Androgenic Alopecia Patients Research Articles

Research work of Prof. De-Eknamkul, including the mechanistic synergy of hair growth promotion by the Avicennia marina extract and its active constituent (avicequinone C) in dermal papilla cells isolated from androgenic alopecia patients

Androgenetic alopecia (AGA) is a genetically-predetermined disorder that affects many people around the world, leading to progressive hair loss. This baldness can negatively impact people’s perceptions of themselves and scientists are searching for a cure. There are only two US Food and Drug Administration-approved drugs used to treat AGA and they both have side effects. If a natural anti-AGA product could be developed with the ability to be effective minus negative side effects, this could be a game-changer for people with AGA. Professor Wanchai De-Eknamkul, Department of Pharmacognosy and Pharmaceutical Botany, Chulalongkorn University, Thailand, an expert in plant natural product biotechnology, is working to develop a natural anti-AGA product. He is a professor at the University’s Natural Product Biotechnology Research Unit, where research is underway to: elucidate the biosynthesis of bioactive natural products by searching for enzymes and genes involved in their biosynthetic pathways; discover bioactive natural compounds from medicinal plants by either enzyme-based or cell-based screening followed by studying their mechanism of actions; and develop high-performance thin-layer chromatography (HPTLC) as a tool for quick screening and identification of bioactive compounds. De-Eknamkul have been working to shed light on the genes and enzymes involved in the biosynthesis of the diterpenoid ‘plaunotol’ in Croton stellatopilosus. In another line of investigation, they are searching for natural compounds with anti-AGA and anti-grey hair activities and a further area of focus is the development of a technique for direct detection of compounds with anti-diabetes, anti-gonorrhoea and anti-AGA activities.

Autologous Micrografts Containing Nanovesicles, Exosomes, and Follicle Stem Cells in Androgenetic Alopecia: In Vitro and In Vivo Analysis Through a Multicentric, Observational, Evaluator-Blinded Study.

The use of micrografts (MCGs) containing human follicle mesenchymal stem cells (HF-MSCs) is a hair loss (HL) treatment that needs to be standardized as seems to have promising effects on hair regrowth (HR-G) also thanks to the presence of extracellular vesicles (EVs). The study aims to report both the in vivo results, obtained in patients affected by androgenic alopecia (AGA) treated using MCGs, and in vitro analysis characterizing the EVs. A multicentric, retrospective, observational, evaluator-blinded study was conducted. Eighty-three AGA patients were initially enrolled [52 suffering from male pattern hair loss (MPHL) at stages I-III vertex by the Norwood-Hamilton scale and 31 suffering from female PHL (FPHL) at stages I-II by the Ludwig scale]. Sixty patients (20 females and 40 males) were treated and analyzed after exclusion and inclusion criteria assessment. The in vivo HR-G was evaluated through photography, physician's, and patient's global assessment scales, in addition to standardized photo-trichograms, during a follow-up for 1 year, while the in vitro analysis was performed through a quantitative, morphological, and dimensional characterization of the EVs population using transmission electron microscopy (TEM) and fluorescent microscopy. A hair density (HD) increase of 28 ± 4hairs/cm2 at T4 after 12 months in the targeted area (TA) of FPHL, compared with the baseline, was observed using computerized trichograms with a statistically significant difference (SSD) in hair regrowth (HR-G) (p = 0.0429). Regarding MPHL, an HD increase of 30 ± 5hairs/cm2 at T4 after 12 months in the TA was observed with an SSD in HR-G (p = 0.0012). The presence of EVs and their interaction with the surrounding cellular population were demonstrated. MCGs containing HF-MSCs and exosomes may fill in as a safe and viable alternative treatment against HL in mild and moderate degrees of AGA both in MPHL and in FPHL. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Characterization of distinct microbiota associated with androgenetic alopecia patients treated and untreated with platelet-rich plasma (PRP).

