Global Photographic Assessment Research Articles

Meta-Analysis of Efficacy of Platelet-Rich Plasma Combined with Minoxidil for Androgenetic Alopecia.

Androgenetic alopecia (AGA) is a prevalent type of hair loss that impacts individuals of both genders. Platelet-rich plasma (PRP) and minoxidil have been employed as therapeutic interventions for AGA, yet the efficacy of their concurrent use remains ambiguous. To perform a comprehensive review and meta-analysis aimed at evaluating the effectiveness of platelet-rich plasma (PRP) in combination with minoxidil for the treatment of androgenetic alopecia (AGA). We conducted a comprehensive search of the databases PubMed, Embase, Web of Science, and Cochrane Library, encompassing their complete records up until December 2023. Eligible studies were randomized controlled trials that compared the combination of PRP and minoxidil with minoxidil or PRP alone in patients with AGA. The primary outcome measure was the change in hair growth as assessed by the hair density or hair thickness. Secondary outcome measures included patient satisfaction, and global photographic assessment. A total of 6 studies involving 343 participants were included in this meta-analysis. The results showed that PRP combined with minoxidil significantly improved hair growth compared to minoxidil or PRP alone. The pooled analysis demonstrated a significant increase in hair density (weighted mean difference [WMD] = 9.14; 95% confidence interval [CI]: 6.57-11.70) and hair diameter (WMD = 4.72; 95% CI 3.21-6.23) in the PRP combined with minoxidil group. Moreover, patients receiving PRP combined with minoxidil reported higher satisfaction rates compared to those using minoxidil or PRP alone. This meta-analysis suggests that PRP combined with minoxidil is an effective treatment for AGA, providing significant improvement in hair growth and patient satisfaction. 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 .

Efficacy and safety of spironolactone versus bicalutamide in female pattern hair loss: A retrospective comparative study.

Female-pattern hair loss (FPHL) is characterized by decreased scalp hair density, thinning of hair shafts, and progressive miniaturization of hair follicles. To compare the safety and efficacy of spironolactone versus bicalutamide in female pattern hair loss [FPHL]. The study design was retrospective, and all eligible females aged between 18 years and 50 years with FPHL were included. We identified 120 patients from our database who fulfilled the inclusion and exclusion criteria, and patients were then categorized into two groups, Group A comprising patients who were taking 100 mg of spironolactone once daily and Group B comprising patients who were taking 50 mg of bicalutamide once daily along with topical minoxidil 2% in both groups. Patient were analysed at approximately at 24 weeks from the commencement of the treatment. Mean reduction in hair loss severity score on Sinclair scale was 19.51% in spironolactone group compared to 28.20% in bicalutamide group at 24 weeks, which was statistically significant. On global photographic assessment, marked improvement was seen in bicalutamide group compared to spironolactone group (p = 0.139). Our study, though limited by its retrospective design and small sample size, showed that bicalutamide has greater efficacy and better safety profile in comparison to spironolactone in the treatment of FPHL.

A Randomized Controlled, Single-Observer Blinded Study on the Safety and Efficacy of a Combination of 678nm Helmet-Type Low-level Laser Therapy and Topical Minoxidil 5% Versus Topical Minoxidil 5% Alone in the Treatment of Male Androgenetic Alopecia

Male pattern androgenetic alopecia is a chronic, progressive condition with significant social and psychological impact. Few preliminary researches have been done on the role of low-level laser therapy as a treatment modality for male pattern hair loss. This is a randomized, controlled, single-observer blinded clinical trial conducted from November 2019 to October 2021 at the East Avenue Medical Center Dermatology Out-Patient Department on the use of low-level laser therapy and topical minoxidil for the treatment of androgenetic alopecia. Twenty-four male adults with Norwood Hamilton Hair Loss Scale of IIa to V were randomly assigned into 2 groups: a control group (monotherapy with topical minoxidil 5%) and a treatment group (678 nm helmet-type low-level laser therapy and topical minoxidil 5%). A statistically significant higher increase in hair density was observed in the treatment group (14.58 and 15.08 for the right and left sides, respectively) compared to the control (5.83 on the right and 5.50 on the left, respectively, p=.000 <.05). In addition, the investigator’s global photographic assessment and patient satisfaction were also significantly higher. Both treatments were well tolerated. The results of this study show that 678 nm helmet-type low-level laser therapy is an effective adjunctive treatment modality to topical minoxidil 5% solution for the treatment of male androgenetic alopecia.

