Defective Expression of the Gap Junction Protein Pannexin-1 Channel Contributes to the Formation of PCOS-Realted Androgenetic Alopecia

Objective: To determine serum pannexin-1 channel levels and their association with hair loss in women with PCOS diagnosed with female androgenetic alopecia (FAGA). Materials and Methods: Thirty-five women with PCOS who presented with diffuse and treatment-resistant progressive hair loss and were diagnosed with FAGA were included in the study. 25 patients who were diagnosed with female androgenetic alopecia but did not have PCOS were considered as the control group. PCOS and control groups were matched by age. Follicular miniaturization, displacement of terminal hairs with vellus hairs, and a diffuse decrease in hair density were accepted as FAGA in the trcihoscopy examination of the vertex and bitempoaral area. On the third day of the menstrual cycle serum FSH, LH, testosterone, PRL and insulin levels were measured. Insulin resistance was calculated with HOMA-IR. Serum pannexin-1 channel levels of each group were mesured with ELISA. Results: Serum pannexin 1 channels levels of FAGA group due to PCOS were found to be significantly higher than FAGA patients in the control group (2.72 ± 1.09 ng/mL vs 1.65 ± 0.97 ng/mL, p < 0.01). Serum LH, insulin and testosterone levels of PCOS group were significantly higher than controls. HOMA-IR values were significantly higher and >2.5 in the PCOS group compared to the controls. PRL values were similar except for one patient with elevated PRL. Serum FSH values were the same in both groups. A positive and significant correlation was found between pannexin 1 channels levels and HOMA-IR and serum testosterone levels (r = 0.650, p Conclusions: In addition to hyperandrogenemia, increased pannexin 1 channel levels may play a role in the etiology of PCOS associated FAGA, as it impairs the communication between the skin and hair follicle.

Serum Gelsolin Levels in PCOS-Related Androgenetic Alopecia

Aim: To compare serum gelsolin levels of women with androgenetic alopecia with PCOS and patients with non-PCOS alopecia. Materials and Methods: A total of 30 PCOS patients who applied to our dermatology clinic with the complaint of hair loss and were diagnosed with androgenetic alopecia (AGA) were included in the study. Thirty patients who were not diagnosed with PCOS but were diagnosed with AGA were considered as the control group. Patients in the control group were matched with PCOS in terms of age. AGA was diagnosed in cases of widespread thinning of the hair on the scalp and preservation of the frontal hairline. All participants underwent a complete clinical examination and blood examination. Serum gelsolin levels of both groups were measured by ELISA. Results: The number, age, and BMI values of the participants in both groups were recorded as similar. Serum total testosterone, insulin, HOMA-IR and LH values were significantly higher in the PCOS with AGA compared to the AGA without PCOS. There is no significant difference between groups in terms of serum FSH levels. Serum gelsolin levels of the PCOS group were significantly lower than the control group (160.1 ± 34.2 ng/mL vs. 188.6 ± 46.7 ng/mL, p Conclusions: Serum gelsolin levels in PCOS patients with androgenetic alopecia were found to be significantly lower than in non-PCOS alopecia patient groups.

Concentrated Growth Factor from Autologous Platelet Promotes Hair Growth in Androgenetic Alopecia

Studies have shown that platelet concentrates can induce the proliferation of the dermal papilla and the vascularization of the perifollicular tissue, as well as accelerate the telogen-to-anagen transition, thereby promoting the regrowth of hair improving the appearance of hair loss. Herein, we report on the application of a new, modified form of platelet concentrates, namely, concentrated growth factors (CGFs), in 15 cases of androgenetic alopecia (AGA). 15 cases of androgenetic alopecia were treated with the use of monthly, subcutaneous injections of autologous CGF in the scalp. A total of 3 injections were administered 4 weeks apart, and the patients were followed up for 6 months. Assessments were performed before the treatments and at 4, 8, 12 and 24 weeks after the first treatment. The treatment outcomes were assessed by taking macroscopic photographs and trichoscopic photomicrographs, as well as by using the Global Aesthetic Improvement Scale (GAIS) and the patient satisfaction survey. In order to determine the safety of the treatment, the injection area was observed for signs of infection or mass evaluation. The photographs showed significant improvement in hair appearance after injections of CGF. The hair photomicrographs showed that CGF promoted the regrowth of hair in balding areas, with an increased hair density and an increased ratio of terminal to vellus hair. The GAIS suggested that CGF treatments were effective in treating AGA, and the majority of patients were satisfied with their improvement. In addition, treatments resulted in a faster rate of hair growth and a decrease in the greasy and unpleasant sensation of the hair of the patients. At the last visit, none of the 15 patients reported experiencing side-effects during the follow-up period. To conclude, the application of CGF can be an effective method in the treatment of androgenetic alopecia.

