Hair Counts Research Articles

Microneedling for Hair Loss.

Microneedling is a relatively novel therapeutic modality introduced in the 1990s where small, fine needles are used to create micro punctures in the skin. It is a minimally invasive procedure used for various dermatological conditions, including androgenetic alopecia (AGA). We comprehensively summarize the literature regarding microneedling in dermatology. We performed linear multivariable regressions to synthesize evidence from the clinical trials that investigated the efficacy of microneedling for AGA. Studies eligible for quantitative analyses were assessed for evidence quality. The exact mechanism of microneedling action is yet to be determined, with theories that include the wound-healing cascade. Microneedling monotherapy significantly increased total hair count more than topical minoxidil 5% (β=12.29; p<0.001). The combination treatment of microneedling with topical 5% minoxidil increased total hair count significantly compared to monotherapy with microneedling (β=7.63, p<0.05). Increasing the overall treatment duration of microneedling and reducing the frequency of microneedling sessions may positively influence an increase in total hair count. There are limited studies that investigate microneedling as a monotherapy for hair loss since majority of the trials combine it with other therapies such as topical minoxidil or platelet-rich plasma. While preliminary results look promising, further investigation of microneedling as a monotherapy in larger, randomized controlled trials will help determine its safety and efficacy, and place in treating AGA.

Efficacy and safety of topical finasteride spray solution for male androgenetic alopecia: a phase III, randomized, controlled clinical trial.

BackgroundOral finasteride is a well‐established treatment for men with androgenetic alopecia (AGA), but long‐term therapy is not always acceptable to patients. A topical finasteride formulation has been developed to minimize systemic exposure by acting specifically on hair follicles.ObjectivesTo evaluate the efficacy and safety of topical finasteride compared with placebo, and to analyse systemic exposure and overall benefit compared with oral finasteride.MethodsThis randomized, double‐blind, double dummy, parallel‐group, 24‐week study was conducted in adult male outpatients with AGA at 45 sites in Europe. Efficacy and safety were evaluated. Finasteride, testosterone and dihydrotestosterone (DHT) concentrations were measured.ResultsOf 458 randomized patients, 323 completed the study and 446 were evaluated for safety. Change from baseline in target area hair count (TAHC) at week 24 (primary efficacy endpoint) was significantly greater with topical finasteride than placebo (adjusted mean change 20.2 vs. 6.7 hairs; P < 0.001), and numerically similar between topical and oral finasteride. Statistically significant differences favouring topical finasteride over placebo were observed for change from baseline in TAHC at week 12 and investigator‐assessed change from baseline in patient hair growth/loss at week 24. Incidence and type of adverse events, and cause of discontinuation, did not differ meaningfully between topical finasteride and placebo. No serious adverse events were treatment related. As maximum plasma finasteride concentrations were >100 times lower, and reduction from baseline in mean serum DHT concentration was lower (34.5 vs. 55.6%), with topical vs. oral finasteride, there is less likelihood of systemic adverse reactions of a sexual nature related to a decrease in DHT with topical finasteride.ConclusionTopical finasteride significantly improves hair count compared to placebo and is well tolerated. Its effect is similar to that of oral finasteride, but with markedly lower systemic exposure and less impact on serum DHT concentrations.

Development and qualification of a machine learning algorithm for automated hair counting.

Determining the amount of hair on the scalp has always been an important metric of patient satisfaction for hair growth and hair retention technologies. While simple in concept, this measurement is a difficult, resource intensive task for the dermatologist and the research scientist. Specifically, counting and measuring hair in phototrichogram images is very time consuming and labour intensive. Due to cost, often only a fraction of available images is manually analysed. There is a need for an automated method that can significantly increase speed and throughput while reducing the cost of counting and measuring hair in phototrichogram images. Recent advances in machine learning and deep convolutional neural networks (deep learning) have led to a revolution in the analysis of image, video, speech, text and other sensor data. Image diagnostics have seen remarkable improvements with completely automated methods outperforming both human experts and human-engineered analysis methods. Deep learning methods can also provide speed and cost benefits. To enable use of a deep learning, we created a data set of 288manually annotated phototrichogram images with marked location and length of each hair (the training dataset). We designed a custom neural network architecture and custom image processing algorithms to best utilize the available training data and to maximize performance for hair counting and length measurement. The performance of the algorithm was qualified by comparing hair count and length measurements to an independent ground truth method, the semi-manual Canfield's Hair Metrix method. Leveraging deep neural networks, we have developed capability to apply machine learning to reduce the time needed to acquire data from phototrichograms of patients' scalp from months to seconds. Our algorithm enables fast and fully automated hair counting and length measurement. The algorithm shows high agreement with human manually assisted analysis (ground truth). We have trained and deployed an algorithm utilizing this technology and have demonstrated the reproducibility, accuracy and speed of this algorithm that, once deployed, requires little to no recurring cost or manual intervention for its operation. The method allows fast analysis of large number of images, reducing study cost and significantly reducing study analysis time.

