Hair Regrowth In Patients Research Articles

Characterization of scalp, eyelash and eyebrow hair regrowth in patients with severe alopecia areata randomized to placebo in brave AA1 and brave AA2 trials

Characterization of scalp, eyelash and eyebrow hair regrowth in patients with severe alopecia areata randomized to placebo in brave AA1 and brave AA2 trials

Effect of Microneedle on Hair Regrowth in Patients with Androgenetic Alopecia: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Abstract Objective Our objective was to assess the effectiveness and safety of microneedle by comparing microneedle plus 5% topical minoxidil treatment and microneedle alone to 5% topical minoxidil. Methods We searched databases such as Embase, PubMed, Cochrane library, VIP Database for Chinese Technical Periodicals, Wanfang, and China National Knowledge Infrastructure in relation to literature. The control group received 5% topical minoxidil solution, whereas the treatment group received either microneedle coupled with minoxidil or microneedle alone. The increase in hair count and hair diameter was the main evaluation criterion for assessing hair regrowth. Data were pooled with Stata 15 software. Results Eight studies with 472 participants were included. Compared with 5% topical minoxidil therapy, microneedle plus minoxidil treatment showed a significant increase in hair count (standard mean difference [SMD] :15.82, 95% confidence interval [CI]: 12.34, 19.31, p < 0.05), but no increase in hair diameter (SMD: −0.21, 95% CI: −2.94, 2.52, p = 0.879 > 0.05). The results of subgroup analysis suggested that microneedle plus minoxidil treatment showed a significant increase in hair count whether the depth of microneedle was less than 1 mm (SMD:1.16, 95% CI: 0.86, 1.42, p < 0.05) or more than 1 mm (SMD:0.52, 95% CI: 0.23, 0.82, p < 0.05). In terms of treatment period subgroup, microneedle combined with minoxidil therapy significantly increased hair count and hair diameter than single 5% topical minoxidil, whether in 12-week period (SMD: 1.08, 95% CI: 0.76, 1.39, p < 0.05) or 21 to 24 weeks period (SMD: 0.64: 95%, CI: 0.35, 0.92, p < 0.05). Conclusion According to this study, the effect of microneedle treatment alone on androgenetic alopecia (AGA) may be limited. However, microneedle plus 5% topical minoxidil treatment had better hair regrowth in hair count and can be considered as an additional therapy option for AGA. Combined with subgroup analysis results, 12-week period and less than 1 mm depth of microneedle penetration were recommended.

Treatment preferences of adults and adolescents with alopecia areata: A discrete choice experiment.

PRODUCTS with janus kinase (JAK) inhibition have been shown to promote hair regrowth in patients with alopecia areata (AA). To guide drug-approval and treatment decisions, it is important to understand patients' willingness to accept the potential risks of JAK inhibition in exchange for potential benefits. We quantified the treatment preferences of adult (≥18 years) and adolescent patients (12-17 years) with AA in the US and Europe to determine the trade-offs they are willing to make between benefits and risks. Preferences for oral AA treatment attributes were elicited using a discrete choice experiment consisting of 12 tasks in which patients chose between two hypothetical treatment alternatives and no treatment. Benefits included the probability of 80%-100% scalp hair regrowth (Severity of Alopecia Tool score ≤ 20) and achieving moderate-to-normal eyebrow and eyelash hair. Treatment-related risks included 3-year probabilities of serious infection, cancer, and blood clots. Preference estimates were used to calculate the maximum level of each risk that patients were willing to accept for increases in treatment benefits. The most important attribute to both adults (n = 201) and adolescents (n = 120) was a 50% probability of achieving hair regrowth on most or all the scalp; however, adolescents placed greater relative importance on this attribute than did adults. Adults were averse to the risks of serious infection, cancer, and blood clots, whereas adolescents were averse to the risk of cancer. For a 20% increase in the probability of 80%-100% scalp hair regrowth, adults were willing to accept a mean (95% confidence interval) 3-year risk of serious infection, cancer, and blood clots of 7.4% (5.5-9.3), 2.5% (1.9-3.1), and 9.3% (6.4-12.2). Adolescents were willing to accept a 3-year risk of cancer of 3.3% (2.4-4.2). Patients with AA in the US and Europe are willing to accept substantial risks to obtain an effective treatment.