The Effect of a Food Supplement and a Hair Lotion on the Progression of Androgenetic Alopecia

Background: Progressing androgenetic alopecia (AGA), in both sexes, can result in severe distress. Treatments with the capacity to slow down the progression of AGA, or even to bring it to a halt, and at the same time don’t come with side effects are consequently highly sought for. Therefore this study investigates the effect of an over-the-counter nutritional supplement and a similarly formulated topical hair lotion on the progression of AGA. Methods: Seventy-nine healthy study participants of both sexes, who were diagnosed with AGA were divided into 4 study groups. The subjects of the first group were treated with the nutritional supplement, the subjects of the second group with the topical hair lotion, the subjects of the third group with both products, and the subjects of the fourth group served as a no-treatment control. At the beginning and at the end of this nine-month study, the participants were evaluated for their hair loss status. They also answered a questionnaire for self-assessment. A part of the subjects from each study group were further analysed by phototrichography, in order to measure the number of anagen and telogen hairs. Results: It turned out that the supplement, the lotion as well as the treatment with both products not only lead to a reduction in hair loss but also to an increased anagen to telogen hair ratio, whereas no such effects could be measured for the control group. Conclusion: The results show that a systemic delivery via a nutritional supplement, as well as a follicular delivery via a topically applied lotion, both resulted in a reduced hair loss rate as well as in an increased anagen to telogen hair ratio. This demonstrates that the tested formulation is effectively slowing down the progression of AGA.

Establishment and molecular characterization of human dermal mesenchymal-like stem cells derived from human scalp biopsy of androgenetic alopecia patient

Development of Dermal cell line has great scope in the field of skin related diseases and regenerative medicine. Alopecia leads to a skin disorder causing balding and its mechanism is not yet understood. In the present study, we have developed and characterized a heterogeneous population of human dermal mesenchymal-like stem cell line from scalp biopsy of androgenetic alopecia patient with a view to isolate cells from the bulge region of the hair follicle. Our study showed that the dermal cells isolated from dermis of skin showed epithelial-like cells expressing CD34 and Keratin 18, which are characteristic of bulge hair follicle cells. These cells also expressed mesenchymal phenotypes and pluripotency markers such as Oct4, Nanog and SOX2. These cells were designated as “Human Dermal Mesenchymal-like Stem Cells (hDMSCs)”. To confirm their epithelial phenotypes, we have grown these cells at low serum concentration and it was observed that 3% serum concentration provided optimum conditions for their growth and maintenance of characteristics. The hDMSCs cells are presently at passage 10. This study reports the establishment of human dermal mesenchymal-like cell line from the dermis of Alopecia patient, which may be used as an in vitro model system to study the mechanism of Alopecia and other related skin disorders.

Efficacy and Safety of a Botanical Topical Serum on Male and Female Androgenetic Alopecia

