Cause Of Hair Loss Research Articles

Comparison of a New 5% Minoxidil Foam and Rogaine® in the Treatment of Androgenetic Alopecia in Chinese Men: A Randomized, Double‐Blind, Phase III, Equivalence Trial

Androgenetic alopecia (AGA) is a common cause of hair loss in adults. We aimed to compare the efficacy and safety of topical generic 5% new minoxidil foam (NMF) versus 5% minoxidil Rogaine® foam in male patients with AGA. A randomized, double‐blind, controlled, phase III, equivalence trial in 10 centers in China between December 25, 2019, and June 28, 2021, was performed. In total, 417 men patients (≥18 years) with AGA were randomized to receive 5% NMF (211 patients) or 5% Rogaine® foam (206 patients) 1 g two times daily for 24 weeks. The primary outcome was the changes in nonvellus target area hair counts (TAHC) from baseline to week 24. Equivalence was concluded if the 95% confidence interval (CI) for the treatment difference between the 5% NMF and Rogaine® groups was within (−8.00, 8.00). After 24 weeks of treatment, the mean difference in the change of nonvellus TAHC between the 5% NMF group and the Rogaine® group was −3.85 ± 1.62 hair/cm2 in full‐analysis set (FAS) and −3.96 ± 1.68 hair/cm2 in per‐protocol set (PPS), and the 95% CI of mean difference was (−7.03, −0.67) in FAS and (−7.26, −0.66) in PPS. No significant differences were found between the two groups in hair diameter, the ratio of terminal hair to vellus hair, the global photographic assessment by investigators, and adverse events (all P > 0.05). 5% NMF is as effective as Rogaine® in increasing hair density and hair diameter in AGA patients and was found to be safe. This trial is registered with CTR20191708.

Comparison between topical cetirizine with minoxidil versus topical placebo with minoxidil in female androgenetic alopecia: a randomized, double-blind, placebo-controlled study

Androgenetic alopecia (AGA) is the most common cause of hair loss in both genders with a higher psychological impact on females. Currently, topical minoxidil is the only FDA-approved treatment for female AGA and it needs life-long application and causes side effects. Cetirizine is an antihistamine that may be effective in hair loss treatment. This study aimed to compare the efficacy and safety of topical cetirizine with minoxidil (group 1) versus topical minoxidil with placebo (group 2) in female patients with AGA. This was a double-blind, randomized, controlled, parallel study conducted at Dermatology Clinic, Cairo University Teaching Hospital (Kasr- Al- Ainy), Egypt. Sixty-six patients with female AGA, aged 20–50 years, Sinclair (II–IV), were randomly assigned to one of the 2 groups for 24 weeks. The trichoscopic parameters, patients’ self-assessment, side effects and global photographic assessment were evaluated. There was a statistically significant change from baseline in frontal and vertex terminal and vellus hair density (P < 0.0005) with a significant increase in vertex hair shaft thickness and average number of hairs per follicular unit in group 1 (P < 0.05). Patients reported significantly better scores in patient self-assessment in group 1 (P < 0.05). Side effects were not significantly different between groups (P > 0.05). Topical cetirizine increases hair shaft thickness and results in a higher clinical improvement from patients’ perspective with a good safety profile (NCT04481412, study start date: July 2020).

The Treatment of Chinese Medicine on Adolescent Alopecia

Hair is made of a kind of protein called keratin. Potential causes of hair loss in teenagers include genetic factors, hormonal imbalances, and underlying medical conditions, stressful or just not eating right .In some cases, hair loss can be reversible with proper treatment. Most of time, it will influence the youngster’s confidence in social activities. They usually feel inferior and don’t want to go out to play with friends. Also they prefer to wear a cap most of time even in indoors. However western medicine does not show a significant effect on it. Here through a case report, introduce the methods and curative effects of traditional Chinese medicine in the treatment of adolescent alopecia. The study was carried out over 10 months with oral intake of Chinese Medicine treatment and external use of Chinese Medicine on whole body on daily basis. The results showed a marked improvement in the hair loss on the patient.

