Global Photographs Research Articles

Role of Autologous Micrografting Technology through Rigenera® System in the Treatment of Androgenetic Alopecia

Introduction: Androgenetic alopecia (AGA) is a common form of baldness, affecting 60–70% of the adult population worldwide, and may have a negative effect on quality life. AGA leads to a progressive thinning of scalp hair and is characterized by a progressive miniaturization of the hair follicle with a specific pattern distribution. Although AGA is a very frequent condition, compelling therapeutic options are still limited. Methods: Herein, we present the protocol of autologous micrografting technology through Rigenera® system allowing to obtain a suspension of autologous micrografts ready to be injected on scalp. This paper combines the results of two studies that evaluated the effects of micrografts in patients with AGA. The first study involved 17 patients who received one micrografts session with a 6-month follow-up. The second study 13 patients who received two micrografts sessions 6 months apart with a follow-up of 6 months after the second session. Clinical assessment involved global photography evaluation and patient’s satisfaction before and after the treatment. Hair measures using TrichoLab were also performed. Results: Most of the patients had a moderate improvement after investigator’s assessment in terms of hair loss reduction and hair density improvement. The assessment of patients was satisfactory in terms of hair improvement and treatment tolerability. Conclusion: In summary, we conclude that this new regenerative approach can be a promising tool for clinicians to obtain a viable, sterile and ready to use micrografts that can be immediately injected into the scalp to improve AGA condition.

Evaluating treatments for male androgenetic alopecia: clinical profile and comparative efficacy of platelet rich plasma and minoxidil with finasteride

Background: Androgenetic alopecia (AGA) is a common, hereditary, and androgen-dependent disorder characterized by progressive hair thinning on the scalp, affecting both men and women. It arises from follicular miniaturization, leading to the conversion of terminal hair into vellus hair. Methods: This study is a single-center, prospective, open-label, randomized, placebo-controlled trial with four parallel arms designed to evaluate treatments for male pattern baldness. Eighty patients were randomized into four groups: Group 1 received topical minoxidil and finasteride solution, group 2 received PRP alone, group 3 received PRP with minoxidil and finasteride solution, and group 4 received normal saline (NS). Interventions were administered monthly over three months, followed by a three-month follow-up period. Treatment effects were assessed using measures such as patient self-assessment, global photography, and the hair pull test. Results: Group 3 (Combined treatment) showed the most significant improvement in the hair pull test after six months (73.33% negative tests), followed by group 2 (PRP treatment) with 60% improvement. Patient satisfaction scores were highest in group 3 across all follow-ups (F1 to F5), demonstrating superior treatment response compared to other groups (p<0.001). Global photography assessments indicated varying results among groups, with group 4 recording the highest proportion of fair improvements (58.5%). Group 3 exhibited the highest percentage of patients with above-average improvement. Conclusions: Our study provides valuable insights into managing AGA, emphasizing the effectiveness of combining PRP with topical treatments compared to individual therapies and placebo.

Supporting Examinations for Hair Disorders

Hair evaluation methods are grouped into three main categories: non-invasive methods (for example: questionnaire, daily hair counts, standardized wash test, 60-s hair count, global photographs, dermoscopy, hair weight, contrasting felt examination, phototrichogram, TrichoScan, and polarizing and surface electron microscopy), semi-invasive methods (for example: trichogram and unit area trichogram), and invasive methods (for example: scalp biopsy). This article explores supporting examinations for the diagnosis of hair disorders.