Androgenetic alopecia (AGA) is a common form of hair loss in both men and women, it affects up to 80% of men and 50% of women during their life. The current treatments approved for AGA are limited, inconstantly effective and might be associated with adverse events. The aim of this study was to evaluate the efficacy and safety of a botanical topical serum (SERUM THICKER) applied for 6 months in 14 males and 10 females with mild to moderate androgenetic alopecia. The hair parameters were assessed using trichoscopy images obtained with high resolution camera FotoFinder Leviacam® and analyzed with optimized software from TrichoLABTM and Vitual tattooTM technology. Hair loss was assessed using a wash-test procedure, and self-assessments were collected via questionnaires. Both at 28 days and 168 days, a significant increase of the hair density was observed, respectively +4.8% (p = 0.038);+11.7% (p < 0.001) for 1 application per day and +5.2% (p = 0.032);+9% (p < 0.001) for 2 applications/week. Reported to the whole scalp, this represents an estimation of hair gain of 7000 hair in 6 months for subjects applying SERUM THICKER once a day and 5000 hair for subjects applying SERUM THICKER twice then once a week. Although, the analysis of hair shedding during washing did not permit to show a time effect or any effect of the application frequency, the analysis showed a marginal time effect in the group treated once a day (p = 0.0674). Regarding efficacy on hair loss and regrowth, although no statistical analysis were performed, it seems that for all questions and for both groups the positive answers were higher after 6 months of treatment than after 1 month. SERUM THICKER represents an interesting, effective, well-tolerated and safe multitarget treatment to address mild to moderate AGA in male and female. Efficacy was observed from one application per week and seems greater once applied once daily.

Re-Densification Effect of Pressure-Injected Peptide-Hyaluronic Acid Combination on Male Androgenic Alopecia

Introduction: Mechanism of male androgenic alopecia (MAGA) is complex and leads to an excessive hair shedding and decreased hair density. Oral, topical, and injectable autologous treatments demonstrate ability to stimulate hair re-growth, but the response is suboptimal or plateaus off. Synthetic combination of the peptide complex and hyaluronic acid (P-HA) demonstrated hair regrowth in alopecia patients. Electronically-operated pneumatic injections (EPI) generate micro-trauma in the dermis and under wound-healing conditions may enhance regeneration effect of P-HA. Methods: Subjects seeking improvement of their male pattern hair loss (Hamilton-Norwood type 2-4) received the P-HA treatments through EPI. The course included 4 treatments every two weeks over the 8-week period. In 6 months, the hair growth was assessed comparative to baseline by global clinical photography and digital phototrichograms. The treatment safety and tolerability were documented through the whole study period. Results: Twelve men (30-45 years old) completed the treatment course with high tolerability and without adverse events. Post-treatment assessment of the previously bald areas showed improved coverage on the clinical photographs. The phototrichograms demonstrated statistically significant increase in terminal hair density by 36%, cumulative hair thickness by 37%, and follicular units by 20%;all contributing to a 38% increase in cumulated hair density (all p Conclusion: Electronic pneumatic injections are well tolerated and can be safely used for the needle-free administration of the peptide-hyaluronic acid combination in MAGA therapy. We achieved significant hair re-densification in the balding scalp. The exact role of the EPI-induced impact in the hair re-growth mechanism remains to be ascertained. .

Treatment of alopecia totalis/universalis/focalis with vitamin D and analogs:Three case reports and a literature review

BACKGROUND Alopecia areata(AA)is an inflammatory disease with autoimmune,environmental,and inherited components directed at the hair follicle,either limited to patchy hair loss over the scalp(Focalis,AF),total loss of scalp hair(Totalis,AT),or total loss of both scalp and body hair(Universalis,AU).Despite multiple treatment modalities,no therapy exists.Vitamin D deficiency in patients with AA/AT/AF influences disease severity and duration,inversely correlating with inflammation histologically.CASE SUMMARY Three girls presented with AT(P1),AU(P2),and AF(P3)at the ages of 1,5,and 5 years,respectively.For P1-P2,all available treatments implemented for 2 years had failed.We started an initial 6-mo repletion with oral cholecalciferol 2000/4000 IU/d,with no apparent effect.Then we attempted immunomodulation using oral calcitriol and its analog paricalcitol.On calcitriol,0.5 mcg/d P1 regrew hair within 6 mo.After 4 years,a relapse with loss of eyebrow hair was resolved after doubling the calcitriol dose to 0.5 mcg×2/d;the results have been maintained for 6 years to date.On calcitriol,0.25 mcg×3/d P2 led to the development of asymptomatic hypercalcemia-hypercalciuria,which was immediately resolved by switching to paricalcitol 2 mcg×3/d;mild tolerable hypercalciuria was maintained.Hair regrowth was observed at 6 mo,stabilizing only as fur at 12 mo.AF in P3 was resolved completely within 3 mo on a daily high dose(8000 IU)of cholecalciferol.CONCLUSION Vitamin D may have immunomodulating therapeutic impact on AT/AU/AF,which needs to be explored with further pilot clinical trials.