Scalp application of antioxidants improves scalp condition and reduces hair shedding in a 24-week randomized, double-blind, placebo-controlled clinical trial.

Increasing hair fullness is a global unmet need for many men and women. An approach to the problem is to decrease hair fall or shedding by reducing scalp stratum corneum oxidation and barrier damage to increase hair retention. This study evaluated a combination of functional antioxidants and barrier-enhancing cosmetic ingredients to improve scalp condition thereby enabling stronger hair anchorage and longer retention. Male and female subjects with normal scalp condition and self-perceived hair thinning participated in a 24-week, double-blind, placebo-controlled, randomized clinical study assessing either a regimen of treatment shampoo and leave-on treatment containing functional antioxidant and barrier-enhancing agents or an identical placebo chassis shampoo control. The functional ingredients were piroctone olamine, zinc pyrithione, zinc carbonate, niacinamide, panthenol and caffeine. At baseline and after 8, 16 and 24weeks of product use, several measurements were taken: hair shedding, total hair count (by phototrichogram), hair samples, TEWL and evaluation of biomarkers of scalp and hair conditions. Subjects also completed self-assessment questionnaires. Statistically significant effects for functional ingredient-containing treatment regimen versus a placebo control shampoo formulation were observed for reduced hair shedding, increased total hair count, reduced TEWL and improvement in scalp biomarker values. Subjects also noticed these improvements assessed via self-assessment questionnaires. These results establish that the use of functional antioxidant and barrier-enhancing agents to further improve scalp condition can enable a reduction in hair shedding and thus an increase in perceived hair fullness. The underlying improvements in scalp condition suggest the hair benefits were achieved as a result of improved scalp skin barrier and scalp condition leading to a viable preventative approach for hair thinning.

Efficacy and Tolerability of N-Acetyl-Cysteine for Treatment of The Early-onset Androgenetic Alopecia in Men

Abstract Background Androgenetic alopecia (AGA), the most common form of hair loss in men, involves the progressive loss of visible pigmented terminal hair on the scalp in response to circulating androgens. AGA is an autosomal disorder which begins in puberty in genetically predisposed individuals. Aim of the Work To study the effectiveness and safety of the reactive oxygen species scavenger Nacetyl-cysteine (NAC) as a single therapy and in combination with the topically applied minoxidil for treatment of the early-onset androgenetic alopecia in men. Patients and Methods The present study included 100 patients with male pattern hair loss whose age ranged from 18 to 30 years old, recruited from dermatology clinics in Ain Shams University Hospital and Kafr El Sheik University Hospital. Results Overall, all treatments could improve significantly some of the trichoscopic parameters as compared to the control group who did not receive any treatment. The number of terminal hair count increased and the vellus hair count decreased in response to either of treatments; minoxidil, NAC, or both as compared to control. These changes were noticed at both the vertex and frontotemporal sites. The treatment was generally tolerable and the side effects encountered did not necessitate stoppage of the treatment course. Conclusion On the basis of the findings of current study we can conclude that, the role of trichoscopy in increasing the accuracy for diagnosing hair disorders as well as to detect response or failure to treatment, N-acetylcysteine (NAC) improved significantly most of the trichoscopic features of AGA and it was was generally tolerable and the side effects encountered did not necessitate stoppage of the treatment course.

Novel Application of Light-Emitting Diode Therapy in the Treatment of Eyebrow Loss in Frontal Fibrosing Alopecia.