Therapeutic maintenance effect of finasteride 1 mg every other month regimen in androgenetic alopecia and study on the difference in response to finasteride treatment: A prospective cohort study.

Finasteride is commonly used for androgenetic alopecia (AGA) treatment. The aim of this study was to assess the therapeutic maintenance effect of a finasteride every other month (EOM) regimen and analyze clinical and laboratory differences in patients with AGA according to their treatment response. One hundred males with AGA who received finasteride 1 mg daily treatment for a year were enrolled in the study. At 1 year follow-up, treatment responses of patients who completed the visit schedule were assessed using five scales. The patients were assigned to good or bad response groups according to their assessment. Further, they were randomly divided into two groups (daily vs. EOM) and treated with finasteride (1 mg) for 1 more year. At 2 years follow-up, treatment efficacy was assessed. At 1-year follow-up, 36 patients completed the schedule, including eight and three patients in the good and bad response groups, respectively. At the 2-year follow-up, 23 patients completed the schedule, with nine in the daily group and 14 in the EOM group. Changes in global photographic assessment in the second year were 1.33 and 1.29 for the daily and EOM groups, respectively. The daily group showed an elevated hair density and lower concentration of dihydrotestosterone (DHT) and the DHT to testosterone ratio (DHT/T). However, the EOM group showed decreased hair density and elevated DHT and DHT/T. Following treatment response assessment after 1 year of treatment, the good response group showed early onset which was associated with maternal AGA. Analysis of serum androgen hormone magnitude of DHT reduction was much greater (54.4% vs. 44.4%). DHT/T was higher in the bad response group (1.98 vs. 2.33). We concluded that the finasteride EOM regimen showed similar maintenance effects to the daily regimen.

Efficacy of autologous dermal sheath cup cell transplantation in male and female pattern hair loss: A Single-Arm, Multi-Center, phase III equivalent clinical study.

A previous, proof-of-concept clinical study suggested that dermal sheath cup cell injections into the affected areas of male/female pattern hair loss (PHL) may have some amelioratory effects, the clinical efficacy of which needs further examination. A phase III equivalent clinical study was conducted to further probe the therapeutic potential of this novel approach and verify its safety and efficacy in improving the appearance of PHL. Thirty-six participants with PHL were injected with dermal sheath cup cell harvested from non-affected occipital hair follicles twice in quarterly intervals. Global photographic assessment and phototrichogram were performed in a blinded manner. Patient-reported outcomes were assessed for 12 months. On global photographic assessment, 30% of the participants showed improvement. The analysis of phototricogram data detected the increases in the cumulative hair diameter, hair cross-sectional area, and mean hair diameter of 107.6 ± 152.6 μm/cm2 , 13069.1 ± 10960.7 μm2 /cm2 , and 0.9 ± 0.9 μm (ratios vs. baseline: +1.4%, +3.4%, and +2.2%), respectively. The female and high terminal hair ratio groups achieved better improvement. Of the total participants, 62.9% noted some degree of improvement. No serious adverse events were detected. This novel approach exhibited visible effects while ensuring safety and patient satisfaction. Therefore, it holds promise as a possible therapeutic option for treating PHL, especially in women.

Efficacy, Tolerability, and Superiority of Propylene Glycol-Free, North American Witch-Hazel (Hamamelis virginiana)-Based Solution of 5% Minoxidil Sulfate for the Treatment of Female Androgenetic Alopecia.