Comparative Efficacy of Topical Tacrolimus 0.1% and Clobetasol Propionate 0.05% in the Treatment of Alopecia Areata (AA)

Alopecia areata patients can choose from a variety of therapy methods. Each method has advantages and limitations, and its suitability varies for each patient. The medical usefulness of topical corticosteroids in AA is yet debatable. Objective: To assess the effectiveness of topical tacrolimus 0.1% vs. topical clobetasol propionate 0.05% while treating alopecia areata. Methods: Randomized-controlled trial (Double blind) conducted in Dermatology Department, CMH-Abbottabad, from November 2022 to April 2023. The seventy (70) patients with alopecia areata who attended to OPD of CMH Abbottabad between the ages of 20 and 50 were included. The non-probability consecutive sampling method was used. For up to 3 months, patients in Group A used clobetasol propionate 0.05% twice daily, while patients in Group B used topical tacrolimus 0.1% twice daily. Patients were evaluated at the start of each session, four weeks later, eight weeks later, and twelve weeks later. The SALT score was used to estimate hair loss at presentation and during the 3-month follow-up. The degree of response has been characterized by following hair re-growth as excellent (>75%), marked (51-75%), moderate (26-50%), or mild (25%). A p-value of <0.05 was considered significant. Results: When the efficacy was compared, 26 (74.3%) patients in group-A (mean age 35.23+7.87 years) shown excellent response, while 14 (40%) patients in group-B (mean age 34.29+7.87 years) with significant p-value was 0.028. Conclusions: Clobetasol propionate 0.05% was more efficacious as a therapy choice for stimulating hair re-growth in patients.

Clinical Benefits of Baricitinib Therapy According to Scalp Hair Regrowth in Patients with Severe Alopecia Areata.

The present analyses report integrated results from BRAVE-AA1 (NCT03570749) and BRAVE-AA2 (NCT03899259) on the clinical benefits of baricitinib treatment on the basis of the amount of scalp hair regrowth through 52weeks of treatment. This posthoc analysis was conducted with data from patients who were treated continuously for 52weeks with baricitinib 4mg or 2mg. Clinical outcomes were assessed using the Severity of Alopecia Tool (SALT) and Clinician-Reported Outcome (ClinRO) for Eyebrow (EB) and Eyelash (EL) hair. Secondary measures included the Hospital Anxiety and Depression Scale and Skindex-16 adapted for alopecia areata. At week52, patients were classified into three subgroups: SALT ≤ 20 response, intermediate response (achieved a 30% improvement from baseline (SALT30) without a SALT score ≤ 20), or nonresponse (never achieved SALT30). The criterion of SALT30 approximates a minimal clinical meaningful response to therapy. At week52, with baricitinib 4 mg treatment, the greatest (70%) improvement in EB and EL was observed in responders, but approximately 50% of patients with intermediate response and 20% of nonresponders experienced complete/nearly complete EB and EL regrowth. Improvement in emotional distress was directionally related to improvements in scalp hair regrowth, while impact on quality of life was proportionately greater for the responder subgroup. Clinically meaningful regrowth in eyebrow and eyelash hair can occur in the absence of complete scalp hair regrowth after treatment with baricitinib. Emotional distress and quality of life improvement is most associated with obtaining a clinical meaningful improvement in scalp hair. BRAVE-AA1, ClinicalTrials.gov number, NCT03570749, start date, 24September2018; BRAVE-AA2, ClinicalTrials.gov number, NCT03899259, start date, 8July2019.

Clinical Outcomes for Uptitration of Baricitinib Therapy in Patients With Severe Alopecia Areata: A Pooled Analysis of the BRAVE-AA1 and BRAVE-AA2 Trials.