Background: Eyebrow loss in the course of frontal fibrosing alopecia (FFA) is becoming a growing issue among older females. It has a considerable negative impact on patients’ quality of life. Since there is no standardized treatment, photobiomodulation with light-emitting diodes (LEDs) could be an option. Here we assess, for the first time, the efficacy of LED therapy in the treatment of eyebrow loss in females with FFA. Methods: 16 female patients with FFA aged 60–74 years were enrolled in the study. LED therapy was performed once a week for a 10-week session. The LEDs’ effectiveness was assessed at the baseline, after 10 irradiations, and 6 months after the end of treatment during a follow-up visit. Results: The therapy was well tolerated. After 10 irradiations, the total eyebrow hair count increased significantly, as did the number of thick hairs and mid-thick hairs (p = 0.002, p = 0.002, and p = 0.044, respectively). During the follow-up visit, the total number of eyebrow hairs remained significantly higher than before treatment (p = 0.002). Conclusion: The study revealed that LED therapy seems to be a novel and promising therapeutic option for eyebrow loss in patients with FFA. It is safe and well tolerated and leads to clinically and cosmetically acceptable improvement.

Variation of Hair Follicle Counts among Different Scalp Areas: A Quantitative Histopathological Study

Introduction: Scalp biopsy is a standard method for the definitive diagnosis of alopecia. The hair count parameters of each scalp area remain unclear. This study aimed to determine hair count values at different scalp locations from histopathology and to establish reference values for each part of the scalp. Methods: We obtained biopsy specimens from the frontal, vertex, temporoparietal, and occipital areas of the scalps of normal deceased subjects. All specimens were evaluated for the number of follicular units, hair counts, hair types, and stages of the hair cycle. Results: In total, 240 specimens were collected from 60 cadavers. Across all scalp sites, the temporoparietal area showed the lowest mean hair count, number of follicular units, terminal and vellus hairs, and terminal-to-vellus hair ratio. The average anagen-to-telogen hair ratio was comparable across all scalp sites. This study did not observe a significant association of hair parameters with gender differences or increasing age in all scalp areas. Conclusions: The present study revealed the diversity of the hair index among different scalp areas and suggested that normal hair count values should be separately standardized on each scalp region. Our findings may provide useful reference values for the histopathological evaluation of hair disorders in Asians.

Three wavelengths integrated: Efficacy and safety of a novel combination for hair removal.

Laser hair removal is one of the most popular aesthetic procedures. The study aimed to assess the efficacy and safety of a novel applicator combining three wavelengths (1064nm, 810nm, and 755nm) for hair removal. This prospective study included a four-session hair removal treatment with three wavelengths combined and emitted simultaneously using an in-motion technique. Patients were treated in eight-week intervals between each session and a follow-up of 3months. Twenty-two men (mean age 41.5years, SD=6.1) were included: two (9.1%) Fitzpatrick skin type II, 19 (86.4%) type III, and one (4.5%) type IV. Treated areas were two abdomens (14%), fourteen backs (64%), and five thoraxes (23%). Hair characteristics were evaluated with a dermatoscopic imaging system. Three months after the last session, the mean decrease in the hair count was of 75.6% (SD 5.9) (p<0.0001), in hair density of 75.6% (SD 5.9) (p<0.0001), in the terminal hair number of 60.1% (SD 55.0) (p<0.0001), and in the vellus hair number of 39.7% (SD 72.9) (p=0.0001). The combined three different wavelengths in a single device provided a wide range of absorption and penetration, allowing for a safe and effective treatment.

Case Study of Hair Regrowth with Topical Cannabidiol (CBD)