Androgenic alopecia (AGA) is the most common type of hair loss in men, and there are many studies on the treatment of hair loss by platelet-rich plasma (PRP). The human scalp contains a huge microbiome, but its role in the process of hair loss remains unclear, and the relationship between PRP and the microbiome needs further study. Therefore, the purpose of this study was to investigate the effect of PRP treatment on scalp microbiota composition. We performed PRP treatment on 14 patients with AGA, observed their clinical efficacy, and collected scalp swab samples before and after treatment. The scalp microflora of AGA patients before and after treatment was characterized by amplifying the V3-V4 region of the 16 s RNA gene and sequencing for bacterial identification. The results showed that PRP was effective in the treatment of AGA patients, and the hair growth increased significantly. The results of relative abundance analysis of microbiota showed that after treatment, g_Cutibacterium increased and g_Staphylococcus decreased, which played a stable role in scalp microbiota. In addition, g_Lawsonella decreased, indicating that the scalp oil production decreased after treatment. The findings suggest that PRP may play a role in treating AGA through scalp microbiome rebalancing.

Autologous Stem Cell-derived Therapies for Androgenetic Alopecia: A Systematic Review of Randomized Control Trials on Efficacy, Safety, and Outcomes.

Androgenic alopecia (AGA), a prevalent and extensively studied condition characterized by hair loss, presents a significant global issue for both men and women. Stem cell therapy has emerged as a promising therapeutic approach for AGA due to its regenerative and immunomodulatory properties. The primary objective of this systematic review was to assess the current literature on the efficacy and safety of cellular and acellular stem cell-derived therapies in the management of AGA. A computerized literature search was conducted in ClinicalTrials.gov, PubMed, and Cochrane Library in October 2023. The online screening process was performed by three independent reviewers with the Covidence tool. The protocol was reported using the Preferred Reporting Items for Systematic Review and Meta-Analyses, and it was registered at the International Prospective Register of Systematic Reviews of the National Institute for Health Research. The search yielded 53 articles from 2013 to 2023. Twelve randomized controlled trials were included. Stem cells and their derivatives were isolated from human adipose tissue, hair follicles, bone marrow, umbilical cord blood, and exfoliated deciduous teeth. These trials showed that stem cell-derived treatments can promote hair regeneration and density. Both cellular and acellular stem cell-based therapies are safe and effective in improving hair regeneration and density in AGA patients. Although the outcomes may be temporary in some cases, regenerative treatments may become useful adjuncts in combination with traditional methods of hair transplantation. Future research should focus on protocol optimization to enhance long-term patient outcomes.

Assessment of cardiovascular risk factors in male androgenetic alopecia: A case control study in a tertiary care hospital of western Odisha

Androgenic alopecia (AGA) is the most common cause of patterned hair loss among males which is characterized by progressive hair loss from the bi-temporal and vertex regions of the scalp. Although previous epidemiological studies found an association between metabolic syndrome (MetS), and cardiovascular disease (CVD) risk among adult AGA male patients, there has been no comprehensive research till now to establish this correlation between AGA and cardiovascular risk and there is a paucity of data regarding this association. Two hundred men were included in the study, N = 100 AGA patients included in the patient group, and the rest in the control group. In both groups, the parameters for MetS such as family history, socioeconomic status, obesity, blood pressure, and lipid profile), and in the presence of the CAA plaques and carotid intima-media thickness (CIMT) using Doppler ultrasonography were established. The degree of AGA was asses by using the Hamilton-Norwood grade (I-VII) system for males. Statistical analysis was performed using the Chi-square test. AGA was found in 11.6% of OPD patients, whereas 3 patients have CAA plaque and 6 cases have C-IMT from the patient's group. There was a statistical association between male AGA with MetS, and insulin-resistant patients (P = 0.001 and 0.0004, respectively). A positive family history of AGA patients, hypertension, DM, and CVD was found to be significantly more frequent in study cases than in the controls (P <0.05). Patients with AGA appear to have a highly prevalent risk of developing CVD and CAA plaque. Therefore, clinical evaluation of each AGA patient’s cases is needed, especially for grade III and above which may help prevent CVD in the future. Timely intervention and lifestyle changes in male AGA patients can fulfil the ultimate objective of reducing cardiovascular complications in the future.

A Machine Learning Algorithm Applied to Trichoscopy for Androgenic Alopecia Staging and Severity Assessment.

