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Literature has revealed that the delta opioid receptor (DOR) exhibited diverse pharmacological effects on neuron and skin. In the present study, we have investigated whether the activation of DOR has hair-growth promotion effects. Compared with other opioid receptor, DOR was highly expressed in epidermal component of hair follicle in human and rodents. The expression of DOR was high in the anagen phase, but it was low in the catagen and telogen phases during mouse hair cycle. Topical application of UFP-512, a specific DOR agonist, significantly accelerated the induction of the anagen in C3H mice. Topical application of UFP-512 also increased the hair length in hair organ cultures and promoted the proliferation and the migration of outer root sheath (ORS) cells. Similarly, pharmacological inhibition of DOR by naltrindole significantly inhibited the anagen transition process and decreased hair length in hair organ cultures. Thus, we further examined whether Wnt/β-catenin pathway was related to the effects of DOR on hair growth. We found that Wnt/β-catenin pathway was activated by UFP-512 and siRNA for β-catenin attenuated the UFP-512 induced proliferation and migration of ORS cells. Collectively, result established that DOR was involved in hair cycle regulation, and that DOR agonists such as UFP-512 should be developed for novel hair-loss treatment.

Background Oxidative damage has been found in various types of hair loss. As a polyphenolic phytoalexin, resveratrol (RSV) is known as an antioxidant, anti-inflammatory and anti-apoptotic agent. Objective Thus, we aim to examine the effects of RSV on hair growth. Methods In vivo C57BL/6 mice were used to evaluate the effects of RSV on hair cycle, hair length, skin thickness, hair follicle diameter, hair cycle score and the percentage of hair cycle stage. Then hair shaft length and hair cycle were evaluated by human hair follicles (HFs) ex vivo. The proliferative activities of human dermal papilla cells (hDPCs) cultured in vitro with RSV were assessed using RTCA. The ability of RSV to protect hDPCs against H2O2-induced oxidative damage is examined by a ROS assay kit. Results Topical application of RSV significantly promoted hair growth and stimulated the transition of hair cycle from telogen into the anagen phase on shaved C57BL/6 mice. Ex vivo experiments showed that RSV increased the hair shaft length of HFs and delayed the entry into catagen. In vitro experiments indicated that RSV proliferated hDPCs and prevented hDPCs from oxidative damage caused by H2O2. Conclusion RSV can promote hair growth and may be a potential candidate for the treatment of hair loss., Graphical Abstract

ZusammenfassungBerichtet wird über eine 46-jährige Patientin, die seit ihrer frühen Kindheit unter einer schweren atopischen Dermatitis leidet und seit ihrem 18. Lebensjahr unter einer Alopecia areata totalis, die mittlerweile in eine Alopecia areata universalis übergegangen ist. Durch die Einleitung einer Therapie mit dem monoklonalen Antikörper Dupilumab wurde erneutes Haarwachstum am Kapillitium, im Gesicht und an den Unterschenkeln beobachtet. Dupilumab blockiert die α‑Untereinheit des IL(Interleukin)-4-Rezeptors, unterbindet die Signalkaskade von IL‑4 und IL-13 und führt so zu einer reduzierten Th2-Immunantwort. Die schwere Ausprägung der Ekzeme und der Juckreiz mit Ein- und Durchschlafstörungen sind bereits 14 Tage nach Beginn der Einnahme zurückgegangen. Die Patientin verträgt das Medikament ohne wesentliche Nebenwirkungen, ihre Lebensqualität ist deutlich verbessert. Patienten mit einer schweren atopischen Dermatitis und einer Alopecia areata könnten von Dupilumab in Zukunft doppelt profitieren.

The use of cannabis for skin diseases and hair regrowth is at the preliminary stage. Legalization Many countries have approved cannabis for medical use; however, four countries Canada, Uruguay, South Africa, and Georgia have legalized it for both medical and recreational purposes. The endocannabinoid system The endocannabinoid system may maintain skin homeostasis; two notable endocannabinoids include 2-Arachidonoylglycerol (2-AG) and N-arachidonoylethanolamine (AEA). Routes of administration and pharmacokinetics Topical cannabinoids can avoid the first-pass metabolism and reduce respiratory side effects; however, the high hydrophobicity of cannabinoids may hinder percutaneous absorption. Skin disorders and hair growth Human clinical studies suggest that cannabinoids may be used in eczema, acne, pruritus, and systemic sclerosis treatment. Cannabidiol (CBD) may enhance hair growth via multiple mechanisms. Safety Topical cannabis may cause mild side effects such as pruritus, burning, erythema, and stinging; they are relatively safer than inhalation and oral cannabis. Cannabis use may be associated with allergic symptoms and reduced immune response to live vaccination. Cannabinoids in practice Despite growing interest, dermatologists should be cautious prescribing cannabinoids due to insufficient clinical data on both efficacy and safety.

