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Lasers Surg Med. 2011 Dec 13. doi: 10.1002/lsm.21132. [Epub ahead of print]

Selective photothermolysis to target sebaceous glands: Theoretical estimation of parameters and preliminary results using a free electron laser.

Sakamoto FH, et al

Abstract

BACKGROUND AND OBJECTIVES:

The success of permanent laser hair removal suggests that selective photothermolysis (SP) of sebaceous glands, another part of hair follicles, may also have merit. About 30% of sebum consists of fats with copious CH(2) bond content. SP was studied in vitro, using free electron laser (FEL) pulses at an infrared CH(2) vibrational absorption wavelength band.

METHODS:

Absorption spectra of natural and artificially prepared sebum were measured from 200 to 3,000 nm, to determine wavelengths potentially able to target sebaceous glands. The Jefferson National Accelerator superconducting FEL was used to measure photothermal excitation of aqueous gels, artificial sebum, pig skin, human scalp, and forehead skin (sebaceous sites). In vitro skin samples were exposed to FEL pulses from 1,620 to 1,720 nm, spot diameter 7-9.5 mm with exposure through a cold 4°C sapphire window in contact with the skin. Exposed and control tissue samples were stained using H&E, and nitroblue tetrazolium chloride staining (NBTC) was used to detect thermal denaturation.

RESULTS:

Natural and artificial sebum both had absorption peaks near 1,210, 1,728, 1,760, 2,306 and 2,346 nm. Laser-induced heating of artificial sebum was approximately twice that of water at 1,710 and 1,720 nm, and about 1.5× higher in human sebaceous glands than in water. Thermal camera imaging showed transient focal heating near sebaceous hair follicles. Histologically, skin samples exposed to ∼1,700 nm, ∼100-125 milliseconds pulses showed evidence of selective thermal damage to sebaceous glands. Sebaceous glands were positive for NBTC staining, without evidence of selective loss in samples exposed to the laser. Epidermis was undamaged in all samples.

CONCLUSIONS:

SP of sebaceous glands appears to be feasible. Potentially, optical pulses at ∼1,720 or ∼1,210 nm delivered with large beam diameter and appropriate skin cooling in approximately 0.1 seconds may provide an alternative treatment for acne. Lasers Surg. Med. © 2011 Wiley Periodicals, Inc.

modified for hair loss treatment blog.

Vitamin-D and hair loss and hair regrowth

Dermatol Online J. 2010;16:3.

Does D matter? The role of vitamin D in hair disorders and hair follicle cycling.
Amor KT, Rashid RM, Mirmirani P.

exerpt..

"...Limited studies have been done in humans to elaborate the role of vitamin D in the hair cycle. A potential application for vitamin D is in chemotherapy-induced hair loss. Topical calcitriol has been shown to protect against chemotherapy-induced alopecia caused by paclitaxel and cyclophosphamide. However, topical calcitriol failed to protect against chemotherapy-induced hair loss caused by a combination of 5-fluorouracil, doxorubicin, and cyclophosphamide and a combination of cyclophosphamide, methotrexate, and 5-fluorouracil [36, 37]. The ability of topical calcitriol to prevent chemotherapy-induced hair loss may therefore depend on the chemotherapy agents used. Of note, the studies in which no effects were observed, were small and may have used doses of vitamin D that were inadequate to protect against chemotherapy-induced hair loss. The more potent vitamin D3 analogs used on mice by Vegesna et al. have yet to be evaluated in humans.....

It has been suggested that an optimal concentration of vitamin D is necessary to delay the aging phenomena, including hair loss. A cross sectional study of 296 healthy men was done to determine the association, if any, between male pattern baldness and serum 25-hydroxyvitamin D levels. Based on this study, the extent and severity of male pattern baldness does not appear to be associated with serum 25-hydroxyvitamin D levels . Additional studies in subjects with age-related or senescent hair thinning as well as in women with female pattern hair loss could be considered to see if there is an association of hair loss with serum 25-hydroxyvitamin D levels.

Because it is known that the absence of VDR leads to hair loss, it was hypothesized that there may be VDR gene polymorphisms (Bsml, Apal, and Taql) in patients with alopecia areata. A study of VDR genotypes in 32 patients with alopecia areata and 27 controls showed no association between these VDR gene polymorphisms and alopecia areata. A separate study also showed that there was no relationship between the VDR gene FokI polymorphism and alopecia areata......

edited for hair loss blog

Autoimmunity. 2011 Sep 19. [Epub ahead of print]

The role of natural killer cells in autoimmune blistering diseases.

Zakka LR, et al

Abstract

The major focus of this paper is to describe and evaluate current information on the role of natural killer cells (NK cells) in the pathogenesis of blistering diseases. Until now, only pemphigus vulgaris (PV) has been studied. One co-culture study demonstrated that CD4(+) T cells from the peripheral blood or perilesional skin of patients with active disease proliferate and secrete cytokines in the presence of major histocompatibility class II-expressing NK cells loaded with antigenic desmoglein self-peptides. Another study showed that NK cells can contribute to a T helper type 2-biased immune response through impaired interleukins (IL)-12 signaling and upregulation of IL, IL-10 and IL-5. Although significant data on other blistering diseases are unavailable at present, some studies implicate NK cells in disease progression. For instance, information on the role of NK cells in psoriasis and their production of tumor necrosis factor-á (TNF-á) will be provided since several TNF-á-inhibitors are used in its treatment. Studies on hair loss due to alopecia areata are also included in this paper because NK cells seem to play a key role in its pathogenesis. This review highlights the potential importance of NK cells and NKT cells as members of the large repertoire of cells and soluble mediators that play a critical role in pathogenesis of blistering diseases and other autoimmune diseases involving the skin. Therefore, the authors advocate a greater focus and interest on the study of the interaction of NK cells and the skin.

J Biotechnol. 2011 Jan 27.

De novo formation and ultra-structural characterization of a fiber-producing human hair follicle equivalent in vitro.
Lindner G, Horland R, Wagner I, Ata B, Lauster R.

Abstract
Across many tissues and organs, the ability to create an organoid, the smallest functional unit of an organ, in vitro is the key both to tissue engineering and preclinical testing regimes. The hair follicle is an organoid that has been much studied based on its ability to grow quickly and to regenerate after trauma. But hair follicle formation in vitro has been elusive. Replacing hair loss due to pattern baldness or more severe alopecia, including that induced by chemotherapy, remains a significant unmet medical need. By carefully analyzing and recapitulating the growth conditions of hair follicle formation, we recreated human hair follicles in tissue culture that were capable of producing hair. Our microfollicles contained all relevant cell types and their structure and orientation resembled in some ways excised hair follicle specimens from human skin. This finding offers a new window onto hair follicle development. Having a robust culture system for hair follicles is an important step towards improved hair regeneration as well as to an understanding of how marketed drugs or drug candidates, including cancer chemotherapy, will affect this important organ.