Androgenic alopecia (AGA) staging is still based on macroscopic scales, yet the introduction of trichoscopy is gradually bringing an important change, even though it remains an eye-based method. However, recently developed artificial intelligence-assisted programs can execute automated count of trichoscopic patterns. Nevertheless, to interpret data elaborated by these programs can be complex. Machine learning algorithms might represent an innovative solution. Among them, support vector machine (SVM) models are among the best methods for classification. Our aim was to develop a SVM algorithm, based on three trichoscopic patterns, able to classify AGA patients and to calculate a severity index. We retrospectively analyzed trichoscopic images from 200 AGA patients using Trichoscale Pro® software, calculating the number of vellus hair, empty follicles and single hair follicular units. Then, we elaborated a SVM model, based on these three patterns and on sex, able to classify patients as affected by mild AGA or moderate-severe AGA, and able to calculate the probability of the classification being correct, expressed as percentage (from 50% to 100%). This probability estimate is higher in patients with more AGA trichoscopic patterns and, thus, it might serve as a severity index. For training and test datasets, accuracy was 94.3% and 90.0% respectively, while the Area Under the Curve was 0.99 and 0.95 respectively. We believe our SVM model could be of great support for dermatologists in the management of AGA, especially in better assessing disease severity and, thus, in prescribing a more appropriate therapy.

Mechanistic synergy of hair growth promotion by the Avicennia marina extract and its active constituent (avicequinone C) in dermal papilla cells isolated from androgenic alopecia patients.

Androgenic alopecia (AGA) is associated with an increased production of 5α-dihydrotestosterone (DHT) by steroid-5α-reductase (5α-R). Crude extracts from Avicennia marina (AM) and its active constituent, avicequinone C (AC), can inhibit 5α-R. We have, herein, explored the potential use of the AM extract and of AC as anti-AGA agents. To this end, we employed human dermal papilla cells (DPCs) isolated from AGA patients' hair that express 5α-R type-1 as well as the androgenic receptor (AR) at high levels. Our in vitro experiments revealed that the AM extract (10 μg/mL) and the AC (10 μM) exhibit multiple actions that interfere with the mechanism that causes AGA. Beside acting as 5α-R inhibitors, both preparations were able to inhibit either the DHT-AR complex formation or its translocation from the cytoplasm into the nucleus (the site of DHT's action). The treatments also increased the gene expression of growth factors in DPCs; these factors play important roles in the angiogenesis associated with hair growth. Moreover, the AM extract suppressed the apoptotic pathway, thereby postponing the initiation of the catagen phase. Taken together, our findings suggest that the AM extract and the AC could serve as natural sources for hair growth promotion and AGA treatment.

Application of lncRNA-miRNA-mRNA ceRNA network analysis in the treatment of androgenic alopecia.

Long noncoding RNAs (lncRNAs) can be used as competitive endogenous RNAs (ceRNAs) to bind to microRNAs (miRNAs) to regulate gene expression. Previous studies have demonstrated that ceRNAs play an important role in the development of tumors. However, it is not clear whether the lncRNA-miRNA-mRNA ceRNA network plays a role in androgenic alopecia (AGA). The hair follicles of three AGA patients and three healthy individuals were collected for high-throughput whole transcriptome sequencing to screen for differentially expressed lncRNAs. Differentially expressed lncRNA target genes were subjected to databases to predict miRNA-mRNA and lncRNA-miRNA relationship pairs, and a ceRNA network was constructed using Cytoscape software. Relative expression was verified by real-time quantitative reverse transcription-polymerase chain reaction (qRT-PCR). 84 lncRNAs were significantly differentially expressed between the hair follicles of AGA patients and those of healthy individuals; 30 were upregulated, and 54 were downregulated. The top 10 upregulated lncRNAs were ENST00000501520, ENST00000448179, ENST00000318291, ENST00000568280, ENST00000561121, ENST00000376609, ENST00000602414, ENST00000573866, ENST00000513358, and ENST00000564194. The top 10 downregulated lncRNAs were ENST00000566804, ENST00000561973, ENST00000587680, ENST00000569927, ENST00000340444, ENST00000424345, ENST00000589787, NR_024344, NR_073026, and NR_110001. The qRT-PCR validation results and receiver-operating characteristic curve analysis indicated that one upregulated lncRNA, LOXL1-AS1 (ENST00000564194), had the most significant clinical diagnostic potential. After further analysis, it was concluded that LOXL1-AS1 could be used as a sponge to target hsa-miR-5193, thereby regulating TP53 expression. The ceRNA network-regulating AGA was constructed through high-throughput sequencing. Our study also identified a key lncRNA that is possibly related to the AGA pathological process.

