and to manage this condition before, during, and after drug administration and to create a sort of practical guide for dermatologists and oncologists., Results and Conclusion: There is an urgent need for prospective studies to clarify the mechanistic basis of alopecia associated with these drugs and consequently to design evidence-based management strategies., (© 2017 Wiley Periodicals, Inc.)

Purpose: Androgenetic alopecia, commonly known as male pattern baldness, is the most common type of progressive hair loss disorder in men. The aim of this paper is to review recent advances in understanding the pathophysiology and molecular mechanism of androgenetic alopecia., Methods: Using the PubMed database, we conducted a systematic review of the literature, selecting studies published from 1916 to 2016., Results: The occurrence and development of androgenetic alopecia depends on the interaction of endocrine factors and genetic predisposition. Androgenetic alopecia is characterized by progressive hair follicular miniaturization, caused by the actions of androgens on the epithelial cells of genetically susceptible hair follicles in androgen-dependent areas. Although the exact pathogenesis of androgenetic alopecia remains to be clarified, research has shown that it is a polygenetic condition. Numerous studies have unequivocally identified two major genetic risk loci for androgenetic alopecia, on the X-chromosome AR⁄EDA2R locus and the chromosome 20p11 locus., Conclusions: Candidate gene and genome-wide association studies have reported that single-nucleotide polymorphisms at different genomic loci are associated with androgenetic alopecia development. A number of genes determine the predisposition for androgenetic alopecia in a polygenic fashion. However, further studies are needed before the specific genetic factors of this polygenic condition can be fully explained.

Androgenetic alopecia (AGA) is a genetically determined progressive hair-loss condition which represents the most common cause of hair loss in men. The use of the medical term androgenetic alopecia reflects current knowledge about the important role of androgens and genetic factors in its etiology. In addition to androgen-dependent changes in the hair cycle, sustained microscopic follicular inflammation contributes to its onset. Furthermore, Prostaglandins have been demonstrated to have the ability in modulating hair follicle cycle; in particular, PGD2 inhibits hair growth while PGE2/F2a promote growth. Due to the progressive nature of AGA, the treatment should be started early and continued indefinitely, since the benefit will not be maintained upon ceasing therapy. To date, only two therapeutic agents have been approved by the Food and Drug Administration and European Medicines Agency for the treatment of AGA: topical minoxidil and oral finasteride. Considering the many pathogenetic mechanisms involved in AGA, various treatment options are available: topical and systemic drugs may be used and the choice depends on various factors including grading of AGA, patients' pathological conditions, practicability, costs and risks. So, the treatment for AGA should be based on personalized therapy and targeted at the different pathophysiological aspects of AGA., (© 2016 Wiley Periodicals, Inc.)