Moth-Eaten Symptomatic Syphilitic Alopecia Associated with Human Immunodeficiency Virus—A Case Report

Syphilitic alopecia (SA) is a rare skin manifestation in secondary syphilis and sometimes indistinguishable from other alopecia. SA is of 2 types, symptomatic and essential, and 3 clinical types, moth-eaten or patchy pattern, diffuse pattern and a combination of both. SA in our case indicated symptomatic SA with moth-eaten hairloss. A 46-year-old Japanese homosexual man experienced hairloss followed by the pruritic skin rash. Physical examination of the scalp showed diffusely spread papulosquamous erythema and incomplete hairloss around the lesions. The scalp lesions appeared as “moth-eaten alopecia”. Serological examination for syphilis and HIV were positive. Thus, SA complicated with HIV infection was diagnosed. He was treated with a single perioral dose of ampicillin for 4 weeks, then his condition improved rapidly and hair regrowth occurred. HIV-infected persons show a high incidence of syphilis. Therefore, HIV test should be considered for patients with alopecia.

A Systemic Review on Topical Marketed Formulations, Natural Products, and Oral Supplements to Prevent Androgenic Alopecia: A Review

Androgens have an intense consequence on the human scalp and body hair.Scalp hair sprouts fundamentally in awol of androgens whereas the body hair hike is vulnerable to the activity of androgens.Androgenetic alopecia(AGA)invoked as males emulate Alopecia due to the cause of the dynamic reduction of scalp hair.Androgens are medium of terminus growth of hair although the body.Local and system androgens convert the extensive terminal follicles into lesser vellus like structure.The out start of this type of alopecia is intensely irregular and the reason behind this existence of enough circulating steroidal hormones androgens and due to genetic predisposition.Effective treatments are available in the market as well as under clinical and preclinical testing.Many herbal formulations are also available but not FDA approved.Different conventional and NDDS formulations are already available in the market.To avoid various systemic side effects of both Finasteride and Minoxidil,topical formulations and natural products(nutrients,minerals,vitamins)now a days are being widely used to treat Androgenic alopecia.CAM(complementary and alternative medicine)provides the option to elect favorable,low-risk,adjuvant and alternative therapies.Herein,we offer a widespread review of topical marketed formulations,natural products,and CAM treatment options for AGA.

Platelet-Rich Plasma for Androgenetic Alopecia in Women: A Single-Center Case Series Study in Qatar

Objective:Androgenetic alopecia (AA) is a progressive hair loss disorder mediated by systemic androgens and genetic factors. A variety of AA treatments have been investigated. Currently, there is emerging evidence and growing interest in the use of platelet-rich plasma (PRP) for AA. This study describes a single-center experience using PRP to treat AA in women.Methods:A retrospective observational study design was employed. The study cohort comprised 20 women >18 years of age who were diagnosed with AA. PRP was prepared using a commercially available PRP kit. Each patient received six PRP treatment sessions at 4-week intervals. The severity of alopecia tool (SALT) scoring system was used to measure the severity of alopecia, and a paired t-test was used to calculate significance levels. Results:The mean pre-intervention and post-intervention total SALT score was 27.5 ± 6.35 and 9.41 ± 3.71, respectively. The difference in the total mean SALT score was 18.33 ± 1.64 and the effect size was 3.52. The scalp area with the largest effect size was the vertex (Cohen d= 2.53). The effect size was similar across other scalp areas (Cohen d= 1.91-2.09). There were no serious adverse effects of the treatment;only mild transient adverse effects were reported. Conclusion:The present study demonstrated the efficacy and safety of PRP injections in treating AA in women. However, these findings require confirmation in well-designed studies using standardized treatment protocols and evaluation methods.