<h3>Introduction:</h3> Discovered in the 1990s, the endocannabinoid system (ECS) is involved with maintaining cellular homeostasis by downregulating the damaging inflammatory response and upregulating regenerative processes. Cannabidiol (CBD) has novel therapeutic effects, different from and synergistic with current hair regrowth therapies. CBD is fat-soluble and poorly absorbed past the epidermis, but topical application of CBD easily reaches hair follicles where it is a CB1 antagonist and agonist of vanilloid receptor-1 (TRPV1) and vanilloid receptor-4 (TRPV4). All these ECS receptors relate to hair follicle function. Blocking the CB1 receptor on the hair follicle with CBD has been shown to result in hair shaft elongation; in addition, the hair follicle cycle (anagen, catagen, and telogen phases) is controlled by TRPV1. The effects of CBD on hair growth are dose dependent and higher doses may result in premature entry into the catagen phase via a different receptor known as TRPV4. CBD has also been shown to increase Wnt signaling, which causes dermal progenitor cells to differentiate into new hair follicles and maintains anagen phase of the hair cycle. <h3>Objective:</h3> This study was conducted to determine if daily topical application of a hemp oil high in CBD concentration would result in significant hair regrowth in the area of the scalp most affected by androgenetic alopecia (AGA). <h3>Methods:</h3> A study was done of 35 (28 men and 7 women) subjects with AGA. Participants used a once daily topical CBD formulation, averaging about 3-4mg per day for 6 months. A hair count of the greatest area of alopecia was carried out before treatment started and after 6 months of treatment. To facilitate consistent hair count analysis, a clear acrylic mold, containing a 1cm² cutout, was made of each subject’s head. <h3>Results:</h3> The results revealed that men did slightly better than women, and the vertex area did better than the temporal areas. On average, there was a statistically significant 93.5% increase in nonvellus hair after 6 months of once daily use. All subjects had some regrowth. There were no reported adverse effects. <h3>Discussion:</h3> Though the exact mechanism of therapeutic effects is not known, CBD is most likely functioning as a CB1 receptor antagonist and potentially also via Wnt messaging. Topical CBD formulation has comparable results to finasteride and comparable results to 5% minoxidil once daily foam. Since the CBD works through novel mechanisms different from finasteride and minoxidil, it can be used in conjunction with these current drugs and would be expected to have synergistic effects. However, safety of this combination would need to be evaluated.

Trichoscopy as a monitoring tool in assessing treatment response in 98 children with tinea capitis: A prospective clinical study.

Tinea capitis (TC) is the most common dermatophyte infection in children. Fungal culture the gold standard diagnostic method takes several weeks and has poor yields. Trichoscopy helps in rapid diagnosis and could work as a monitoring tool during antifungal therapy. Our main objective is to document the evolution of trichoscopic features with treatment and their correlation with clinical parameters in patients of TC. Forty-six and 52 children with clinically diagnosed TC that was confirmed by potassium hydroxide microscopy, received griseofulvin and terbinafine, respectively. Recruited children were subjected to clinical and trichoscopic assessment by calculation of CASS (clinical assessment severity score) and counting of TAHC (Total Altered hair count; negative and positive), respectively, at baseline and follow-up at 2, 4, and 6 weeks. McNemar, Wilcoxon singed ranked test and Spearman-rho correlation of various parameters was evaluated. Follow-up trichoscopy revealed significant (p < 0.009) disappearance of negative TAHC like black dot (second week onward), corkscrew, horseshoe and zigzag hair at 4 weeks and short broken hair, erythema telangiectasia hemorrhage (ETH) resolved at 6 weeks. Positive TAHC (regrowing hair) shows significant increase at 6 weeks (p < 0.001). CASS and negative TAHC showed significant difference at 4 weeks (p < 0.001) by analyzing boxplot graph. Therefore, trichoscopic resolution occurred before the clinical cure. Terbinafine subjects showed a higher clinical cure rate at 4 weeks (p=0.02) as compared to griseofulvin. To conclude, trichoscopy is a good monitoring tool that could document the disappearance of almost all dystrophic hair at 4 to 6 weeks and is a more sensitive tool than microscopic examination. Regrowing hair and perifollicular scaling are markers of recovery.

Effect of Different Pulse Durations on the Efficacy of Long-Pulsed Alexandrite-Assisted Hair Removal; A Split-Face Comparison Study.

Introduction: Laser-assisted hair removal is widely used by a large number of patients complaining of unwanted hair. However, little is known about the effect of varying the pulse duration on clinical results and side effects. This study aimed to investigate the effectiveness of hair removal using an alexandrite laser with different pulse durations. Methods: Fifty female patients with facial hirsutism were subjected to a hair removal procedure with an alexandrite laser, using 3 and 10 milliseconds pulse durations on each side of the face every 5 weeks for three sessions. Photographs were taken and hair counts were checked before the treatment and one month postoperatively. Results: one month after the laser treatment, the clearance rate was 56% with both 3 and 10 milliseconds pulse durations. There was not any significant difference in clinical efficacy or the side effect profile. Conclusion: Using a 755 nm alexandrite laser for hair removal is an effective and safe method for delaying hair regrowth and this delay is not markedly different by increasing the pulse duration from 3 to 10 milliseconds.