Androgenetic alopecia leads to progressive hair loss in susceptible individuals if left untreated. Topical minoxidil represents an evidence-based treatment for female androgenetic alopecia, though with variable success. Treatment of minoxidil non-responders remains challenging, as does treatment of patients with propylene glycol sensitivity or irritable scalp syndrome. Single-center, retrospective cohort of 50 female patients with androgenetic alopecia failing to respond to a minimum of 6 months of standard 5% topical minoxidil solution either once daily or b.i.d. depending on the severity of the alopecia. Patients were switched to propylene glycol-free, North American Witch Hazel (Hamamelis virginiana)-based solution of 5% minoxidil sulfate (5% minoxidil sensitive solution). Efficacy and safety of treatment were evaluated, including stereotactic global photography and epiluminiscence microscopy with digital imaging taken at baseline, at 3, and at 6 months of treatment. 70% of patients showed observable clinical improvement with combined global photographic and epiluminiscence microscopic assessment with digital imaging, and 22% epiluminiscence microscopic-only improvement as evidence of treatment efficacy. The treatment was well tolerated, particularly in patients with propylene glycol sensitivity and patients with irritable scalp syndrome. These results suggest that propylene glycol-free, North American witch hazel (Hamamelis virginiana)-based solution of 5% minoxidil is effective and safe for treatment of female androgenetic alopecia, specifically in minoxidil non-responders and patients with propylene glycol sensitivity or irritable scalp syndrome.

The Efficacy and Safety of Dr. SKS Hair Booster Serum (a Cocktail of Micronutrients and Multivitamins) in Adult Males and Females With Androgenetic Alopecia: An Open-Label, Non-randomized, Prospective Study.

Background Androgenetic alopecia (AGA) is frequently encountered in dermatological practice; however, there is a lack of approved treatment. At present, only three therapies have been approved for on-label use in androgenetic alopecia: minoxidil, finasteride, and lower-level laser therapy. Micronutrients are primary elements in the normal hair follicle cycle, and their role in androgenetic alopecia is a growing matter of research nowadays. This study aims to investigate the clinical efficacy and safety of Dr. SKS Hair Booster Serum, a cocktail of micronutrients and multivitamins (copper, niacinamide, hyaluronic acid, thiamine, riboflavin, and biotin), in male and female patients with androgenetic alopecia. Methods We did an open-label, non-randomized, multicenter, prospective study across five hair clinic chains in India (Mumbai, Hyderabad, Jabalpur, Balaghat, and Nagpur). Eligible participants were patients with a confirmed diagnosis of androgenetic alopecia based on clinical examination and trichoscopic findings, age of 18 years or older, and any gender. Each patient received Dr. SKS Hair Booster Serum, 1 ml in volume, once a month by mesotherapy or derma roller/derma pen for up to six months. All patients were subjected to a 60-second hair counttest (comb test), hair pulltest, global photographic assessment (GPA), trichoscopy assessment, patient self-assessment questionnaire, and safety assessment at baseline and six months after the treatment. Results One thousand patients (500 males and females each) with androgenetic alopecia were analyzed. There was a significant reduction in hair fall with bulb (<0.0001) and without bulb (<0.0001) six months after the treatment versus baseline. There was a significant improvement in the number of hairs removed per pull (<0.0001), global photographic assessment score (<0.0001), hair growth rate (<0.0001), follicular hair density (<0.0001), vellus hair density (<0.0001), and terminal hair density (<0.0001) six months after the treatment versus baseline. The majority of patients (95%) were satisfied with six-monthtreatment of Dr. SKS Hair Booster Serum. No major adverse events were reported during the study. Conclusion Dr. SKS Hair Booster Serum was found to be a safe and effective treatment for androgenetic alopecia, with 95% patient self-assessment score.

Efficacy of autologous platelet-rich plasma therapy versus topical Minoxidil in men with moderate androgenetic alopecia: a randomized open-label trial

