Diffuse Hair Loss Research Articles

Topical Finasteride versus Topical Spironolactone in the Treatment of Androgenetic Alopecia

Abstract Background: Androgenetic Alopecia (AGA) is a non-scarring alopecia that affects both males and females. It is characterized by a progressive miniaturization of hair follicles with a characteristic pattern distribution in genetically predis-posed men and women. Topical finasteride is being investigated as a new treatment for AGA with fewer side effects than oral finasteride. Topical Spironolactone is the most commonly used off-label anti-androgen for the treatment of AGA. In the treatment of AGA, it acts by decreasing the production and competitively blocking the androgen receptor in the target tissue. Aim of Study: The aim of this study was to evaluate the role and compare the effect of topical finasteride and topical spironolactone in the treatment of (AGA). Patients and Methods: After meeting inclusion and ex-clusion criteria and diagnosis of AGA was clinically established by the characteristic distribution of frontal and vertex hair in males and the Christmas tree pattern of diffuse hair loss at middle hairline in females. It was dermosopically established by the characteristic hair shaft thickness heterogeneity, peripilar brown depressions (peripilar signs) and focal atrichia and also folliscope established for hair density. Cases included in this study had Norwad-Hamilton Scale types I to VII for men and Ebling Scale types I to IV for women. Result: Our study shows that a topical spironolactone is better than topical finasteride in male and female group. Conclusion: In this study, topical finasteride and topical spironolactone are good options for management of androgenic alopecia but topical spironolactone is better than topical finasteride with few side effects when compared to oral administration.

Ischemia-modified albumin as a possible marker of oxidative stress in patients with telogen effluvium

BackgroundTelogen effluvium is the most common form of non-scarring alopecia characterized by diffuse hair loss. Ischemia-modified albumin is a marker of oxidative stress and inflammation. ObjectiveThe aim of this study was to compare the levels of ischemia-modified albumin of telogen effluvium patients with healthy controls. MethodsNinety-one patients diagnosed with telogen effluvium and 35 healthy volunteers were included in the study. Serum ischemia-modified albumin level was determined by a fast-colorimetric method, and albumin cobalt binding test. The results were evaluated statistically. ResultsThere was no statistically significant difference between the serum albumin values of patient and control groups (p=0.739). Serum ischemia-modified albumin values were significantly higher in the patients with telogen effluvium than healthy controls (p<0.001). Study limitationsBody mass index values of the patient and control groups could not be calculated. ConclusionsTo the best of the authors’ knowledge, this is the first clinical study to investigate the role of oxidative stress in the pathogenesis of telogen effluvium using ischemia-modified albumin as a biomarker. Based on the results of the present study, it can be considered that oxidative stress plays an important role in the pathogenesis of telogen effluvium. There is a need for further studies to support the results of this study, to demonstrate the possible effects of oxidative stress, and to investigate the other oxidative stress markers in the pathogenesis of telogen effluvium.

Comparative Study on the Efficacy of Diphenylcyclopropenone Alone and in Combination with Intralesional or Systemic Corticosteroids for the Treatment of Extensive or Refractory Alopecia Areata