Transgender patients on masculinizing and feminizing hormonal therapy undergo myriad physical and psychologic changes. Dermatologists are uniquely qualified to guide patients in the gender-affirming process, especially as it relates to hair. Given the paucity of literature guiding dermatologists in this process, a systematic review was performed to better understand the physiologic changes of hair in patients on masculinizing and feminizing hormonal therapy as well as the variety of treatment options that exist to help transgender patients to attain their desired hair growth pattern. This review reports findings and treatment options supported by the performed literature review as well as treatment recommendations based on the authors’ own experiences treating this unique patient population.

Hair is an epidermal appendage, composed of a protein called keratin. The hair follicle supports the hair shaft and regulates its growth. Around 100 strands of hair are lost everyday due to the hair growth cycle. Excessive loss of hair is termed as Alopecia. Alopecia areata affects nearly 2% of the general population at some point during their lifetime. Though hair has hardly any functional attributes in humans, alopecia is not only a great cosmetological concern but also a psychological trauma! The Case below demonstrates the Homoeopathic Management of Alopecia Areata in a 6 year old patient, with a positive family history of the same, who had previously taken allopathic medicines, without much improvement in his condition. Integrated knowledge of Trichology paves way for Individualistic Homoeopathic Remedy Selection and its application through Clinical Training.

Alopecia areata (AA) is a complex autoimmune condition that causes non-scarring hair loss and may present at any age. It typically presents with sharply demarcated round patches of hair loss. AA presents heterogeneously and is influenced by both environmental and genetic factors. There is no effective pharmacological treatment currently available for this disorder so far. We had an opportunity to treat a patient with AA using acupuncture. The patient was a 23-year-old male who presented to us with a complaint of sudden hair loss in patches in two demarcated round areas in a diameter of 2–3 cm on the back of the head for the past year. He was diagnosed as AA by AA progression index. After a long treatment course of about 3 months with acupuncture, this patient showed significant hair growth.

Introduction: Hirsutism is a condition of unwanted, male-pattern hair growth in women. Aims: The objective of this study is to assess the severity of hirsutism in the patients attending a tertiary care hospital. It also aims to find out the relation between the grades of hirsutism and the various demographic variables. Materials and Methods: 100 adult females were recruited. Hirsutism was measured quantitatively by modified Ferriman-Gallwey scoring. Other demographic variables like age, religion, education, occupation, family income, family history, marital status were assessed Results: The mean modified Ferriman-Gallwey scoring was 13.86±4.12. Severe hirsutism (modified Ferriman- Gallwey score ≥15) was seen in 38% of the cases. Severe grade of hirsutism was seen to be higher in females aged greater than 25 than younger women (p=0.009). 23 women were suffering from polycystic ovarian syndrome (PCOS). Graduates had exceedingly high degree of hirsutism compared to females who had received primary education (p=0.006). In our study, married women had tremendous amount of hairiness compared to unmarried women (p=0.03). There was also a significant association between the educational status and the hirsutism severity. Working women had a serious amount of hirsutism in contrast to students (p=0.001). Conclusion: Severe hirsutism was found in 38% of the cases in our study. And an association was seen between hirsutism severity and demographic variables like age, marital status, educational and occupational status. Keywords: Hirsutism, Modified Ferriman-Gallwey scoring, Polycystic ovarian syndrome, Hypothyroidism, Demographic variables.

Background Platelet-rich plasma (PRP) is effective in the treatment of androgenetic alopecia (AGA). Aims The purpose of this study is to assess the effect of PRP on the proliferation of human follicle dermal papilla cells (HFDPCs), to observe the effect of PRP on the growth of hair follicles and hair shaft in vitro, to measure growth factors, and to evaluate the efficacy and safety of PRP injection. Patients/methods The effect of PRP on the proliferation of HFDPCs was observed. The length of hair follicle and hair shaft in vitro was measured. Then, the concentration of growth factors (EGF, FGF-2, FGF-7, IGF-1, HGF, PDGF-BB, and VEGF-A) was evaluated. Half-head injection of PRP was conducted to 10 males. Three treatments were conducted at 30-day intervals. Digital photographs were taken; hair diameter, hair density, unit density of hair follicles, and terminal hair/ vellus hair were analyzed. Results Platelet-rich plasma significantly promoted the proliferation of HFDPCs. Under the PRP culture, the hair follicle and hair shaft were grown, and the hair growth length on the 3rd and 6th days was greater than that of the control. PRP contained growth factors such as EGF, FGF-2, FGF-7, IGF-1, HGF, PDGF-B, and VEGF-A. Hair diameter, hair density, and unit hair follicle density on the PRP injection side peaked in the 6th month. The terminal hair/ vellus hair of the PRP injection side reached a peak in the 4th month. The average patient satisfaction during the entire treatment was 5.4 points (0-10 points). Conclusion Platelet-rich plasma can promote hair growth. PRP injection is safe and effective for the treatment of AGA.