Baricitinib is an oral selective Janus kinase 1/2 inhibitor that has achieved clinically meaningful outcomes for scalp, eyebrow, and eyelash hair regrowth in patients with severe alopecia areata (AA) at week 36 of treatment. Treatment with baricitinib, 4 mg, has resulted in higher response rates than baricitinib, 2 mg, at weeks 36 and 52. To determine the efficacy of uptitration to baricitinib, 4 mg, for 24 weeks in patients who had previously not responded to baricitinib, 2 mg (Severity of Alopecia Tool [SALT] score of >20). BRAVE-AA1 and BRAVE-AA2 are multicenter, placebo-controlled, phase 3 randomized clinical trials that were initiated on September 24, 2018, and July 8, 2019, respectively, with follow-up to 200 weeks (data cutoffs of November 11, 2021, and November 5, 2021, respectively). This pooled analysis reports long-term extension data up to week 76. At baseline, 1200 adult patients with severe AA (SALT score ≥50) were randomly assigned in a 3:2:2 ratio to receive baricitinib, 4 mg; baricitinib, 2 mg; or placebo. Patients treated with baricitinib remained on the same treatment dose until week 52. Patients were considered nonresponders to baricitinib, 2 mg, if they had a SALT score greater than 20 after 52 weeks of therapy. The proportions of patients achieving a SALT score of 20 or lower and clinician-reported outcome for eyebrow hair loss and eyelash hair loss scores of 0 or 1 (full coverage or minimal gaps) with 2-point or higher improvements from baseline (among those with baseline scores ≥2 [significant gaps to no notable hair]) were analyzed through week 76. At week 52, of the 340 patients (mean [SD] age, 38.4 [12.9] years; 212 [62.4%] female) treated with baricitinib, 2 mg, 212 (62.4%) had a SALT score higher than 20 and were uptitrated to baricitinib, 4 mg. Two-thirds of these patients (142 of 212 [67.0%]) had a baseline SALT score of 95 to 100, indicating very severe AA. At week 76, 55 of the 212 patients (25.9%) had achieved a SALT score of 20 or lower. During the same period, response rates for clinician-reported outcome scores of 0 or 1 increased from 19.3% (31 of 161 patients) to 37.9% (61 of 161 patients) for eyebrows and from 24.1% (33 of 137 patients) to 40.9% (56 of 137 patients) for eyelashes. In this pooled analysis of the BRAVE-AA1 and BRAVE-AA2 trials, uptitration of baricitinib, 2 mg, to baricitinib, 4 mg, in those who did not respond to the 2-mg dose resulted in meaningful improvement of response rates over the subsequent 24 weeks for scalp, eyebrow, and eyelash hair loss. ClinicalTrials.gov Identifiers: NCT03570749 and NCT03899259.

EFFICACY OF METHOTREXATE ALONE OR WITH LOW-DOSE PREDNISONE IN ALOPECIA AREATA TOTALIS

This study aimed to evaluate the efficacy of methotrexate alone or in combination with low-dose prednisone in treating alopecia areata totalis. A randomized controlled trial was conducted among 100 patients diagnosed with alopecia areata totalis. Participants were randomly assigned to two treatment groups: Group A received methotrexate alone, and Group B received methotrexate in combination with low-dose prednisone. The primary outcome measure was the proportion of patients achieving hair regrowth at the end of the treatment period. Secondary outcomes included the time of hair regrowth, the duration of treatment response, and adverse events. Of the 100 patients, 50 were assigned to Group A and 50 to Group B. The study findings revealed that both treatment regimens, methotrexate alone and methotrexate with low-dose prednisone, showed efficacy in promoting hair regrowth in patients with alopecia areata totalis. In Group A, 30 patients (60%) achieved hair regrowth, while in Group B, 40 (80%) achieved hair regrowth. The combination therapy group demonstrated a higher proportion of patients achieving hair regrowth than the methotrexate-alone group. The time for hair regrowth was also shorter in the combination therapy group compared to the methotrexate alone group. Adverse events were minimal and comparable between the two groups. The results of this study suggest that both methotrexate alone and methotrexate in combination with low-dose prednisone are effective treatment options for alopecia areata totalis. The combination therapy showed superior efficacy in achieving hair regrowth and reducing the time to regrowth compared to methotrexate alone. The findings support the use of combination therapy as a potential treatment approach for patients with alopecia areata totalis. However, further research with a larger sample size is warranted to validate these results and establish the optimal dosing and long-term safety of combination therapy in this patient population.