Abstract Background Alopecia areata (AA) is an autoimmune disorder characterized by transient, non-scarring hair loss with preservation of the hair follicle. It affects nearly 2% of the general population at some point during their lifetime. Extent of the disease can vary widely from localized hair loss in well-defined patches to diffuse or total hair loss, which can affect all hair-bearing sites. Patchy alopecia areata affecting the scalp is the most common type. Objectives The aim of this study is to evaluate the efficacy and safety of topical diphenylcyclopropenone alone and in combination with intralesional steroids or systemic steroids for the treatment of extensive and/or refractory cases of alopecia areata. Patients and Methods The study included 21 patients suffering from alopecia areata during January 2018 till November 2018. They were recruited from the Outpatient Clinic of Dermatology, Ain Shams University Hospital and El-houd EL-marsoud Hospital. All patients gave written consent to participate in this work after explanation of the technique, expectations, possible side effects and alternative treatments. The study was approved by Research Ethical committee of Ain Shams University. Results We found that about three quarters of AA patients were males and majority were young adults aged 15 to 50 years. The duration of the disease was more than one year and mean age of first onset was 15 years. About half of the patients was of refractory type. All patients recalled previous history of AA and 90% treated by combined therapy. Scalp was affected in all patients and eyebrow in half of them while nails were affected in 10%. Mean SALT score at time of presentation was 59%. Dermoscopic examination revealed that majority of the patients (95%) had yellow dots; two third had black dots and vellous hair; while exclamation and short thin hairs were found in approximately one third of the patients. The study found that there is statistically significant difference between mean SALT scores among the three treatment modality groups at start of treatment course specifically between group II (40.6 (±20.9)) and group III (82.5 (±21.7)) (p = 0.04). Conclusion DPCP is an effective and safe treatment of extensive and refractory AA especially with intralesional steroid. Older age at onset of the disease is good indicator for a better prognosis. No statistical significant difference between treatment modalities regarding response stratified by other demographic and clinical feature of AA patients.

Diffuse nonscarring hair loss of the scalp is an early sign of juvenile systemic lupus erythematosus: a case report

Juvenile systemic lupus erythematosus is a rare multisystemic autoimmune disorder characterized by several clinical and immunological features. In the present case, a 13-year-old female presented with diffuse nonscarring hair loss at the frontal and vertex of the scalp. The hairs were dry, fragile, and easily detached. She had patches of erythema on the palmar aspects of both hands. She had no other cutaneous, nail, or mucous membrane manifestations. Erythrocyte sedimentation rates were elevated. The titer of antinuclear antibody was positive, and anti-double strand DNA antibody was positive. Otherwise, all laboratory and radiological investigations were normal.

Serum ferritin and vitamin D levels should be evaluated in patients with diffuse hair loss prior to treatment.

IntroductionVarious factors like physiological and emotional stress, drugs and nutritional deficiencies can result in hair loss. Results of laboratory tests examining the underlying aetiology of hair loss vary in patients.AimWe aimed to compare the serum levels of ferritin, folate, vitamin B12, zinc, thyroid stimulating hormone and vitamin D in patients complaining of diffuse hair loss and in healthy individuals.Material and methodsFifty-four patients with hair loss (47 females, 7 males) and 55 healthy individuals within the control group (47 females, 8 males) were included in this study. Serum levels of ferritin, folate, vitamin B12, zinc, thyroid stimulating hormone and 25-hydroxyvitamin D were evaluated in all participants retrospectively.ResultsSerum concentrations of folate, vitamin B12, zinc and thyroid stimulating hormone were similar in the two groups. However, the mean serum ferritin and 25-hydroxyvitamin D levels were significantly lower in patients with hair loss than in healthy individuals. The mean serum ferritin levels of the patients and healthy individuals were 14.72 ±10.70 ng/ml and 25.30 ±14.41 ng/ml, respectively. The mean serum 25-hydroxyvitamin D levels of the patients and healthy individuals were 14.03 ±8.09 ng/ml and 17.01 ±8.59 ng/ml, respectively. Eleven (20.4%) patients had low serum ferritin levels, while 43 (79.6%) patients had low vitamin D levels.ConclusionsThe results obtained from this study reveal that serum ferritin and 25-hydroxyvitamin D levels are generally low in patients complaining of hair loss. Therefore, serum ferritin and vitamin D levels should be evaluated and supplemented prior to treatment in all patients complaining of diffuse hair loss.

Autosomal-dominant hypotrichosis with woolly hair: Novel gene locus on chromosome 4q35.1-q35.2.