Aesthetic of Light and Time: An Intellectual History of Pictorialism from India

Pictorialism emerged in the last quarter of the nineteenth century as a global aesthetic movement that argued for photography’s artistic status on par with other plastic arts more powerfully than ever. Archives from South Asia demonstrate the movement’s thriving life in the subcontinent with Calcutta emerging as a centre and its bilingual amateur photographer-writers as major participants simultaneously engaging in globally circulating specialist discourses on pictorialism and popular discussions of their practice aimed at public pedagogy. By looking into Bangla periodical press this paper investigates how Bengali pictorialists used popular Bangla magazines in the early twentieth century to establish their distinct voice regarding what counted as artistic photography as they engaged with a non-specialist mass readership. Mass-circulated Bangla articles were not vernacular translations of knowledge and practices produced in metropolitan locations and disseminated in transregional languages like English. Vernacular was an extension of Bengali amateur photographers’ participation in global photography, as they remained grounded in their historical specificity. These amateur photographers were bilingual intellectuals who wrote in English for a global public and in Bangla for a Bangla-reading publics and refraining from translating culture as they moved across languages. Indeed, articulations in vernacular didn’t mean a venularization of practice; they indicate plurality of belonging and affiliation that crafted the pictorialist aesthetic of the Bengali amateurs. By unpacking this intellectual history, this paper decenters the Euro-US-centric history of pictorialism towards writing an interconnected history of the artistic movement, while also complicating the category of modern Indian art.

A comparative study of fractional CO2 laser with topical triamcinolone acetonide versus intralesional triamcinolone acetonide in the treatment of alopecia areata.

Alopecia areata (AA) is a non-scarring alopecia of chronic autoimmune etiology with heterogenous severity against the anagen hair follicle over the scalp, beard, or any part of the body and is associated with a significant psychological morbidity in the mental status of the patients leading the patients to seek treatment for cosmetic reasons. The management of AA is very unpredictable and is associated with various cosmetic adverse effects. This study aimed at comparing the efficacy and safety of a novel procedure of laser-assisted drug delivery system of steroids with the first-line procedure of intralesional steroids (ILS) for the treatment of patchy AA. To assess and compare the efficacy and safety of fractional CO2 laser in combination with topical triamcinolone acetonide aqueous solution and intralesional triamcinolone acetonide as a monotherapy and in the treatment of AA. A total of 60 patchy AA patients were included in this study. Patients were randomized into two equal groups: Group A and Group B with 30 patients in each group using a computer-generated block randomization. Patients in Group A received fractional CO2 laser with topical triamcinolone acetonide aqueous solution and Group B received ILS. Both groups received treatment for five settings with each setting a gap of 3 weeks. The efficacy and safety of treatment modalities in both groups were assessed using global photograph assessment (GPA)-scale, lesional area density score percentage of improvement (LAD score improvement %), visual discomfort scale (VDS), visual analogue scale, and documentation of adverse effects in each setting. Efficacy of treatment modality-assessed using means score of GPA-scale and LAD score improvement % suggests quicker results to patients in Group B in initial settings but drastic improvement happens to patients in Group A in subsequent settings. At the end of 5th setting, GPA-scale and LAD score improvement % suggest maximum efficacy in patients in Group A and they are statistically significant (P-value < 0.001). The mean VDS in both groups suggests maximum discomfort in Group A, yet the patient satisfaction at the end of 5th setting was maximum with patients in Group A and they are statistically significant (P-value < 0.001). Cosmetic notable adverse effect of atrophy of skin was documented in 30% of patients in Group B. This study showed that fractional CO2 laser with topical triamcinolone acetonide is a better treatment modality than the intralesional triamcinolone acetonide for the treatment of AA with respect to efficacy, safety, and adverse events.

Invention of automated numerical algorithm adopting binarization for the evaluation of scalp hair coverage: An image analysis providing a substitute for phototrichogram and global photography assessment for hair diseases

BackgroundThe efficacy of therapeutic modalities for hair disease can be evaluated globally by photo assessment and more precisely by phototrichogram (PTG). However, the latter procedure is laborious, time consuming, subject to inter-observer variation, and requires hair clipping. ObjectiveTo establish an automated and patient/investigator friendly methodology enabling quantitative hair amount evaluation for daily clinical practice. MethodsA novel automated numerical algorithm (aNA) adopting digital image binarization (i.e., black and white color conversion) was invented to evaluate hair coverage and measure PTG parameters in scalp images. Step-by-step improvement of aNA was attempted through comparative analyses of the data obtained respectively by the novel approach and conventional PTG/global photography assessment (GPA). ResultsFor measuring scalp hair coverage, the initial version of aNA generally agreed with the cumulative hair diameter as assessed using PTG, showing a coefficient of 0.60. However, these outcomes were influenced by the angle of hair near the parting line. By integrating an angle compensation formula, the standard deviation of aNA data decreased from 5.7% to 1.2%. Consequently, the coefficient of determination for hair coverage calculated using the modified aNA and cumulative hair diameter assessed by PTG increased to 0.90. Furthermore, the change in hair coverage as determined by the modified aNA protocol correlated well with changes in the GPA score of images obtained using clinical trials. ConclusionThe novel aNA method provides a valuable tool for enabling simple and accurate evaluation of hair growth and volume for clinical trials and for treatment of hair disease.