Hair loss treatment blog hair regrowth hair loss treatment

EMBO J. 2003 May 15; 22(10): 2400–2410.

Copyright © 2003 European Molecular Biology Organization
Laminin-10 is crucial for hair morphogenesis
Jie Li,
et al

Discussion

This study, for the first time, describes the critical role of the extracellular matrix/BMZ in skin morphogenesis. We have shown that laminin-10 is the primary laminin of elongating hair germs, and that absence of laminin-10 results in arrest of hair follicle development at the hair germ elongation phase. Interestingly, the application of exogenous laminin-10 promoted restoration of hair follicle development in Lama5 –/– skin. To our knowledge, this is the first instance of protein-mediated therapy in the correction of a cutaneous developmental defect. The method we employed, incubation of full-thickness embryonic skin in a laminin-10-containing solution, effectively resulted in the diffusion of laminin-10 into the BMZ of developing hair follicles. ....snip.. .As small amounts of laminin-11 were present in our purified laminin-10 samples, we cannot rule out the possibility that laminin-11 might also facilitate hair follicle development. However, as laminin â2-deficient mice have no hair defects (Noakes et al., 1995), and a downregulation of the laminin â2 chain was seen during mouse hair germ elongation in our studies, it is not likely that laminin-11 plays a major role in hair follicle development in the skin.Our results, as well as the results of a number previous studies, suggest that laminin-10 supports hair follicle development through a mechanism other than the maintenance of dermal–epithelial cohesion. A comparison between inhibition of laminin-5 and laminin-10 in the skin illustrates this point. In human skin xenografts, laminin-5 antibodies induced extensive epidermal detachment (Lazarova et al., 2000; M.P.Marinkovich, unpublished data) within 24 h of application, while in our studies, skin treated with laminin-10 antibodies did not show blisters or epidermal detachment even after 3 weeks. Similarly, extensive blistering is seen in patients with HJEB, who lack laminin-5. Absence of laminin-5 in Lama3 –/– mice produced extensive epidermal detachment as well as detachment-associated cell death (anoikis) (Ryan et al., 1999). In contrast, in our studies, we were unable to demonstrate significant epidermal detachment or anoikis in Lama5 –/– mouse skin. On the other hand, while inhibition of laminin-10 in both human and murine skin produced marked effects on hair follicle development, no hair follicle defects were demonstrated in laminin-5/6 null mouse skin (Ryan et al., 1999), and hair follicle development is typically normal in HJEB patients (Skoven and Drzewiecki, 1979). In conclusion, laminin-5 and laminin-10 appear to have non-overlapping functions in the skin, with laminin-5 promoting epidermal adhesion and laminin-10 promoting epithelial development.In our studies of BMZ structure in Lama5 –/– skin, lamina densa assembly was markedly abnormal, while exogenous laminin-10 corrected these defects. These results highlight the role that laminin-10 plays in lamina densa assembly in epithelial BMZs. However, the question arises as to whether BMZ assembly is necessary for hair follicle formation. For example, a number of alterations of BMZ assembly have been described in skin that do not affect hair follicle development. The absence of â4 integrin in humans produces junctional epidermolysis bullosa with pyloric atresia. In this disease, hemidesmosome formation is markedly abnormal and dermal– epidermal cohesion is severely impaired, but hair follicle abnormalities have never been reported in conjunction with this syndrome (Fine et al., 2000). Similarly, â4 integrin null mice show a similar lack of epidermal cohesion and hemidesmosome formation, but normal hair follicle development. Even the combined absence of á6â4 integrin and á3 integrin in Intá3/Intá6 –/– mice, which produced extensive impairment of lamina densa and hemidesmosome formation as well as extensive disruption of epidermal adhesion, did not significantly affect hair follicle formation. From these observations, it appears likely that neither an epithelial attachment defect nor a BMZ assembly defect can by themselves account for the lack of hair follicle development in Lama5 –/– skin.In contrast to â4 or á3 integrin deficiency, ablation of â1 integrin markedly inhibited hair follicle development. Findings in â1 integrin conditionally null skin were remarkably similar to our findings with Lama5 –/– skin, and include formation of an interrupted lamina densa and arrest of hair follicle development at the hair germ elongation stage. These previous findings correlate well with our studies of antibody-induced â1 integrin inhibition in the developing human scalp xenografts, in which â1 inhibition inhibited hair follicle development. As á3â1 integrin is a major laminin-10 receptor (Kikkawa et al., 2000), these results support a model in which laminin-10 promotes hair follicle development through â1 integrin signaling. This remains to be further studied.It appears likely that the lack of epithelial proliferative downgrowths in mutant skin grafts are the direct result of impaired Shh production and signaling evidenced by a decrease in expression of Shh and its downstream effector Gli1 in Lama5 –/– skin. Thus, it is possible that interruption of a specific signaling pathway arrested hair follicle development in Lama5 –/– mice. Shh expression and signaling are known to depend on the correct signaling of regulators such as isoforms of the BMP, WNT and TGF families of proteins, and it is possible that laminin-10 may in turn influence the localization, expression or activity of one or more of these proteins. Of note, it is interesting that the alterations of epithelial development in Lama5 –/– skin are selective, and do not affect other aspects of skin development such as epidermal differentiation or blood vessel formation.As the effects of laminin-10 appear specifically directed at the elongating hair germ, it is tempting to speculate that laminin-10 required for this process would be located in the follicular epithelial BMZ and be of keratinocyte origin. Alternatively, it has previously been suggested that a dermal signal is required for elongation of hair germs. In particular, laminin-10 is a component of dermal blood vessels, and has been shown to act as a potent substrate for â1 integrin-mediated endothelial cell signaling and migration (Doi et al., 2002). Thus, it is possible that interactions mediated by laminin-10 in blood vessels could account for dermal contributions necessary for hair germ elongation. Additional experiments are currently under way to compare the contributions of keratinocyte and blood vessel laminin-10 towards hair follicle development.It is also possible that lack of laminin-10 could impair blood vessel function. This could produce hypoxic conditions which impact on hair follicle development either in the hair regrowth cycle or embryonic skin morphogenesis. However, blood vessels were shown to form in mutant skin, and viability in both Lama5 –/– and Lama5 +/+ grafts was equivalent, approaching 100%, and with a lack of significant apoptosis in the absence of laminin-10. Therefore, hypoxia as a sole explanation for lack of hair follicle development in Lama5 –/– grafts seems unlikely. Similarly, no differences in apoptosis were seen in â1 integrin-deficient hair follicles.

