Mean Hair Density Research Articles

Quantitative trichoscopic analysis of hair density in people attending tertiary care hospital - A cross-sectional study.

Hair is important to trace evidence commonly encountered in almost all criminal cases. Forensic anthropologists routinely compare the morphological characteristics of the hair samples to determine a transfer. Assessment of parameters such as hair density, hair diameter, follicular units, and empty hair follicle/yellow dots are useful for the diagnosis of various hair disorders, monitoring treatment outcomes, and research purposes. The study aimed to analyze the relationship between age and hair density. The present cross-sectional observational study was carried out at the Department of Dermatology at a tertiary care center. All the subjects attending the Dermatology Outpatient Department fulfilling inclusion criteria were studied. Data were collected after the approval from the Institutional Ethical Committee. The procedure was explained and a written consent was taken. Each patient's hair was parted in the middle and images from a point of roughly 5 inches from the patient's glabella were taken. The parameters such as hair thickness, hair density, hair count, follicular units, and empty hair follicles/yellow dots were noted. In the present study, the majority of the study subjects belonged to the age group 26-35 years (38%), followed by 18-25 years (34.7%), 36-45 years (20.7%), and least in the age group of 46-55 years (6.7%). In the present study, the mean unit density in males was 104.78 ± 14.33 and that of females was 108.36 ± 17.60. Mean hair density varies concerning age group in the study population.

Genetic parameters for novel climatic resilience indicators derived from automatically-recorded vaginal temperature in lactating sows under heat stress conditions

BackgroundLongitudinal records of automatically-recorded vaginal temperature (TV) could be a key source of data for deriving novel indicators of climatic resilience (CR) for breeding more resilient pigs, especially during lactation when sows are at an increased risk of suffering from heat stress (HS). Therefore, we derived 15 CR indicators based on the variability in TV in lactating sows and estimated their genetic parameters. We also investigated their genetic relationship with sows’ key reproductive traits.ResultsThe heritability estimates of the CR traits ranged from 0.000 ± 0.000 for slope for decreased rate of TV (SlopeDe) to 0.291 ± 0.047 for sum of TV values below the HS threshold (HSUB). Moderate to high genetic correlations (from 0.508 ± 0.056 to 0.998 ± 0.137) and Spearman rank correlations (from 0.431 to 1.000) between genomic estimated breeding values (GEBV) were observed for five CR indicators, i.e. HS duration (HSD), the normalized median multiplied by normalized variance (Nor_medvar), the highest TV value of each measurement day for each individual (MaxTv), and the sum of the TV values above (HSUA) and below (HSUB) the HS threshold. These five CR indicators were lowly to moderately genetically correlated with shoulder skin surface temperature (from 0.139 ± 0.008 to 0.478 ± 0.048) and respiration rate (from 0.079 ± 0.011 to 0.502 ± 0.098). The genetic correlations between these five selected CR indicators and sow reproductive performance traits ranged from − 0.733 to − 0.175 for total number of piglets born alive, from − 0.733 to − 0.175 for total number of piglets born, and from − 0.434 to − 0.169 for number of pigs weaned. The individuals with the highest GEBV (most climate-sensitive) had higher mean skin surface temperature, respiration rate (RR), panting score (PS), and hair density, but had lower mean body condition scores compared to those with the lowest GEBV (most climate-resilient).ConclusionsMost of the CR indicators evaluated are heritable with substantial additive genetic variance. Five of them, i.e. HSD, MaxTv, HSUA, HSUB, and Nor_medvar share similar underlying genetic mechanisms. In addition, individuals with higher CR indicators are more likely to exhibit better HS-related physiological responses, higher body condition scores, and improved reproductive performance under hot conditions. These findings highlight the potential benefits of genetically selecting more heat-tolerant individuals based on CR indicators.