Chitosan and Aloe Vera decorated nanoparticulate system loaded with Minoxidil as a suggested topical formulation for alopecia therapy

Minoxidil (Mxd) is a common medication used for hair regrowth in patients exhibiting different types of alopecia, especially androgenetic alopecia (AGA), but it has some negative aspects such as causing adverse effects and having limited permeation through the outer skin layers. In this study, minoxidil was encapsulated into niosomes and then loaded into chitosan nanoparticles and Aloe vera for creating a nanocomposite (Cs@Alo/Nio-Mxd), which will be used as a topical formulation to overcome these difficulties. The various prepared samples were physico-chemically characterised by their loading efficiency, TEM, SEM, zeta potential, FTIR and in vitro release profiles. The hair growth potential of the prepared formulations was evaluated by an in vivo study using rats with induced alopecia. Thirty-six rats with induced alopecia were randomised into six groups of six rats each. Group 1 (Negative control): rats served as normal and were treated with normal saline, Group 2: rats were treated with topical application of empty nanocomposites. Group 3 (Positive control): rats were treated with topical application of 5% Mxd, Group 4: rats were treated with topical application of (Cs-Mxd NPs), Group 5: rats were treated with topical application of (Cs@Alo-Mxd NPs). Group 6: rats were treated with topical application of (Cs@Alo/Nio-Mxd) nanocomposite. All formulations were applied once daily for 21 days. The treated skin was observed, photographed, and its histological features were examined. Results specified that Cs@Alo/Nio-Mxd nanocomposite could be preferentially deposited into the hair follicles, causing a significant increase (p < 0.05) in skin thickness, total hair follicle number per field, hair follicle diameter, hypodermis hair follicle number and anagen induction percentage.

Trajectories For Scalp Hair Regrowth In Patients With Severe Alopecia Areata Treated With Baricitinib

Trajectories For Scalp Hair Regrowth In Patients With Severe Alopecia Areata Treated With Baricitinib

The Efficacy, Safety, and Recurrence Rate of Diphenylcyclopropenone Topical Immunotherapy for Alopecia Areata: A Systemic Review and Meta‐Analysis

Background and Objective. Diphenylcyclopropenone topical immunotherapy is widely used in the treatment of alopecia areata. However, previous studies have shown significant differences in its efficacy. We conducted this systemic review and meta‐analysis to investigate the efficacy, safety, and recurrence rate of diphenylcyclopropenone topical immunotherapy for alopecia areata. Methods. Literatures related to diphenylcyclopropenone topical immunotherapy for alopecia areata between January 1st, 2002, and July 2nd, 2022, were searched in the following databases: PubMed, Embase, Cochrane Library, Sinomed, WanFang Data, and Chinese Medical Journal Network. Results. This meta‐analysis included a total of 40 moderate to high quality studies involving 3,002 patients. The overall rate of any hair regrowth was 69%, and the overall rate of complete hair regrowth was 23%. The rate of any hair regrowth in patients with alopecia totalis or alopecia universalis was 42%, and the rate of any hair regrowth in patients with other types of alopecia areata was 75%. Common side effects were mild contact dermatitis (36%), severe contact dermatitis (31%), regional lymphadenopathy (22%), hyperpigmentation (22%), and hypopigmentation (7%). The recurrence rate was 37%. Conclusion. Diphenylcyclopropenone topical immunotherapy is an effective treatment for various types of alopecia areata, and most of its common side effects are acceptable.

Hair loss following COVID-19 infection - the state of current knowledge and treatment approaches.