BackgroundPlatelet-rich plasma (PRP) is an adjunctive treatment in androgenetic alopecia (AGA). Its role as a monotherapy, when compared to FDA-approved therapies in moderate grades of androgenetic alopecia is not established.ObjectivesWe sought to study the efficacy and safety of standardized non-activated PRP preparation against topical minoxidil in AGA.MethodsMen aged 20–50 with Grade III and IV (Modified Hamilton-Norwood) AGA were randomized to receive 5% Minoxidil (×6 months) or PRP injections (monthly ×3). The primary endpoints were global photographic assessment at week 24, change in target area hair counts, density, and anagen hair at week 12. Other outcomes were subjects’ satisfaction and adverse events.ResultsIn total, 64 participants were randomized. At week 24, 56% responded to Minoxidil arm and 38% to PRP (p = 0.124). There was a significant increase in target area hair count and density at week 12 within the groups. The difference between the groups was not statistically significant. Adverse events occurred in 53% and 37% of the PRP and minoxidil groups, respectively. Patient satisfaction was better with Minoxidil.ConclusionPRP is effective in the treatment of moderate grades of androgenetic alopecia in men, although perhaps not different from minoxidil. Side effects occur more frequently with PRP.

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 &gt; 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).

Long-Term (Over 10 Years) Evaluation of Efficacy and Safety of Finasteride in Japanese Men with Androgenetic Alopecia: Summary of Three Investigations

Introduction: Finasteride has been the standard medical treatment for androgenetic alopecia (AGA) for over 20 years. We started AGA treatment with finasteride in 1999 in Japan, and have demonstrated 3 investigations as long-term and/or large-scale studies (3,177 cases in 2.5 years, 801 cases in 5 years, 532 cases in 10 years, respectively). The objective of this study is to summarize the three investigations, and to consider it as a base for future studies over the next 20 to 30 or more years. Methods: Vertex photographs and/or forehead photographs were taken and recorded for every patient at each examination and used for evaluation for more than 20 years. Efficacy was assessed using the Norwood-Hamilton scale (N-H) and the modified global photographic assessment (MGPA) score, which is the standardized 7-point rating score using scalp photographs. Adverse reactions were assessed through self-reported evaluations by patients in two investigations Results: All three of the investigations demonstrated high evaluations of improvement (MGPA≧5; 87.1%, 99.4%, and 91.5%, respectively), and higher evaluations of prevention of disease progression (MGPA≧4; 99.6%, 100%, and 99.1%, respectively). Furthermore, the early-stage AGA group (N-H I-III at first visit) and the younger group (less than 40 years of age at first visit) showed more improvement with long-term AGA treatment with finasteride than the other groups did. Two of the investigations showed safety of long-term AGA treatment with finasteride, revealing the low onset rates of adverse reactions (adverse reactions: 0.7% in 2.5 years and 6.8% in 10 years, respectively). Neither of the two investigations recognized Post Finasteride Syndrome adverse reaction at all. Conclusion: Long-term (greater than 10 years) AGA treatment with finasteride 1 mg/day demonstrated a high efficacy and safety based on large-scale studies in Japanese men. For patients at the early stage of classification of AGA (within N-H I-III or earlier) and/or younger than 40 years of age, we recommend starting treatment with 1 mg/day finasteride.

A study to assess the efficacy of fractional carbon dioxide laser with topical platelet-rich plasma in the treatment of androgenetic alopecia.

Owing to the inadequate response to and limitations of the approved medications for androgenetic alopecia, novel therapies are warranted to enhance outcomes. The objective of this paper is to ascertain the effectiveness of fractional carbon dioxide laser followed by platelet-rich plasma application on hair regrowth and to compare the two laser settings. Seven participants were enrolled in this half-head pilot study based on different laser pulse energy and density values (12 mJ, 800 spots/cm2 and 22 mJ, 400 spots/cm2). Ten treatment sessions were performed every 2 weeks with 12-week follow-up. The evaluation methods were based on hair density from standardized phototrichograms, global photographic assessment, and patient satisfaction. Significantly increased total and terminal hair densities were observed during treatment in both groups as compared with baselines. The mean total hair density has weekly increased significantly with high pulse energy (1.42 hair/cm2) as compared to low pulse energy (1.04 hair/cm2) throughout the study period (p = 0.023; 4.89 hair/cm2). Global photographs and patient satisfaction scores demonstrated improvement, but only the latter showed statistical significance (p = 0.029). The average pain intensity scores were not different between the groups (p = 0.760) all over the procedure. The adverse events were minor and well tolerated. This synergistic treatment remarkably leads to hair restoration and high patient satisfaction. The parameters of 22-mJ beam energy with 400 spots/cm2 density are appropriate and superior to 12-mJ beam energy with 800 spots/cm2. Albeit higher energy, no more pain is indicated in the high pulse energy group. Trial registration number (TRN): TCTR20180619004, Thai Clinical Trials Registry (TCTR) since 2018-05-15 13:39:48.

