Hair Disorders Research Articles

Secondary alopecia induced by aesthetic procedures: An unrecognized potential complication.

Surgical facelifts and noninvasive techniques such as mesotherapy, hyaluronic fillers and botulinum toxin, among other procedures are widely used nowadays to reverse skin ageing and achieve rejuvenation effects. Secondary alopecia due to cosmetic procedures is a rare side effect and is poorly described in the literature. The mechanisms in which hair loss develops after an aesthetical procedure or surgical technique are not well known. The development of secondary scarring alopecia or non-scarring alopecia depends upon the interaction between different external factors, the individual host response and the extent of damage to the hair follicle anatomy. Current knowledge hints at the type of substance used, pressure to hair structures and vasculature due to the materials used, previously unknown or unaware hair disorder, and poor surgical techniques to be the main factors contributing to the development of secondary alopecia. Physicians and patients must be aware of all the substances used for the procedures and be attentive to any change in hair density or hair loss. Clinicians must have a low threshold to take biopsies if the risk of scarring alopecia may occur. Herein, we review the clinical, trichoscopic, histopathological findings and potential pathophysiological mechanisms of hair loss due to different aesthetic procedures.

The identification of trichoscopic features of allergic scalp contact dermatitis: a pilot-study of a single center.

Very few reports have described trichoscopic patterns of allergic scalp contact dermatitis (ASCD), which is usually an exclusion diagnosis on hair disorders. Trichoscopy is a simple, diffused method for investigating scalp diseases and may help to establish the characteristic findings of ASCD. A retrospective chart review was conducted on patients who visited the outpatient hair consultation at the Department of Experimental, Diagnostic, and Specialty Medicine of the University of Bologna, Italy, from January 2020 to September 2021. The inclusion criteria were based on the previous diagnosis of ASCD, patch test positivity; recover after allergen suspension and absence of other scalp diseases besides androgenetic alopecia on the patients in use of topical minoxidil. All trichoscopic features were described. ASCD was observed in 12 patients. The allergens were as follows: topical minoxidil (58.33%), p-phenylenediamine (PFD) (33.33%), wig, nickel, methylchloroisothiazolinone, and methylisothiazolinone (MCI/MI-Kathon CG) in one patient each, with multiple positive patients. Scales were classified as diffuse, patchy, white, and yellowish, and vascular patterns were classified as arborizing vessels, twisted red loops, simple red loops, bushy red loops, red dots, and globules besides atypical vessels. The main findings were erythema (100%), white scales (100%), arborizing vessels (91.2%), and simple red loops (91.2%). Trichoscopy is a useful tool to help on the diagnosis of ASCD.

A Comment on Mercantilism in the Trichological Sciences.

A quasi-scientific interest in hair loss and hair care originated in a London barbershop, and became known as trichology, with the Institute of Trichologists being founded. Other corporations successively followed, offering paid courses by home-study for training of initiates who desire more knowledge about hair. Trichologists are not medically qualified but are taught the practice of care and treatment of the hair and scalp in health and disease within their restricted but specialized role. With the advent of opportunities in the social media, and of epiluminiscence microscopy, a procedure practiced by the guild of trichologists long before its nominal introduction as trichoscopy into dermatologic practice, representatives of the medical profession are following the example of the trichologists in offering online courses, though with a better understanding of clinical-pathological correlations based on their academic learning. Despite the enthusiasm emerging with its establishment as a dermatologic tool in the diagnosis of hair and scalp disorders, caution is warranted not to elevate trichoscopy to something like a fetish status. As a diagnostic procedure, trichoscopy is to be understood as representing an integral part of a comprehensive dermatological examination. The Hippocratic Oath is one of the oldest binding documents in history, allegedly still held sacred by physicians: to treat the ill to the best of one's ability, to preserve a patient's privacy, and to teach the secrets of medicine to the next generation without fee. And yet, as in no other field of medicine, paid online courses on trichoscopy are flourishing and with a primary commercial aim. However, dermato-trichology, or trichiatry require the same due diligence as any other medical discipline, with respect to its practice and its ethics. Medical artistry is neither reducible to a single hand-held diagnostic technique nor is it negotiable.