Quality of life in patients with central centrifugal cicatricial alopecia: a preliminary study

Central centrifugal cicatricial alopecia (CCCA) is a common cause of hair loss among patients of African and/or Caribbean descent, and there is little data exploring the quality of life of patients with this condition. This pilot demonstrates that CCCA has a significant impact on overall quality of life, and patients may benefit from resources to address psychosocial aspects of this diagnosis.

ODP408 Elevated DHEAS and Acute Hair Loss in an Adult Male with Trichorhinophalangeal Syndrome Type 1: a Case of Male PCOS

Abstract Background Male androgenic alopecia is a common cause of hair loss in both men and women. Although genetic and hormonal factors likely play a role, the etiology is mostly unknown. PCOS is a highly heritable disease with elevated prevalence of reproductive abnormalities in first-degree relatives (FDRs) of patients with PCOS, which may be due to an underlying genetic defect in steroidogenesis. A recent meta-analysis revealed that male FDRs of patients with PCOS had significantly increased levels of DHEAS compared with controls. We present a young adult male who developed acute hair loss with biochemical evidence of hyperandrogenism. Clinical Case A 21-year-old man presented for evaluation of hyperandrogenism after experiencing progressive loss of posterior patch of hair over 3 weeks. He also endorsed acne, intermittent headaches, striae, and difficulty losing weight for the past 2 years. He denied facial rounding, vision changes, and use of glucocorticoids or supplements. Physical examination was notable for height of 67 inches, BMI 30.5 mg/m 2, BP 120/78, recession of the frontotemporal and occipital hairline, sparse posterior scalp hair, bulbous nose, long philtrum, mild facial acne, 2, 3 toe syndactyly, and thin purple striae on bilateral flanks and axillae. Labs revealed elevated DHEAS 1065.7 mcg/dL (ref. 238.4-539.3) and normal 8 AM total testosterone of 382 ng/dL (240-871). Cosyntropin stimulation test revealed baseline cortisol level of 10.6 mcg/dL with ACTH of 22.2 pg/mL (5-46) and 60-minute cortisol level of 24.8 mcg/dL, 17-OH progesterone level 81 ng/dL (18-164), and 17-OH pregnenolone 1040 ng/dL (55-455). Workup for Cushing's revealed multiple normal midnight salivary cortisol levels and mild intermittent elevation of 24-hour urinary free cortisol levels. CT scan of the adrenals was negative for a mass. Exome sequencing revealed a heterozygous de novo pathogenic variant (c.1614_1615delTCinsAT: p. C538X) in the TRPS1 gene (NM_0141112.2). Family history was significant for a 20-year-old sister with PCOS and elevated DHEAS of 443 ug/dL (51-321). Mid-parental height was 69.6 inches. Conclusion Trichorhinophalangeal syndrome Type 1 (TRPS1) is a rare genetic disorder characterized by hair, craniofacial, and skeletal abnormalities such as androgenetic alopecia, bulbous nasal tip, and cone-shaped epiphyses. To our knowledge, the hair findings in TRPS are not associated with hyperandrogenism which prompted further investigation. Evaluation for endocrine causes of hyperandrogenism such as Cushing's disease, congenital adrenal hyperplasia, and adrenal tumor were negative. However, our patient's elevated DHEAS is likely due to male PCOS, as previously described in male FDRs of patients with PCOS. Thus, genetic susceptibility to PCOS and rare genetic syndromes should be considered in the differential diagnosis of young men with clinical and biochemical evidence of hyperandrogenism. Reference: Shan D et al. Reproductive Health in First-degree relatives of Patients with Polycystic Ovarian Syndrome: a Review and Meta-analysis. JCEM. 2022 Jan;107(1); 273-295. Presentation: No date and time listed

Clinico-mycological profile and trichoscopic findings among pediatric tinea capitis patients: A cross-sectional study from northern India (Haryana)