Hypotrichosis simplex (HS) with and without woolly hair (WH) comprises a group of rare, monogenic disorders of hair loss. Patients present with a diffuse loss of scalp and/or body hair, which usually begins in early childhood and progresses into adulthood. Some of the patients also show hair that is tightly curled. Approximately 10 genes for autosomal recessive and autosomal dominant forms of HS have been identified in the last decade, among them five genes for the dominant form. We collected blood and buccal samples from 17 individuals of a large British family with HS and WH. After having sequenced all known dominant genes for HS in this family without the identification of any disease causing mutation, we performed a genome-wide scan, using the HumanLinkage-24 BeadChip, followed by a classical linkage analysis; and whole exome-sequencing (WES). Evidence for linkage was found for a region on chromosome 4q35.1-q35.2 with a maximum LOD score of 3.61. WES led to the identification of a mutation in the gene SORBS2, encoding sorbin and SH3 domain containing 2. Unfortunately, we could not find an additional mutation in any other patient/family with HS; and in cell culture, we could not observe any difference between cloned wildtype and mutant SORBS2 using western blotting and immunofluorescence analyses. Therefore, at present, SORBS2 cannot be considered a definite disease gene for this phenotype. However, the locus on chromosome 4q is a robust and novel finding for hypotrichosis with woolly hair. Further fine mapping and sequencing efforts are therefore warranted in order to confirm SORBS2 as a plausible HS disease gene.

Treating Female Diffuse Hair Loss Using Nourkrin® Woman (With Marilex®) - An Open-Label, Subjective, Outcome Study On Hair Growth And Appearance, Self-Confidence And Treatment Satisfaction

Treating Female Diffuse Hair Loss Using Nourkrin® Woman (With Marilex®) - An Open-Label, Subjective, Outcome Study On Hair Growth And Appearance, Self-Confidence And Treatment Satisfaction

Androgenetic alopecia in women. Trichoscopy as a diagnostic method to simplify the proper diagnosis — case report

Hair loss is a common problem seen in dermatology. Both women and men are affected. Androgenetic alopecia is one of the most frequent type of hair loss observed in women. The diagnostic process is complex and includes different noninvasive procedures, laboratory tests and sometimes requires scalp biopsy. Trichoscopy is fairly new and useful diagnostic method that enables making the right diagnosis. Treatment of hair loss is often complicated and long‑lasting but in some cases it may be helpful to follow recommendations of various scientific boards. Here, we present a case of a woman with diffuse hair loss whose trichoscopic examination allowed to diagnose androgenetic alopecia.

A case control study of relationship between body iron stores and non scarring diffuse hair loss in non menopausal women

A case control study of relationship between body iron stores and non scarring diffuse hair loss in non menopausal women - IJCED- Print ISSN No: - 2581-4710 Online ISSN No:- 2581-4729 Article DOI No:- 10.18231/2581-4729.2019.0017, IP Indian Journal of Clinical and Experimental Dermatology-IP Indian J Clin Exp Dermatol

Co-Morbidities Associated With Diffuse Hair Loss in Women

Co-Morbidities Associated With Diffuse Hair Loss in Women

Diffüz Saç Dökülmesi Olan Kadın Hastalarda Serum Demir, Ferritin, Çinko ve Folik Asit Düzeylerinin Değerlendirilmesi

