The Hair in the Garland: Hair Loss and Social Stress Among Women in South India.

Hair diversity, its style, colour, shape and growth pattern is one of our most defining characteristics. The natural versus temporary style is influenced by what happens to our hair during our lifetime, such as genetic hair loss, sudden hair shedding, greying and pathological hair loss in the various forms of alopecia because of genetics, illness or medication. Despite the size and global value of the hair care market, our knowledge of what controls the innate and within-lifetime characteristics of hair diversity remains poorly understood. In the last decade, drivers of knowledge have moved into the arena of genetics where hair traits are obvious and measurable and genetic polymorphisms are being found that raise valuable questions about the biology of hair growth. The recent discovery that the gene for trichohyalin contributes to hair shape comes as no surprise to the hair biologists who have believed for 100years that hair shape is linked to the structure and function of the inner root sheath. Further conundrums awaiting elucidation include the polymorphisms in the androgen receptor (AR) described in male pattern alopecia whose location on the X chromosome places this genetic contributor into the female line. The genetics of female hair loss is less clear with polymorphisms in the AR not associated with female pattern hair loss. Lifestyle choices are also implicated in hair diversity. Greying, which also has a strong genetic component, is often suggested to have a lifestyle (stress) influence and hair follicle melanocytes show declining antioxidant protection with age and lowered resistance to stress. It is likely that hair research will undergo a renaissance on the back of the rising information from genetic studies as well as the latest contributions from the field of epigenetics.

Background: Hair loss is a significant health problem; hence, individuals experiencing hair loss immediately visit a doctor for treatment. Diffuse (symptomatic) alopecia can be the result of various external and internal factors. A doctor should determine the cause of the hair loss and prescribe treatment, including topical agents.
 Aim: to study the clinical efficacy of hair spray with peptides in the treatment of patients with diffuse alopecia and its effect on the trichogramma parameters.
 Materials and methods: Thirty female patients with diffuse alopecia, aged from 18 to 59 years, were monitored in the Center of Medical Cosmetology of the I.I. Mechnikov North-Western State Medical University. In a controlled comparative study, the patients were divided into two equal groups. In group 1 (main), the drug of choice was a spray based on peptides; while in group 2 (comparison), a cosmetic product based on enzymes was applied. The drugs were used topically for 3 months. Patients were examined using questionnaires (objective assessment by the doctor and subjective evaluation by the patient) and photographs and by assessing the morphometric parameters of hair growth before treatment, 3 months after the start of treatment, and 1 month after treatment termination.
 Results: In group 1, in the parietal zone, the hair density increased significantly by 19% after 3 months and by 23% after 4 months. The number of anagen hair increased by 8% after 3 months and by 16% after 4 months, with a corresponding decrease in the number of telogen hair compared to the initial level. In the occipital zone, the number of anagen hair increased by 7% after 3 months and by 13% after 4 months, with the corresponding dynamics of telogen hair compared to the initial level. The cosmetic product has been shown to be tolerated well, and no allergic reactions were noted.
 Conclusion: The peptide-based spray can be recommended for patients with diffuse alopecia as a topical therapy.

Background : Alopecia areata is a chronic autoimmune disease, involving non-scarring hair loss, which affects hair follicles and sometimes nails. Hair loss pattern presents as patchy alopecia, ophiasis, ophiasis inversa (sisapho), reticularis or diffuse. Alopecia areata is common disorder and can impact on patient’s quality of life. Purpose : To review commonly used evidence based treatments of alopecia areata. Review : A number of treatments for alopecia areata have been showed to stimulate hair growth but there is no universally proven therapy that sustains remission. There is high rate of spontaneous remission in alopecia areata makes difficult to assess effectiveness of treatment (spontaneous remission occurs in up to 80% of patients). Numerous of topical and systemic treatment for alopecia areata have been assessed by randomized controlled trials. However management of patients with alopecia areata is still challenging. Conclusion : A number of treatments were found to be effective for alopecia areata. Based on randomized controlled trials, contact immunotherapy has the highest therapeutic evidence based level. Potent topical corticosteroid and intralessional corticosteroids are recommended for limited patchy hair loss and contact immunotherapy for extensive patchy hair loss and alopecia areata totalis/universalis.