Background: Tinea capitis (TC) is the most common cause of hair loss in pediatric patients leading to varied manifestations. Essentially, TC is a superficial infection which affects hair shaft, hair follicle, and the scalp. Aims and Objectives: The aims of this study were to describe the clinic-mycological characteristics and trichoscopic findings of TC among pediatric patients. Materials and Methods: This cross-sectional study was undertaken in Shaheed Hasan Khan Mewati, Government Medical College and Hospital after obtaining approval from the Institutional Ethics Committee. All the pediatric patients of TC enrolled during the study period of 1.5 year (between January, 2020 and June, 2021). Trichoscopy was performed and findings were recorded on a predesigned pro forma. All participants were clinically examined and sample of hair and scalp scrapping was taken for mycological investigation (potassium hydroxide [KOH] and Sabouraud Dextrose Agar culture). Results: Among 100 children of TC (M/F=2.2), gray patch type TC was most common, whereas pustular variant was least common. Trichoscopic findings were seen in all 100 cases with short broken hair being most common. Perifollicular scaling was statistically significant in gray patch TC, black dot, and comma shape in black dot TC and, crock screw hair and thick crust in kerion TC. By combining perifollicular scaling, comma hair, short-broken hair, black dot, and erythema, a sensitivity of 98.8% was achieved. KOH revealed fungal spore/hyphae in 79% patients with ectothrix pattern (56.9%) more commonly than endothrix pattern (34.2%). Trichophyton violaceum (25.9%) was the most common species isolated among culture positive patients. Conclusion: Trichoscopy could be a simple, valuable, non-invasive, rapid, and easy to perform method for diagnosing tinea capitis in resource poor settings, where mycological culture facility is not available and in situations where delay in treatment can be counterproductive.

Evaluating the Efficacy of Platelet Rich Plasma and 1550 nm Fractional Laser in Combination and Alone for the Management of Androgenetic Alopecia.

Androgenetic alopecia (AGA) in men and women is the most common cause of hair loss. Affected individuals may experience psychological distress and social withdrawal. Current treatment options for AGA, such as minoxidil and finasteride, vary in efficacy and have side effects. Platelet-rich plasma (PRP) and photobiomodulation are among treatment options that have gained popularity in recent years. While less is known about the effectiveness of fractional lasers for combating hair loss, research suggests that by creating microscopic thermal injury zones, fractional lasers may cause an increase in hair growth from a wound healing process. In this study, we evaluated the efficacy and safety of PRP and 1550 nm fractional erbium-glass laser as monotherapy or combination treatment for AGA in 60 patients. All patients experienced improvement in AGA, but patients treated with the combination therapy had greater improvement in hair density. Overall, PRP and 1550 nm in combination or alone are good treatment choices for AGA, with no side effects. J Drugs Dermatol. 2022;21(11):1166-1169. doi:10.36849/JDD.6750.

The Triumph of JAK Inhibitors for the Treatment of Alopecia Areata

Alopecia areata (AA), with a disease incidence of 2% in the USA, is the most common immune-mediated cause of hair loss in the world. There were no FDA approved treatments for AA in the past. All treatment modalities used alone or in combination with each other, were prescribed off label. The JAK inhibitor baricitinib was approved by the FDA in June 2022. While it’s a significant leap forward, we are still missing the safety profile data in multiple areas. Topical JAK inhibitors are being tested along with sublingual options including tofacitinib, ruxolitinib, and ritlecitinib. In this review, we discuss the JAK inhibitor baricitinib in detail, along with its dosing regimen, challenges presented in the clinic, missing data, and what the future may hold.

A clincodermoscopic evaluation of chronic diffuse hair loss among females in a Tertiary Care Center