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Hair Loss Treatment at the Proctor Clinic.

Eur J Dermatol. 2000;10:443-50.

Normalisation of hair follicle morphology iin alopecia areata mice after hair loss treatment with squaric acid dibutylester.
Gardner S, et al

Hair loss in Alopecia areata is a non-scarring, reversible disorder, presumably caused by an autoimmune attack on anagen hair follicles. Treatments are numerous, and most of these are ineffective. However, the elicitation of contact dermatitis on the affected skin is commonly associated with hair regrowth. A major advance in the study of hair loss due to alopecia areata has been the introduction and characterisation of the C3H/HeJ mouse model that exhibits many features of the human disease. In this study we examined the effects of squaric acid dibutylester treatment on hair follicles and the associated leukocyte infiltrate in alopecia areata mice with hair lsss by light and transmission electron microscopic analysis. This was compared with unaffected normal mice and alopecic untreated mice. Experimental mice were treated unilaterally with the contact allergen squaric acid dibutylester and the skin was assessed after hair regrowth. The characteristic pathological picture of alopecia areata was observed in alopecic but not normal mice. Nine of eleven experimental mice regrew hair on the treated side only and this was associated with a reduction in peri/intrafollicular inflammatory cell infiltrates, hair follicle dystrophy, melanin incontinence/clumping, and an increase in the numbers of hair follicles in full anagen. This normalisation of hair follicle status after treatment reflects the successful reversal of disease in these mice. snip....

Dermatol Online J. 2010 Feb 15;16(2):3.

Does D matter? The role of vitamin D in hair disorders and hair follicle cycling.
Amor KT, Rashid RM, Mirmirani P.

Exerpt (edited for hair loss blog use)

...Another potential application for vitamin D is in hair loss due to scalp psoriasis, which is associated with an increased telogen to anagen ratio. Although vitamin D3 analogs have been used in combination or as an alternative to topical steroids to treat scalp psoriasis for many years, their ability to combat the associated alopecia has not been thoroughly evaluated. A placebo-controlled trial with 26 patients showed that calcipotriol did not affect the telogen to anagen ratio after 6 weeks of treatment [40], but the optimal effect of calcipotriol on scalp psoriasis is not seen until 8 weeks [41]. Thus, the follow up may have been too brief to detect an effect of calcipotriol on hair loss.

It has been suggested that an optimal concentration of vitamin D is necessary to delay the aging phenomena, including hair loss. A cross sectional study of 296 healthy men was done to determine the association, if any, between male pattern baldness and serum 25-hydroxyvitamin D levels [42]. Based on this study, the extent and severity of male pattern baldness does not appear to be associated with serum 25-hydroxyvitamin D levels (p=0.60) [42]. Additional studies in subjects with age-related or senescent thinning as well as in women with female pattern hair loss could be considered to see if there is an association of hair loss with serum 25-hydroxyvitamin D levels.

Because it is known that the absence of VDR leads to alopecia, it was hypothesized that there may be VDR gene polymorphisms (Bsml, Apal, and Taql) in patients with alopecia areata. A study of VDR genotypes in 32 patients with alopecia areata and 27 controls showed no association between these VDR gene polymorphisms and alopecia areata [43]. A separate study also showed that there was no relationship between the VDR gene FokI polymorphism and alopecia areata [44]. These studies were small and limited to only one ethnic group, Caucasians in Turkey.

Conclusion
Extensive data from animal models clearly show that the VDR, independent of vitamin D3 hormone, plays an important role in the hair follicle cycle, specifically anagen initiation. Studies have demonstrated the ability of vitamin D3 analogs to stimulate hair regrowth, but clinical trials of calcitriol in humans have been unable to replicate these results. Reasons for this may be that more potent analogs of vitamin D3 were used in the animal studies than the human trials. Also, the mechanism of hair recovery in nude mice may not be applicable to humans with alopecia. The latter is reflected in one study that used nude mice with congenital alopecia, which does not have an equivalent in humans. This review shows the need for further exploration of the role of vitamin D and the VDR in the hair cycle. For clinical hair disorders in which there is an abnormal hair cycle, such as chemotherapy-induced alopecia, treatments that up regulate the expression of the vitamin D receptor may be successful. Developments of such treatments are a future area of study. Furthermore, studies on the optimal levels of local and systemic vitamin D levels are still limited and there is currently no evidence-based data to recommend vitamin D supplementation for various types of alopecia. In order to fully understand the effects of vitamin D supplementation in hai rloss treatment, future studies should compare results in vitamin D deficient patients to those in vitamin D sufficient patients.

Hai rloss treatment

Rom J Morphol Embryol. 2009;50:719

The importance of histopathologic aspects in of dissecting cellulitis of the scalp.
Brãniºteanu DE,.

hair loss blog edited

Dissecting cellulitis of the scalp or dissecting folliculitis also known as "perifoliculitis capitis abscedens et suffodiens" (PCAS), is a rare, severe and distinct dermatological disease and cause of hair loss. It most probably occurs because of follicular occlusion via hyperkeratosis, having the same mechanism of acnea conglobata and hidradenitis suppurativa. These dermatoses may be associated or may have an isolated evolution. PCAS is one of the primitive cicatricial air loss of neutrophilic type. What is characteristic for the histopathologic picture of the disease is the deep inflammatory infiltrate, placed at the reticular derm or hypoderm level. snip.. Here is the case of a 24-year-old male with records of acne conglobata and cicatricial hair loss of the scalp, with relapsed inflammatory nodular lesions on the surface of the alopecic plaques and follicular pustules on their margin. The patient had followed before hospitalizing a systemic treatment with antibiotics (azithromycin, tetracycline, ciprofloxacin, in therapeutic schemes that the patient cannot mention, but anyway of short time) and after that a treatment with retinoids (isotretinoin, 20-30 mg/day, in two successive therapies of one month each). The evolution of the disease under these treatments was with outbreaks and short times of remission of the acne lesions and nodular lesions of the scalp. The clinical diagnosis of PCAS is difficult, especially in the initial stage of the disease, as it was the case of the patient presented here. snip....

edited for hair loss blog use

Hair Loss Treatment at the Proctor Clinic

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Hair Root Status in treatment of Hair loss
Hautarzt. 1977;28:136

Significance of hair root status method

Braun-Falco O, Heilgemeir GP

The significance of proposition of the hair root status method is reported. The percentage composition of the hair root patterns of neighboring areas of the capillitium and the behavior of the percentage of the individual hair root shapes were examined at time zero and 120 days later. These examinations were carried out in the frontal, parietal and occipital regions of each of 10 male test persons with clinically normal hair growth and statistically evaluated. The hair root pattern of neighboring areas is the same within the different regions of the capillitium. Thus the hair root patterns investigated in the different regions of the capillitium are representative of this respective region. The hair root patterns of males with clinically normal hair regrowth (for the frontal, parietal and occipital region) does not differ with time. Therefore, examination of the hair root pattern at four week intervals can be used for controlling the hair regrowth capacity and therapeutic effects. The significance of the hair root status method in treatment may be relative small in the individual case in a person with normal hair regrowth, but useful when evaluated in a collective of subjects.