Exploring the Mechanisms and Molecular Targets of Taohong Siwu Decoction for the Treatment of Androgenetic Alopecia Based on Network Analysis and Molecular Docking.

PurposeTaohong Siwu decoction (THSWD) is traditionally used to treat androgenic alopecia (AGA) in clinical practice of traditional Chinese medicine. This study used a network pharmacology approach to elucidate the molecular mechanism governing the effect of THSWD on AGA.Materials and MethodsThe major active components and their corresponding targets of THSWD were screened. AGA-related targets were obtained by analyzing the differentially expressed genes between AGA patients and healthy individuals. The protein–protein interaction networks of putative targets of THSWD and AGA-related targets were visualized and merged to identify the candidate targets for THSWD against AGA. Gene ontology (GO) biological processes and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis for core targets were performed. Finally, the key effective components and core targets screened were verified by molecular docking.ResultsIn this study, 69 compounds and 202 compound targets of THSWD, as well as 1158 disease targets, were screened. Forty-five interactive targets were identified for constructing the “ingredient-targets” network. The functional annotations of target genes were found to be related to oxidative stress, reactive oxygen species, and hydrogen peroxide. Pathways involved in the treatment of AGA included apoptosis and PI3K-AKT signaling pathways. The luteolin, quercetin, kaempferol, baicalein, and beta-carotene were identified as the vital active compounds, and AKT1, TP53, JUN, CASP3 and MYC were considered as the core targets. Assessment of molecular docking revealed that these active compounds and targets had good-binding interactions.ConclusionThe results indicated that the effects of THSWD against AGA may be related to anti-inflammation and anti-oxidation properties of the compounds through the specific biological processes and the related pathways.

Regenerative Biotechnologies in Plastic Surgery: A Multicentric, Retrospective, Case-Series Study on the Use of Micro-Needling with Low-Level Light/Laser Therapy as a Hair Growth Boost in Patients Affected by Androgenetic Alopecia

A new biotechnology based on micro-needling (MND) with low-level light/laser therapy (LLLT) that is used for hair re-growth (HR-G) needs to be standardized. The study aims to report the clinical outcomes resulting from a multicentric, retrospective, observational, case-series study in which MND with LLLT was used on patients affected by androgenic alopecia (AGA). Twenty-six patients were initially enrolled of which 15 males were classified as stages I–III of vertex by the Norwood–Hamilton scale, and 11 females was classified in stages I–II by the Ludwig scale. Twenty patients (10 females and 10 males) were analyzed after their screening (the exclusion and inclusion criteria evaluation). The HR-G assessment was evaluated with photography, as well as the physician’s and patient’s global assessment scales, in addition to standardized phototrichograms, during a short follow-up at T0-baseline, T1-16 weeks. Encouraging results represented by a hair density increase of 12 ± 2 hairs/cm2 at T1 after 16 weeks (16 weeks vs. 0 weeks) in the targeted area, compared with the baseline results (59 ± 2 hairs/cm2 at T1 versus 47 ± 2 hairs/cm2 at baseline), were observed using computerized trichograms with a statistically significant difference in hair re-growth (p = 0.0238). The effectiveness of MND with LLLT use has been demonstrated in mild to moderate AGA patients.