Amaç: Diffüz saç dökülmesi kadınlarda en sık görülen saç hastalıklarından biridir ve etiyolojisinde pek çok faktör rol oynamaktadır .Bu çalışmanın amacı, diffüz tipte saç dökülmesi olan kadın hastalarda serum demir, ferritin, çinko ve folik asit düzeylerinin rolünü araştırmaktır. Gereç ve Yöntemler: Bu çalışmada Ekim 2017-Mayıs 2018 tarihleri arasında dermatoloji polikliniğine başvuran, son 6 aydır skar yapmayan saç dökülmesi olan 60 kadın hasta ile 60 sağlıklı kadın (kontrol grubu) incelendi. Kontrol grubu, nevus şikâyeti ile başvuran ve saç dökülmesi olmayan bireylerin dosyalarından retrospektif olarak taranarak oluşturuldu. İki grupta da sistemik hastalığı ve ilaç kullanım öyküsü olan bireyler ile gebelik, emzirme döneminde olan hastalar çalışma dışı bırakıldı. Her iki grubun serum demir, ferritin, çinko ve folik asit değerleri istatistiksel olarak karşılaştırıldı. Bulgular: Hasta grubunun yaş ortalaması 34,3 (17-53) yıl, kontrol grubunun ise 30,5 (16-56) yıl idi. Saç dökülmesi olan grupta, kontrol grubuna göre serum çinko ve folik asit düzeylerinin ortalaması daha düşük olmasına rağmen istatistiksel olarak anlamlı bir fark yoktu (p>0,05). Saç dökülmesi olan grupta kontrol grubuna göre serum demir, ferritin düzeylerinin ortalaması daha yüksek saptandı, fakat istatistiksel olarak anlamlı bir fark bulunamadı. (p>0,05). Sonuç: Saç dökülmesi yakınmasıyla gelen kadın hastalarda demir eksikliği anemisi, folat ve çinko eksikliği hastalığa neden olabilecek faktörler olarak düşünülmektedir. Laboratuvar testlerinde bir eksiklik tespit edilmediğinde, çinko, folik asit ve demir içeren preparatlarla tedavi uygulamasının etkisiz ve gereksiz olacağını düşünüyoruz.

A cross-sectional study of cutaneous changes in patients with acquired thyroid disorders

Background: Thyroid disorders are quite common in India. Thyroid hormone affects the skin and its appendages, and the cutaneous manifestations are more notable during deficiency or excess state. Apart from this, thyroid diseases are accompanied by various autoimmune dermatoses. Aim: The present study was designed to assess the dermatological manifestations in patients with thyroid disease. Materials and Methods: This was a hospital-based, cross-sectional, descriptive study conducted in a tertiary care center in Northern India over a period of 1 year. A total of 126 newly diagnosed patients with acquired thyroid disorders were enrolled in the study. All the patients were assessed for cutaneous, hair, nail changes, and associated autoimmune dermatological diseases. Results: Out of 126 patients, 113 had hypothyroidism and 13 had hyperthyroidism. Females outnumbered males in both the study groups. Some patients had more than one dermatological manifestation. The most common dermatological manifestation in hypothyroid patients was generalized xerosis (67.25%), followed by diffuse hair loss (47.78%) and coarse hair (44.24%). In hyperthyroid patients, the most common manifestation was thin soft hair (61.53%), followed by warm skin (53.84%) and Jellinek's sign (38.46%). Chronic urticaria was the most common associated autoimmune dermatological disease in both the study groups. Conclusion: In some instances, the initial and the most prominent complaint of the patient is related to alterations in the skin, and therefore, the dermatologist is at times being the first physician consulted. Identifying the endocrinopathy is very important so that the patients might receive corrective rather than symptomatic treatment.

Diffuse hair loss in females

Diffuse hair loss in females

CLINICAL NUTRITION PROGRAM IMPROVES FATIGUE, ANXIETY, BRAIN FOG AND IMMUNO-HORMONAL AND GASTROINTESTINAL SYMPTOMS IN A 40 YEAR OLD FEMALE WITH SYSTEMIC ERYTHEMATOUS LUPUS