Efficacy of QR678 Neo® hair growth factor formulation for the treatment of hair loss in Covid-19-induced persistent Telogen Effluvium-A prospective, clinical, single-blind study.

Telogen Effluvium (TE) in a post-Covid-19 patient causes excessive shedding of hair. No definite treatment is available till now. Past studies demonstrates that QR678Neo® has shown promising results in various types of Alopecia. In this study, we aim to establish efficacy of QR678Neo® hair growth factor formulation administration in Covid-19-induced persistent TE for treatment of hair loss and for hair regrowth. Twenty adult patients (all females) presenting with persistent TE starting few weeks after recovery from Covid-19 infection, and continuing beyond 6months were included for the study. A 1.5mL solution of QR678Neo® hair growth factor formulation was administered in the scalp per session. A total of 8sessions (one session every 4weeks) were done. The results were assessed at the baseline, after 4thsession, and 1month after 8th session. Most of the patients showed significant reduction in hair fall; 89% patients showed excellent hair growth. Global photographic assessment score showed marked improvement, which maintained even post therapy. Videomicroscopic assessment showed increase in the hair count (mean =29.32) after 8th session, that further improved even post therapy. The subjective assessment scores for overall hair growth, appearance of hair, reduction in visibility of the scalp, and hair loss were 4, 4.5, 4.25, and 5, respectively. Management of Covid-19-induced persistent Telogen Effluvium has been unclear and futile so far. Intra-dermal administration of QR678Neo® hair growth factor formulation in the scalp, reduces hair fall, improves hair regrowth, and increases the hair density.

Evaluation of efficacy of intradermal injection therapy vs derma roller application for administration of QR678 Neo® hair regrowth formulation for the treatment of Androgenetic Alopecia-A prospective study.

Non-surgical hair restoration is one of the most exciting and innovative fields in cosmetic surgery today.The addition of latest technique like derma roller seeks to achieve better results for delivering pharmaceutical solution for hair growth in comparison with topical administration. We aim to compare intradermal injection vs. derma roller technique for administration of QR678Neo® hair regrowth therapy for the treatment of androgenetic alopecia (AGA) in male and female patients. A sum of 50 patients in the age range of 20-70years with AGA were included and divided into 2 groups; Group A (intradermal) and Group B (derma roller). Intradermal injection of QR678Neo® formulation and derma roller with superficial application of QR678Neo® was given in each group. Assessment was done using hair pull test, global photographic assessment, video-microscopic assessment, and patient subjective assessment at baseline, 6months, and 1year. Significant diminution in hair fall was seen in both the groups. All the video-microscopic assessment factors were better in intradermal injection group compared to the derma roller group, but not significant. Erythema and pain were high in derma roller group in compare to intradermal. Derma roller technique is more convenient and easy to perform, especially when the availability of a trained person to carry out intradermal injection is not feasible, it gives satisfactory results. It is also beneficial in needle phobic and apprehensive patients. Though the results are more efficacious with intradermal scalp injection technique, this study established satisfactory results with derma roller technique as well.

Effect of intralesional injection of autologous platelet rich plasma in patterned hair loss

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; Regenerative effects of platelet-rich plasma’s (PRP) are utilized in treating various dermatological conditions. The present study compared the efficacy of intradermal autologous PRP in various grades of patterned hair loss with topical minoxidil and finasteride.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; Patients with patterned hair loss were randomized to receive either minoxidil 5% in (male), 2% in (female) and finasteride 1 mg (only in male) or PRP in addition to the above treatment. A total of 6 sittings were given to PRP group patients at interval of 21 days each over a total period of 4 months. All patients were followed up for the first time after 21 days of initiating the treatment and then after four months of starting the treatment.&lt;strong&gt;&lt;/strong&gt;&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results:&lt;/strong&gt; Baseline demographic and clinical characteristics were similar in both the treatment groups. When assessed at the second follow up, hair wash test, hair pull test, V/T ratio, yellow dot test, mean hair diameter and global photographic assessment were favourable in significantly higher proportion of patients in the PRP group as compared to non-PRP group. Five non-PRP patients (6.7%) perceived no change in hair fall as compared to none in the PRP group. None of the cases reported increase in hair fall. Adverse effects reported (itching, erectile dysfunction, decreased libido and dizziness) were similarly distributed among the patients in both the treatment groups.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; Minoxidil and finasteride form the backbone of patterned hair loss treatment; adding PRP can achieve clinically better results with minimal side effects.&lt;/p&gt;