Introduction: Telogen effluvium is a non-scarring hair loss that can occur after COVID-19 infection. It usually occurs after about 3 months, causes diffused hair loss and lasts up to 6 months. The purpose of this narrative review is to collect and summarize the effects of potential methods to promote hair regrowth in patients after COVID-19 infection.&#x0D; Material and method: The article reviews available in PubMed and ResearchGate databases, studies on telogen effluvium and SARS-CoV-2. Due to the limited literature, articles on telogenetic hair loss progressing independently of COVID-19 were also included in the review.&#x0D; Results: Hair loss after COVID-19 infection occurs in almost 30% of patients. This is likely related to pro-inflammatory cytokines released during infection and the pro-thrombotic effect of the virus. Telogen effluvium is the most common type of alopecia occurring after COIVD-19 infection - about 86% of all cases. It affects women more often than men. It seems that its severity may correlate with the severity of the infection. Other than female gender and a history of chronic disease, it is unlikely to find any other contributing factors. Effective treatments seem to include the use of oral supplements such as vitamin D, polyunsaturated fatty acids and zinc. In addition, topical application of minoxidil and high-platelet plasma treatments have shown good outcomes.&#x0D; Conclusions: Given the fairly common occurrence of hair loss after COVID-19 infection, it seems reasonable to seek the most effective strategies for its treatment. At present, it appears that the best results are obtained by combining different treatment approaches.

A Summary of Pre-Clinical and Clinical Evidence for Cannabinoid Hair Follicle Effects

The endocannabinoid system (ECS), discovered in the 1990s, is a system involved with maintaining cellular homoeostasis by down-regulating the damaging inflammatory responses and upregulating regenerative processes. Tetrahydrocannabinol (THC), Cannabidiol (CBD), tetrahydrocannabivarin (THCV) and cannabidivarin (CBDV) are all phytocannabinoids that have novel therapeutic effects on hair growth through the ECS receptors on hair follicles. These cannabinoids are fat-soluble and poorly absorbed past the epidermis, but topical application easily reaches hair follicles where CBDV, THCV and CBD act as partial or full CB1 antagonists and agonists of vanilloid receptor-1 (TRPV1) and vanilloid receptor-4 (TRPV4). All these ECS receptors relate to hair follicle function. THC on the other hand has the opposite effects decreasing hair shaft elongation and matrix production. A summary of the pre-clinical and clinical cannabinoid research is reviewed. The studies confirm that for androgenetic alopecia (AGA) the method of action is different from and synergistic with current hair regrowth therapies. Blocking the CB1 receptor on the hair follicle has been shown to result in hair shaft elongation and matrix production via keratinocytes, 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. Two recent six-month duration clinical trials of adults with androgenetic alopecia (AGA) have revealed an average 93.5% increased hair count with CBD alone, and 164% increased hair count with hemp extract high in CBD, THCV, CBDV and menthol. A current study is underway to look at punch biopsies of the areas of hair regrowth in patients treated with a combination of CBD, THCV isolate, menthol and caffeine. Another study is underway looking at using hexahydrocannabinol (HHC) a hydrogenated version of THC to decrease facial hair growth as a cosmetic effect

Maintenance, withdrawal, and re-treatment with ritlecitinib and brepocitinib in patients with alopecia areata in a single-blind extension of a phase 2a randomized clinical trial

Maintenance, withdrawal, and re-treatment with ritlecitinib and brepocitinib in patients with alopecia areata in a single-blind extension of a phase 2a randomized clinical trial

18883 Androgenetic alopecia pattern hair regrowth in patients with alopecia areata treated with oral JAK inhibitors

Alopecia areata (AA) is a nonscarring autoimmune hair loss disorder for which new medications such as JAK inhibitors can result in significant hair regrowth. We present 2 cases of patients with long-standing AA treated with oral JAK inhibitors who regrew hair in a male-pattern baldness distribution. Both patients reported a 10-year history of AA with >50% hair loss and denied a history of androgenetic alopecia (AGA). At 3-month follow up, both experienced diffuse hair regrowth with notable bitemporal recession.

18739 A comparison of the gut and skin microbiome in siblings with and without alopecia areata

Alopecia areata (AA) is an autoimmune disease thought to be caused by several factors including stress, genetic predisposition and autoreactive CD8+NKG2D+ T cell attack on the hair follicle. It has been proposed that priming of cytotoxic T cells may be initiated by antigen presenting cells in the gut mucosa, as mediated by the microbiome. A case series of hair regrowth in patients with alopecia universalis after receiving fecal transplants for recalcitrant C. difficile infection has been reported, implicating the gut microbiome in AA development.