Background: Diffuse alopecia in females is a common complaint and still a major challenge in the practice of dermatology. Female androgenetic alopecia (FAGA), chronictelogen effluvium (CTE), and diffuse alopecia areata(AA) are its three main causes for diffuse hair loss. It is often difficult one from the other and clinical data, physical examination, biochemical tests, dermoscopy, and some cases biopsy may be needed for a definitive diagnosis.In this study, scalp dermoscopy as a main tool used to differentiate between different causes of hair loss and definitive role of dermoscopy in the treatment follow up. Objectives: Our aim is to evaluate and determine dermoscopic findings of different causes of diffuse alopecia that can be used as the clinical indicator of the disease. Another aim is to study the correlation of haemoglobin, S. ferritin and TSH levels in different causes of diffuse alopecia in females. Methods: Total50 patients were enrolled for this prospective study and was conducted for a period of 6 months. Detailed history, Clinical examination, Dermoscopic evaluation, complete hemogam, S. ferritin and Thyroid profile was done. Results: Most of them (66%) were between age group 18 to 30. Out of total cases 31 cases were TE, 9 cases were FAGA, 7 cases of diffuse Alopecia. Dermoscopic findings seen were yellow dots in 41 patients, thinning of hair in 33 patients, vellus hairs in 14 patients, peripilar sign in 12 patients, hair diameter diversity more than 20 % (HDD) in 8 patients, exclamation mark hair in 7 patients, honey comb pigment pattern and loss of follicles in 3 patients each. Conclusion: In TE cases most common dermoscopic findings were Yellow Dots, In FPHL most common and specific finding was HDD &gt; 20%. A thorough dermascopic evaluation and follow up is must for different patterns of hair loss among females.

BH08: A rare cause of hair loss in a child

BH08: A rare cause of hair loss in a child

A study to compare the efficacy and safety of platelet rich plasma and topical minoxidil fortified with finasteride in the treatment of androgenic alopecia in male patients

: Androgenetic alopecia (AGA) is one of the most common causes of hair loss among men and has very limited treatment options. Platelet‑rich plasma (PRP) seems to be a new technique which may improve hair regrowth and has shown promising results. : This study was aimed at comparing the efficacy and safety of intradermal platelet rich plasma (PRP) therapy and topical minoxidil (5%) fortified with finasteride (0.1%) in the treatment of androgenetic alopecia. : This was a prospective interventional study. In the study, patients were randomized into two groups – Group A (given PRP therapy) and Group B (given minoxidil fortified with finasteride therapy). Both groups were followed up over a period of 12 months, and final analysis was done with the help of global photography, standardized hair growth questionnaire, patient satisfaction score. A total of 60 patients clinically diagnosed with AGA were enrolled in the study with 30 patients in each group. : At the end of 12 months, 60 patients were evaluated to compare the efficacy of intradermal PRP and topical minoxidil therapy. It was observed that at end of 12 month, 22 (73.3%) patients in group A showed 1-25% improvement in hair growth and 8 (26.7%) patients showed 26-50% improvement while in group B 21 (70%) had 1-25% improvement in hair growth and 8 (26.7%) had 26-50% improvement.

Evaluating the Role of lncRNAs in the Incidence of Cardiovascular Diseases in Androgenetic Alopecia Patients.

Hair loss occurs in patients with Androgenetic Alopecia (AGA). The pattern of hair loss is different between men and women. The main cause of hair loss is increased cell apoptosis and decreased regeneration, proliferation and differentiation processes in hair follicles. Long Non-Coding RNAs (lncRNAs) are one of the most important molecules that regulate the processes of apoptosis, regeneration, proliferation and differentiation in hair follicles. Since studies have shown that lncRNAs can be effective in the development of cardiotoxicity and induction of cardiovascular disease (CVD); so effective lncRNAs in the regulation of regeneration, proliferation, differentiation and apoptosis of hair follicles can be involved in the development of CVD in AGA patients with. Therefore, this study investigated the lncRNAs involved in increasing apoptosis and reducing the processes of regeneration, proliferation and differentiation of hair follicles. The aim of the current study was to evaluate the role of lncRNAs as a risk factor in the incidence of CVD in AGA patients; it will help to design treatment strategies by targeting signaling pathways without any cardiotoxicity complications.