Hair regrowth following fecal microbiota transplantation in an elderly patient with alopecia areata: A case report and review of the literature

BACKGROUND Alopecia areata is a hair loss disease associated with genetics,autoimmunity,and other factors.There is an intriguing link between alopecia areata and gut dysbiosis.Fecal microbiota transplantation(FMT)has been recommended to treat Clostridium difficile(previously known as Clostridioides difficile)infection,and has also shown potentials in the treatment of inflammatory bowel disease,irritable bowel syndrome,and non-alcohol fatty liver disease.CASE SUMMARY An 86-year-old man,with a history of sigmoid colon carcinoma,suffered from recurrent abdominal pain and distension,and diarrhea for six months,with inappetence.At admission,he was also diagnosed with depression.Upon physical examination,the patient presented with a 1.5 cm×2.0 cm alopecia areata on his right occiput.Due to the negative results of laboratory testing,capsule endoscopy,and colonoscopy,the patient was diagnosed with noninfectious diarrhea,depressive disorder,and patchy alopecia areata.Considering that noninfectious diarrhea in the elderly patient was mainly caused by gut dysbiosis,he was given six rounds of FMT.His diarrhea improved remarkably one month after FMT,with improved appetite and disappearance of abdominal pain,distension,and depressive symptoms.Surprisingly,he reported new hair growth on the affected region of his scalp,with some of his white hair gradually turning to black,without taking any other therapies for alopecia areata before and after FMT.CONCLUSION FMT might act as a potential therapy for patients who suffer from alopecia areata.Large and well-designed studies are required to confirm the role of FMT in alopecia areata.

Combination therapy with topical minoxidil and nano-microneedle-assisted fibroblast growth factor for male androgenetic alopecia:a randomized controlled trial in Chinese patients

To the Editor:Male androgenic alopecia(MAA)is the most common hair loss disorder characterized by miniaturization of hair follicles and progressive hair loss.[1]Although oral drugs,topical agents,and laser therapy can promote hair growth,minoxidil is the only topical therapy approved by the United States Food and Drug Administration.Fibroblast growth factors(FGFs)have a wide range of biological functions.The basic FGF(bFGF)promotes the growth of the hair follicle in mice,indicating its potential as a therapeutic agent for MAA.[2]The nano-microneedle is a new device that can promote transdermal absorption of topical drugs,[3]and increase drug penetration by up to 10 or 20 times.In this study,we compared the safety and efficacy of topical minoxidil,nano-microneedle-assisted FGF,and a combination of the two.

Alopecia treatment using minimally manipulated human umbilical cord-derived mesenchymal stem cells:Three case reports and review of literature

BACKGROUND Alopecia areata(AA)is a common autoimmune disease characterized by hair loss.AA appears in extensive forms,such as progressive and diffusing hair loss(diffuse AA),a total loss of scalp hair(alopecia totalis),and complete loss of hair over the entire body(alopecia universalis).Recently,mesenchymal stem cells(MSCs)have been identified as a therapeutic alternative for autoimmune diseases.For this reason,preclinical and case studies of AA and related diseases using MSCs have been conducted.CASE SUMMARY Case 1:A 55-year-old woman suffered from AA in two areas of the scalp.She was given 15 rounds of minimally manipulated umbilical cord-MSCs(MM-UC-MSCs)over 6 mo.The AA gradually improved 3 mo after the first round.The patient was cured,and AA did not recur.Case 2:A 30-year-old woman,with history of local steroid hormone injections,suffered from AA in one area on the scalp.She was given two rounds of MM-UC-MSCs over 1 mo.The AA immediately improved after the first round.The patient was cured,and AA did not recur.Case 3:A 20-year-old woman,who was diagnosed with alopecia universalis at the age of 12,was given 14 rounds of MM-UC-MSCs over 12 mo.Her hair began to grow about 3 mo after the first round.The patient was cured,and alopecia universalis did not recur.CONCLUSION MM-UC-MSC transplantation potentially treats patients who suffer from AA and related diseases.