Current understanding and treatment of sex hormone-related hair diseases

Hair follicle (HF) growth is regulated by local and systemic environments. Sex hormones, a systemic factor, paradoxically promote and suppress hair growth in different sites of the body, leading to diseases such as hirsutism, androgenetic alopecia, and female pattern hair loss. The past decades have seen progress in the treatment of sex hormone-related hair diseases, but the pathogenesis of some of these diseases remains obscure and even controversial. We review the biological effects of major sex hormones on hair growth and summarize their known impacts. We discuss the different responses of animal and human HFs to sex hormones, summarize the pathogenesis of sex hormone-related hair diseases, and highlight the benefits of and controversies in the current management of these diseases. Finally, we discuss future research directions such as interactions between sex hormones and the immune system and the possible role of epigenetics in these hair disorders.

Possible Association of Female-Pattern Hair Loss with Alteration in Serum 25-Hydroxyvitamin D Levels

Background and Aim: Most women who experience diffuse hair loss suffer from female-pattern hair loss (FPHL). Several mechanisms other than androgen have been suggested as contributing to the process. Serum 25-hydroxy vitamin D [25-(OH) D] has been associated with other hair disorders. The present study aimed to assess the female-pattern hair loss possible association with variation in serum 25-hydroxyvitamin D levels. Patients and Methods: This case-control study was conducted on 72 FPHL diagnosed female patients attending dermatology department of Tertiary Care Hospitals in Jamshoro and Karachi from November 2021 to October 2022. Females aged 18-40 years with skin prototypes III and IV were enrolled. About 72 healthy females were considered as control group. Study protocol was approved by the institutional research and ethical committee. Careful history, socioeconomic status, FPHL family history, menstrual history, and drug intake were recorded from cases and control. Patients were classified as having stage I, II, or III FPHL based on a clinical evaluation of the pattern of hair loss using Ludwig's scale. 25-OHD levels over a period of 4 months were measured to minimize seasonal bias. Females with 25-OHD levels <20 ng/ml were deficient, insufficient 21–29 ng/ml, sufficient >30 ng/ml, and intoxication >150 ng/ml. SPSS version 26 was used for data analysis. Results: The overall mean age was 28.6±2.4 years. Age-wise distribution of patients were as follows: 9 (12.5%) in 18-25 years, 24 (33.3%) in 26-30 years, 21 (29.2%) in 31-35 years, and 18 (25%) 36-40 years. Serum 25-(OH) D levels in FPHL patients were significantly lower (15.4 ± 8.25 ng/ml) than in controls (46.42 ± 19.92 ng/ml). The mean vitamin D level did not differ significantly between patients with and without family history (14.46 ± 8.62 and 13.9 ± 8.24 ng/ml, respectively. The mean vitamin D level differed significantly between the three Ludwig's degrees (13.15 ± 8.49, 14.23 ± 6.74, and 24.9 ± 6.42 ng/ml, respectively): between degrees I and III, as well as between degrees II and III. Conclusion: The present study showed that hair loss varied significantly across all age groups. Premenopausal women with vitamin D deficiency have higher rates of hair loss, which is most profound in the age groups 26-30, followed by 25-30. Furthermore, changes in serum 25-(OH) D levels, whether deficient or sufficient, may play a role in the etiology of FPHL. Keywords: Female Pattern Hair Loss (FPHL), Vitamin D, Serum 25-hydroxy vitamin D

Scalp disease analysis using deep learning models

Alopecia areata, folliculitis, hair loss, and dandruff are common scalp hair disorders caused by nutritional imbalances, stress, and pollution in the environment. Specialized treatments, such as hair physiotherapy, have arisen to address this issue. This paper pro-poses a deep learning model that can analysis the scalp diseases with high accuracy, using this model we can predict the scalp diseases which makes easier for them to treat the dis-ease with good treatment using the mobile phones we can predict the diseases simply us-ing its image. This paper deals with an advanced classification model which predicts scalp disease. More than 1100 images are used as training dataset, CNN is used for the classifi-cation and the high accuracy is achieved using VGG16, VGG19 and MobileNetV2.