Herbal Cosmetics have growing demand on the earth market and is a precious gift of nature. Herbal formulations continuously have attracted gigantic concentration on the grounds that of their good endeavor and comparatively lesser or nil side effect with synthetic medications. Herbs and spices have been used in retaining and embellishing human magnificence because time immemorial. Hair loss problem is of great significance to both men & women. The essential issues associated with hair loss are hair fading, dandruff & falling of hair. Alopecia is the medical term for hair loss or baldness. It is an embarrassing condition for any person, as he/she looks extra aged than ordinary. Many forms of medication are available to treat alopecia in special procedure of medication like Allopathic, Homeopathic, Ayurveda or can also be surgical like hair transplantation however none of them is wholly ample. This hindrance could be solved by the use of natural medicines obtained from herbs. Various herbs are being used to preclude the hair loss and remorse of hairs including aloe vera, brahmi, nagarmotha, amla, bhringraj, and lots of different herbs. Being average medicines there are various advantages of making use of them like patient compliance, less side-results, convenient availability, inexpensive and multiple mode ofapplications to treat Alopecia and other hair diseases . KEYWORDS: Herbal Medicine, Herbal Cosmetics, Natural Herbs, Hair Growth Activity, Hair Cycle, Brahmi, Nagarmotha, Amla, Bhringraj, Alopecia, Alopecia Areata, Allopathic, Homeopathic, Ayurveda, Beauty, Hair Loss, Hair Fading, Dandruff, Falling of Hair, Herbal formulations, Bacopa Monnieri, Cyperus Rotundus, Emblica Officinalis, Medicinal plants, Cosmetics.

Controversy on the role of iron and a clinical trial with intermittent iron and nutritional supplements in

Psoriasis affects approximately 0.123% of the population in China. Scalp is the first site of involvement in nearly 50% of the patients. Hair loss is a possible feature in psoriasis of any type. In 1972, Shuster has first distinguished three types of psoriatic alopecia: circumscribed alopecia, diffuse alopecia, and scarring alopecia. Psoriatic alopecia was found to be circumscribed in 75% of the cases and diffuse in 25%. Scarring alopecia is a rare form, which most often occurs in areas of long-standing lesions. We herein report two cases of psoriatic scarring alopecia and discuss the differential diagnosis of hair loss in psoriasis and the possible pathogenic role of T cells in psoriatic alopecia.

Background Alopecia is a common adverse effect of chemotherapy treatment for cancer; for some patients, it results in complete hair loss. The effect of hair loss among patients remains an important nursing issue. Aim The aim of this study was to examine the effect of scalp cooling on the development of alopecia in female patients receiving cancer chemotherapy. Sample Fifty female patients with first-stage primary breast cancer fit for primary chemotherapy were randomly allocated to two equal groups using block randomization. The study group patients were to use the scalp cooling, whereas the control group patients did not use it. Design A randomized clinical trial design was used in this study. Sitting This study was conducted at the Surgical Oncology Department and Dermatology Clinic at Ain Shams University Specialized Hospital. Tools Data collection tools included demographic and clinical data sheet, modified WHO hair loss scale, self-reported hair loss scale, and hair re-growth scale. An instruction brochure for patients was prepared by the researchers. Results The results demonstrated protective effect of cooling as assessed by modified WHO hair loss scale, where at the end of follow-up, 92% of the study group patients had successful protection, compared with 64.0% in the control group (P=0.02). Moreover, by self-reported hair loss scale, 68.0% of the patients in the study group reported less hair loss not requiring a wig, compared with only 12.0% of those in the control group (P Conclusion It is concluded that scalp cooling provides significant successful protection from hair loss during cancer chemotherapy course, and for 2 months after completing the treatment. Recommendations It is recommended that scalp cooling should be initiated 15 min before infusion, maintained during, and for 30 min following completion of chemotherapy session. Further study of the long-term effect of scalp cooling on protection from alopecia, with psychological and clinical assessment is proposed.

Androgenetic alopecia affects both men and women. In men it produces male pattern hair loss with bitemporal recession and vertex baldness. In women it produces female pattern hair loss (FPHL) with diffuse alopecia over the mid-frontal scalp. FPHL occurs as a result of nonuniform hair follicle miniaturization within follicular units. Diffuse alopecia is produced by a reduction in the number of terminal fibres per follicular unit. Baldness occurs only when all hairs within the follicular units are miniaturized and is a relatively late event in women. The concepts of follicular units and primary and secondary hair follicles within follicular units are well established in comparative mammalian studies, particularly in sheep. However, discovery of these structures in the human scalp hair and investigation of the changes in follicular unit anatomy during the development of androgenetic alopecia have provided a clearer understanding of the early stages of androgenetic alopecia and how the male and female patterns of hair loss are related. FPHL is the most common cause of alopecia in women and approximately one-third of adult caucasian women experience hair loss. The impact of FPHL is predominantly psychological. While men anticipate age-related hair loss, hair loss in women is usually unexpected and unwelcome at any age. Treatment options to arrest hair loss progression and stimulate partial hair regrowth for FPHL include the androgen receptor antagonists spironolactone and cyproterone acetate, the 5α-reductase inhibitor finasteride and the androgen-independent hair growth stimulator minoxidil. These treatments appear to work best when initiated early. Hair transplantation should be considered in advanced FPHL that is resistant to medical treatments. Hair transplantation requires well-preserved hair growth over the occipital donor area. The psychological impact of FPHL may also be reduced by cosmetic products that improve the appearance of the hair. These agents work to minimize hair fibre breakage, improve hair volume or conceal visible bald scalp.