Event Abstract Back to Event CLINICAL NUTRITION PROGRAM IMPROVES FATIGUE, ANXIETY, BRAIN FOG AND IMMUNO-HORMONAL AND GASTROINTESTINAL SYMPTOMS IN A 40 YEAR OLD FEMALE WITH SYSTEMIC ERYTHEMATOUS LUPUS Tatiana Habanova1* 1 The Pilates Wellness Center, United States Background: A 4o year old female presented with fatigue and anxiety in maintaining her work schedule as a dietician while caring for her two young children and living an active life. She required daily naps, many times working from home in bed. She had constant brain fog and difficulty finding words. She was often “under the weather” taking months to recover. She experienced painful menstrual cramps two weeks prior to menses which were themselves irregular. Constant irritable bowel symptoms, caused her to use activated charcoal to cope with severe bloating and discomfort. Strict sun avoidance was necessary otherwise a rash developed and she expressed great concern over her progressive diffuse patchy hair loss. A recent diagnosis of Systemic Erythematous Lupus (SLE) was made by a rheumatologist but she states her symptoms have been occurring for 2 years prior to diagnosis. No treatment was prescribed at time of diagnosis. Her diet was unrestricted, she drank red wine or light beer every other day, does not smoke, had exercise intolerance, slept well yet woke up fatigued, surgical history significant for cholecystectomy and a family history significant for gastrointestinal cancers. Methods: The patient had a strong adverse clinical reaction to Th-2 stimulators. Blood chemistry revealed lab low Total Cholesterol (131 mg/dl); functionally low Vitamin D (36 ng/ml); lab high CRP (5.6 mg/l), AST (49 U/L) and ALT (62 U/L); functionally high Monocytes (10.3%). She was placed on an anti-inflammatory diet and supplement protocol including sublingual vitamin D, turmeric, resveratrol, glutamine and multi-vitamin/mineral with therapeutic levels of chromium and vanadium. Results: After 120 days on her treatment plan, the patient reported significant improvements: hormonal and gastrointestinal symptoms, as well as patchy hair, lose resolved 100%; fatigue improved 95% with now only needing one nap per month and she now distinguishes feeling tired vs feeling fatigued and adjusts her activities accordingly to avoid “crashing”; she no longer experiences exercise intolerance and started gentle exercise four times per week without negative consequences; she was ill twice during her treatment plan both episodes resolved within two weeks; she can tolerate brief sun exposure (3-5 min) without a rash developing; and states her anxiety has reduced by 90% as she feels capable of living an active life and juggling her work schedule with family time while successfully managing her SLE symptoms. Conclusions: The author suggests further investigation into clinical nutrition and supplementation in the treatment of fatigue, anxiety, brain fog, and immune-hormonal and gastrointestinal symptoms, in patients with a history of SLE. The research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. Keywords: Autoimmunity, Systemic erythematous lupus, supplementation, Anti-inflammatory diet, Fatigue Conference: International Symposium on Clinical Neuroscience, Orlando, United States, 24 May - 26 May, 2019. Presentation Type: Poster Presentation Topic: Clinical Neuroscience Citation: Habanova T (2019). CLINICAL NUTRITION PROGRAM IMPROVES FATIGUE, ANXIETY, BRAIN FOG AND IMMUNO-HORMONAL AND GASTROINTESTINAL SYMPTOMS IN A 40 YEAR OLD FEMALE WITH SYSTEMIC ERYTHEMATOUS LUPUS. Front. Neurol. Conference Abstract: International Symposium on Clinical Neuroscience. doi: 10.3389/conf.fneur.2019.62.00072 Copyright: The abstracts in this collection have not been subject to any Frontiers peer review or checks, and are not endorsed by Frontiers. They are made available through the Frontiers publishing platform as a service to conference organizers and presenters. The copyright in the individual abstracts is owned by the author of each abstract or his/her employer unless otherwise stated. Each abstract, as well as the collection of abstracts, are published under a Creative Commons CC-BY 4.0 (attribution) licence (https://creativecommons.org/licenses/by/4.0/) and may thus be reproduced, translated, adapted and be the subject of derivative works provided the authors and Frontiers are attributed. For Frontiers’ terms and conditions please see https://www.frontiersin.org/legal/terms-and-conditions. Received: 09 Apr 2019; Published Online: 27 Sep 2019. * Correspondence: Dr. Tatiana Habanova, The Pilates Wellness Center, Wellington, United States, drhabanova@yahoo.com Login Required This action requires you to be registered with Frontiers and logged in. To register or login click here. Abstract Info Abstract The Authors in Frontiers Tatiana Habanova Google Tatiana Habanova Google Scholar Tatiana Habanova PubMed Tatiana Habanova Related Article in Frontiers Google Scholar PubMed Abstract Close Back to top Javascript is disabled. Please enable Javascript in your browser settings in order to see all the content on this page.