Use of Topical Finasteride Vs Systemic Finasteride in Male Pattern Baldness

In this study we have analyzed the use of finasteride which is a type P-selective 5a-reductase inhibitor. By decreasing dihydroxytestestrone (DHT) level, it is found to be effective in the treatment of male androgenic alopecia. In this study, we compared the effect of topical vs. systemic finasteride in the treatment of androgenic alopecia. Our study is a randomized clinical trial study having 30 male patients. They have come for alopecia treatment at Nesam hospital, Coimbatore, India. We have selected male patients with androgenic alopecia and divided them into two groups (A, B), randomly having 15 patients in each group. For group A, Topical finasteride (0.1%) with minoxidil (5%) solution was given. Group B patients received topical minoxidil with oral finasteride (1mg) tablets. All patients were regularly followed up till the end of 6 months. A Patient had a first review in the first week followed by monthly follow up. Following parameters were taken into account: size of bald area, total hair count, and terminal hair. Data was analyzed by Chi-square statistical test. Each month the terminal hair, size of bald area and hair count between the two groups were compared. In the initial few months group, A showed good improvement. But Serial measurements indicated that a significant increase in hair counts and terminal hair counts is seen in both groups. This study showed that on long term follow-up of more than 3 months, both topical and systemic finasteride groups had similar results.

Comparative study of efficacy of topical minoxidil versus topical minoxidil with finasteride in androgenetic alopecia

&lt;p&gt;&lt;strong&gt;Background:&lt;/strong&gt; Minoxidil and finasteride are most common drugs used in androgenetic alopecia. The objective of the study was to know the efficacy of topical minoxidil solution with and without finasteride.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods:&lt;/strong&gt; In total about 30 subjects, aged 18-45 years, who came for outpatient consultation for male pattern androgenetic alopecia were randomized into two groups. Group A was treated with 0.1% topical finasteride and 5% minoxidil solution and Group B was treated with 5% minoxidil solution after taking informed consent from subjects of both groups.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results:&lt;/strong&gt; Analysis of the extent of bald area, hair count and number of terminal hair showed better results in group A compared to group B.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Better results were obtained with combination of topical minoxidil with finasteride than with plain topical minoxidil.&lt;/p&gt;

Hair Regrowth with Cannabidiol (CBD)-rich Hemp Extract - A Case Series.

Androgenetic alopecia (AGA) is the most common cause of hair loss. Several FDA approved medications are available but offer limited results. Studies have shown that the endocannabinoid system (ECS) is a key player in hair follicle cell growth. The ECS cannabinoid type one (CB1) receptors are well expressed in the hair follicle cells. Cannabidiol CBD is a negative allosteric modulator of the CB1 receptor and has been shown to result in hair shaft elongation. In addition, the hair follicle cycle phases are controlled by the ECS vanilloid receptor-1 (TRPV1). CBD has also been shown to increase Wnt signaling pathways that are involved in the differentiation of dermal progenitor cells into new hair follicles and maintaining the anagen phase of the hair cycle. The effects of CBD on hair growth are dose dependent and higher doses may result in premature entry into the catagen phase via a receptor known as vanilloid receptor-4 (TRPV4). Topical application of CBD reaches hair follicles where it is a CB1 negative modulator, and TRPV1, and TRPV4 agonist. A study was done of 35 subjects with AGA using a once daily topical hemp oil formulation, averaging about 3-4 mg per day of CBD and minimal amounts of other cannabinoids for six months. A hair count of the greatest area of alopecia was carried out before treatment and again after six months. The results revealed that men did slightly better than women, and the vertex area did better than the temporal areas. On average there was statistically significant 93.5% increase in hair after 6 months. All subjects had some regrowth. There were no reported adverse effects. Since the CBD works through novel mechanisms different from finasteride and minoxidil it can be used in conjunction with these current drugs and would be expected to have synergistic effects.

Platelet-rich plasma for androgenic alopecia: A randomized, placebo-controlled, double-blind study and combined mice model experiment.