Low-level light therapy versus topical 5% minoxidil in the management of androgenetic alopecia in males: A randomised controlled trial

BackgroundAndrogenetic alopecia (AGA) is the most common non-scarring alopecia affecting men with progressive patterned hair loss and has significant impact on quality of life. Topical minoxidil and oral finasteride are approved for the management of AGA. Low-level light therapy (LLLT) has recently been approved for the management of AGA. Aim of the study was to compare the efficacy of LLLT with 5% minoxidil in male androgenetic alopecia. MethodsThis study was a single-blind randomised controlled trial which included 91 male patients during the study period. Group 1 included 48 patients receiving 5% topical minoxidil application twice daily for 6 months and Group 2 included 43 patients receiving LLLT with the wavelength of 633 ± 10 nm three sessions per week each of 10 min for 06 months. Patients were evaluated at baseline, 3 months, and 6 months with clinical photography and dermoscopy. The data was analysed using SPSS ver 20. ResultsOut of 91 enrolled, 75 completed the study (38 in group 1 and 37 in group 2). At the end of 6 months, 7(18.4%) showed no change, 20 (52.6%) showed mild to moderate growth, and 11 (28.9%) showed excellent growth in the minoxidil group. In the LLLT group; 10 (27%) showed no change, 21 (56.7%) showed mild to moderate growth and 6 (16.2%) showed excellent growth. The mean hair density in the minoxidil group at baseline, 3 months, and 6 months was 97.6 ± 21.6, 116.4 ± 20.4, and 134.6 ± 24, respectively. The mean hair density in the LLLT group at baseline, 3 months, and 6 months was 104.8 ± 22.7, 117.3 ± 25.1, and 130 ± 25.7, respectively. There was a statistically significant (p < 0.001) increase in hair density and improvement in clinical photography from baseline at 3 months and 6 months in both groups. There was no significant difference in the two groups at 3 and 6 months. ConclusionThe results of the LLLT group were comparable to the minoxidil group. No major adverse effects were found in the groups and can be used safely in the treatment of AGA.

Evaluation of the efficacy of microneedling without and with minoxidil 5% and autologous platelet-rich plasma for androgenetic alopecia in men.

Androgenetic alopecia is the most common form of non-cicatricial hair loss in men. The condition also affects young adults and can cause significant psychological distress. In addition to widely accepted methods, clinicians have at their disposal a number of therapies for which there are no established treatment algorithms. The study was conducted on a selected group of 92 men aged between 20 and 50 years. The patients were divided into three groups, each with a different therapeutic algorithm: group A - three microneedling treatments 1 month apart, group B - three microneedling treatments 1 month apart and daily topical application of 5% minoxidil, group C - three platelet-rich plasma treatments 1 month apart. Each group showed an increase in mean hair number and density. However, only group C demonstrated a statistically significant increase in hair shaft thickness. Currently, there is no clear consensus in the literature regarding algorithms for microneedling and platelet-rich plasma treatment of the scalp. For the study, we selected a minimum effective algorithm that yielded satisfactory results.

Efficacy of Adipocyte-Derived Stem Cells-Conditioned Media in Telogen Effluvium.

To assess the effectiveness of adipocyte-derived mesenchymal stem cells-conditioned media (ADSC-CM) formulation in telogen effluvium patients. A retrospective cohort study was conducted at a dermatology clinic in Jeddah, Saudi Arabia. The study included 50 consecutive patients aged 20-70 years, who were diagnosed with telogen effluvium. All patients received five monthly sessions of the same commercial ADSC-CM formulation, using a standardized application protocol. Pre- and post-intervention changes in trichometry parameters were analyzed. There was a significant increase in mean hair density (up to 29.01 hair/cm2; effect size 0.7-1.0), cumulative hair thickness (up to 2.67 units; effect size 0.7-1.4), and the number of follicular hair units (up to 19.96%; effect size 1.0-1.3) in all scalp regions (p < 0.001), associated with a decrease in mean trichometry-derived Sinclair scale by 0.8-1.3 (p < 0.001). Positive outcomes were observed in 70%-92% of the patients depending on the parameter and scalp region. There was no impact of the patient's age on ADSC-CM efficacy. ADSC-CM was successfully applied as a new treatment option for patients with telogen effluvium. These findings provide another therapeutic and research area for dermatologists to optimize the management of telogen effluvium and reduce its impact on patients.