Telogen Effluvium, Diagnosis and Management: A Narrative Review

Telogen effluvium (TE) is a type of alopecia characterized by diffuse, frequently acute hair shedding. Another chronic type with a more gradual onset is also observed. TE is the most prevalent cause of non-scarring diffuse hair shedding. It is a reactive process induced by hormonal changes, metabolic stress, or drugs. An increase in telogen hair loss (HL) does not imply a reason because TE may be confused with other hair disorders. Dermoscopy, a modern diagnostic method, can be used to distinguish a variety of hair diseases. This review discusses the putative causal variables, clinical manifestations, diagnostic techniques, and therapeutic approaches.

A STUDY OF THE PATTERN OF DERMATOLOGICALAND SEXUALLY TRANSMITTED DISEASES IN ADOLESCENTS AND YOUNG ADULTS IN EASTERN UTTAR PRADESH

Introduction: Adolescents and young adults are high-risk groups for skin and sexually transmitted diseases, especially in developing or lowincome countries. The present study was conducted to give an insight on the various dermatological and sexually transmitted diseases in adolescents and young adults in the age group of 10-24 years. Materials and Methods: This is a retrospective study where all the records of the patients who presented at a speciality clinic for adolescents and young adults were assessed. Those patients who consulted the treating dermatologist were included in the study. The records of 422 patients between the ages of 10 and 24 years, attending the tertiary care centre in Eastern Uttar Pradesh during 2020 and 2021 were included in this retrospective study. Results: Out of 422 patients, there were 164 males and 258 females. The mean age of all patients was found 19.433.57 years. The most common dermatological disease was Dermatophytic fungal infections seen in 67(15.8%) patients followed by chronic Idiopathic Urticaria in 57(13.5 %) patients followed by acne Vulgaris in 46(10.9%) patients. Among infestations, Scabies was seen in 41 (9.7%) patients. The next common dermatoses were Post Inammatory Hyperpigmentation seen in 40 patients. In hair disorders, telogen efuvium was the most common manifestation seen in 39(9.2%) patients. Among sexually transmitted infections (STI), Vulvovaginal Candidiasis was diagnosed in 19 patients and genital warts in one male patient. Conclusion: Fungal infections are common in adolescents and young adults. Acne Vulgaris is also common in this age group

Regulatory Effects of Thai Rice By-Product Extracts from Oryza sativa L. cv. Bue Bang 3 CMU and Bue Bang 4 CMU on Melanin Production, Nitric Oxide Secretion, and Steroid 5α-Reductase Inhibition.

Alopecia and gray hair are common hair abnormalities affecting physical appearance and causing psychological problems. Chemical treatments partially restore hair disorders but have distressing side effects. Bioactive plant compounds constitute promising sources of potential medicinal substances instead of chemical agents, producing high side effects. In this study, we focused on the waste of local rice cultivars: Bue Bang 3 CMU (BB3CMU) and Bue Bang 4 CMU (BB4CMU) from the north of Thailand. The rice bran oil (RBO), defatted rice bran extract (DFRB), and rice husk (H) were determined for in vitro hair revitalization in melanin production, nitric oxide (NO) secretion, and steroid 5α-reductase inhibition. The results indicated that BB4CMU-RBO with high contents of iron, zinc, and free fatty acids showed a comparable induction of melanin production on melanocytes (130.18 ± 9.13% of control) to the standard drug theophylline with no significant difference (p > 0.05). This promising melanin induction could be related to activating the NO secretion pathway, with the NO secretion level at 1.43 ± 0.05 µM. In addition, BB4CMU-RBO illustrated a significant inhibitory effect on both steroid 5α-reductase genes (SRD5A) type 1 and type 2, which relates to its primary source of tocopherols. Hence, rice bran oil from the Thai rice variety BB4CMU could be applied as a promising hair revitalizing candidate, from natural resources, to help promote hair growth and re-pigmentation effects.