A 4-year-old girl was evaluated for hair loss of a few weeks' duration. History of the present illness, medical history, and review of systems were obtained from the parents, who described progressive diffuse hair loss with hair dryness and brittleness, with no change in the child's eating habits or any other unusual symptoms. No fever, weight loss, diarrhea, vomiting, abdominal pain, chronic cough, dyspnea, change in appetite, change in bowel habit, or urinary symptoms were noted. On further questioning, her nutritional history revealed that she always favored cow's milk in her diet. The patient has been healthy with no significant medical history, surgical history, psychiatric history, or history of hospitalization. She was taking no medications. Her mother's pregnancy and the child's birth history were uneventful. The child was up-to-date on her vaccinations. Her physical examination showed a healthy-appearing child who was at 50% on the height chart and 70% on the weight growth chart. She was afebrile with a respiratory rate of 24 breaths per minute, pulse rate of 110 beats per minute, and pulse oximetry of 99% on room air. Skin examination revealed interstitial diffuse patchy alopecia with very dry hair and nonscarred, normal-appearing scalp. The hair pull test was normal, with 4 hairs extracted. Results of examination of her eyes (including visual acuity) and lungs were normal, and no abnormalities were found on heart, abdominal, musculoskeletal, and neurologic examinations. Laboratory workup showed normal electrolytes, blood urea nitrogen, creatinine, and blood sugar levels. Her complete blood cell count with differential was normal, ferritin concentration level was 110 ng/mL (reference, 40-200 ng/mL), iron level was 75 microg/dL (reference, 35-175 microg/dL), and total iron-binding capacity was 310 microg/dL (reference, 245-400 microg/dL). Levels of liver enzymes, total bilirubin, serum protein, and albumin were normal, as were the results of urinalysis. Thyroid function test results were normal and levels of vitamins A and D were also normal. Low levels of serum zinc were measured repeatedly at 48 and 61 microg/dL (reference, 66-144 microg/dL) at 2 different laboratories. She was started on zinc supplement (50 mg daily) for 6 months and her diet was modified. The hair loss stopped in 3 weeks. Follow-up in 4 months showed no evidence of alopecia, with normal-looking hair.

Diffuse alopecia (DA) is a disease characterized by a diffuse hair loss associated with alterations in physiological hair cycle due to an exposure of hair follicles to various endogenous and exogenous factors. The disease is mainly caused by alterations in the cyclicity of hair follicle phases anagen, telogen and catagen. Pathogenetic therapy for DA is based on the initiation and lengthening of the anagen phase, in particular, via inhibition of catagen. Given a high prevalence of DA following a new coronavirus infection (COVID-19), the search for an effective medicine for the SARS-CoV-2 virus-associated DA is extremely important. The use of drugs derived from natural products can have a beneficial effect on the disease following COVID-19. The study was aimed to assess the efficacy of the combination of Selencin (homeopathic drug) and Selencin Peptide Active (peptide lotion) for the treatment of DA associated with prior coronavirus infection (COVID-19). A total of 34 patients with a confirmed diagnosis of telogen/anagen DA, who noted the relationship between DA and a new coronavirus infection, were treated with both systemic (pills) and topical (peptide lotion) Selencin for 2 months. The study showed a high efficacy of the treatment, i.e., a significant reduction in hair loss, as well as restoration of their structure and increase in volume. Also, after 2 and 4 months of treatment, there was a normalization of dermatoscopic picture of the scalp and an improvement in the special tests (PULL test). Thus, the use of the combined drug Selencin for SARS-CoV-2 virus-associated DA has a pronounced therapeutic effect. The drug can be used as the main treatment for this disease if it associated with COVID-19.

Hair loss is a common complaint, and an understanding of the hair cycle is vital in order to interpret whether hair loss is secondary to medication use, as the use of prescription medications is widespread. When there is a temporal association between the onset of hair loss and the commencement of a medication, the medication is commonly presumed to have caused the hair loss. Drug-induced alopecia is a result of either rapid termination of the normal growth phase (anagen effluvium) or a premature conversion of actively growing hairs into the dormant, resting phase (telogen effluvium). Hair loss, in particular telogen effluvium, may, however, occur in response to a number of triggers including fever, hemorrhage, severe illness, and stress. Because hair loss is often delayed and because diffuse alopecia often begins sub-clinically, it may be challenging to determine the primary of alopecia. As a rule of thumb, adverse drug reactions are reversible provided the causative drug is avoided; however, identifying the culprit medication can be difficult. This chapter will review the normal hair cycle and discuss the major drugs that have been associated with alopecia, along with their mechanism (s) of action.