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.

Alopecia areata affects not only scalp hair but also other sites of body hair, including eyebrows. Our objective was to investigate the importance of eyebrows in the treatment goals of patients with alopecia areata. Through an online questionnaire, subjects were asked to assess satisfaction with the visually depicted level of response to treatment, using edited photographs depicting a range of eyebrows and scalp hair growth. The questionnaire was completed by 1,741 adults. Absent or partial growth of eyebrows and scalp hair elicited25% satisfaction. Images depicting either complete eyebrows or complete scalp hair achieved satisfaction in50% of participants. More participants were satisfied with complete eyebrows and no scalp hair (69%) than complete eyebrows and partial scalp hair (51%). Only when both eyebrows and scalp hair were completely regrown did extreme satisfaction levels reach 90.4%. Limitations include the online nature of the survey, lack of control group, and self-reported severity of alopecia areata in participants. These results suggest that eyebrows may be as important as scalp hair for patients assessing theoretical responses to treatment for alopecia areata. Future clinical studies should consider growth of eyebrows as an outcome measure on par with scalp hair growth.

Background Cancers are one of the main reasons of morbidity and mortality globally. Chemotherapy-induced alopecia (CIA) is one of the most alarming, terrifying, and traumatic adverse effects. A range of therapeutic measures has been suggested to alleviate CIA, but at present, there is no accepted pharmacological therapy that can assure prevention or management. Aim The aim of the present study was to evaluate the efficacy of QR 678 Neo® therapy in the treatment of persistent chemotherapy-induced alopecia in women and men treated with cytotoxic chemotherapy for breast and lung cancers, respectively. Methods A total of 8 male patients with history of lung cancer and 12 female patients with history of breast cancer in the age range of 25-60 years, with WHO classification of grade I and II persistent alopecia who had undergone chemotherapy treatment, were selected for the study. At each visit, 1.5 mL solution of QR 678® was injected into the scalp skin of patients. A total of 8 sessions were performed at an interval of 3 weeks each. All the patients were evaluated with standard global photography, video microscopic assessment, and patient self-assessment questionnaire at baseline, 6 months, and 1 year. Results Marked improvement was seen in the global assessment score at 6 months (mean-8) which was maintained even after 1 year. Mean score increase in hair count at 6 months was 12.71 which further increased at 1 year. High satisfaction score was given by patients for slowing of hair loss (mean = 4.2) and also for overall hair growth. For appearance and growth of hair, the mean value was 3.4 and 3.8, respectively. Conclusion The formulation of QR 678® and QR 678® Neo showed to be significantly safe and efficient for chemotherapy-induced alopecia in both men and women. Improvement in hair growth was maintained even at 1 year of follow-up. No patient had any severe adverse effects, and injections were also easily bearable by most of them.

Throughout human history, women have paid great attention to the beauty of their hair, and modern women are no exception. About 63% of young American women use different nutritional supplements to prevent hair loss. Diffuse hair loss is quite common in women and can occur against the background of various events: pregnancy, pre- and post-menopause, chronic diseases, etc. The most common is telogen effluvium (TE), which begins 2-3 months after the trigger event. Usually, TE process stops on its own, but can also become chronic. For many women, pregnancy and associated psycho-emotional stress become the triggering event, and in 75% of cases hair loss can become chronic.In fact, TE is a violation of the hair growth cycle. First of all, it is necessary to exclude the trigger factor from the patient's life and only then to start normalizing the hair growth cycle and improve the quality of hair follicle nutrition. The most effective topical remedy for the treatment of diffuse hair loss is minoxidil. The reasons for its clinical effectiveness have not been fully studied, but it is known that it prolongs the hair growth phase. Unfortunately, after cancellation of the drug, hair loss is often renewed. Avoiding these effects is possible with a comprehensive approach to therapy. Inclusion of additional components in the therapy scheme, such as vitamin and mineral complexes, growth stimulants, specialized care products, allows to maintain and improve the results of treatment with minoxidil.

There are only a few drugs that have been used for the treatment of female pattern hair loss (FPHL).Through use of the Dermatologic Life Quality Index (DLQI) and a modified hair growth questionnaire, we aimed to evaluate the effect of dexpanthenol (DXP) as a new option for FPHL.Women who received 500 mg intramuscular DXP weekly for FPHL were included in this study. They were evaluated in terms of DLQI and laboratory characteristics, before and after DXP treatment, and were examined with a modified hair growth questionnaire.Overall satisfaction with the appearance of the hair was described by the patients as 57.1% " I am satisfied," 28.6% "I am very satisfied," and 14.3% "I am neutral (neither satisfied nor dissatisfied)." There was a statistical difference between the mean DLQI scores before and after DXP treatment (P .001). No statistical difference was found in the laboratory characteristics of the patients before and after DXP treatment (P 0.05). No side effect was reported during DXP treatment.Dexpanthenol is a safe and novel drug that may increase the quality of life in patients with FPHL.