Modified for hair regrowth blog

Doru T et al
Dermatology Online Journal 15: 1

....better understanding of the EGF family ligands and receptors, as well as their interplay and physiological phases, has the potential to produce a revolution in the treatment of hair loss. Availability of topical EGFR blockers and the development of more specific molecules that will stimulate the hair regrowth pathways will build on the fact that EGFR blockade can produce long-term hair growth. An apparent lack of tolerance to the hair regrowth effect after long term treatment, as recently seen, contrasts with other systemic and cutaneous toxicities of medications from the EGFR blocking class, thus creating the possibility of clinically relevant long-lasting effects.

Edited for hair loss blog use

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J Am Acad Dermatol. 1986;15:571

Structural and functional changes of normal aging skin.
Fenske NA, Lober CW.

Solar-induced changes to skin are more prevalent and profound in older persons and, thus, are often inappropriately attributed to the aging process, per se. Structural and functional alterations caused by intrinsic aging and independent of environmental insults are now recognized in the skin of elderly individuals. Structurally the aged epidermis likely becomes thinner, the corneocytes become less adherent to one another, and there is flattening of the dermoepidermal interface. The number of melanocytes and Langerhans cells is decreased. The dermis becomes atrophic and it is relatively acellular and avascular. Dermal collagen, elastin, and glycosaminoglycans are altered. The subcutaneous tissue is diminished in some areas, especially the face, shins, hands, and feet, while in others, particularly the abdomen in men and the thighs in women, it is increased. The number of eccrine glands is reduced and both the eccrine and apocrine glands undergo attenuation. Sebaceous glands tend to increase in size but paradoxically their secretory output is lessened. The nail plate is generally thinned, the surface ridged and lusterless, and the lunula decreased in size. There is a progressive reduction in the density of hair follicles per unit area on the face and scalp, independent of male-pattern alopecia. The hair shaft diameter is generally reduced but in some areas, especially the ears, nose, and eyebrows of men and the upper lip and chin in women, it is increased as vellus hairs convert to cosmetically compromising terminal hairs. Functional alterations noted in the skin of elderly persons include a decreased growth rate of the epidermis, hair, and nails, delayed wound healing, reduced dermal clearance of fluids and foreign materials, and compromised vascular responsiveness. Eccrine and apocrine secretions are diminished. The cutaneous immune and inflammatory responses are impaired, particularly cell-mediated immunity. Clinical correlates of these intrinsic aging changes of the skin include alopecia, pallor, xerosis, an increased number of benign and malignant epidermal neoplasms, increased susceptibility to blister formation, predisposition to injury of the dermis and underlying tissues, delayed onset and resolution of blisters and wheals, persistent contact dermatitis, impaired tanning response to ultraviolet light, increased risk for wound infections, prolongation of therapy necessary for onychomycosis, and thermoregulatory disturbances.

key words hair loss treatment hair regrowth

Cell Stress Chaperones. 2008; 13:31

Prevention of chemotherapy-induced alopecia in rodent models
Joaquin J.

edited exerpt...

....Finally, we carried out chemotherapy experiments to demonstrate that induced hairloss could be prevented. Targeted delivery of heat to skin areas in which hair loss induction is to be inhibited will preclude the induction of a stress protein response in tumors not located in the heated areas. However, although the stress protein response is an intracellular protective response, the possibility needed to be considered that heat exposure of skin and embedded structures could induce signals that could affect chemotherapy of a tumor located elsewhere. .... Results revealed that localized heat treatment did not significantly reduce the antineoplastic effect of cyclophosphamide (Fig. 2c; see p values included in the graph). This finding was confirmed in a second, similarly powered experiment.In summary, our data indicate that localized activation of a stress protein response is an effective new method for preventing chemotherapy-induced hair loss in animal models. As was hoped based on the known broad protective effects of an activated stress protein response, the method appears to afford protection against a diverse range of antineoplastic agents and combinations. Chemotherapy protocols utilized in the clinic not only differ in the drug or drug combination used but also in the number of drug doses administered per treatment cycle, the interval between doses and the duration of drug administration (i.e., injection or infusion). A preliminary experiment suggested that a one-time activation of a stress protein response protects the hair follicles of young rats from the toxic effects of a 5-day regimen of daily etoposide. If this result translates to humans, the present heat preconditioning method for preventing chemotherapy-induced alopecia should be compatible with or capable of adaptation to many of the chemotherapy protocols in clinical use.Although heat preconditioning was utilized primarily to induce a protective response, several experiments were conducted in which a similar response was obtained following s.c. or i.d. administration of GA or 17AAG, respectively. Effective methods of liposomal delivery of compounds deep into the hair follicles were developed.....

.. Over all, in this recent study, by comparing finasteride tablet and gel groups with each other for hair loss treatment, it was found that, the therapeutic response to the tablet group was better than gel group, but in fifth and sixth months of treatment, treatment response in both groups was ideitical.

Like other studies, these results show topical finasteride gel works and if used for male pattern hair loss patients, who experienced hair loss in recent years, it canreplacement of oral therapy, especially in those who worry about oral drug died-effects...

Stroke and uric acid. Many of the same treatments that work in hair loss treatment also ameliorate stroke

Can Vet J. 2009 May; 50(5): 511–514. PMCID: PMC2671874

Copyright and/or publishing rights held by the Canadian Veterinary Medical Association
Color dilution alopecia in a blue Doberman pinscher crossbreed

Roberta Perego, et al

Abstract
A 6-year-old male, blue Doberman pinscher crossbreed was presented with coat abnormalities; in particular, flank hair loss and pruritus. Based on medical the history, clinical evidence, and histopathological examination, color dilution alopecia was diagnosed. The dog was with oral melatonin treated for 3 months without success.
Résumé
Alopécie à dilution de couleur chez une race croisée de Doberman Pinscher bleu. Un Doberman Pinscher âgé de 6 ans est présenté avec des anomalies du pelage; en particulier, une alopécie du flanc et du prurit. En fonction de l’anamnèse, des signes cliniques et de l’examen histopathologique, l’alopécie à dilution de couleur a été diagnostiquée. Le chien a été traité sans succès à la mélatonine pendant 3 mois.(Traduit par Isabelle Vallières)

Dermatology. 1992;185:82

Psoriatic alopecia: acute and chronic hair loss in 47 patients with scalp psoriasis.
Runne U, Kroneisen-Wiersma P.