A randomized blinded retrospective study: the combined use of micro-needling technique, low-level laser therapy and autologous non-activated platelet-rich plasma improves hair re-growth in patients with androgenic alopecia

ABSTRACT Introduction Mini-invasive therapies based on autologous non-activated Platelet-Rich Plasma (ANA-PRP), Low-Level Laser Therapy (LLL-T), and Micro-Needling Technique (MN-T) used in combining for hair re-growth need to be standardized. Objectives The work aims to show in vivo outcomes resulted from retrospective case-series study in which ANA-PRP + MN-T + LLL-T were used in combined in patients affected by Androgenic alopecia. Methods 23 patients were treated, of which 13 males were classified in stage I–V by the Norwood–Hamilton scale, and 10 females were classified in stage I–III by the Ludwig scale. Assessment of hair re-growth was evaluated with photography, physician’s and patient’s global assessment scale, and standardized phototrichograms during a follow-up: T0 – baseline, T1 – 12 weeks, T2 – 23 weeks, T3 – 44 weeks, T4 – 58 weeks. Results Interesting outcomes represented by a hair density increase of 81 ± 5 hairs/cm2 and 57 ± 7 hairs/cm2 respectively at T1 and T2 compared with baseline (173 ± 5 hairs/cm2 at T1 and 149 ± 9 hairs/cm2 at T2 versus 92 ± 2 hairs/cm2 at baseline) were observed using computerized trichograms. Expert Opinion The main limitation in the autologous regenerative therapies and biotechnologies in hair-regrowth is the extreme variability of PRP products used, in the absence of standardized protocols and widely shared. Appropriate PRP preparations have to be pick after carefully thinking about their bio-molecular specifications and intended indications for use in patients. This approach will aid in matching the optimal PRP product to specific patient factors, leading to improved outcomes and the elucidation of the cost-effectiveness of this treatment. The combined use of biotechnologies as the association of PRP with micro-needling and low-level laser therapy may improve the results in terms of hair count and hair density compared with those obtained by alone PRP. All the procedures must be performed in the full respect of international and local rules. Conclusions The effect of the combined use of MN-T, LLL-T, and ANA-PRP has been demonstrated.

A randomized, double-blind, vehicle-controlled clinical study of hair regeneration using adipose-derived stem cell constituent extract in androgenetic alopecia

Accumulating evidence suggests that adipose‐derived stem cell constituent extract (ADSC‐CE) helps hair regrowth in patients with androgenetic alopecia (AGA). However, the effects of ADSC‐CE have not been demonstrated in a randomized, double‐blind, vehicle‐controlled clinical trial. In this randomized, double‐blind, vehicle‐controlled clinical trial, 38 patients (29 men) with AGA were assigned to an intervention group (IG), with twice‐daily self‐application of the ADSC‐CE topical solution over the scalp with fingers, or to a control group (CG). Changes in hair count and thickness at 16 weeks from the baseline were evaluated using a phototrichogram. Overall, 34 (89%) patients (mean age, 45.3 years) completed the study. The phototrichogram at week 8 showed more increase in hair count in the IG than in the CG, and intergroup differences in the change of hair count remained significant until week 16 with overall changes of 28.1% vs 7.1%, respectively. Similarly, a significant improvement in hair diameter was observed in the IG (14.2%) after 16 weeks when compared with hair diameter in the CG (6.3%). Our findings suggest that the application of the ADSC‐CE topical solution has enormous potential as an alternative therapeutic strategy for hair regrowth in patients with AGA, by increasing both hair density and thickness while maintaining adequate treatment safety.

The effect of platelet rich plasma on hair regrowth in patients with alopecia areata totalis: A clinical pilot study.