Optimal use of topical minoxidil in management of female pattern hair loss in India: an expert opinion

&lt;p&gt;Female pattern hair loss (FPHL) is a common cause of hair loss and is associated with a reduction in quality of life and psychological morbidity. It is characterised by nonscarring progressive thinning of hair with gradual reduction in the number of hairs, with prevalence increasing with advancing age. A differential diagnosis of FPHL includes conditions like chronic telogen effluvium, diffuse alopecia areata, and some cases of scarring alopecia such as frontal fibrosing alopecia. A comprehensive history and thorough clinical examination are essential in establishing the diagnosis of FPHL. Additionally, dermoscopy is a valuable tool for appropriate diagnosis, specifically in early stages of the disease. Due to the chronic course and progressive nature of FPHL, long-term management is essential for sustained effects. Medical treatment with minoxidil remains the mainstay treatment for FPHL. Other therapeutic modalities include topical therapies like biomimetic peptides, systemic therapies like oral anti-androgen drugs such as finasteride and spironolactone as well as oral minoxidil in selected cases. Dermatosurgical procedures like platelet rich plasma, microneedling, low level laser and hair transplantation have been used. The role of diet has also been debated. The current article provides an overview on the optimal use of topical minoxidil for management of FPHL in Indian clinical practice.&lt;/p&gt;

Natural products for male androgenetic alopecia.

Androgenetic alopecia (AGA) is the most common cause of hair loss in men, often requiring medical attention. The US FDA approved topical minoxidil and oral finasteride to treat AGA. Topical minoxidil requires a long-term application to observe improvement; oral finasteride may cause undesirable side effects. Therefore, natural products may be an alternative when patients are skeptical about these two conventional treatments. Physicians may also suggest natural products in conjunction with topical minoxidil or oral finasteride to enhance clinical outcomes. This article reviews the prospect of natural products in treating male AGA. A systematic search was conducted in PubMed, CINAHL, Scopus, Web of Science, and EMBASE (Ovid) on July 19, 2021. In addition, the bibliographies of selected articles were hand-searched to identify relevant studies. After deduplication and screening, 11 clinical studies meet the criteria for detailed review. The selected clinical studies suggest that saw palmetto, caffeine, melatonin, marine extracts, rosemary oil, procyanidin, pumpkin seed oil, and cannabidiol oil might be considered in male AGA treatment.

Comparative histological and immunohistochemical study on the effect of platelet rich plasma/minoxidil, alone or in combination, on hair growth in a rat model of androgenic alopecia

BackgroundAndrogenic alopecia (AGA) is the commonest cause of hair loss in men with limited treatment options. Aim of the workTo compare the efficacy of PRP and minoxidil on experimentally induced AGA in adult male albino rats. Materials and methodsThirty male albino rats were used. Group I (control group). Group II (AGA group): received testosterone only. Group III: received topical minoxidil. Group IV: received PRP /three days. Group V: received PRP and topical minoxidil. ResultsGroups III, IV, and V showed significant increase in mean epidermal thickness, mean numbers of total hair follicles and anagen hair follicles, and decrease in telogen hair follicles compared to AGA group. Group V showed the best results. AGA group showed perifollicular fibrosis and follicular streamers. They were absent in PRP group and group V. Significant decrease of Ki-67 positive cells in AGA. PRP and minoxidil groups showed a significant increase in number of Ki-67 positive cells compared to control and AGA groups. Group V showed the highest number of Ki-67 positive cells. ConclusionPRP was more effective than minoxidil in treatment of experimentally induced AGA in rats. The best results were obtained when PRP and minoxidil were administered together.

Telogen effluvium after COVID-19 vaccination among public in Saudi Arabia.

Number of reports linked Telogen effluvium to coronavirus disease 2019 (COVID-19) infection. However, data about Telogen effluvium after COVID-19 vaccination are limited. To estimate prevalence of Telogen effluvium among those who received COVID-19 vaccination. A cross-sectional study was performed during July 2021. Adults who received one of recognized COVID-19 vaccine irrespective of previous COVID-19 infection were asked to fill a questionnaire. The majority of participants were females (90.3%). The most common age group was between 21 and 30 years (51.9%). Out of 991 participants who were included in the current analysis, 670 (67.6%) reported post-vaccination hair fall. The probable causes of post-vaccination hair fall were vaccine-related in 185 (27.6%) participants, other causes in 326 (48.7%) participants, and unclear in 326 (48.7%) participants. Post-vaccination hair fall was significantly higher among females compared with males (68.5% versus 57.9%, P = 0.036), those who did not suffer compared with those who suffered from hair fall before vaccination (72.1% versus 63.4%, P = 0.003), and those who did not report compared with those who reported preexisting conditions that might be related to hair fall (74.5% versus 57.3%, P < 0.001). We are reporting a high prevalence of post-vaccination hair fall, which affected approximately two-thirds of participants who received COVID-19 vaccines. Only 28% of these participants were apparently vaccine related. The role of COVID-19 infection and stress caused by infection and vaccine cannot be excluded. Primary care physician and dermatologist need to consider the possibility of COVID-19 vaccine as a potential cause of hair loss.