The prevalence of metabolic syndrome in male patients of early onset androgenic alopecia compared to age matched controls

<p class="abstract"><strong>Background:</strong> Androgenic alopecia is most common type of non-scarring alopecia in men. It is associated with high risk of cardiovascular events. Aim was to study the prevalence of metabolic syndrome in male patients of early onset androgenic alopecia.</p><p class="abstract"><strong>Methods:</strong> A case-control study was conducted at the dermatology out-patient department over a period of 6 months which included 100 patients of androgenic alopecia and 100 age matched controls. All subjects were aged 20 to 35 years and underwent detailed history, clinical examination including trichoscopic examination and measurement of waist circumference and blood pressure. Fasting blood sugar, triglyceride and high-density lipoproteins were tested following overnight fasting. Diagnosis of metabolic syndrome was based on criteria of national cholesterol education program (NCEP) adult treatment panel III. Chi square test was used as a test of significance. P value <0.05 was considered statistically significant.<strong></strong></p><p class="abstract"><strong>Results:</strong> Prevalence of metabolic syndrome was more in androgenic alopecia patients than in controls (48% versus 18%, p value <0.001). Androgenic alopecia patients had higher prevalence of increased waist circumference (76% versus 28%, p value <0.0001), increased diastolic blood pressure (32% versus 12%, p value=0.007), increased serum triglycerides (46% versus 24%, p value=0.0011) and decreased serum high-density lipoproteins (36% versus 18%, p value=0.0042) compared to controls.</p><p class="abstract"><strong>Conclusions:</strong> Early screening for metabolic syndrome and its components is beneficial in patients with androgenic alopecia to reduce cardiovascular mortality.</p>

Evaluation of the Effectiveness of Personalized Treatment of Trace Element and Vitamin Status in Men with Initial Stages of Androgenic Alopecia Treated with Conservative Therapy

Background. Androgenic alopecia (AGA) is the most common form of pathological hair loss with multiple micronutrient disorders involvedin its occurrence and development.
 Aimto evaluatethe effectiveness of personalized treatment of micronutrient deficiencies in patients with early stages of AGA and conservative therapy using a vasodilator drug minoxidil based on evidence-based medicine.
 Methods. A total 48 patients with stages IIV of AGA (according to the NorwoodHamilton scale) were recruited to experimental prospective clinical study evaluating the effectiveness of pharmaceutical forms of trace elements and vitamins. The primary diagnosis of micronutrient deficiency was carried out by comparing laboratory parameters of patients with AGA and 25 healthy volunteers. After that, conservative treatment with 5% topical minoxidilin AGA patients was enriched with 2-month personalized systemic supplementation of pharmaceutical forms of trace elements and vitamins. At the end of the study, the correspondence between changes in trace elements and vitamins content in the plasma and the trichogram parameters before and after conservative therapy was assessed.
 Results. The majority (96%) of the examined patients with AGA were characterized by mono- or polynutrient deficiencies. Personalized correction made it possible to restore the content of Se, Mg, Fe and vitamin E to the baseline levels and to achieve a significant increase in Zn, vitamin D and folic acid plasma content. The relationship between changes in the level of micronutrients and trichogram parameters was recorded only for Se (decrease in anagen hairs: r = 0.43; p = 0.037; decrease in hair density: r = 0.45; p = 0.028) and folic acid (an increase in anagen hairs: r = 0.41; p = 0.024); the positive effect of vitamin E on hair density was also detected.
 Conclusion. The results of the study allow to recommend a personalized treatment of folic acid and vitamin E deficiencies, with possible refusal to use the Se-containing drugs in conservative therapy of patients with the early stages of AGA.

Research on Mental Stress Recognition of Depressive Disorders in Patients With Androgenic Alopecia Based on Machine Learning and Fuzzy K-Means Clustering.