Efficacy of Qigong for the treatment of alopecia universalis: a clinical case report

Qigong is a part of traditional Chinese medicine. According to the antique treaties, the foundations of traditional Chinese medicine are based in maintaining the harmony between Qi (energy), Jing (essence) and Shen (spirit). Alterations in this harmony can develop and determine the appearance of disease. Therapeutic effects of Qigong are helpful in the prevention and treatment of several diseases. It's main role in restoring body functions is due to the communication between internal organs, tissues and cells. The main goal of this work is to show the efficacy of Qigong in the treatment of a dermatological disease characterized by the appearance of circular or oval patches of missing hair, known as alopecia universalis. For western medicine the exact cause of this illness is not totally revealed, however, it's attributed to psycological, genetics and metabolic alterations. From the traditional Chinese medicine perspective, hair alterations are framed in the area of the water energy, represented by the kidney organ. The results of Qigong treatment suggested that the cranial hair follicles had been activated since the first treatment. As treatment progressed, the cranial hair follicles continued to grow, what's more, the brightness and pigmentation of the hair also increased. Therefore, in the clinical conditions evaluated, Qigong could be an effective alternative treatment in consideration of the visible evidence about rapid and long lasting results. Besides, we did not observe any side effects of Qigong in this case.

TREATMENT OF 42 CASES OF ALOPECIA AREATA WITH PLUM-BLOSSOM NEEDLE

In the present study, 42 cases of alopecia areata were treated by tapping the locus with plum-blossom needle and rubbing the local skin with fresh ginger. After 1 - 3 courses of treatment, 41 cases were cured, with the cure rate being 97. 62%.

Frontal fibrosing alopecia update

Frontal fibrosing alopecia(FFA) is a recently described form of primary cicatricial alopecia, characterized by progressive recession of the frontotemporal hairline and eyebrow loss, occurring predominantly in postmenopausal women. The incidence of FFA has increased significantly during the last decade and we may be facing an epidemic of the disease. Because this condition causes permanent hair loss, prompt diagnosis and treatment are essential for obtaining optimal outcome. This article reviews existing knowledge on epidemiology, etiopathogenesis, clinico-histological features, diagnosis,and treatment modalities of FFA.

Lichen Planopilaris is a Common Scarring Alopecia among Iraqi Population

Background: Scarring alopecia like discoid lupus erythematosus, lichenplanopilaris and scarring folliculitis are common skin problems where differentiations between them are often difficult in many cases. Objective: To report, study and evaluate cases of lichen planopilaris and characterize the different clinical points in favor of this disease. Patients and Methods: This case series descriptive study was done at Department of Dermatology-Baghdad Teaching Hospital from January 2010 to November 2012. Sixty seven patients were included where histological and dermatological examinations were carried out to all patients regarding all relevant points related to the disease. Punch biopsies were performed from ten patients for histopathological study. Results: The mean age of onset of the disease was 36.7 ± 5 years with a mean duration of the disease being 4.4 ± 3 years. The male to female ratio was 1.4:1. The characteristic lesions were pigmented scarring moth eaten alopecia surrounded by pigmented hyperkeratotic follicular papules involving mainly the fronto-vertical and parietal scalp. Conclusions: Lichen planopilaris is a common cause of scalp scarring alopecia in adult and it has many characteristic clinical features which can facilitate differentiation from other pathologic scalp conditions like discoid lupus erythematosus.

Breast Cancer Cutaneous Metastasis after Scalp Cooling for Alopecia Prevention

Scalp cooling is a widely used method to prevent chemotherapy-induced transient alopecia. Although the success rates in maintaining hair can be high, authors have expressed their concerns regarding the risk of scalp metastasis after scalp cooling. We report a case of breast cancer scalp metastasis in a patient submitted to scalp cooling for alopecia prevention and discuss the physiopathology, risks and benefits of this treatment for patients under this treatment.

Surgical Treatment of Scarring Alopecia Associated with Acne Keloidalis Nuchae

Acne keloidalis nuchae (AKN) is a relatively rare chronic inflammatory condition that leads to alopecia on the occipital scalp. Multiple large keloids and alopecia associated with long-lasting folliculitis impair the psychosocial functioning of patients. We report successful treatment of alopecia associated with AKN. When a 23-year-old male was referred to us, a large area of alopecia and multiple keloids associated with AKN were found. Following total excision of the lesion, the defect was reconstructed with two rotation flaps elevated bilaterally. Most patients with AKN undergo conservative treatments including oral antibiotics and local steroid injections. As surgical treatments, excision followed by skin grafting or second-intention healing has been reported. However, all of the previously-reported treatments have left alopecia on the occipital region. Although long scars might be left in the scalp, local flap reconstruction would be an option for the treatment of large areas of alopecia associated with AKN.