Symptomatic hair loss and alopecia were seen in psoriatic lesions of the scalp in 47 patients. snip... Hair loss varied in intensity from protracted to moderate and massive (36% in tufts). It presented as acute (51%), chronic (36%) or chronic recurrent (13%). Thirteen patients (28%) became aware of the hair loss with the beginning of therapy. snip... This infiltrate can alter the follicle epithelium and may lead to a granulomatous foreign-body reaction with destruction of the hair follicle. After topical antipsoriatic treatment, most of the reexamined patients showed complete hair regrowth, while 5 developed a residual scarring. Therefore, in the patient with circumscribed or diffuse symptomatic alopecia, with or without scarring, psoriatic alopecia should be considered.

J Clin Endocrinol Metab.1987;65:188

The effects of N,N-diethyl-4-methyl-3-oxo-4-aza-5 alpha-androstane-17 beta-carboxamide, a 5 alpha-reductase inhibitor and antiandrogen, on the development of baldness in the stumptail macaque.

Rittmaster RS, et al

We used a primate model of male-pattern baldness to test the efficacy of a topically applied 5 alpha-reductase inhibitor and antiandrogen (4-MA) in the prevention and treatment of baldness. Six periadolescent stumptail macaques were given daily topical applications of either 4-MA in dimethylsulfoxide or dimethylsulfoxide alone for 27 months. The three control monkeys developed varying degrees of baldness and hair loss, while the three 4-MA-treated monkeys retained their juvenile pattern of hair growth. The percentage of actively growing hair follicles in the frontal scalp did not change in the 4-MA-treated group while a significant decrease occurred in the control group. Skin 5 alpha-reductase activity was reduced in the scalp of the 4-MA-treated monkeys. We conclude that topical 4-MA can prevent the development of baldness in the stumptail macaque, a primate model of androgen-dependent baldness.

edited for hair loss blog

Dermatology.1995;190:192

Protection against chemotherapy-induced hair loss by cyclosporin A.
Hussein AM, et al

edited for hair loss blog

BACKGROUND: We have previously shown that several agents will protect against chemotherapy-induced hair loss in the newborn rat animal model. Such protective agents render the hair follicle keratinocytes resistant to chemotherapy possibly by the expression of P-glycoprotein (Pgp). Cyclosporin A is a potent inhibitor of Pgp. METHODS AND RESULTS: Efficacy of CSA was tested in its effects on chemotherapy-induced hair loss in the newborn rat animal model. CSA, when applied topically, protected rats from local hair loss induced by various agents. CONCLUSION: The mechanism of protection against hair loss by CSA and its relationship to Pgp remain uncertain. The potential clinical applicability of this observation remains to be determined.

Geburtshilfe Frauenheilkd. 1988 Apr;48(4):203-14.

Hormonal diagnosis in so-called androgenetic alopecia in the female

Moltz L.

Androgenetic alopecia or pattern hair loss occurs quite frequently. Up to 79% of women suffer at least temporarily from varying degrees of intermittent diffuse hair loss in the centro-parietal and/or fronto-temporal regions. A.A. is caused by an androgen excess acting on the hair follicle for prolonged periods of time in the presence of a genetic predisposition. However, often hyperandrogenemia cannot be demonstrated in such patients. 125 women with clinically typical a.A. were investigated prospectively under standardized conditions. ... snip... Using low-dose antiandrogens, estrogens, prolactin suppressants, corticoids, iron-II-preparations as well as estrogen-containing hair lotions hair loss was arrested in 74 of 104 treated women, while regrowth of hair was accomplished in 16 patients. 14 women did not respond to therapy.

Edited for blog

Gynakologe. 1980;13:1-17.

Clinical use of antiandrogens in the female

Moltz L, Schwartz U, Hammerstein J.

PIP: The use of antiandrogens (principally cyproterone acetate CPA) to treat women with symptoms of hypersecretion of androgens such as hair loss is discussed. ..snip... Seborrhea and endogenous acne can be effectively treated with all types of antiandrogen preparations. Androgenetic alopecia (pattern hair loss) can also be treated in a majority of cases with CPA preparations. CPA treatment should not last longer than 12 months. High dosage CPA use by ovulating women causes suppression of the preovulatory LH and FSH peaks but has little effect on basal levels; in postmenopausal women, the basal LH and FSH levels are significantly reduced. Use of CPA by itself causes a significant decrease in the levels of testosterone and delta-4-andostendion 3,17-dion. Use of CPA/EE combinations causes an increase in SHBG and the blood cortisol levels. Protein metabolism, hematopoesis, blood coagulation, and liver function are not affected by CPA use. Reduced glucose utilization and an increase in triglyceride levels are observed during CPA use. snip....

Edited for hair loss blog

Lancet. 1977;2:253-4.

Doxorubicin-induced hair loss and possible modification by scalp cooling.
Edelstyn GA, et al

PMID: 69866

J Craniofac Surg.2009;20:1484
Double scalping flap: a versatile technique in scalp reconstruction.

Papadopoulos O, et al

edited for hair loss blog

Scalp reconstruction is a challenging area in plastic surgery. The susceptibility of potentially exposed brain tissue is almost always a concern along with the provision of adequate soft tissue coverage in cases of full-thickness defects. ...snip.. . Disadvantages that may be considered are the loss of hair-bearing skin at the occipital region and the poor color and texture match between scalp skin and the split-thickness skin graft that is used on the donor site. We present 2 patients with exemplary case of neglected malignancy of the scalp and their successful treatment using the double scalping flap. ..snip...

Link: http://www.drproctor.com

Hautarzt. 1992;43(3):158

Hidrotic ectodermal dysplasia syndrome

Wollina U, et al

edited for hair loss blog

We report on a 23-year-old women suffering from a hidrotic ectodermal dysplasia with baldness, xerodermia, kyphosis of the chest, hypopigmented mamillae, disturbances of the menstrual cycle, dysphonia and keratitis punctata superficialis recidivans. The complex condition is classified as a tricho-oculo-dermo-vertebral syndrome. Immunohistological findings suggest a combined alteration of epithelial differentiation of hair follicles and interfollicular epidermis.

Hautarzt. 1992;43(3):158

Hidrotic ectodermal dysplasia syndrome--trichooculodermatovertebral syndrome

Wollina U, et al

edited for hair loss blog

We report on a 23-year-old women suffering from a hidrotic ectodermal dysplasia with baldness, xerodermia, kyphosis of the chest, hypopigmented mamillae, disturbances of the menstrual cycle, dysphonia and keratitis punctata superficialis recidivans. The complex condition is classified as a tricho-oculo-dermo-vertebral syndrome. Immunohistological findings suggest a combined alteration of epithelial differentiation of hair follicles and interfollicular epidermis.