Synergism and antagonism of the components of essential micronutrients in the treatmentof diffuse hair loss (in Russian only)

Synergism and antagonism of the components of essential micronutrients in the treatmentof diffuse hair loss (in Russian only)

Vitmain D level in female pattern hair loss with normal androgen level

Objectives The aim of this study was to assess serum vitamin D level in women with female pattern hair loss (FPHL) to approve its relation in this disorder. Background FPHL is the main cause of diffuse hair loss in adult women and majorly affects patient's personal satisfaction. FPHL is the preferred term for androgenetic alopecia in women as the relation between androgens and this illness is not proved. Androgen excess has not been demonstrated in FPHL. The connection between serum 25-hydroxy vitamin D and FPHL has not been considered altogether. Patients and methods In this case–control study, we studied serum vitamin D level concentration among 31 FPHL patients aged 20–40 years in comparison with 31 healthy female controls matched for age, skin phototype, socioeconomic level, and outdoor exposure. Measurements were conducted by enzyme-linked immunosorbent assay. The study was conducted within a 4-month period, from July to October 2016. Results The mean serum vitamin D level was significantly lower in FPHL patients (18 ± 7.57 ng/ml) than in controls (35.09 ± 15.39 ng/ml; P Conclusion The lack or inadequacy vitamin D may assume a conceivable part in the pathogenesis of FPHL.

Bi-allelic Mutations in LSS, Encoding Lanosterol Synthase, Cause Autosomal-Recessive Hypotrichosis Simplex

Hypotrichosis simplex (HS) is a rare form of hereditary alopecia characterized by childhood onset of diffuse and progressive scalp and body hair loss. Although research has identified a number of causal genes, genetic etiology in about 50% of HS cases remains unknown. The present report describes the identification via whole-exome sequencing of five different mutations in the gene LSS in three unrelated families with unexplained, potentially autosomal-recessive HS. Affected individuals showed sparse to absent lanugo-like scalp hair, sparse and brittle eyebrows, and sparse eyelashes and body hair. LSS encodes lanosterol synthase (LSS), which is a key enzyme in the cholesterol biosynthetic pathway. This pathway plays an important role in hair follicle biology. After localizing LSS protein expression in the hair shaft and bulb of the hair follicle, the impact of the mutations on keratinocytes was analyzed using immunoblotting and immunofluorescence. Interestingly, wild-type LSS was localized in the endoplasmic reticulum (ER), whereas mutant LSS proteins were localized in part outside of the ER. A plausible hypothesis is that this mislocalization has potential deleterious implications for hair follicle cells. Immunoblotting revealed no differences in the overall level of wild-type and mutant protein. Analyses of blood cholesterol levels revealed no decrease in cholesterol or cholesterol intermediates, thus supporting the previously proposed hypothesis of an alternative cholesterol pathway. The identification of LSS as causal gene for autosomal-recessive HS highlights the importance of the cholesterol pathway in hair follicle biology and may facilitate novel therapeutic approaches for hair loss disorders in general.

Alopecias in lupus erythematosus

Several patterns of hair loss can occur in lupus erythematosus (LE). Alopecias which show histological characteristics of LE are LE-specific, and include discoid LE (DLE), diffuse or patchy hair loss...