Psychiatric factors in alopecia areata: A case report

Zinc is an essential element for hair growth and may act as a strong inhibitor in accelerating follicle regression, besides being an accelerator for the recovery of the hair follicle.This study investigated the status of zinc in Kurdish adults with hair loss and its relation with each of the four types of hair loss. We investigated the zinc status of a sample of Kurdish adults with hair loss who attended the Dermatology Outpatient Clinics at Azadi Teaching Hospital in Duhok, Kurdistan Region, Iraq. We included a total of 200 subjects in this study, of which 125 had hair loss with a diagnosis of alopecia areata, female pattern hair loss, male pattern hair loss, and telogen effluvium, and 75 were sex- and age-matched apparently healthy subjects without hair fall as a control group. Serum samples were used to measure zinc by colorimetric technique. In participants with hair loss, we found significantly lower serum zinc levels (p=0.002) compared with the control group. The telogen effluvium group had the lowest mean serum zinc level (p=0.006) and higher odds ratio compared with other hair loss groups (4.61). Overall, severe zinc deficiency was found in 12 (9.6%) subjects with hair loss, whereas none of the controls had severe zinc deficiency. Mild-to-moderate zinc deficiency was observed in 43 (34.4%) subjects with hair loss compared to one (1.3%) in the control group. Conclusions: Our results showed that lower zinc status is linked to hair loss, especially alopecia areata and telogen effluvium in the Kurdish population.

OBJECTIVES The study aimed to assess the effects of quarantine on non-scarring hair fall and to determine the relationship between sun exposure and hair fall. METHODOLOGY This cross-sectional study was conducted in Karachi from January to June 2022 . Ethical approval was taken from the institutional ethical review committee. Participants were recruited by non-probability convenience sampling technique after obtaining informed consent. Those with dermatologic diseases of the scalp (cicatricial alopecia, alopecia areata, seborrheic dermatitis, infections), high-stress levels, post-pregnancy, thyroid disorders, hormonal disorders and COVID-19 were excluded from the study. Hair loss was assessed using a self-filled questionnaire regarding the history of comorbidities, demographics, education, institute status during quarantine, hair fall experience and personal habits. RESULTSThe study consisted of 137 participants after exclusion criteria were applied. Among these, 95.6% complained of increased hair fall during quarantine. Most participants were women (63.4%) compared to men (36.6%). The average age of the hair fall group was 20 years. Only 15.3% of participants spent more than 1-2 hours in the sun, and the majority had their hair covered when going out during quarantine. CONCLUSION Hair fall is high during quarantine, particularly among women of young age group. Personal habits and exposure to the sun for a short time at noon can affect hair fall in quarantine, although no direct correlation was found. Hair fall during lockdown is inversely related to certain comorbidities.

Background: Hair loss, commonly associated with genetics, hormones, or health conditions, is prevalent. Dandruff, resulting in flaky scalp skin, is also widespread. Ayurvedic herbal remedies show potential for addressing these hair issues. This clinical trial assesses the efficacy and safety of an ayurvedic hair oil in healthy adults with hair loss (alopecia). The aim is to evaluate its purported benefits in reducing hair fall, stimulating hair growth and alleviating scalp dandruff. Methods: This 8-week study involved 30 subjects with hair fall. After obtaining subject consent, a test hair oil was applied topically. Assessments included evaluating hair-fall, scalp dandruff, hair-growth rate, density, and thickness. Ayurvedic assessment determined hair type. Phototrichogram, pluck-test measured growth, with endpoints including pull-test, combing-test, dermatological evaluation, and subjective questionnaires. Statistical analysis used R software (Version: 4.1.2). Results: The study revealed significant therapeutic efficacy. The mean hair-growth rate increased significantly by 227µm/day (79.92±69.31%) over 8 weeks (p<0.01). Hair-fall decreased by 63.49±21.44%, from 97 to 31 hairs. Hair-thickness and density improved by 34.26±16.36% (p<0.01) and 39.82±34.3% (p<0.01) respectively. Scalp dandruff showed a reduction of 76.33±15.95% (p<0.01). The A:T ratio shifted positively from 3:1 to 5:1, indicating an increase in hairs in the anagen phase. No adverse effects were observed. Conclusions: Consistent use of 'moha: 5-in-1' hair oil over 8 weeks was well-tolerated and found effective. It significantly decreased hair fall, promoted hair growth, and improved scalp health by reducing dandruff. This confirms its safety and efficacy among study participants, establishing it as suitable choice for holistic daily hair care.