Platelet rich plasma (PRP) has been accepted as a potential therapy for treating androgenetic alopecia (AGA). To fully clarify the underling molecular mechanisms of PRP action on hair growth and promote its clinical applications. In this study, we used mice models and protein biochip to explore the specific mechanisms of PRP regulating hair growth. Then, we performed a randomized, placebo-controlled, double-blind, half-head study of 52 AGA patients to verify the therapeutic efficacy of PRP in Chinese AGA patients. The results confirmed that PRP treatment boosted hair regrowth, accelerated hair cycling, and the effect sustained for more than one hair cycle in mice. Protein biochip evaluation confirmed remarkably upregulated β-Catenin, PDGF, and AKT signaling and repressed p53 signaling in PRP injection group. Clinically, mean hair count, density, diameter, and anagen hair ratio in PRP group showed a significant improvement at 6month comparing to control side. Overall, we elucidated the specific molecular mechanism of PRP action on hair growth and proved the therapeutic efficacy and safety of PRP in Chinese AGA patients.

707 Hypoxia induced Multipotent Stem Cell-Secreted Proteins Induce Hair Growth in a Phase 1a/2b trial in Male Pattern Baldness

A Phase 1b/2a clinical trial was performed to study the safety and efficacy of a bioengineered human cell-derived formulation, termed Hair Stimulating Complex (HSC), in stimulating hair growth and preventing hair loss in subjects with male pattern baldness. HSC contains naturally secreted growth factors known to be important in hair growth, including follistatin, KGF, VEGF, PLGF, HGF, and angiogenin. These growth factors are key to stimulating the hair follicle stem cells, supporting keratinocyte migration into the follicle to result in new hair formation, and promoting angiogenesis to supply increased nutrients to support the highly metabolically active anagen phase. Several ELISA and cell-based assays, including a human outer root sheath assay, are used to release the clinical product. The study was a double-blind, 2:1 randomized, single center trial in 36 subjects with Norwood Hamilton scores of 3V, 4, and 5. All subjects tolerated well the twenty 0.1cc intradermal injections, distributed between the vertex and temporal regions, administered at baseline, 6, and 12 weeks, with no signs of a serious adverse reaction reported. Canfield image analysis of treated sites were taken at baseline and 18 weeks. At the 18-week time point, 75% of the HSC subjects responded to treatment and showed new hair growth and a cessation in hair loss whereas 63% of the control subjects continued to lose hair. Canfield imaging at week 26 will assess total hair count numbers as well as vellus, non-vellus hairs and hair thickness. These results clearly demonstrate the safety and efficacy of intradermal injections of HSC in subjects with androgenetic alopecia and support initiating a larger phase 2 dosing study.

Results of low-level laser therapy in the treatment of hair growth: An Egyptian experience.

Recently, low level laser therapy was evaluated as an effective stimulating hair growth. Hair loss is the most common complaint in dermatology (specially females). It causes a significant psychosocial distress and decreased quality of life in affected patients and exists in different types, but the most common types are androgenetic alopecia and telogen effluvium (TE). Although there are many treatments with highest levels of medical evidence, but patients who exhibit intolerance or poor response to these treatments need additional treatment modalities. To evaluate the efficacy and safety low level laser therapy for female pattern hair loss (FPHL) and TE. A prospective interventional study included 20 female patients, 13 were diagnosed as FPHL, and 7 were diagnosed TE. Patients received two sessions per week with Hair Growth System (TOPHAT655) a bicycle-helmet type device. Treatment session of 20 minutes for 16 successive weeks (total of 32 treatments) with follow-up. Patients were evaluated by software-analyzed trichoscopic images, as the primary endpoint was the percent increase in hair counts from baseline to post-treatment. Global photography and patient satisfaction were determined as a secondary end point. Twenty patients completed the study (13 FPHL, 7 TE). FPHL patients baseline hair counts were 222.3 ± 33.5 (N = 13), in TE patients baseline hair counts were 271.2 ± 39.0 (N = 7). Post-treatment hair counts were 255.3 ± 30.4 (N = 13) In FPHL patients (P = .007), and 294.2 ± 38.1 (N = 7) in TE patients (P = .143). Low level laser therapy of the scalp at 655 nm significantly improved hair counts in FPHL, and there is no significance difference in TE patients with no serious adverse events. Additional studies should be considered to determine the long-term effects of low-level laser therapy treatment on hair growth and maintenance, and to optimize laser modality.