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.

HOME-BASED LASER DEVICES. EFFICACY AND SAFETY

BACKGROUND Home-based light and laser devices are effective for the treatment of various dermatological problems OBJECTIVES To systematically review and evaluate the efcacy and safety of commercially available home-based laser devices for various dermatological applications METHOD A comprehensive literature search was performed on Google Scholar and PubMed. Prospective clinical trials were included, while animal studies, non-English articles, and studies that did not focus on home use or dermatological indication were excluded. A total of 675 articles were identied regarding home use devices. After screening the articles for inclusion and exclusion criteria, 44 studies involving 1,951 participants were selected, including 21 randomized control trials, 5 non-randomized controlled trials, and 18 case series. RESULTS There was signicantly more evidence for the safety or efcacy of Intense pulse light, but this study focused on using home-based laser devices. Most studies evaluated short-term hair reduction up to 3 and 6 months. Devices were found to be effective for short-term hair removal, with side effects ranging from erythema and edema to blisters. The use of laser for skin rejuvenation is based on the fact that laser-treated areas can have islands of healthy skin left behind, which accelerate recovery. Patients who underwent treatment in a recent prospective, split-face study were evaluated by a blinded dermatologist and showed at least a 1-point improvement in wrinkles, dyschromia, and diffuse redness in 75% of participants Low-level laser therapy stimulates hair growth. Patients who used the device for 15 minutes per week for 26 weeks demonstrated signicant improvement in mean terminal hair density and overall hair growth compared to the control group. CONCLUSION Available information from current clinical trials indicates that home-based laser devices are adequate for the short treatment of hair removal, skin rejuvenation, and hair removal. Additional controlled trials are recommended to better quantify the safety and efcacy of available devices.

Short-Term Efficacy of Autologous Cellular Micrografts in Male and Female Androgenetic Alopecia: A Retrospective Cohort Study.

PurposeAutologous cellular micrografts (ACM) is a novel treatment method in hair loss, and few data are available regarding its efficacy. The present study was carried out to assess the short-term clinical efficacy of a single application of ACM in the treatment of male and female androgenetic alopecia (AGA).Materials and MethodsThis was a single-center retrospective study involving 140 consecutive adults with confirmed AGA, who received a single session of ACM (Regenera Activa®). Efficacy was evaluated 1–6 months after treatment, by analyzing the change of trichometry parameters, which were assessed using TrichoScan digital image analysis.ResultsDepending on the scalp region, there was increase in mean hair density by 4.5–7.12 hair/cm2, average hair thickness by 0.96–1.88 μm, % thick hair by 1.74–3.26%, and mean number of follicular units by 1.30–2.77, resulting in an increase of cumulative hair thickness by 0.48–0.56 unit. Additionally, the frontal region showed a significant decrease in % thin hair (−1.81%, p = 0.037) and yellow dots (−1.93 N/cm2, p = 0.003). A favorable response was observed in 66.4% of the participants in the frontal region. Further, a gender-specific effect of treatment was observed.ConclusionACM is a promising treatment in AGA with a short-term favorable response observed in up to approximately two-thirds of patients.