Acta Derm Venereol. 1989;69(3):190

An experimental study evaluating the effect of minoxidil on the growth cycle of hair follicles.Gobé GC,

The possibility that topically-applied minoxidil might affect the growth cycle of hair follicles was studied in inbred Herston white mice and HRA/Skh1 hairless mice. In the normal follicular cycle, the anagen or growth phase can be followed by autoradiographic demonstration of [3H]thymidine uptake in proliferating matrical cells, and the catagen or regression phase can be recognised, using light microscopy, by the presence of greatly increased death of matrical cells by apoptosis. Using these two markers, the effects of topically-applied minoxidil on follicular kinetics were studied, during neonatal hair growth and the spontaneous wave of hair loss that occurs 16 to 17 days after birth. Minoxidil at strengths of either 1% or 3%, applied daily to the dorsal skin of newborn mice from birth until 25 days of age, was found to have no recognisable effect. Despite this negative result, however, the study does show the potential for the use of apoptosis as a marker for catagen in research in dermatopathology.

Arch Dermatol.Apr;120(4):449''

edited

Transverse microscopic anatomy of the human scalp. A basis for a morphometric approach to disorders of hair loss and hair regrowth

follicle.Headington JT.

Transverse sections of cylindrical scalp biopsy specimens can provide excellent samples for histologic, quantitative morphometric analyses of the follicles and hair. This study describes and illustrates the morphologic details of the normal transverse anatomy of follicular structures, including the various phases of the normal hair regrowth cycle.

J Invest Dermatol.1984;83(2):118

Distribution of epidermal growth factor receptors in rat tissues during embryonic skin development, hair formation, and the adult hair growth cycle.

Green MR, Couchman JR.

edited)... In a previous study on neonatal rat skin a close positive correlation was found between epidermal growth factor (EGF) receptor tissue distribution and areas of potential epithelial cell proliferation. We now report on the binding distribution of [125I]EGF, representing the tissue localization of available EGF receptors, during embryonic rat skin development including hair follicle formation and the adult hair growth cycle. At 16 days embryonic development a relatively low receptor density is seen over all the epidermal cell layers but by 17 days, with the onset of very rapid epidermal proliferation, labeling increases and becomes restricted to the basal epidermal cells....snip... During the catagen and telogen phases of the hair cycle, receptors are observed in high numbers on all the undifferentiated or dedifferentiating cells of the degenerating epithelial strand and secondary hair germ. Dermal cells are, in general, less heavily labeled than the basal epithelial cells of skin except for the developing striated muscle (panniculus carnosus) in embryonic skin which is more heavily labeled. The data are discussed in terms of a possible role for the EGF receptor and associated EGF or EGF-like ligands in specific areas of epithelial tissue morphogenesis during embryonic skin maturation, hair follicle development, and hair cycling.

Hair loss regrowth and hair loss treatment

Hair loss treatment reviews and blogs

J Invest Dermatol.1991;96(2):191

Distribution of proteoglycans during the hair growth cycle in human skin.

Westgate GE, et al

The involvement of proteoglycans in hair growth has been recognized through the observation of increased hair growth in diseases such as the mucopolysaccharidoses and pre-tibial myxedema, which involve an increase in skin proteoglycan content. In an attempt to understand this, ...snip... These results provide further evidence that hair regrowth is associated with the presence of chondroitin proteoglycans in the follicle environment and that the cessation of growth is associated with their removal. Further studies are underway to characterize the relationship between hair growth and proteoglycans.

Med Arh. 1994;48(2):57-9

The effect of nutritional deficiency on hair roots (trichogram)

Muteveliæ-Arslanagiæ N.

In this study, we have presented consequences of nutritive deficit on status of pilosebaceus follicle at two groups of examples, dermatological patients and patients who were wounded and/or operated, and without manifest signs of hair loss. Values of serum's iron, factors of saturation of iron, Hb, hematocrit and state of protein metabolism, were not in all cases, complementary with prescription of trichogram. Telogenic defluvium, dystrophic of mixed, has been found even at cases with normal (physiological) values of those parameters as consequence of high sensitive hair follicle to minimal deficit which is hand to detect by lab test. At group of patients who were wounded and/or operated it was found higher percent of dystrophic and mixed effluvium (acute hair shedding) as consequence of hard damage to the hair follicle. Percent of telogenic efluvium is the same at the both groups of patients. At this time, those damages are reversible in condition which permit normal diet and remove all physical and psychical of stress.

EMBO J. 1995 Nov 1;14(21):5216-23.

Expression of a dominant negative mutant of epidermal growth factor receptor in the epidermis of transgenic mice elicits striking alterations in hair follicle development and skin structure.

Murillas R, et al

Epidermal growth factor receptor (EGFR) is a key regulator of keratinocyte biology. However, the physiological role of EGFR in vivo has not been well established. To analyze the role of EGFR in skin, we have generated transgenic mice expressing an EGFR dominant negative mutant in the basal layer of epidermis and outer root sheath of hair follicles. Mice expressing the mutant receptor display short and waved pelage hair and curly whiskers during the first weeks of age, but subsequently pelage and vibrissa hairs become progressively sparser and atrophic. Eventually, most mice present severe alopecia. Histological examination of the skin of transgenic mice shows striking alterations in the development of hair follicles, which fail to enter into catagen stage. These alterations eventually lead to necrosis and disappearance of the follicles, accompanied by strong infiltration of the skin with inflammatory elements. The interfollicular epidermis of these mice shows marked hyperplasia, expression of hyperproliferation-associated keratin K6 and increased 5-bromo-2-deoxyuridine incorporation. EGFR function was inhibited in transgenic skin keratinocytes, since in vivo and in vitro autophosphorylation of EGFR was almost completely abolished on EGF stimulation. These results implicate EGFR in the control of hair cycle progression, and provide new information about its role in epidermal growth and differentiation.

Hair loss and hair regrowth

Cell Prolif. 1991 Jul;24(4):367-74.

Growth and cell kinetics of human hair papilla cells in vitro. An autoradiographic and flow cytometric study.
Bassukas ID, et al

Hair papilla, a distinct specialized dermal compartment, plays a fundamental role in the biology of hair growth. Recently some attention has been focused on hair papilla cells (HPC) as possible targets for drugs influencing the hair growth. Isolation and cultivation of the HPC facilitates screening for such drugs. In the present work, growth and cell kinetics of human occipital scalp follicle HPC have been studied in vitro. HPC grow according to a Gompertz function, i.e. with considerable growth delay long before becoming confluent cultures, due probably to elongation of the potential doubling time (Tpot) and to a parallel increasing cell loss rate. The [3H]dT labelling index of the HPC strongly depends on the age of the subculture; the cycle time being about 4 days. A potential doubling time of about 93 h, indicative of growth fraction (GF) = 1, and a duration of S phase and G2 + M phase of about 8 h each were found by the combined application of continuous labelling with [3H]dT and DNA flow cytometry.