Under the new trend of industry 4.0 software-defined network, the value of meta heuristic algorithm was explored in the recognition of depression in patients with androgenic alopecia (AGA), and there was an analysis on the effect of comprehensive psychological interventions in the rehabilitation of AGA patients. Based on the meta heuristic algorithm, the Filter and Wrapper algorithms were combined in this study to form a new feature selection algorithm FAW-FS. Then, the classification accuracy of FAW-FS and the ability to identify depression disorders were verified under different open data sets. 54 patients with AGA who went to the Medical Cosmetic Center of Tongji Hospital were selected as the research objects and rolled into a control group (routine psychological intervention) and an intervention group (routine + comprehensive psychological interventions) according to different psychological intervention methods, with 27 cases in each group. The differences of the self-rating anxiety scale (SAS), self-rating depression scale (SDS), Hamilton depression scale (HAMD), and physical, psychological, social, and substance function scores before and after intervention were compared between the two groups of AGA patients, and the depression efficacy and compliance of the two groups were analyzed after intervention. The results showed that the classification accuracy of FAW-FS algorithm was the highest in logistic regression (LR), decision tree (DT), K-nearest neighbor (KNN) algorithm, support vector machine (SVM) algorithm, and random forest (RF) algorithm, which was 80.87, 79.24, 80.42, 83.07, and 81.45%, respectively. The LR algorithm had the highest feature selection accuracy of 82.94%, and the classification accuracy of depression disorder in RF algorithm was up to 73.01%. Besides, the SDS, SAS, and HAMD scores of the intervention group were lower sharply than the scores of the control group (p < 0.05). The physical function, psychological function, social function, and substance function scores of the intervention group were higher markedly than those of the control group (p < 0.05). In addition, the proportions of cured, markedly effective, total effective, full compliance, and total compliance patients in the intervention group increased obviously in contrast to the proportions of the control group (p < 0.05). Therefore, it indicated that the FAW-FS algorithm established in this study had significant advantages in the recognition of depression in AGA patients, and comprehensive psychological intervention had a positive effect in the rehabilitation of depression in AGA patients.

Relationship between the exercise and severity of androgenic alopecia.

Androgenic alopecia (AGA) is the most common type of alopecia. At present, the study on AGA mostly focuses on drugs, laser technology and hair transplantation, while the lifestyle factor that may delay the course of AGA and improve the condition of AGA is neglected. This study aims to investigate the relationship between the exercise and severity of androgenic alopecia, and to help AGA patients to choose suitable forms and amounts of exercise. Patients, who were diagnosed with AGA from May 13, 2020 to August 25, 2020, were the subjects of the survey. Through the internet online questionnaire survey, the information regarding demographics, exercise forms (lifestyle exercises, stretching exercises, aerobic exercises, and anaerobic exercises), exercise frequency (0-2 times/week, 3-4 times/week, and 5-7 times/week), exercise duration (<30, 30-60, and >60 min/time), and family history (androgenic alopecia, alopecia areata, and scarring alopecia) was obtained. Combination of patient self-assessment and doctor's photo examination was used to evaluate the changes (improvement, aggravation, and natural course) of the condition after 6 months of exercise. Single factor analysis and logistic regression analysis were used to study the factors related to the changes before and after exercise. A total of 592 AGA patients were recruited. Among them, 215 were male patients (36.32%), and 377 were female patients (63.68%); 91 patients (15.37%) were improved after 6 months of exercise, 448 patients (75.68%) were in natural progress, and 53 patients (8.95%) were aggravated. A total of 439 AGA patients were involved in non-life sports. After 6 months of exercise, 137 patients (31.21%) with scalp itching and scaling were reduced, 65 patients (14.81%) with greasy scalp was reduced, and 204 patients (46.47%) with anxiety and depression symptoms were improved compared with the previous period, and 356 patients (81.10%) showed that their sleep quality was improved compared with before. The changes in the condition before and after exercise are related to exercise style (P<0.001), exercise frequency (P=0.033), exercise duration (P=0.044), but not related to gender (P=0.358) and family history (P=0.052). The degree of improvement in AGA patients, who performed aerobic exercise, was 5.416 times of those who only performed life-like exercises (OR=5.416, P<0.001); the degree of improvement in AGA patients with each exercise time >60 min was 3.106 times of those with each exercise time <30 min (OR=3.106, P=0009). Doing aerobic exercise or each exercise time >60 min helps to delay the progress of AGA and improve the symptom of AGA.

SULT1A1 (Minoxidil Sulfotransferase) enzyme booster significantly improves response to topical minoxidil for hair regrowth.