English

BACKGROUND Androgenetic alopecia (AGA) is a genetically determined disorder characterized by the gradual conversion of terminal hairs into indeterminate, and finally into vellus hairs. It is the most common cause of hair loss affecting more men and occasionally women. Platelet-rich plasma (PRP) therapy is one of the newer treatment options and has shown promising results. We wanted to evaluate the safety and efficacy of PRP in the treatment of AGA. METHODS A prospective cohort study was done on thirty patients of AGA. The stage of alopecia was evaluated according to the Hamilton-Norwood scale (males) and the Ludwig scale (females). All patients were treated with six intradermal PRP sittings with an interval of 4 weeks between each sitting and were evaluated at the end of 6 months using global photography, hair pull test, patient’s satisfaction rating and hair density. RESULTS Out of 30 patients, majority were in the age group of 21 - 25 years (40 %). 23 were males and 7 were females. Among male patients, maximum number of patients (39.13 %) were having grade 4 AGA followed by grade 3 (30.43 %). Among females, maximum number of patients (57.14 %) were having grade 1 AGA. At baseline, 66.67 % patients showed positive hair pull test whereas all patients showed negative hair pull test at the end of study. Baseline mean hair density was 78.96 ± 9.66 hairs / cm2 and at the end of study it was 105. 46 ± 9.21 hairs / cm2 . On an analogue scale ranging from 0 to 10, the overall mean change in the clinical rating of patient satisfaction was 6.83, which denoted satisfactory for most patients. CONCLUSIONS All patients treated with PRP showed increase in hair density in dermoscopic photomicrographs at the end of the study. PRP is a simple, effective and safe treatment for AGA. KEYWORDS Androgenetic Alopecia, Platelet-Rich Plasma

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.

The Battle begins: Is strip surgery really necessary?

To measure the effects of previous Follicular Unit Transplantation (FUT) procedure. The study was conducted in a private hair transplant clinic after obtaining informed consent. Only those patients were included who had a previous strip harvest surgery (FUT) and opted for Follicular Unit Excision/Extraction (FUE) procedure. In all the patients, the donor hairs were trimmed to about 1-2mm length. The width of the scar, the hair density above and below the scar, and hair angles above and below the scar were measured. All the patients underwent FUE procedure using 0.9mm serrated punch. Twenty attempts were made above and below the scar (about 0.5cm), and the total number of hair and transections was measured. All the data were analyzed statistically. Ten patients were included. The average width of the scar was 2.47 mm. The mean hair density was found to be 155.4 hairs per cm2 above the scar and 130.8 per cm2 below the scar. The mean hair angle was found to be 28.21 degrees above the scar and 39.19 degrees below the scar in midline occipital above the scar (P < .05). The average hair count was found to be 49.8 hairs above the scar and 47.2 hairs above the scar (P < .05). The transection of hair was doubled below the scar (P < .05) CONCLUSION: The Follicular Unit Transplantation (FUT) procedure does leave some impacts on the donor area other than the scar only. The change in angle results in higher transection of hair above the scar.

Evaluation of Hair Density and Hair Diameter in the Adult Thai Population Using Quantitative Trichoscopic Analysis

The data of hair density and hair diameter in the Asian population, especially in Thais, are limited. We aimed to evaluate hair density and hair diameter of members of the Thai population at different scalp sites and to determine the effect of sex and aging as well as to compare the results with those in groups of other ethnicities. Healthy Thais whose hair examination findings were normal were evaluated. Two hundred and thirty-nine subjects participated in this study, of whom 79 were male and 160 were female. Hair density and hair diameter were analyzed at four different scalp sites using quantitative trichoscopic analysis. The highest hair density in Thais was observed in the vertex area. Hair densities at four different scalp sites were significantly different from one another; only hair density at the vertex site showed no significant difference from that in the occipital area. In contrast, hair diameter did not show any statistically significant differences for the different sites. We observed decreased mean hair density with increasing age and found statistically significant differences between participants in their 20s and those in their 60s, while hair diameter remained consistent. Comparing our results with a previous study in other ethnicities, the hair densities in Asians are generally lower. In conclusion, hair density in the Thai population varies at different scalp sites. Aging is a factor in declining hair density. Asians have a lower hair density compared to Caucasian and African populations.

Growth factor concentrations in platelet-rich plasma for androgenetic alopecia: An intra-subject, randomized, blinded, placebo-controlled, pilot study.