Skin Disease Prevalence amongst Rural Communities in KwaZulu-Natal Province, South Africa

Little information is known of skin diseases within rural communities in KwaZulu-Natal, South Africa. There is an urgent need to identify plants with antimicrobial activity as there is an increase in the incidence of new and re-emerging infectious diseases. The present study compares species from two different localities used to treat common skin diseases, the parts used, and the method used to prepare traditional cures. The prevalence of skin disease compared to other ailments were also compared. Traditional healers from northern (seven main districts) and mid-KwaZulu-Natal (three main districts) muthi markets were randomly selected and interviewed after obtaining consent. Data collected included the specific plants used to treat skin diseases, common names, parts of the plant used, the collection locality, and the conditions treated by the traditional healers. Fourteen plant species were collected and traded in northern KwaZulu-Natal based on their curative properties and their use to treat wounds, skin lesions, rashes, burns, and scratches compared to only six in mid-KwaZulu-Natal. Approximately 43 percent of species were common to all districts, possibly due to their wide distribution. People with skin diseases formed the majority of traditional healer consults. Most conditions were very similar, possibly due to rural communities following a similar lifestyle. Skin infections and eczema were commonly treated conditions, followed by acne, hair disorders, and bruises. Skin diseases are common amongst rural community dwellers in KwaZulu-Natal regardless of location, possibly due to their association with HIV infection. The plants used by traditional healers to treat various conditions are related to geographical distribution and abundance patterns.

Advances in microneedles research based on promoting hair regrowth.

Alopecia is the most common and difficult-to-treat hair disorder. It usually brings a significant psychological burden to the patients. With the growing popularity of alopecia, the study of alopecia has gained more attention. Currently, only minoxidil and finasteride have been approved by the FDA for the treatment of alopecia, but the efficacy has always been unsatisfactory. As a new form of transdermal drug delivery, microneedles have been widely used in the treatment of alopecia and have proven to be effective. Microneedles delivery can improve the efficiency of local drug delivery and patients' compliance, which can achieve better therapeutic effects on hair-related diseases. Therefore, microneedles have gained much attention in the field of alopecia and hair regrowth promotion in recent years. This review summarizes the last decade of research on the microneedles delivery design for the treatment of alopecia or promotion of hair regrowth and provides a comprehensive evaluation of this field.

Positioning of Low Alcohol or Alcohol-Free Minoxidil Formulation for the Management of Androgenetic Alopecia: Indian Perspective.

Topical minoxidil is used for treating different hair disorders. Even though it is an effective therapy, many patients show poor compliance due to the cost, side effects, and duration of treatment. Topical minoxidil is the mainstay treatment for androgenetic alopecia (AGA). Recently, low alcohol or alcohol-free topical minoxidil formulation has proven to be an alternative for patients suffering from AGA, including those with poor compliance with other therapies. Thus, the current article provides the positioning of low alcohol or alcohol-free topical minoxidil to manage AGA in Indian clinical practice.

Trichoscopy in Alopecia Areata and Trichotillomania in Skin of Colour: A Comparative Study.

Alopecia areata (AA) and trichotillomania (TTM) are the two common causes of localised non scarring alopecia. While AA is an autoimmune disorder, TTM is an impulse control disorder which makes the treatment of the two entities completely different. Trichoscopy is a non-invasive tool used to diagnose hair disorders, which not only is extremely helpful in diagnosing AA and TTM but also differentiates them from other hair disorders as well. The aim of our study is to describe the various trichoscopic features of AA and TTM and to compare the frequency of each trichoscopic feature in order to establish diagnostic clues for differentiating AA and TTM. Trichoscopy was performed on clinically diagnosed cases of AA and TTM with DL4 dermoscope and the images were analysed by 2 dermatologists independently. The frequency of trichoscopic features in AA and TTM was compared using chi square test. Twenty-four patients of TTM and 50 patients of AA were included in the study with mean age of AA being 30 years and mean age of TTM being 23.4 years. Exclamation mark hair, tapered hair, coudability hair, pigtail hair, clustered vellous hair, clustered regrowing hair and white hair were significantly more in alopecia areata. Conversely broken hair of different length, trichoptilosis, flame hair, mace hair, coiled hair, hair powder, fractured hair, v sign and burnt matchstick sign were the common features in TTM. To conclude, even though there is an overlap of trichoscopic features in AA and TTM, it is possible to distinguish the two if an assemblage of specific features are present.