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.

Follicular proteoglycans are key players with structural, functional, and regulatory roles in the growth and cycling behaviour of the hair follicles. The expression pattern of specific proteoglycans is strongly correlated with follicular phase transitions, which further affirms their functional involvement. Research shows that bioactive proteoglycans, e.g., versican and decorin, can actively trigger follicular phase shift by their anagen-inducing, anagen-maintaining, and immunoregulatory properties. This emerging insight has led to the recognition of “dysregulated proteoglycan metabolism” as a plausible causal or mediating pathology in hair growth disorders in both men and women. In support of this, declined expression of proteoglycans has been reported in cases of anagen shortening and follicular miniaturisation. To facilitate scientific communication, we propose designating this pathology “follicular hypoglycania (FHG),” which results from an impaired ability of follicular cells to replenish and maintain a minimum relative concentration of key proteoglycans during anagen. Lasting FHG may advance to structural decay, called proteoglycan follicular atrophy (PFA). This process is suggested to be an integral pathogenetic factor in pattern hair loss (PHL) and telogen effluvium (TE). To address FHG and PFA, a proteoglycan replacement therapy (PRT) program using oral administration of a marine-derived extract (Nourkrin® with Marilex®, produced by Pharma Medico Aps, Aarhus, Denmark) containing specific proteoglycans has been developed. In clinical studies, this treatment significantly reduced hair fall, promoted hair growth, and improved quality of life in patients with male- and female-pattern hair loss. Accordingly, PRT (using Nourkrin® with Marilex®) can be recommended as an add-on treatment or monotherapy in patients with PHL and TE.

Androgenetic alopecia (AGA) is the most common type of hair loss in adults and may be particularly distressing for gender minority patients, given the close relation between hair and gender expression. Furthermore, use of gender affirming hormones such as testosterone in transmen and estrogen/antiandrogens in transwomen has a direct effect on hair growth distribution and density. Clinicians should thus be knowledgeable about the effects of sex hormones on the hair growth cycle to comfortably diagnose and treat AGA in gender minority patients.

Objectives: A retrospective case-series study comparing autologous activated platelet-rich plasma (AA-PRP) versus autologous non-activated platelet-rich plasma (A-PRP) in hair re-growth was reporte...

Hair loss can significantly affect quality of life. Patients seeking treatment for hair loss find that many surgical or medication options involve significant risks or side effects. DEEPLY ROOTED® is a nutritional supplement that combines botanical and natural ingredients with the goal of effectively reducing hair loss and stimulating hair growth—without the side effects of many standard treatments. DEEPLY ROOTED’s active ingredients have both anti-inflammatory and adaptogenic properties, and inhibit dihydrotestosterone without the use of hormones, drugs, or industry by-products. This 3-month prospective study evaluates the effectiveness of DEEPLY ROOTED® for the prevention of hair loss. Healthy female subjects complaining of hair loss were enrolled, and supplied with three months of DEEPLY ROOTED®, without other compensation. The primary endpoint was a significant increase in hair growth. This was measured using anonymously collected patient data to evaluate hair growth and quality, as well as blinded Investigator hair assessment data. Patients who ingested DEEPLY ROOTED® over a three-month period reported noticeable improvement of hair growth (91%), increased hair volume (86%), and improved hair quality (86%). Subjects were noted to exhibit an increase in the number of new hairs, hair thickness and scalp coverage. No significant adverse effects were reported. DEEPLY ROOTED® safely helped over 90% of otherwise healthy women with self-perceived hair thinning to improve hair quality and quantity. The unique combination of botanical and natural ingredients provided a drug-free alternative for the management of hair loss.

BACKGROUND Monofilament thread therapy (PLLA) and minoxidil have been used as alternative treatments for female androgenetic alopecia. AIM The aim was to determine the efficacy and safety of thread therapy combined with minoxidil in female androgenetic alopecia. PATIENT AND METHODS Twenty-seven women were enrolled in this randomized half-split study based on a left-head to the right-head pattern. Thread therapy (PLLA) treatment was unilaterally performed (once); minoxidil was bilaterally applied for 6 months. Global photographs and dermoscopy assessments were performed in the baseline and every 2 months till the end of treatment. Global photographs underwent blinded review by three independent dermatologists. RESULTS Mean hair density increased from 114 ± 27 to 143 ± 25/cm2 (P

Hair is an essential aspect of image and is correlated with youth, elegance, fitness and achievement. Hair loss leads to lowered self-esteem, lack of confidence and depression amongst affected individuals. The US Food and Drug Administration (FDA) permitted management options for male Androgenetic Alopecia (AGA) are topical Minoxidil and oral Finasteride. These agents are beneficial in controlling hair loss, but can only induce minimal new hair growth.