Minoxidil is a widely used over-the-counter topical treatment for hair loss. The response rate for topical minoxidil is relatively low. Minoxidil is a pro-drug, converted to its active form, minoxidil sulfate, by SULT1A1 enzymes located in the scalp. Recently, a novel topical formula that increases the activity of SULT1A1 in hair follicles was reported. To evaluate any benefit of applying the SULT1A1 enzyme booster prior to daily 5% minoxidil treatment. Male androgenic alopecia patients were recruited to a randomized blinded placebo-controlled study. Patients were randomized to receive 5% topical minoxidil plus the novel formula or minoxidil plus a sham adjuvant. Patient's hair growth was monitored using global photography over 60days. Twenty-four males with androgenic alopecia (Norwood scale average 4.4, range 2-6) were randomized and completed the trial: 12 in the active arm and 12 in placebo. 75% of the subjects who used the SULT1A1 adjuvant with their daily minoxidil treatments for 60days regrew hair versus 33% of those using the placebo adjuvant (p=0.023). In a small cohort of androgenetic alopecia men, adding the SULT1A1 adjuvant to their daily minoxidil treatment regimen improved hair regrowth.

Autologous stromal vascular fraction cells combined with platelet-rich plasma for androgenic alopecia treatment: a case series

Background: Stromal vascular fraction cells (SVFs), which can be produced using a mechanical or digestive enzymatic process, are heterogeneous cells with the potential to grow hair in androgenic alopecia patients. Platelet-rich plasma (PRP) is an autologous cell source that is widely used to treat androgenic alopecia. However, the combined use of PRP and SVFs to treat alopecia is rarely reported. Case presentation: This case series describes three cases of androgenic alopecia, including a32-year-old male, a 43-year-old male, and a 65-year-old male. Androgenic alopecia in these patients was treated by injecting the bald area of the scalp with local autologous PRP combined with SVFs. Follow-up was performed 1–3 months after treatment, which showed good results. The hair grew denser, with increased thickness for each strand. The hair pull test revealed that the hair remained intact. Conclusion: The combination of PRP and SVFs affected all cycles of the hair growth process. SVFs are multipotent cells with the potential to become antioxidant, anti-inflammatory, or anti-fibrotic cells. SVFs can regenerate cells that secrete the growth factors, that are essential for angiogenesis, which can improve therapeutic outcomes. This case series will enrich the existing literature by expanding available treatment options for androgenic alopecia.

Carotid Intima-Media thickness (C-IMT) in androgenic alopecia patient

Bachground: Androgenic alopecia is a prevalent hair loss that affects 80% of males and 50% of women throughout their lives. The objective of this research was to evaluate the thickness of the Carotid Intima-Media (C-IMT) in young androgenic alopecia patients. Methods: The research comprised 30 young women with AGA. Furthermore, 30 people who were seemingly healthy, age and sex matched as a control group. All patients were chosen from the Dermatology and Andrology outpatient clinic, Benha University Hospitals. Every patient was exposed to With history, dermatological exam to assess the severity of AGA, via general clinical examination and excluding other skin conditions, Laboratory Investigations: Serum lipid profile: serum cholestenol, triglycerides (TGs), lipoprotein (HDL) high density and lipoprotein of very low density (VLDL), Carotid intima-media thickness measurement (C-IMT) Results: In patients and lipid profile controls, there was no statistically significant difference. In the sick group, there was a statistically significant rise in CIMT compared to the control group. Conclusion: Increased CIMT susceptibility to atherosclerosis in AGA patients is indicative.

A Scoping Review of Pharmacotherapy, Complementary, and Alternative Medicine (CAM), and Surgical Therapies for Androgenic Alopecia

Androgenic alopecia (AGA) is the most common form of non-scarring alopecia, affecting millions of men and women in the United States (U.S.). This review highlights alternative and complementary treatment options for AGA. The treatment regimens for AGA have increased in pharmacotherapeutics, surgical, and complementary (CAM) categories. Each of the different treatment approaches can now be utilized by dermatologists to combat patient hair loss. The U.S. Food and Drug Administration (FDA) has approved only two agents to treat AGA: prescription-only, oral finasteride and over-the-counter (OTC), topical minoxidil. Increased availability of therapies claiming hair regrowth properties, coupled with limited pharmacotherapeutic options for AGA, lead patients to seek alternative treatments. Increased awareness of the current evidence supporting complementary and alternative therapies among dermatologists will facilitate appropriate and timely education of AGA patients.