Role of Certain Plant Ingredients on Hair Disorders.

For maintaining healthy, attractive appearance hair has the vital role. Hair problems are common and can diminish self-esteem and selfconfidence of a person. Many forms of hair problems, baldness, alopecia, hair fall, gray hair, dryness, and most common dandruff require clinical care by a health care professional. Hair is sensitive to changes in the environment, diet, and overall health. Identifying these changes and resorting to the wisdom of Ayurveda for their coping mechanisms can help maintain good hair health. Ayurveda formulations always have attracted considerable attention because of their good activity and comparatively lesser side effects with synthetic drugs. This review gives knowledge regarding the beneficial effects and recent progress of medicinal plants for the treatment of hair disorders.

A community-based study of hair care practices, scalp disorders and psychological effects on women in a Suburban town in Southwest Nigeria.

The scalp hairs on an average African is dry with low tensile strength and a tendency to break easily. This is mostly due to poor penetration of the natural oils on the scalp and the very curly hair texture. Various techniques developed to manage African hair are associated with certain hair and scalp disorders and are sources of distress. This was a cross-sectional survey to compare natural African hair and chemically processed (relaxed) hair to determine the effect of hair care and grooming practices on common scalp disorders and the psychological effect in Nigerian women. Questionnaires were administered to women at the market, churches and outreaches with many women in attendance to document the hair grooming practices, common scalp symptoms and psychological effects experienced. They were also examined for the presence of seborrhoeic dermatitis and traction alopecia. The study involved 452 women (62.17%) with relaxed hair and 275 women (37.83%) with natural (untreated) hair. Women with relaxed hair experienced significantly more flaking of the scalp (P = 0.046, x2 = 6.16), hair breakage (P = 0.023, x2 = 11.35) and hair loss (P = 0.020, x2 = 7.87) than those with natural hair. The most common psychological effects of hair scalp disorders in all participants were feeling of uneasiness 142 (19.5%), frustration 49 (6.7%), poor body image 40 (5.5%) and anger 38 (5.2%). Significantly more women with relaxed hair experienced moderate hair loss from traction than women with natural hair (P = 0.014, x2 = 8.52). Nigerian women experienced clinical and psychological distress consequent to their hair grooming practices. Individuals with relaxed hair had more physical symptoms, hair loss and psychological disturbances than those with natural hair.

Molecular Basis of Hereditary Hair Diseases.

The hair follicle is an appendage of the skin that undergoes hair cycles throughout life. Recently, numerous genes expressed in the hair follicles have been identified, and variants in some of these genes are now known to underlie hereditary hair diseases in humans. Hereditary hair diseases are classified into non-syndromic and syndromic forms. In the Japanese population, the non-syndromic form of autosomal recessive woolly hair, which is caused by founder pathogenic variants in the lipase H (LIPH) gene, is the most prevalent hereditary hair disease. In addition, other types of hereditary hair diseases are known in Japan, such as Marie-Unna hereditary hypotrichosis, hypohidrotic ectodermal dysplasia, and tricho-rhino-phalangeal syndrome. To ensure correct diagnoses and appropriate patient care, dermatologists must understand the characteristics of each hair disorder. Elucidation of the molecular basis of hereditary hair diseases can directly tell us which genes are crucial for morphogenesis and development of hair follicles in humans. Therefore, continuation of "wet laboratory" research for these diseases remains important. To date, several syndromic forms of hereditary hair diseases have been approved as designated intractable diseases in Japan. As part of our efforts in the Project for Research on Intractable Diseases through the Ministry of Health, Labour, and Welfare of Japan, we anticipate that more hereditary hair diseases be recognized as designated intractable diseases in the future, which will be to the benefit of the affected individuals.