Efficacy and Safety of Oral Minoxidil 5mg Once Daily in the Treatment of Male Patients with Androgenetic Alopecia: An Open-Label and Global Photographic Assessment.

IntroductionOral minoxidil is an antihypertensive vasodilator known to stimulate hair growth. The use of low-dose oral minoxidil for the treatment of male androgenetic alopecia (AGA) is receiving increasing attention. The aim of this study was to evaluate the efficacy and safety of oral minoxidil for the treatment of male AGA.MethodsThis was an open-label, prospective, single-arm study. Thirty men aged 24–59 years with AGA types III vertex to V were treated with oral minoxidil 5 mg once daily for 24 weeks. Efficacy was evaluated by hair counts, hair diameter measurements, photographic assessment, and self-administered questionnaire. The safety of the treatment was closely monitored by means of physical examinations and laboratory investigations.ResultsThere was a significant increase in total hair counts from baseline at weeks 12 (mean change + 26, range 182.5–208.5 hairs/cm2) and 24 (mean change + 35.1, range 182.5–217.6 hairs/cm2) (both p = 0.007). Photographic assessment of the vertex area by an expert panel revealed 100% improvement (score > + 1), with 43% of patients showing excellent improvement (score + 3, 71–100% increase). The frontal area also showed a significant response but less than that of the vertex area. Common side effects were hypertrichosis (93% of patients) and pedal edema (10%). No serious cardiovascular adverse events and abnormal laboratory findings were observed.ConclusionOral minoxidil 5 mg once daily effectively increased hair growth in our male patients with AGA and had a good safety profile in healthy subjects. However, oral minoxidil should be used carefully with men who have severe hypertension and increased risk for cardiovascular events.Electronic supplementary materialThe online version of this article (10.1007/s13555-020-00448-x) contains supplementary material, which is available to authorized users.

Evaluation of efficacy of QR 678 and QR678 neo hair growth factor formulation for the treatment of female pattern alopecia in patients with PCOS-A prospective study.

Hair is an essential identity of women. Femininity, sexuality, attractiveness, and personality are symbolically linked to a woman's hair. Female pattern hair loss is found in 20%-30% of patients with polycystic ovary syndrome (PCOS). The aim of the present study was to evaluate the efficacy of QR678® and QR678 Neo® therapy in the treatment of female alopecia with PCOS. A total of 20 females diagnosed with PCOS in the age 25-50years, with complaints of female pattern alopecia with Ludwig, grades I, and II were selected for the study. At each visit, 1.5ml solution of QR678® was injected in the scalp skin of patients. A total of eight sessions were performed at an interval of 3week each. All the patients were evaluated with standard global photography at baseline, 4th and 8th session, and 2months after 8th session. Marked improvement was seen in the global photographic assessment score (mean=8) which was maintained for over 1year. In videomicroscopic assessment, after four sessions the patients had 8.07 fewer vellus hair, 6.07 more terminal hair, and average hair shaft diameter was 0.82μm wider. After eight sessions, they had 11.66 fewer vellus hair, 13.77 more terminal hair, and hair shaft diameter was 2.86μm wider than at baseline. Intra-dermal injections of QR 678® hair growth factor formulation is an effective option for female pattern alopecia with PCOS. This is the first of its kind study using QR678® and QR678 Neo® in PCOS patients.