To Study the Effect of Activated Platelet-Rich Plasma in Cases of Androgenetic Alopecia

Context: Growth factors released from platelets act on stem cells in the bulge region of follicles and thus stimulate the development of new hair follicles. Aims: Primary aim of the study was to assess the efficacy and safety of activated platelet rich plasma in AGA. Settings and Design: Prospective double arm non-randomized pre-post study. Material and Methods: Activated Platelet-rich plasma was injected in either anterior half of alopecia scalp in first 20 patients and posterior half in next 20 patients (Group I) and the other half was injected with placebo (Group II). Each patient received a total of 5 session of aPRP, 15 days apart. Statistical analysis used: Quantitative variables were compared using student T test and Mann-Whitney Test between two groups. A p value of &lt; 0.05 was considered statistically significant. Results: 40 male patients with a clinical diagnosis of AGA (stage II to VI) were recruited but only 35 patients completed the whole study. At 1 month and 3 months follow-up, Group I showed statistically significant increase in hair count, hair density and anagen/telogen ratio as compared to Group II. Conclusion: aPRP is a safe and good alternative to medical treatment. It seems to have a stabilizing effect on hair fall and may be considered as a measure to prevent progression of alopecia in early stages.

Lyophilized growth factor intralesional injection in female pattern hair loss: A clinical and trichoscopic study.

Various therapeutic modalities have been tried for female pattern hair loss (FPHL) treatment. To our knowledge, no previous studies had evaluated the therapeutic effect of lyophilized growth factor (L-GF) intralesional injection in FPHL. The current study aimed to evaluate the efficacy and safety of intralesional L-GF injection in FPHL by clinical and trichoscopic evaluation. This study included 20 patients with FPHL. All patients received three treatment sessions of intralesional injection of L-GF 4 weeks apart. Patients were followed-up for further 3 months. The outcome was evaluated by trichoscopy, photography score, patient's satisfaction score and side effects were reported. Trichoscopic evaluation showed significant posttreatment increase in all hair parameters associated with a significant decrease in vellus hair count. Ludwig's grade II showed posttreatment significant differences in all trichoscopic parameters from the baseline. No significant differences were detected regarding all trichoscopic parameters between the two Ludwig's grades posttreatment. 80% of patients showed photography score improvement that was significantly higher in Ludwig's grade II than in grade I. 100% of patients showed improvement in patient's satisfaction score with insignificant difference between Ludwig's grades. Intralesional injection of L-GF is safe and improved various trichoscopic hair parameters and clinical scores in FPHL.

Nonablative radiofrequency for the treatment of androgenetic alopecia: An open‐label study

AbstractIntroductionAndrogenetic alopecia (AGA) is the most common type of progressive hair loss, and current treatments are limited. Wound healing has been associated with hair regrowth; consequently, its mechanism has been suggested for treatment of hair loss. Nonablative radiofrequency (RF), which induces wound healing mechanisms through thermal damage, has been shown to increase hair growth when applied to the scalp. In this study, we aim to evaluate a specially adapted non‐ablative RF device as a noninvasive, nonsystemic treatment for AGA.MethodsAn open‐label study was conducted to evaluate the efficacy of a nonablative RF device for treatment of AGA. Patients diagnosed with Hamilton–Norwood Stage 3 or above were recruited and received 10 weekly RF treatment sessions. Hair counts were performed before and after treatment manually by a medical resident.ResultsTen male and 10 female subjects were recruited. Hair count, hair density (per cm2), vellus hair density (per cm2), terminal hair density (per cm2), cumulative thickness (mm/cm2), number of follicular units, density of follicular units (per cm2), and average hair per unit increased from before to after treatment. Only the increases in hair count, overall hair density, terminal hair density, cumulative thickness, and average hair count/unit were statistically significant (p &lt; .05).DiscussionWe observed significant improvement in hair growth in 19 out of 20 patients. Overall, significant improvement was observed in total hair counts, terminal hair counts, hair shaft thickness, and in the number of follicular units. Further clinical research is warranted to further explore nonablative RF for treatment of AGA.