Statistical observation of American Laser center states that females on an average spend over $10,207 in their lifetime to remove unwanted hairs. This study was aimed to evaluate the action of homoeopathic medicine Oleum jecoris aselli as a homoeopathic internal (3X and 30C) and external medicine (Q, 6C and 30C) in treatment of abnormal upper lip hair growth. The whole study was conducted on female volunteers eventually determining the efficacy of external application over administration of internal medicine in treatment of abnormal hair growth or Hirsutism.

Background Androgenetic alopecia (AGA) is the most common type of hair loss in men. It is commonly known as a male pattern baldness. It is characterized by a stepwise miniaturization of the hair follicle, resulting from alteration in the hair cycle dynamics, leading to vellus transformation of terminal hair follicle. In AGA, the duration of anagen phase gradually decreases and that of telogen phase increases, the maximum length of the new anagen hair becomes shorter than that of its predecessor, leading to miniaturization and eventually a bald appearance. Aim of the work To assess the expression of NRF2 in the scalp of men with androgenetic alopecia. Patients and Methods This case control study included 28 male patients whose age ranged from 18 to 45 years old. They were diagnosed as having AGA according to Norwood-Hamilton scale. Further, 28 age and sex matched healthy male controls were recruited. All patients and controls were recruited from the dermatology outpatient clinic of Ain-Shams University Hospitals, during the period of September 2018 to April 2019. Results A group of Twenty-eight male patients with AGA were recruited to the study. The of patients ranged from 18 to 45 years (mean = 33.46 years ± 9.9 SD). Twenty-eight age matched male healthy volunteers without AGA were e recruited. The majority of AGA patients had positive family history of AGA in their first degree relatives. None of our patients had a medical history of systemic diseases like diabetes mellitus or hypertension. Conclusion The current study showed that alteration of Nrf2 levels may play an important role in the pathogenesis of AGA.

INTRODUCTION AND OBJECTIVE:Permanent genital hair removal is required before gender-affirming vaginoplasty to prevent complications from intravaginal hair growth. No prior studies have directly com...

Introduction: Tocilizumab (TCZ), a recombinant humanized antihuman monoclonal antibody targeting interleukin-6 (IL-6) signaling, is often utilized in the management of autoimmune disease. Few reports have demonstrated hair growth changes in patients on TCZ. Case Presentation: Herein, we review the literature and report a 21-year-old woman with progressive alopecia areata (AA) presenting with AA improvement while on TCZ for concomitant posterior uveitis. Discussion: Our case demonstrates the potential ability of TCZ to disrupt IL-6 signaling involved in AA, leading to hair loss and regrowth.

Wir prasentieren den Fall einer 46-jahrigen Patientin, die an einer entzundlich aktiven Alopecia areata universalis leidet. Nach frustranem Einsatz von topischen und systemischen Glukokortikoiden, einer Creme-PUVA-Therapie und Dithranol in aufsteigender Dosierung wurde die Patientin mit 2‑mal 5 mg pro Tag Tofacitinib per os behandelt. Nach ca. 4 bis 6 Monaten zeigte die Patientin ein Haarwachstum, das bei guter Vertraglichkeit bis zum 18. Therapiemonat zur vollstandigen Wiederbehaarung gefuhrt hat. Der Fall zeigt eindrucksvoll, dass die Off-label-Anwendung von Tofacitinib eine potenzielle therapeutische Option in der Indikation Alopecia areata darstellen kann.

Background: Topical minoxidil is the only US FDA- approved drug for the treatment of female pattern hair loss (FPHL). While the safety profile of topical minoxidil is excellent, the efficacy of minoxidil in hair growth is extremely low. A recent survey of 8000 people observed that only 4% of hair loss patients using an over-the-counter minoxidil were very satisfied with their results. In contrast, in clinical studies with an intervening physician, approximately 30%-40% of patients demonstrate an appreciable benefit. Compliance with topical drug regimens is often a major obstacle, limiting their effectiveness. Topical minoxidil leaves a greasy residue on the hair, which is especially problematic for women who do not wash their hair daily. Aims: We set out to develop an "After Minoxidil" companion spray to minoxidil that removes residual minoxidil from the hair, where it is not needed, yet leaves minoxidil on the scalp where it is required. We hypothesized that improving the cosmetic properties of minoxidil would improve patient compliance with the drug and subsequently improve clinical outcomes. Methods: A cohort of 20 FPHL patients was recruited to use the novel "After Minoxidil" spray and report changes in hair quality on a Likert scale. Results: In our cohort of FPHL patients, the novel "After Minoxidil" spray restored ease of styling and reduced greasiness to preminoxidil level in 65% and 85% of subjects, respectively. The average reduction in perceived greasiness was 78%. Importantly, 70% of subjects interviewed stated they would likely continue to use the minoxidil and "After Minoxidil" treatment regimen for 6 months, vs 0% willing to use minoxidil alone. Conclusion: The novel "After Minoxidil" spray improved ease of hair styling and reduced greasiness following application of topical minoxidil ; thus, the novel "After Minoxidil" spray may help improve drug compliance and efficacy.