Int J Dermatol. 1990 Jul-Aug;29(6):446-50.

The biological effects of a pulsed electrostatic field with specific reference to hair Electrotrichogenesis.

Maddin WS

This comparative, controlled study demonstrates the positive biologic effect on hair regrowth of a pulsed electrical field administered according to a regularized treatment schedule over 36 weeks. Mean hair count comparisons within the groups significantly favor the treatment group, which exhibited a 66.1% hair count increase over baseline. The control group increase over baseline was 25.6%. It is notable also that 29 of the 30 treatment subjects (96.7%) exhibited hair regrowth or no further hair loss. The process is without side effects and untoward reactions. The rationale of this phenomenon is unclear but is considered to be due to an electrophysiologic effect on the quiescent hair follicle, similar to that documented with respect to bone fracture and soft tissue repair enhancement. The electrical pulse may cause increased cell mitosis through calcium influx, involving both the hair follicle sheath and dermal papilla cells.

Hair Loss Blog

Acta Derm Venereol. 1980;60(2):171-72.

Photochemotherapy for alopecia areata.

Claudy AL, Gagnaire D.

Patients with hair loss due to alopecia areata (plaque type and totalis type) were treated with oral photochemotherapy. Successful results were obtained in 7 cases. snip... Hair regrowth was related to the light energy delivered and was not dependent on the duration of the disease. No relapses occurred after discontinuation of the treatment. The hypothesis concerning the mechanisms of hair regrowth are discussed.

edited

Z Hautkr. 1982 Mar 15;57(6):393-405.Treatment of alopecia areata totalis and maligna with Solvezink

Wolowa F.

Treatment with Solvezink has been performed in 284 patients: 42 with hair loss due to alopecia areata, 106 with alopecia totalis (preserved axillar and pubic air as well as eyelashes and brows) and 136 with alopecia maligna. The duration of the treatment including maintenance therapy was up to 6 years. In patients with alopecia areata a state without relapse of 1 to 4 years was achieved in 42,8% of cases, in alopecia totalis and maligna a maintenance therapy was necessary to ensure a permanent regrowth of the hair. When applied correctly, Solvezink was well tolerated. The dosages and the treatment intervals of the treatment should be adjusted individually.

Dermatology. 2004;209(2):117-25.

An open, randomized, comparative study of oral finasteride and 5% topical minoxidil in male androgenetic alopecia.
Arca E, et al.

BACKGROUND AND AIM: Androgenetic alopecia (AGA) or male pattern hair loss is undoubtedly the most common form of hair loss in males. It is a condition which may cause cosmetic and psychosocial problems in androgen-dependent cases. In this open, randomized and comparative study we evaluated the efficacy of oral finasteride and 5% topical minoxidil treatment for 12 months in 65 male patients with mild to severe AGA. METHODS: We randomly assigned 40 (61.53%) patients to receive 1 mg/day oral finasteride for 12 months, and 25 (38.47%) patients applied 5% topical minoxidil solution twice daily for 12 months. RESULTS: There were no significant differences between the 2 groups considering age, age of onset of hair loss, family history and type of hair loss. In the clinical evaluation at the endpoint of treatment, the clinical cure rates (i.e. increased intensity of hair) were 80% (32/40) for the oral finasteride group and 52% (13/25) for the 5% topical minoxidil group. Encountered side effects were all mild, and there was no need to stop the treatment. In the group given oral finasteride, side effects were noted in 7 patients: 6 patients suffered from loss of libido, and 1 patient had an increase in other body hairs; irritation of the scalp was seen in 1 patient in the group administered 5% minoxidil. These adverse events disappeared as soon as the treatment was stopped. The laboratory data on both drug groups did not show any statistically or clinically significant intragroup changes from baseline values to the endpoint (p > 0.05), except the level of serum total testosterone which was increased, and free testosterone and serum prostate-specific antigen in the finasteride group which were statistically decreased from baseline values to the endpoint . CONCLUSION: In this comparative study of systemic finasteride and topical minoxidil, it was concluded that both drugs were effective and safe in the treatment of mild to severe AGA, although oral finasteride treatment was more effective. Adverse events were not considered important either, and these side effects disappeared as soon as the treatment was stopped.

Hormonal treatment for male-pattern hair loss: implications for cancer of the prostate?

Anderson WR, Harris NM, Holmes SA.

BJU Int. 2002 Nov;90(7):682-5. Review.

PMID: 12410747 [PubMed - indexed for MEDLINE]

Health News. 1999 Oct 25;5(13):4.

Where's the hair?

Sawaya M.
University of Miami School of Medicine, USA.

Article on hair loss and hair loss treatment

Drugs. 1999 Jan;57(1):111-26.

Finasteride: a review of its use in male pattern hair loss.
McClellan KJ, Markham A.

The 5alpha-reductase inhibitor finasteride blocks the conversion of testosterone to dihydrotestosterone (DHT), the androgen responsible for male pattern hair loss (androgenetic alopecia) in genetically predisposed men. Results of phase III clinical studies in 1879 men have shown that oral finasteride 1 mg/day promotes hair growth and prevents further hair loss in a significant proportion of men with male pattern hair loss. Evidence suggests that the improvement in hair count reported after 1 year is maintained during 2 years' treatment. In men with vertex hair loss, global photographs showed improvement in hair growth in 48% of finasteride recipients at 1 year and in 66% at 2 years compared with 7% of placebo recipients at each time point. Furthermore, hair counts in these men showed that 83% of finasteride versus 28% of placebo recipients had no further hair loss compared with baseline after 2 years. The clinical efficacy of oral finasteride has not yet been compared with that of topical minoxidil, the only other drug used clinically in patients with male pattern hair loss. Therapeutic dosages of finasteride are generally well tolerated. In phase III studies, 7.7% of patients receiving finasteride 1 mg/day compared with 7.0% of those receiving placebo reported treatment-related adverse events. The overall incidence of sexual function disorders, comprising decreased libido, ejaculation disorder and erectile dysfunction, was significantly greater in finasteride than placebo recipients (3.8 vs 2.1%). All sexual adverse events were reversed on discontinuation of therapy and many resolved in patients who continued therapy. No other drug-related events were reported with an incidence > or =1% in patients receiving finasteride. Most events were of mild to moderate severity. Oral finasteride is contraindicated in pregnant women because of the risk of hypospadias in male fetuses. CONCLUSIONS: Oral finasteride promotes scalp hair growth and prevents further hair loss in a significant proportion of men with male pattern hair loss. With its generally good tolerability profile, finasteride is a new approach to the management of this condition, for which treatment options are few. Its role relative to topical minoxidil has yet to be determined.