Efficacy of Dr. SKS Hair Booster Serum in the Treatment of Female Pattern Alopecia in Patients With PCOS: An Open-Label, Non-randomized, Prospective Study.

Background Many patients with polycystic ovary syndrome (PCOS) exhibit female pattern hair loss (FPHL). A more advanced, efficient, and suitable therapeutic approach is required to effectively manage FPHL in patients with PCOS. Aim Dr. SKS Hair Booster Serum is composed of copper, niacinamide, hyaluronic acid, thiamine, riboflavin, and biotin; each of these constituents has demonstrated individual efficacy in promoting hair growth and enhancing hair quality. We hereby assess the effectiveness of this novel hair formulation in treating FPHL in PCOS. Methods This was an open-label, non-randomized, multicenter, prospective, large study with a wide range of age groups. The study involving 1,000 females aged 25-50 years, diagnosed with PCOS and having complaints of FPHL with Ludwig grades I and II. Each patient received a monthly session of Dr. SKS Hair Booster Serum, with 1 mL of serum administered through injection into the superficial layer (dermis) of the scalp using a tiny infusion via an insulin syringe, mesotherapy, or via a derma roller/derma pen. All the patients were subjected to standard global photography, video microscopic assessment (vellus hair counts, terminal hair counts, and hair shaft diameter), and a subject self-assessment questionnaire at baseline and six months after the treatment. Results After six months of the treatment, the hair shaft diameter, terminal hair counts, and hair growth rate were significantly increased than baseline (p≤0.0001), and a significant reduction was noted in vellus hair counts than baseline measurement (p<0.00001). These findings are suggestive of improved hair regrowth after the treatment. No adverse events were recorded during the study. Statistically significant improvements were observed in hair parameters (overall hair fall rate, hair texture, hair volume, and scalp itching) after six months of treatment than baseline. Conclusion Dr. SKS Hair Booster Serum has been shown to be an effective treatment for FPHL in patients with PCOS. This study marks the first investigation into the use of Dr. SKS Hair Booster Serum in patients with PCOS.

Imaging Tools for Noninvasive Hair Assessment.

Trichology tools historically have been limited in their ability to provide noninvasive detailed assessments of the hair and scalp. Recent advances in diagnostic and treatment monitoring technologies have begun to fill this gap. Global photography previously relied on a film camera and stereotactic imaging equipment but has been simplified by the advent of cameras that use software analysis and provide adjustable outlines to match facial features for the capture of standardized views. Reflectance confocal microscopy (RCM) and optical coherence tomography (OCT) both enable in vivo visualization of subcutaneous structures and provide new insight into the dynamic subclinical changes of alopecia. Recent efforts focus on training convolutional neural networks to quantify various hair parameters on OCT scans. When scalp biopsy is necessary, trichoscopy, RCM, and OCT can guide in selecting biopsy sites. Because of the growing clinical applications of these technologies, clinicians should be aware of the advantages and limitations of noninvasive hair-imaging tools.

Injections of platelet-rich plasma prepared by automatic blood cell separator combined with topical 5% minoxidil in the treatment of male androgenetic alopecia.