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.

The aim of this study was to elucidate the relationships between the thickness, number, and frequency of scalp skin harvests and alopecia risk.In a PubMed search, the search terms (scalp AND graft AND alopecia) were used, resulting in 148 papers. Among 21 abstracts, 11 full papers were reviewed, and 3 papers were ultimately analyzed.The donor-site alopecia rate was significantly higher in patients who experienced hair growth on their grafts than in those who did not (odds ratio = 10.875, 95% confidence interval, 2.677-44.178; P

Background: Klotho is a newly identified anti-aging protein that plays a pivotal role in regulating ageing. However, whether klotho expresses in human hair follicles (HFs) and whether klotho expression correlates with hair growth have not yet been clearly shown. Objectives: To find the role of Klotho as a regulatory factor for human hair growth Methods: In this study, we examined the expression pattern of klotho in human scalp skin and its role in hair growth. Klotho was expressed in human scalp skin and HF both gene and protein levels. Results: In human scalp skin, prominent klotho expression was observed in the epidermis. Klotho expression in the epidermis was increased with keratinization from basal layer to stratrum coneaum. In human anagen HFs, prominent klotho expression was observed in the epithelium. Klotho expression in the epithelium was increased with keratinization in henle layer and hair cuticle. In human catagen HFs, klotho expression was observed in epithelial strand. Gene transfection of klotho siRNA was markedly inhibited the human hair growth and promoted apoptosis process in organ cultured human follicles. Conclusion: Altogether, these results indicate that klotho might be an important regulatory factor for human hair growth and hair cycle change.

Localized hypertrichosis with traumatic panniculitis is considered a rare condition. Previous articles have reported occurrence in females aged between 20 and 35 years. Possible mechanisms of trauma-induced localized hypertrichosis include hyperemia and angiogenesis induced by local inflammation, which can alter the hair growth cycle. The presence of inflammatory cells and lipomembranous changes on histopathology can support the diagnosis. We herein present a 35-year-old female patient with localized hypertrichosis following blunt trauma.

Many women present in general practice with the complaint of excessive hair growth on the face, chest or limbs. This article aims to cover the normal physiology of hair growth, how to define excessive hair growth in a woman, and when it is essential to refer a patient for urgent secondary care advice and further management.

Background There is a time lag between hair follicle harvesting and implantation, during this time hair follicles suffer ischemic injury. We need a holding medium or a solution to minimize or neutralize ischemic injury. Aims and Objective To evaluate plasma as a graft holding solution in terms of its efficacy in hair growth and hair graft survival. Method and Material A split scalp study was performed. The left side was designated as the control area (Group A) where grafts implanted were kept in Ringer’s lactate, and the right side behaved as the test area (Group B) and received grafts preserved in autologous plasma. The p-value was calculated. Observations MTT staining for grafts stored in Ringer’s lactate at 12 and 72 hours showed poor hair follicle cells’ survival while grafts kept in plasma showed viable cells even after 72 hours.The hair count and density in plasma group were significantly higher than those in the Ringer’s lactate group. There was an improvement in hair thickness in both groups from 6 months to 12 months. Conclusion Autologous plasma is an easily available graft holding solution. Platelets along with the plasma provide multiple growth factors promoting epithelialization, neovascularization, and action on hair follicle stem cells to improve growth. The fibrin coating around the graft makes it sticky and prevents dehydration. The split scalp controlled study certainly shows the advantages of using plasma over other extra cellular graft holding solutions.

The purpose of this review is to explore the effectiveness of low-level laser therapy (LLLT) in the treatment of adult androgenic alopecia (AGA). A systematic search of studies on LLLT for AGA was conducted mainly in Pubmed, Embase, and Cochrane Systematic Reviews. The standardized mean difference (SMD) in the changes of hair density treated by LLLT versus sham devices was analyzed. The meta-analysis included 8 studies comprising a total of 11 double-blinded randomized controlled trials. The quantitative analysis showed a significant increase in hair density for those treated by LLLT versus sham group (SMD 1.316, 95% confidence interval, CI 0.993 to 1.639). The subgroup analysis demonstrated that LLLT increases hair growth in both genders, in both comb- and helmet-type devices, and in short- and long-term treatment course. The subgroup analysis also showed a more significant increase of hair growth for the LLLT versus sham in the low-frequency treatment group (SMD 1.555, 95% CI 1.132 to 1.978) than in the high-frequency group (SMD 0.949, 95% CI 0.644 to 1.253). The review was limited by the heterogeneity of included trials. LLLT significantly increased hair density in AGA. The meta-analysis suggests that low treatment frequency by LLLT have a better hair growth effect than high treatment frequency. LLLT represents a potentially effective treatment for AGA in both male and female. The types of LLLT devices and LLLT treatment course duration did not affect the effectiveness in hair growth.