Link: http://www.drproctor.com

Dermatology. 2004;209(2):117-25.

An open, randomized, comparative study of oral finasteride and 5% topical minoxidil in male androgenetic alopecia.

Arca E, Açikgöz G, Taºtan HB, Köse O, Kurumlu Z.

Department of Dermatology, Gülhane Military Medical Academy, School of Medicine, Etlik-Ankara, Turkey. earca@gata.edu.tr

BACKGROUND AND AIM: Androgenetic alopecia (AGA) is undoubtedly the most common form of hair loss in males. It is a condition which may cause cosmetic and psychosocial problems in androgen-dependent cases. In this open, randomized and comparative study we evaluated the efficacy of oral finasteride and 5% topical minoxidil treatment for 12 months in 65 male patients with mild to severe AGA. METHODS: We randomly assigned 40 (61.53%) patients to receive 1 mg/day oral finasteride for 12 months, and 25 (38.47%) patients applied 5% topical minoxidil solution twice daily for 12 months. RESULTS: There were no significant differences between the 2 groups considering age, age of onset of hair loss, family history and type of hair loss. In the clinical evaluation at the endpoint of treatment, the clinical cure rates (i.e. increased intensity of hair) were 80% (32/40) for the oral finasteride group and 52% (13/25) for the 5% topical minoxidil group. Encountered side effects were all mild, and there was no need to stop the treatment. In the group given oral finasteride, side effects were noted in 7 patients: 6 patients suffered from loss of libido, and 1 patient had an increase in other body hairs; irritation of the scalp was seen in 1 patient in the group administered 5% minoxidil. These adverse events disappeared as soon as the treatment was stopped. The laboratory data on both drug groups did not show any statistically or clinically significant intragroup changes from baseline values to the endpoint, except the level of serum total testosterone which was increased, and free testosterone and serum prostate-specific antigen in the finasteride group which were statistically decreased from baseline values to the endpoint . CONCLUSION: In this comparative study of systemic finasteride and topical minoxidil, it was concluded that both drugs were effective and safe in the treatment of mild to severe AGA, although oral finasteride treatment was more effective. Adverse events were not considered important either, and these side effects disappeared as soon as the treatment was stopped.

Hair Loss Blog

A male volunteer with frontal alopecia or male pattern hair loss was treated simultaneously with 20 mg cyproterone acetate and 5 mg minoxidil topically (daily). During treatment with both drugs, new hair growth was observed on the alopecic scalp. The new hair was lost after discontinuing minoxidil treatment, although cyproterone acetate hair loss treatment was continued.

Drugs. 1987 Feb;33(2):107-22.

Topical minoxidil. A preliminary review of its pharmacodynamic properties and therapeutic efficacy in alopecia areata and alopecia androgenetica.

Hair Loss blog

Clissold SP, Heel RC.

When minoxidil is administered orally for periods in excess of 1 month, hypertrichosis occurs as a side effect in a majority of patients. Consequently, topical minoxidil has been developed to try to improve hair growth in patients with alopecia areata and alopecia androgenetica. Preliminary studies have shown that topical minoxidil promotes cosmetically acceptable hair regrowth in a variable proportion of patients with alopecia areata. Data from a large multicentre trial indicate that cosmetically worthwhile results are achieved in about one-third of subjects with alopecia androgenetica after 1 year of treatment. A much higher proportion (about 80%) of patients with alopecia androgenetica exhibited some non-vellus hair regrowth after 1 year, and whether more of these patients would develop a cosmetically acceptable result with a longer treatment period is an important area of future investigation. Initial indications suggest that less severe disease is a predictor of likely response. Thus, topical minoxidil would seem to be a useful treatment modality for patients with alopecia androgenetica--a disease for which no other safe and effective drug therapy exists. Results from treating patients with alopecia areata with topical minoxidil, although encouraging, have been more variable and require further evaluation. Even though a number of questions remain to be answered about topical minoxidil (as would be expected at this stage in its development), it would seem to be the first available drug with the potential to promote substantial hair regrowth in these divergent diseases.

J Am Acad Dermatol. 1999 Oct;41(4):550-4.

The effects of finasteride on scalp skin and serum androgen levels in men with androgenetic alopecia (pattern Hair Loss).
Drake L, et al

BACKGROUND: Data suggest that androgenetic alopecia is a process dependent on dihydrotestosterone (DHT) and type 2 5alpha-reductase. Finasteride is a type 2 5alpha-reductase inhibitor that has been shown to slow further hair loss and improve hair growth in men with androgenetic alopecia. OBJECTIVE: We attempted to determine the effect of finasteride on scalp skin and serum androgens. METHODS: Men with androgenetic alopecia (N = 249) underwent scalp biopsies before and after receiving 0.01, 0.05, 0.2, 1, or 5 mg daily of finasteride or placebo for 42 days. RESULTS: Scalp skin DHT levels declined significantly by 13.0% with placebo and by 14.9%, 61.6%, 56. 5%, 64.1%, and 69.4% with 0.01, 0.05, 0.2, 1, and 5 mg doses of finasteride, respectively. Serum DHT levels declined significantly by 49.5%, 68.6%, 71.4%, and 72.2% in the 0.05, 0.2, 1, and 5 mg finasteride treatment groups, respectively. CONCLUSION: In this study, doses of finasteride as low as 0.2 mg per day maximally decreased both scalp skin and serum DHT levels. These data support the rationale used to conduct clinical trials in men with male pattern hair loss at doses of finasteride between 0.2 and 5 mg.

Nippon Rinsho. 2008 May;66(5):892-6.

Hair follicle regeneration

Itami S.

Hair growth cycle is coordinated with complex processes that are dependent on the interactions of follicular stem cells and dermal papilla cells (DPCs). For the past 10 years, the developmental mechanism of hair follicles has been extensively studied, and spatial and temporal expressions of many molecules are required for the hair morphogenesis. These molecules are also required for hair cycle progression. Androgen receptor, which is a ligand dependent transcription factor, plays an important role in human hair cycle. Frontal scalp DPCs from androgenetic alopecia (AGA) are the target cells of androgen action. Minoxidil and Finasteride were recently introduced for the treatment of AGA, and cell therapy using DPCs is a next strategy for the innovative treatment.

Hair Loss treatment Blog

Hair Loss Treatment Blog