Platelet-rich plasma (PRP) has been increasingly accepted as a potential therapy in the treatment of androgenetic alopecia (AGA), However, there remains a dearth of data on the effectiveness of PRP prepared by automatic blood cell separator with a combination of topical minoxidil for the treatment of AGA. To evaluate the efficacy and safety of PRP prepared by automatic blood cell separator combined with topical 5% minoxidil therapy in male AGA. Thirty male patients with mild/moderate AGA were enrolled in a randomized double-blind controlled study. Patients were randomly divided into two treatment arms: (group A) PRP prepared by automatic blood cell separator combined with topical 5% minoxidil group; (group B) PRP prepared by automatic blood cell separator combined with a topical placebo group. Trichoscopic assessments regarding hair density/quantity and mean hair diameter were performed at baseline and follow-up. Clinical efficacy of global photography and patient satisfaction were conducted to verify the therapeutic efficacy of the treatment, and the occurrence of adverse reactions was recorded. We detected a significant increase in all patients in hair density and quantity after PRP treatment (p < 0.05), and there was no significant difference in mean hair diameter. Although hair density/quantity was more pronounced in group A than in group B, the difference between groups was not statistically significant (p > 0.05). In terms of clinical efficacy and patient satisfaction, group A was superior to group B, and no serious adverse reactions occurred. We hereby conclude that the injections of PRP prepared by an automated method are effective and safe in the treatment of mild-to-moderate male AGA patients, and its combination with topical 5% minoxidil therapy was superior to PRP monotherapy with better clinical efficacy and higher patient satisfaction.

Hair Evaluation Methods

The three main Hair assessment methods in alopecia are Non-invasive (questionnaire, daily hair counts, standardized wash test, 60-s hair count, global pictures, dermoscopy, hair weight, contrasting felt examination, phototrichogram, TrichoScan), semi-invasive (trichogram and unit area trichogram), and intrusive procedures (e.g., scalp biopsy). No method is ideal or realistic. These are useful for patient diagnosis and monitoring when interpreted carefully. Daily hair counts, wash tests, etc. are good ways to evaluate a patient's shedding. Hair clinics use procedures like global photography. Phototrichogram is exclusively used in clinical trials. These procedures (like scalp biopsy) require processing and interpretation expertise. In this review article, we discuss the various hair evaluation methods.

Clinical study on the efficacy and tolerability of an oral supplement based on arginine, l-cystine, zinc and B6 vitamin (Cystiphane®) in patients with telogen effluvium.

Telogen effluvium (TE) is a common cause of non-cicatricial hair loss with no treatment-standardized protocol. The aim of our study was to evaluate the efficacy, tolerability, and patient compliance of a treatment with an oral supplement based on arginine, l-cystine, zinc and B<inf>6</inf> vitamin (Cystiphane®, Laboratoires Bailleul, Geneva, Switzerland) with hair-growth properties, administered 4 times daily, in patients affected by TE. We recruited 20 patients, aged between 18 and 70 years old, affected by TE. Patients were asked to take the oral supplement as a monotherapy, four tablets daily, in one or two administrations during meals. The study lasted 3 months. We evaluated the efficacy and tolerability of the treatment both qualitatively by collecting the clinician's opinion through a clinical evaluation and clinical-anamnestic form filled in by the researcher, and quantitatively through global photography and trichoscopy. We collected the patient's opinion through a self-assessment test, at the beginning of the recruitment and after 3 months of treatment. Eighteen patients were evaluated. After 3 months of taking the supplement, the researcher rated an average improvement of 2.89 at the clinical evaluation. For what concerns hair quantity, at the control trichoscopy, the mean trichoscopic value had risen to +2.055, whereas for hair diameter the mean trichoscopic diameter value had increased to +1.83. After 3 months of treatment, patients gave an average efficacy opinion of 3.61. The oral supplement has proved effective as an adjuvant in the treatment of TE in our cohort of patients.

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.

Comparative Efficacy of Topical Finasteride (0.25%) in Combination with Minoxidil (5%) Against 5% Minoxidil or 0.25% Finasteride Alone in Male Androgenetic Alopecia: A Pilot, Randomized Open-Label Study.