BACKGROUND Platelet-rich plasma (PRP) is a popular procedure for the treatment of androgenetic alopecia (AGA). AIM To ascertain the role of minoxidil 5% lotion alone versus minoxidil 5% lotion and PRP versus minoxidil 5% lotion, PRP with microneedling in AGA. MATERIAL AND METHODS Ninety-three AGA patients with Hamilton-Norwood score 1-5 were grouped into three groups A, B, and C. Patients in group A (control group) were treated with minoxidil 5% lotion twice daily (n = 31), whereas patients in group B underwent treatment with minoxidil 5% lotion twice daily and PRP (n = 31), and group C patients received minoxidil 5% lotion twice daily, PRP, and microneedling (n = 31). Baseline and post-treatment photographs were taken along with dermoscopic evaluation. Selection of the dermoscopic variables included in the evaluation process was based on the published literature and dermoscopists' expertise and experience. Hair pull test was performed before and during follow-up. RESULTS Post-treatment, hair pull test was negative in 27 patients (87.1%, P

The hormone dihydro testosterone (DHT) and the catalyst 5α-reductase are key contributors to hair loss due to androgenetic alopecia (AGA). Also, dermal bacteria and their toxins have been implicated in hair loss. A preliminary study by the authors with six male volunteer subjects showed that ostrich antibodies against above causative substances were quite effective in promoting hair regrowth. The present study included 13 men and 4 women, with ages ranging from 39 to 78. Pre- and post-treatment hair counts were also incorporated into the study procedure. In all instances but one, the subjects had a hair-growth effect about 3 months after the antibody was applied to the scalp, and the study participants with hair growth were pleased with the results and with the ease of use of the antibody solution.

Background: Techniques of hair transplantation are evolving with time both in terms of use of better methods of graft harvestment and implantation. The result of the procedure ultimately depends on the tenderness with which grafts are handled. Aims: The aim of this study was to evaluate efficacy and feasibility of using implanter in premade slits for implantation of the graft. Materials and Methods: This technique was used in 104 patients who were willing to undergo hair transplantation by follicular unit extraction. After administration of local anesthesia, the recipient sites were created. Thereafter, the processes of scoring the skin with a motorized punch, graft extraction, and implantation using implanter into the premade slits were performed simultaneously. These patients were followed up to look for the time period of initiation of hair growth. Improvement was assessed by comparing basic and specific classification (BASP) at the baseline and during subsequent follow-up. Results: Of 104 patients, 103 (99%) were men and one (1%) was woman. According to pretransplant BASP score, 98 (94.2%) patients were having severe type and 6 (5.8%) were having mild type. As per the posttransplant BASP score, patients having severe and mild type were 24 and 80, respectively. Improvement in the BASP score (from severe to mild type) was seen in 74 (71%) patients and no change was seen in 30 (29%) patients. Hair growth started becoming visible after two to five months and “good” results were obtained in all except two patients after a follow-up period varying from 8 to 18 months. Conclusion: Placement of the grafts into premade slits using implanter will help in improved results because of minimal graft handling, more graft placement in less time, and thereby reducing body out of time. Limitation: No objective assessment was carried out to document regrowth of hair in our study.

The modified Ferriman-Gallwey (mFG) scale is accepted as a useful clinical scoring system in the evaluation of hirsutism.To prevent overlooking hirsutism diagnoses and facilitate patient examinations in ongoing pandemic conditions by simplifying the mFG score.This study included 227 patients who were diagnosed with hirsutism and had mFG scores of ≥ 8. Hair distribution and hair growth intensity of nine different body regions in the mFG score were examined.Among our patients with hirsutism, terminal hair was present on the chin in 97.4% (In addition to the chin and thighs being the main regions of terminal hair growth, examination of the upper lip or lower abdomen can sufficiently help predict hirsutism. During the ongoing pandemic conditions when we need to follow social distancing rules, a practical approach to the mFG scoring system will facilitate the work of many physicians, including dermatologists, and will shorten the patient's stay in the clinic.