Autologous rich plasma (PRP) is blood plasma with enhanced concentration of platelets and is enriched with several growth factors which stimulate tissue regeneration. The current study aimed to investigate the effect of PRP on hair regrowth in patients with alopecia areata (AA) totalis. Ten subjects (28.9 ± 6.28 years; five males and five females) with clinically diagnosed AA totalis for at least 3 years who had not received any treatment within 3 months prior to the study were recruited. Blood sample was collected in thrombocyte harvesting tubes. The PRP was separated via centrifugation. The patients' scalp was divided sagittally into two approximately equal parts. In each patient, 4 mL of PRP was injected intradermally into the left or right side of the scalp; in each point, 0.1 mL of PRP was injected. Each patient was followed up monthly for 4 months. No hair regrowth was seen in eight patients and in two patients only <10% hair regrowth was observed. Totally, no significant effect was found for PRP on hair regrowth (p > .05). There was no side effect during treatment. Single dermal PRP injection did not prove to have any effect on hair regrowth in these patients.

Efficacy and Safety of a Low-Level Light Therapy for Androgenetic Alopecia: A 24-Week, Randomized, Double-Blind, Self-Comparison, Sham Device-Controlled Trial.

Previous studies have reported the benefits of low-level/light laser therapy (LLLT) for the promotion of hair regrowth. However, the effectiveness of LLLT for the treatment of androgenetic alopecia (AGA) is still a topic of debate. To investigate the efficacy and safety of LLLT on hair regrowth in patients with AGA. This 24-week, randomized, double-blind, self-comparison, sham device-controlled trial enrolled 100 patients with AGA. All participants were randomly assigned to receive the investigational LLLT on one side of the head and sham light treatment on the contralateral side, 3 times weekly for 30 minutes each, over a 24-week period. Global scalp photography, phototrichogram assessment, the investigator's global assessment (IGA) of hair regrowth, and the subject's assessment of the treatment satisfaction were used for evaluation. After 24 weeks of treatment, the LLLT-treated scalp exhibited significantly greater hair coverage than the sham light-treated side (14.2% vs. 11.8%, p < .001). A significantly greater improvement from baseline in hair thickness, hair count, hair coverage, and IGA were also observed in the LLLT-treated side than in the sham light-treated side at the 12- and 24-week visits. No serious adverse events were observed. The use of LLLT might be an effective, safe, well-tolerated treatment for AGA.

Ruxolitinib for the treatment of severe alopecia areata

To the Editor: Recent advances in our understanding of the pathogenesis of alopecia areata (AA) 1 Xing L. Dai Z. Jabbari A. et al. Alopecia areata is driven by cytotoxic T lymphocytes and is reversed by JAK inhibition. Nat Med. 2014; 20: 1043-1049 Crossref PubMed Scopus (495) Google Scholar have led to the use of Janus kinase (JAK) inhibitors for the treatment of AA. 2 Liu L.Y. Craiglow B.G. Dai F. King B.A. Tofacitinib for the treatment of severe alopecia areata and variants: a study of 90 patients. J Am Acad Dermatol. 2017; 76: 22-28 Abstract Full Text Full Text PDF PubMed Scopus (177) Google Scholar , 3 Kennedy Crispin M. Ko J.M. Craiglow B.G. et al. Safety and efficacy of the JAK inhibitor tofacitinib citrate in patients with alopecia areata. JCI Insight. 2016; 1: e89776 Crossref PubMed Google Scholar There are considerably more data regarding the JAK1/3 inhibitor tofacitinib for treatment of AA than the JAK1/2 inhibitor ruxolitinib. 4 Mackay-Wiggan J. Jabbari A. Nguyen N. et al. Oral ruxolitinib induces hair regrowth in patients with moderate-to-severe alopecia areata. JCI Insight. 2016; 1: e89790 Crossref PubMed Google Scholar , 5 Vandiver A. Girardi N. Alhariri J. Garza L.A. Two cases of alopecia areata treated with ruxolitinib: a discussion of ideal dosing and laboratory monitoring. Int J Dermatol. 2017; 56: 833-835 Crossref PubMed Scopus (22) Google Scholar In an open-label study of 12 patients with moderate-to-severe AA, high-dose ruxolitinib was efficacious. 4 Mackay-Wiggan J. Jabbari A. Nguyen N. et al. Oral ruxolitinib induces hair regrowth in patients with moderate-to-severe alopecia areata. JCI Insight. 2016; 1: e89790 Crossref PubMed Google Scholar We present a series of 8 patients with severe AA treated with ruxolitinib and show that hair regrowth may be achieved at a lower dose.