Minoxidil, Platelet-Rich Plasma (PRP), or Combined Minoxidil and PRP for Androgenetic Alopecia in Men: A Cost-Effectiveness Markov Decision Analysis of Prospective Studies.

BackgroundAndrogenetic alopecia (AGA) is the most common cause of hair loss in men. In this study, we evaluated the cost-effectiveness of minoxidil monotherapy, minoxidil and platelet-rich plasma (PRP) combined therapy, and PRP monotherapy for the long-term treatment of early-onset AGA Hamilton-Norwood stages I-V in men.MethodologyMarkov modeling was performed to analyze the base-case parameters from 18 level I/II studies. The model base-case assumes a healthy 25-year-old man presenting to a dermatologist or plastic surgeon’s office as a new patient for the evaluation and treatment of AGA Hamilton-Norwood stages I-V (non-severe AGA in men). Simulations began at an age of 25 years and ran over 35 years. Analyses were conducted from healthcare and societal perspectives. Outcomes included incremental cost-effectiveness ratios (ICER) and net monetary benefits (NMB). Willingness-to-pay (WTP) thresholds were set at $50,000 and $100,000. Deterministic and probabilistic sensitivity analyses were performed to evaluate uncertainty over 10,000 simulations.ResultsFrom a healthcare perspective, compared to minoxidil monotherapy, the ICER for minoxidil+PRP was $52,036/quality-adjusted-life-year (QALY) and the ICER for PRP monotherapy was $439,303/QALY. The NMB of minoxidil monotherapy was $914,887, minoxidil+PRP was $914,350, and PRP monotherapy was $904,572 at a WTP threshold of $50,000. When the WTP threshold was increased to $100,000, the NMB of minoxidil+PRP was $1,843,908, minoxidil monotherapy was $1,831,237, and PRP monotherapy was $1,822,246. Societal trends were similar.ConclusionsMinoxidil 5% topical twice-daily monotherapy provided cost-effective treatment for men with AGA Hamilton-Norwood stages I-V at a WTP threshold of $50,000, whereas combining minoxidil 5% with PRP provided cost-effective treatment at a WTP threshold of $100,000.Level of evidence: Level II.

Significance of iron levels in patients with non-cicatricial alopecias: a cross sectional study

&lt;p class="abstract"&gt;&lt;strong&gt;Background: &lt;/strong&gt;Among all the nutritional causes of hair loss, iron levels are found to be important key nutrient. Synthesis of hair involves many steps which require iron as a cofactor. The intention of present study is to evaluate relationship between iron and hair loss. The objectives of the study are to study the clinical patterns, demographic and epidemiological factors associated with hair loss and to find association between iron study parameter (Hb, serum iron, serum ferritin, TIBC) and hair loss.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods: &lt;/strong&gt;The study was a cross section- observational study, conducted among the patients with diagnosed non-cicatricial alopecias from June 2018 to April 2019. A total of 50 study participants were recruited. Specific investigations like hair pull test and trichogram were done. Chi square test was applied and p&amp;lt;0.05 was considered significant.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results:&lt;/strong&gt; Among the total 50 participants 35 (70%) were males and 15 (30%) were females. Mean (±SD) age was 44 (±9.5) years. Mean (SD) of haemoglobin, serum iron, TIBC and ferritin are 9.6 (±2.6), 75.5 (±50), 365 (±54) and 106 (±87) respectively. Trichogram result proves telogen hair- 22 (44%), dystrophic hair loss- 14 (28%) and anagen hair loss-14 (28%). Hair pull test was positive in 27 (54%). Higher proportion of male pattern hair loss was associated with lower haemoglobin and low serum ferritin levels. (p value -0.046, 0.031)&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; Significant association was found between the diagnosis of non cicatricial alopecia and mean values of haemoglobin and serum ferritin with lower haemoglobin and low serum ferritin was mostly associated with male pattern hair loss.&lt;/p&gt;

Investigation of plasma thiol/disulfide balance in male patients with androgenetic alopecia.