Androgenetic alopecia (AGA) is the most common cause of hair loss in males which remains a therapeutic challenge. To compare the efficacy of topical 5% minoxidil and 0.25% finasteride combination (MNF) over 5% minoxidil (MNX) or 0.25% finasteride (FNS) alone by assessing hair count, physician assessment score (PAS), and patient satisfaction score (PSS). Pilot randomized open-label study where 60 male patients with AGA ≥ III grade were randomized into three treatment groups and evaluated over 24 weeks. Improvement in hair count was assessed manually using dermoscopy. Global photographs were used to assess PAS. Side effects were evaluated using relevant laboratory investigations. At the 12th and 24th week, all three groups showed significant improvement in total hair density as compared to baseline (P < 0.001). None of the groups was superior to the other (P > 0.05) at the 12th week but at 24th week, MNF was comparatively superior (P < 0.02). At the 12th week and 24th week, all three groups showed significant improvement in terminal hair density as compared to baseline (P < 0.001). In the 12th week, MNF was comparatively superior (P = 0.028) and at the 24th week, MNF was comparatively superior (P < 0.02). PAS and PSS were significantly better with MNF and MNX compared to FNS (P < 0.004). Side effects such as scaling and itching were reported with MNF and MNX. Topical minoxidil 5% and finasteride 0.25% had an overall better efficacy compared to monotherapy without significant side effects.

Efficacy of autologous stromal vascular fraction injection in the treatment of androgenic alopecia

Androgenic alopecia (AGA) is a common condition associated with loss of terminal hair on the scalp in a specific pattern in both males and females. Management of AGA is usually challenging as the approved therapeutic options are limited. Our aim was to evaluate the efficacy of non-enzymatic stromal vascular fraction (SVF) as a new promising treatment for AGA. From April to December 2021, this prospective study included 30 patients with AGA who were enrolled from the University Hospitals' dermatology outpatient clinics. Patients received a single session of autologous SVF injection and were then followed up for 6 months. There was an increase in hair shaft caliber from 0.037 ± 0.01 mm before treatment with SVF to 0.056 ± 0.02 mm after 6 months of treatment. Also, hair count/cm2 increased from 130.87 ± 14/cm2 to 151.93 ± 22.36/cm2 and terminal to vellus hair ratio increased from 77.06 ± 10.47% to 81.45 ± 11.98% at the end of the study. No significant difference was recorded between male and female groups as regard response to treatment. We concluded that SVF is an effective line of treatment for AGA with significant improvement regarding hair density, hair diameter, global photography, and patient satisfaction.

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.

Trichogenic effect of low level laser therapy combined with platelet-rich plasma for the management of androgenetic alopecia

Background: (AGA) is a very common hair disorder in men, Topical minoxidil and more recently low-level light therapy and Platelet-rich plasma therapy have been used in the management of (AGA). Objectives: To assess the Trichogenic effect of LLLT combined with PRP in the management of AGA. Patients and methods: Forty seven patients with AGAwere subjected to PRP therapy plus LLLT, affected area of all patients were treated for three months and then follow up for another three months. Efficacy was evaluated using global photography, folliscopic pictures analysis, answers for standardized hair growth questions and score of patient Gratification. Results: There was statistically significant improvement in diameter, vellus hair, terminal hair and density after treatment for three months although these improvements were decreased at three month after stoppage of treatment but still better than the baseline. Conclusion combination of LLLT with PRP could be a good treatment modality of AGA.

Prevalence of female pattern hair loss in postmenopausal women: a cross-sectional study

Abstract Objective: To identify the prevalence of female pattern hair loss (FPHL), hair characteristics, and associated factors in healthy postmenopausal women. Methods: Two hundred postmenopausal women aged 50 to 65 years were recruited. Each participant was evaluated for FPHL according to Ludwig’s classification using standardized global photography in all six views and trichoscopy for hair density and diameter. Three dermatologists re-evaluated all pictures for confirmation of FPHL. The time since menopause, levels of scalp sebum, serum testosterone, estradiol, thyroid stimulating hormone, and hemoglobin; family history of hair loss, as well as an evaluation of low self-esteem were evaluated. Women who underwent recent hair loss treatments were excluded. We used simple and multivariable logistic regression analysis to identify the factors affecting FPHL. Results: In total, 178 postmenopausal women were evaluated for hair-loss patterns. The average age and time since menopause were 58.8±4.1 and 9.2 ± 5.6 years, respectively. The prevalence of FPHL was 52.2% (95% CI, 44.6-59.8). Severity of FPHL by Ludwig grades I, II, and III was 73.2% (95% CI, 62.9-81.8), 22.6% (95% CI, 14.6-32.4), and 4.3% (95% CI, 1.2-10.7), respectively. Logistic regression analysis revealed that age, time since menopause, and body mass index were all significantly associated with FPHL. After adjusting for age and family history of FPHL, only body mass index ≥25 kg/m2 was significantly associated with FPHL (adjusted OR = 2.65, 95% CI, 1.23-5.70). Conclusion: The prevalence of FPHL was high in postmenopausal women, raising the need for hair loss awareness in menopause clinics. Early detection and proper treatment of FPHL may increase the quality of life in postmenopausal women.