Trichoscopic features of androgenic alopecia and telogen effluvium

Introduction: Hair loss is a cause of emotional and mental distress, especially in the modern age of social media. Hair loss can be classified as Cicatricial and Non-Cicatricial, based on the permanence of the damage wrought to the hair follicles. The conditions selected for evaluation in this particular study are androgenetic alopecia and telogen effluvium, owing to their higher rate of incidence and their amenable response to timely intervention.Trichoscopy aids in diagnosis, determination of biopsy site and acts as a prognostic tool. In this study, we will enumerate trichoscopic features of the scalp in androgenic alopecia (AGA) and telogen effluvium (TE) on the basis of follicular patterns, interfollicular patterns and hair signsMaterial and Methods: It is a cross-sectional and observational study is suited for estimating the prevalence of each trichoscopic feature in AGA and TE. The study was conducted in the Department of Dermatology, Venereology and Leprosy, Subbaiah Institute of Medical Sciences, Shimoga, Karnataka. The study was conducted between January 2020 to December 2020 with sample size of 100 patients.Results: In the 100 cases of AGA and TE, 69% had AGA and 31% TE. Hair pull test was positive in 90% patients of TE. Yellow dots (69%), empty hair follicles, (65%) peripilar sign (71%), vellus hair (95%) and variation in hair shaft diameter in frontotemporal areas (98%) are the characteristic findings in AGA patients. The follicular features present in TE are peripilar sign (10%), yellow dots (29%) and vellus hair (30%). The characteristic finding is that the variation in hair – shaft diameter is prevalent in fronto-temporal (15%) and occipital areas (65%).Conclusion: The characteristic follicular features on Trichoscopy observed in AGA were peripilar sign, yellow dots and empty hair follicles. The characteristic hair shaft pattern observed was vellus hair. Variation in hair shaft diameter was more prevalent in fronto-temporal areas. TE is said to be a disease of exclusion on Trichoscopy. It is important to differentiate this condition from AGA, where-in the variation in hair shaft thickness is present in fronto-temporal areas and absent in occipital area.

Hair Loss Severity and its Impact on Quality of Life in Patients Suffering from Androgenic Alopecia

Background: Androgenic alopecia (AGA) is a common form of nonscarring alopecia encountered in daily dermatology practice. Both apparent and imperceptible AGA has a significant impact on an individual's personality, where physical appearance plays an important role in the probable prospects for marriage as well as other social aspects. Hair loss, thus, can severely hamper them for both men and women with clinical severity of alopecia not necessarily correlating with the quality of life (QoL) of the patient. Objectives: The objective is to assess the QoL in patients with AGA attending a tertiary care hospital in western India and compare QoL with hair loss severity (HLS), rated by both dermatologist and patient. Materials and Methods: One hundred and four patients, clinically diagnosed with AGA, consenting for the study over a period of 1 year were included. Demographic data of the patients were recorded. QoL was assessed using skindex-16 questionnaire; HLS was assessed through self-administered questionnaires completed by patients and dermatologists. Data were analyzed using Wilcoxon signed-rank test, Kendall's tau correlation coefficients, and Chi-square test. Results: The mean global score of Skindex–16 was 45.75 ± 16.90, with highest scores from emotions (64.93 ± 23.26). A positive correlation was found between the patients' HLS rating (r = 0.33, P &lt; 0.0001) and the clinical HLS rating. However, patient rated the extent of their hair loss as more severe than the dermatologist. Patient-related HLS significantly correlated with the mean global score of Skindex–16 (P &lt; 0.0001) as well as with all the subdomain scores (P &lt; 0.0001), whereas dermatologist-rated HLS only significantly correlated with the global score of Skindex–16 (P = 0.04) but not with the subdomain scores. Limitations: As Skindex-16 is a self-reported questionnaire, there may be a recall bias. Another limitation of our study is the sample size; a study with a bigger sample size is required to vindicate our findings. Conclusion: The study demonstrates that AGA patients perceived their HLS as more severe than the dermatologist. Both patient-related HLS and dermatologist-rated HLS showed statistical correlation with the total global Skindex-16 score. Hence, dermatologists need to be more alert and should address the psychosocial and QOL issues, when treating patients with AGA.