Androgenetic alopecia (AGA) is the most common cause of hair loss in men. In addition to genetic and hormonal factors, oxidative stress (OS) is suggested as a factor in the etiology. In this study, we aimed to investigate the presence of OS due to thiol disulfide balance deterioration in male patients with AGA. A total of 45male AGA patients and 42healthy male controls were included in the study. Native thiol, disulfide, and total thiol levels were assessed through automated spectrophotometry. The relationship between total protein, albumin, native thiol, disulfide, and total thiol levels in addition to demographic and clinical characteristics of the patients were examined. The mean age of the patients was 32.6±10years, and the median AGA duration in the patients was 3years. There was no statistically significant difference in terms of native thiol, disulfide, total thiol levels, disulfide/total thiol, disulfide/native thiol, and native thiol/total thiol ratios between AGA patients and controls. Native thiol and total thiol levels negatively correlated with age and AGA duration, while disulfide levels only correlated with age.Albumin and native thiol levels were significantly lower in patients with low vitamin D levels (p=0.040 and p=0.021, respectively); however, total thiol and native thiol/total thiol ratio values were significantly higher. According to this study, thiol disulfide homeostasis is in balance in male patients with AGA. In patients with emotional stress and vitamin D deficiency, the balance appears to be shifted in favor of oxidative stress.

How can we assess severity and treatments in frontal fibrosing alopecia?

British Journal of DermatologyVolume 185, Issue 6 p. e204-e204 Plain Language Summary How can we assess severity and treatments in frontal fibrosing alopecia? First published: 17 December 2021 https://doi.org/10.1111/bjd.20791AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat Abstract Linked Article: Olsen et al. Br J Dermatol 2021; 185:1221–1231. Frontal fibrosing alopecia (FFA) is one of the most common causes of permanent or scarring hair loss. This distressing condition may affect both sexes and all races, although it is most common in post-menopausal white women. The cause of this hair loss condition is unknown, although there may be a genetic susceptibility and hormonal factors may be important. The associated inflammation in the scalp occurs at the level of where the hair follicle stem cells reside, leading to permanent loss of the follicle and the hair shaft that it produces. Classically there is slowly progressive hair loss affecting the front of the scalp and the temples often with redness and scaling around the follicle openings. Some patients notice itching or burning at the involved sites. Eyebrow hair loss occurs in almost 90% of individuals and can precede the scalp hair loss. To date, treatment is usually with antinflammatory topical and systemic agents and anti-androgens but clinical trials assessing the effectiveness of each treatment are currently lacking. In this paper, an international team of experts in hair disorders from 21 countries sought to obtain a consensus agreement on the criteria for diagnosing and assessing the severity of FFA. Each recommendation needed at least 90% agreement from authors for acceptance. A point scoring method that includes clinical features as well as features seen on biopsy (where a small section of tissue is removed for testing) allows for two categories of FFA – those with the typical hairline recession and those who may present with some of the alternate findings first. Other clinical features that are frequently seen with FFA are tiny yellowish or skin-coloured bumps (papules) on the face and prominent veins on the forehead and they are included in a staging recommendation that captures all of the main clinical features. The authors also propose a method of assessing the degree of hair loss or regrowth after treatment through measuring hair density across the affected scalp before and at set timepoints in follow-up after treatment. Recommendations for a quality of life tool to assess patient response to treatment is also noted. The authors hope these guidelines will allow the collection of accurate and reproducible clinical and laboratory data, providing the means to both determine the cause of FFA, and to assess the safety and effectiveness of treatment. Volume185, Issue6December 2021Pages e204-e204 RelatedInformation