Clinical observation of basic fibroblast growth factor (bFGF) combined with minoxidil in the treatment of male androgenetic alopecia.

Androgenetic alopecia (AGA) has been one of the most common progressive hair loss in the world, which affects 80% of white males. To date, only minoxidil and finasteride have been approved by FDA for the treatment of AGA. However, limited therapeutic effect and the toxic adverse events of these drugs limit their applications. Therefore, it is still an urgent clinical problem to find effective therapeutic drugs and medication regimen. The goal was to explore the efficacy and side effects of basic fibroblast growth factor (bFGF) combined with minoxidil in the treatment of male patients with early stage of androgenetic alopecia (AGA). Using a randomized control method, 80male patients with androgenetic alopecia in Hamilton grade II-IV were randomly divided into two groups, with 40 patients in each group. The Group A: 1ml minoxidil for external use twice a day; Group B: 3500IU basic fibroblast growth factor (bFGF) and 1ml minoxidil for external use twice a day. The selected patients received global photograph evaluation before treatment, 3months after treatment, and 6months after treatment, and the curative effect was judged according to the changes in the area and degree of hair loss on the top of the head and anterior parietal area of the patients shown in the photographs before and after treatment. At the same time, each patient had a satisfaction questionnaire survey before treatment, 3months after treatment, and 6months after treatment. During the research period, the adverse reactions of the patients were recorded. After 3months and 6months of treatment, the effective rate of the two groups was statistically significant (p<0.05), and the patients' hair conditions in the Group B improved significantly compared with those in the Group A. After 6months of treatment, the difference in treatment satisfaction between the two groups was statistically significant (p<0.05). The patients in the Group B were more satisfied than those in Group A. During the patient's medication, no serious adverse reactions occurred in the two groups, and the incidence of adverse reactions between the two groups was not statistically significant (p>0.05). Compared with 5% minoxidil alone, the combination of basic fibroblast growth factor (bFGF) +5% minoxidil in the treatment of male patients with early stage of androgenetic alopecia improved treatment efficiency and patient satisfaction.

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.

Clinical Use of Extracellular Vesicles in the Management of Male and Female Pattern Hair Loss: A Preliminary Retrospective Institutional Review Board Safety and Efficacy Study.

BackgroundPattern hair loss is a common disorder in female and male patients. ObjectivesTo assess the safety, efficacy, and satisfaction of a single extracellular vesicle (EV) treatment over 6 months.MethodsA retrospective open-label study among 22 female and 9 male patients who demonstrated early stages of alopecia or were in remission from previous medical and surgical treatments. The amount of undiluted or diluted volumes of EV solution used was determined by the extent and degree of alopecia. Global photography, Patient Global Aesthetic Improvement Scale (PGAIS) and Investigator Global Aesthetic Improvement Scale (IGAIS) questionnaires, and trichoscan measurements were compared at baseline and 6 months in 3 response categories.ResultsFrequent growth responses were observed: older aged females and younger aged males, shorter history of alopecia, earlier stages of hair loss, larger and undiluted volumes of XoFlo, previous positive responses to medical and surgical treatments, and absence or control of disease factors affecting the hair. Global photography, trichoscan for density, follicle diameter, terminal: vellus ratio, and PGAIS/IGAIS satisfaction questionnaires at baseline and 6 months were useful in assessing clinical efficacy. No significant adverse reactions were observed.ConclusionsIntradermal injections with varying doses of EVs were safe and effective among indicated alopecic female and male patients. Findings suggest that the presence of positive factors, absence of conditions known to negatively affect hair growth, and administration of larger volumes of XoFlo may have a significant influence on the use of this new cell-free therapy. Level of Evidence: 4