BackgroundOral contraceptive pills (OCPs) are considered one of the most important birth control methods in the world. However, these pills were designed for female administration rather than males. This study was designed to investigate patterns of OCPs use and abuse among Jordanian males, according to the community pharmacists’ observations.MethodA mixed-method explanatory sequential study was conducted using an online self - administered survey and semi-structured in-depth interviews for community pharmacists. The interviews were utilized using a conceptual framework. Inductive thematic analysis and descriptive/regression analyses were completed using Nvivo and SPSS, respectively.ResultsA total of 158 questionnaire responses and 22 interviews were included in our analysis. Around half (48.4%) of the questionnaire responses confirmed that males could use OCPs for hair growth enhancement, muscle gain and acne treatment 12.7%, 31.7% and 4.4%, respectively. Through the interviews, the majority of the pharmacists highlighted that most of the males use OCPs for bodybuilding purposes, according to recommendations by their coaches at the gym. The most abused OCPs containing estrogen (Ethinyl estradiol) and progestins (Drospirenone or Levonorgestrel).ConclusionThis study provided insight into unexpected uses of OCPs by males in Jordan. Community pharmacists have a crucial role in the management of OCPs use and abuse, However, restricted regulations and monitoring must be released and implemented on the community to limit such practices.

Background The expanded scalps are usually used to repair the scalp defects. However, hair growth direction and hair density of the expanded scalps may be inconsistent with those of the defective sites, resulting in unsatisfactory results. Aims The aim of this study is to assess the effect of local flap modification and follicular unit extraction (FUE) on the repair of poor appearance of temporal and sideburn after unsatisfactory tissue expansion. Methods In our study, 19 patients with problems of hair growth direction or hair density after surgery were treated with following four methods: Single local flap modification; Removal of hair follicles by FUE to reduce follicle density; Removal of disordered hair follicles by FUE and ectopic transplantation simultaneously; Removal of hair follicles by FUE and ectopic transplantation after local flap modification. The follow-up periods of 19 patients varied from 6 months to 30 months, and natural, standardized aesthetic sideburn for each patient was achieved. Results All incisions healed by first intention and all flaps survived well. The scars involved in the removal of FUE hair follicles were not obvious. Conclusions Our results revealed that the ideal and cosmetic results can be obtained by flexible using of local flap modification, single FUE method, and FUE ectopic hair transplantation to repair the dissatisfied postoperative outcomes of temporal and sideburn cicatricial alopecia after tissue expansion.

Background Oral contraceptive pills (OCPs) are considered one of the most important birth control methods globally. However, these pills were designed for female administration rather than males. This study was designed to investigate patterns of OCPs use and abuse among Jordanian males, according to the community pharmacists’ observations. Method A mixed-method explanatory sequential study was conducted using an online self-administered survey, followed by semi-structured in-depth interviews for registered pharmacists, assistant pharmacists and pharmacy interns. The interviews were utilized using a conceptual framework. Inductive thematic analysis and descriptive/regression analyses were completed using Nvivo and SPSS, respectively. Results A total of 158 questionnaire responses and 22 interviews were included in our analysis. Around half (48.4%) of the questionnaire responses confirmed that males could use OCPs for hair growth enhancement, muscle gain and acne treatment 12.7%, 31.7% and 4.4%, respectively. Through the interviews, the participating pharmacists highlighted that males use OCPs mostly for bodybuilding purposes, according to recommendations by their coaches at the gym. The most abused OCPs containing estrogen (Ethinyl estradiol) and progestins (Drospirenone or Levonorgestrel). Conclusion This study provided insight into unexpected uses of OCPs by males in Jordan. Community pharmacists have a crucial role in the management of OCPs use and abuse. However, restricted regulations and monitoring must be released and implemented on the community to limit such practices.

Too much hair in the wrong place or too little in the right place can cause severe psychological distress for some people. Alopecia is best divided into scarring (cicatricial alopecia) and non-scarring causes. Scaring alopecia is usually due to a deep seated skin problem and often requires a skin biopsy for diagnosis. Treatment should be initiated quickly, before the alopecia becomes more widespread, as it is usually irreversible once scaring develops. Non scaring alopecia can be further sub divided into patterned, patchy and diffuse hair loss.

Acquired Hypertrichosis Lanuginosa A 51-year-old woman presented with rapidly progressing hair growth on her face, neck, and upper body, findings consistent with acquired hypertrichosis lanuginosa....

Hair supplements are a vast and growing industry. Patients often turn to oral supplements to address hair concerns as they are easily accessible. There are numerous products on the market, many with thousands of reviews (both positive and negative). Nutritional supplements are regulated by the FDA as foods instead of drugs, meaning they do not have to prove their efficacy and safety before becoming available to consumers. While some oral supplements have strong evidence supporting their use for hair growth, many ingredients have not been tested in clinical trials, have only in vitro evidence for hair growth, or have only been tested in animals. Given these industry characteristics, it is important for dermatologists to be aware of the safety and utility of these ingredients to provide appropriate counseling to their patients. The goal of this review is to evaluate the efficacy of popular hair growth oral supplement ingredients and formulations. This review does not address the topical formulations of these ingredients and their effects on hair growth.

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.