A 12 weeks, randomized and double-blind evaluation of the efficacy of oral supplements of probiotics (Lactogut and Lactogut Kidz) on atopic dermatitis in adults and children

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; The primary objective of the study was to evaluate the efficacy and safety of oral probiotics in the treatment of atopic dermatitis (AD) using the scoring atopic dermatitis (SCORAD) index, serum IgE levels and absolute eosinophil count (AEC). The secondary objective of the study was to determine the association of oral probiotic therapy and improvement in AD using global photographs, dermoscopic images (fotofinder) and individual patient satisfaction.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; This was a randomized, double-blind study conducted on 70 patients (20 adults and 50 children) with moderate to severe AD. The participants were randomized into control arm and treatment arm. The treatment arm received conventional and probiotic therapy and only conventional therapy was provided to the control arm. The research was carried out in five visits. For each visit, SCORAD was calculated and response compared using clinical and videodermoscopic images. Patient satisfaction was documented using a quality of life questionnaire during each visit.&lt;strong&gt;&lt;/strong&gt;&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results:&lt;/strong&gt; Across the treatment arm, the mean serum IgE levels were greatly decreased in contrast to the control arm over the 12 weeks period. SCORAD score was significantly lowered in the treatment arm (55.20%) compared with 18.95% in the control arm. Dermoscopic assessment, global photographic assessment and patient satisfaction in the treatment arm showed statistically significant improvement in AD compared to the control arm.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; The decrease in SCORAD scores demonstrated strong associations with the use of probiotics in patients with AD as an adjunct to conventional therapy. Thus, in both adults and children suffering from moderate to severe AD, probiotic supplement can be administered effectively as an adjunct therapy.&lt;/p&gt;&lt;p class="abstract"&gt; &lt;/p&gt;

The effect of platelet-rich plasma on female androgenetic alopecia: A randomized controlled trial

Platelet-rich plasma (PRP) may be a useful treatment for androgenetic alopecia (AGA), although objective studies are needed. To determine whether PRP injections improve female AGA. Prospective randomized controlled trial of 30 women diagnosed with AGA. Patients received subdermal scalp injections of Eclipse system PRP or placebo saline at weeks 0, 4, and 8. Outcome measures were changes in hair density (hair/cm2), hair caliber (mm), and blinded global photographic assessment (improved or not improved) at week 24. Blinded global photographic assessment indicated that 57% of patients receiving PRP versus 7% of patients receiving saline improved at week 24 from baseline (P<.01). Compared to baseline, there was improvement in mean density in the PRP group versus the placebo group at week 8 (+71.1 vs -26.7 hairs/cm2; P<.01) and week 24 (+105.9 vs -52.4 hairs/cm2; P<.01). Compared to baseline, there was improvement in mean caliber in the PRP group versus the placebo group at week 8 (+0.0043 vs -0.0034mm; P<.01) and week 24 (+0.0053 vs -0.0060mm; P<.01). Adverse effects included headache, scalp tightness, swelling, redness, and postinjection bleeding. Two patients lost to follow-up. PRP with the Eclipse system is a safe and effective intervention for female AGA.

The effectiveness of combination therapies for androgenetic alopecia: A systematic review and meta-analysis.

Androgenetic alopecia (AGA) is the most common type of baldness affecting both men and women. Studies investigating combination therapies for AGA reported greater efficacy than monotherapy but without rigorous examination. The authors performed a meta-analysis and systemic review to further verify the evidence. To evaluate the effectiveness of three common combination therapies of minoxidil with finasteride, low-level laser light therapy (LLLT) or microneedling versus minoxidil monotherapy. We conducted a systematic review of randomized controlled trials (RCTs) of combination therapies consisting of topical minoxidil for AGA through April 2020. Quality assessment and data analysis were performed by Review Manager 5.3. Fifteen studies met the inclusion criteria involving a total of 1172 AGA patients. We conducted meta-analysis for three groups of combined treatment separately, and all were superior to monotherapy in terms of global photographic assessment (P < .05). Combination of LLLT or microneedling with minoxidil also showed significant increase in hair count (P < .05) compared to monotherapy. The present study suggests that combination therapy could be an effective, safe and promising option for the treatment of AGA. However, more RCTs are needed to further investigate and confirm the efficacy of combined treatment.