Hair Loss Treatment

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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

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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.

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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.