Cystine-thiamin-containing hair-growth formulation modulates the response to UV radiation in an in vitro model for growth-limiting conditions of human keratinocytes

BackgroundUltraviolet radiation (UVR) is known to be harmful to normal human epidermal keratinocytes (NHEKs) of the epidermal skin layer, as well as to hair-follicle-associated keratinocytes. An oral formulation containing l-cystine, thiamin, calcium d-pantothenate, medicinal yeast, keratin and p-aminobenzoic acid (Panto[vi]gar®) has demonstrated clinical efficacy for the treatment of diffuse telogen effluvium; however, its mode of action at the cellular level, and in particular whether protective mechanisms are involved, has yet to be elucidated. ObjectivesTo assess the capacity of ingredients of this oral formulation, both separately and in combination, to modulate the effects of UVR in growth-limited NHEKs in vitro. MethodsNHEKs were incubated in keratinocyte basal medium, keratinocyte basal medium lacking cystine, thiamin, calcium d-pantothenate, folic acid and biotine (minimal growth medium [MGM]) or MGM plus test compound. Test compounds comprised the following four ingredients related to the oral formulation: l-cystine, thiamin, calcium d-pantothenate and folic acid (a proposed metabolite of p-aminobenzoic acid), and a combination of these (Panto[vi]gar®-in vitro correlate; P-IC). The effect of different doses of these compounds on the metabolic activity and proliferation of NHEKs was tested, as well as their influence on the impact of UV light on NHEKs assessed by monitoring metabolic activity, cell number and apoptosis induction. ResultsCompared with basal medium, MGM reduced the proliferation of NHEKs in a time-dependent manner. Reduced proliferation is a characteristic of the multifactorial and complex phenotype associated with diffuse hair loss. l-cystine (50 μM) increased metabolic activity and proliferation 3-fold versus MGM (p < 0.05). Thiamin also had a significant effect (p < 0.05) on proliferation and metabolic activity of NHEKs, but calcium d-pantothenate and folic acid did not when tested individually in this in vitro model. In the presence of P-IC, metabolic activity increased 4-fold and proliferation 3-fold compared with MGM alone (p < 0.05 for both).Following UV irradiation, cells in MGM showed a 72% reduction in metabolic activity, while P-IC-treated cells showed only a 12–18% reduction. The observed prevention of the UV-induced reduction in metabolic activity was not simply due to filtering UVR by the P-IC components, as P-IC-mediated reduction of this effect persisted even when P-IC was washed out during UV irradiation. ConclusionThis study demonstrated that l-cystine and thiamin are essential for proliferation of epidermal keratinocytes and suggests a novel, UV-protective potential of formulations combining l-cystine and thiamin in growth-limited inter-follicular NHEKs in vitro.

Comparative evaluation between two nutritional supplements in the improvement of telogen effluvium.

PurposeTelogen effluvium (TE) is defined as a diffuse hair loss characterized by shortening of the anagen phase and precipitation of the telogen phase, with a consequent reduction of total hair volume. Nutritional supplementation is indicated under conditions in which TE is related to dietary disorders. The aim of this clinical study was to compare the efficacy of two different supplements in monotherapy for TE.Patients and methodsFemale adult patients were randomized to receive two oral nutritional supplements (group 1: a supplement composed of zinc, biotin, iron, vitamins A, C, E, and B complex, folic acid, magnesium, and amino acids of keratin and collagen and group 2: calcium pantothenate cystine, thiamine nitrate, medicinal yeast, keratin, and aminobenzoic acid) to treat hair loss for 180 days. They were evaluated clinically and by digital trichoscopy.ResultsClinical evaluation showed significant clinical improvement (P<0.05) for the evaluated parameters: hair loss, hair volume, density of hair (scalp cover), hair shine, hair strength, in 180 days. At 90 days evaluation, group 1 showed significant improvement for all parameters, while group 2 did not show any significant improvement for hair shine and hair strength. In the digital trichoscopy, there was a significant improvement only in group 1 (11.09%×7.76%) after 180 days.ConclusionIn idiopathic TE, the nutritional component should be suspected; the supplementation of an association of nutrients in recommended daily intake can lead to significant improvement of the condition from the first trimester of use. The use of an association with proven efficacy and a safety profile and posologic convenience facilitate its indication and patient adherence.