Hair and scalp-related disorders are a trending topic in dermatology, with a significant increase in number of consultations in the last decade.

Hair and scalp-related disorders are a trending topic in dermatology, with a significant increase in number of consultations in the last decade.

Trichoscopic Diagnosis of Structural Hair Defects in a Clinical Setting: A Cross-Sectional Analytical Study

Background: Trichoscopy is a simple, noninvasive procedure practiced in the diagnosis of a multitude of scalp and hair disorders. Hair shaft abnormalities usually represent a diagnostic challenge to dermatologists. Objectives: The aim of the study was to determine the practicality, versatility, and value of using the handheld dermoscope in the assessment of hair shaft abnormalities and the diagnosis of different hair/scalp disorders. Methods: Eight hundred and seven patients of both sexes, aged from 1 to 76 years, with complaints pertaining to scalp and hair, were the subjects of the study. All patients were examined by the handheld dermoscope, and 400 were additionally examined by the folliscope, digital dermoscope, or their hairs mounted for light microscopy. Results: Based on trichoscopic findings, more than half the patients demonstrated thinned terminal hairs and a predominance of single-haired scalp pilosebaceous units (57% and 55.5%, respectively). Over a quarter of the patients showed hair diameter heterogeneity, upright regrowing hairs, and increased vellus hairs (37%, 31%, and 25%, respectively). Other trichoscopic findings included scalp scaling (19%), hair weathering (12%), thinned wavy hairs (10.5%), brush-like hair fractures (9%), exclamation mark hairs (9%), and longitudinal cleavage (trichoptilosis) (8%). The clinical diagnostic spectrum was topped by the following diagnoses in order of frequency: female pattern hair loss, telogen effluvium, traction alopecia, and trichotillomania. Trichodynia appeared to be significantly associated with numerous hair shaft abnormalities. Conclusion: Most hair shaft abnormalities can be reliably diagnosed with high accuracy using a handheld dermoscope in an office setting. Skillful knowledge of dermoscopy is an important aid in the diagnosis of hair and scalp disorders.

Hair Loss and Androgen’s Role in the Era of COVID-19

The new coronavirus (SARS-COV2), which causes coronavirus illness, has expanded globally, impacting millions of individuals. In comparison to female patients, males have a higher prevalence, morbidity, and death rate from this condition, according to international statistics. Androgens have been implicated in the pathophysiology of COVID-19. This review's objective is to explain the potential connection between the pathophysiology of androgen and the infectivity mechanism of the coronavirus as well as the association between SARS-COV2 and hair disorders. This might assist in clarifying androgen's involvement in COVID-19 prognosis and therapy.

Evaluation of Scalp Hair Density and Diameter in the Arab Population: Clinical Office-Based Phototrichogram Analysis.

Knowing normal values of scalp hair thickness and density is beneficial for diagnosing hair disorders, monitoring responses to therapy, performing hair transplants, and conducting relevant research. Such normal values have not yet been studied for Arabs. To assess the hair density and diameter of the Arab population at different scalp sites using phototrichogram. A cross-sectional descriptive study was performed at King Saud University Medical City from December 2021 to August 2022. The study was conducted on Arab adults who were not suffering from any hair disorder. The study was conducted using a questionnaire and clinical examination by phototrichogram. A total of 120 participants were enrolled in this study. The mean hair density was 147.1± 7.8 hairs/cm2, and the mean hair diameter was 87±4.9 μm. There were significant differences between hair density (P=0.0001) and diameter (P=0.0001) in different regions of the scalp. Females had higher hair density than males at occiput (P=0.038). Arab hair has a higher thickness and lower density than hair of other ethnicities. This needs to be considered when diagnosing and/or treating hair problems in Arabs.