Platelet-rich plasma (PRP), processed from autologous peripheral blood, is used to treat androgenetic alopecia (AGA). To determine the efficacy of PRP for hair growth promotion in AGA patients in a randomized, blinded, placebo-controlled, pilot clinical trial (NCT02074943). The efficacy of an 8week, five session, PRP treatment course was determined by measuring hair density and hair caliber changes in 10 AGA affected patients. For each PRP sample, the concentrations of selected growth factors were determined using a multiplex assay system. The clinical results were then correlated with the growth factor concentrations in PRP. At 16weeks, 8weeks after the last PRP injection, treated areas exhibited increased mean hair density (+12.76%) over baseline compared to placebo (+0.99%). Mean hair caliber decreased in both treated and placebo regions (-16.22% and -19.46%, respectively). Serial analysis of PRP significant variability in concentrations between patients. Overall, there was a positive correlation between GDNF concentration and hair density (P=.004). Trends, though not statistically significant, were also observed for FGF2 and VEGF. Small sample size and lack of comparative cohorts receiving protocol variations limit confidence in the study data. This small pilot clinical trial suggests PRP treatment may be beneficial for AGA. However, the variable hair growth responses between patients indicate there is a significant opportunity to improve PRP therapy protocols for hair growth promotion. The variability in growth factor concentration in PRP suggests standardization of growth factors postprocessing might improve hair growth responses.

Hair Styling Procedures and Hair Morphology: A Clinico-Microscopic Comparison Study.

Background:The present study is a cross-sectional comparison to evaluate the association between hair loss and hair structural changes (gross and microscopic), and hairstyling procedures in women.Methods:We included 94 women; and collected data on sociodemographics, clinical history, sun-exposure, and hair-product use history. Women who reported blow drying of hair, hair straightening, use of hair iron or perming in the past 6 months were classified as cases. Age matched (±2 years) women who did not report any of the above procedures in the past 6 months were controls. The following tests were done: hair pull test; hair density assessment; hair breakage index (HBI); and microscopic examination. A logistic regression model was used for estimation of the odds ratio (OR) and 95% confidence intervals (CI).Results:The mean (standard deviation [SD]) age in the case and control group was 26.4 (6.3) and 27.4 (6.3) years, respectively (P = 0.43). There was no significant difference in the mean (SD) HBI (1.05 [0.08] vs 1.07 [0.05], P = 0.22) or hair density (3.28 [0.41] vs 3.16 [0.39], P = 0.19). Cases were significantly more likely to have microscopic changes compared with controls (OR: 22.0, 95% CI: 4.3, 112.6; P < 0.001). Sun exposure for more than 3 h was significantly associated with microscopic changes (OR: 6.7, 95% CI: 1.2, 39.1; P = 0.03).Conclusion:Women with hairstyling procedures in the past 6 months were more likely to have microscopic changes, even though there was no difference in the hair assessment parameters. Specific guidelines on use of hairstyling procedures for Indian hair should be developed.

Accelerated hair growth by combining thread monofilament and minoxidil in female androgenetic alopecia.

Monofilament thread therapy (PLLA) and minoxidil have been used as alternative treatments for female androgenetic alopecia. The aim was to determine the efficacy and safety of thread therapy combined with minoxidil in female androgenetic alopecia. Twenty-seven women were enrolled in this randomized half-split study based on a left-head to the right-head pattern. Thread therapy (PLLA) treatment was unilaterally performed (once); minoxidil was bilaterally applied for 6months. Global photographs and dermoscopy assessments were performed in the baseline and every 2months till the end of treatment. Global photographs underwent blinded review by three independent dermatologists. Mean hair density increased from 114±27 to 143±25/cm2 (P<.001) in the combined group and from 113±24 to 123±19/cm2 in the minoxidil group (P<.001). The mean change from baseline between the two groups was also compared (P=.003). Global photographs showed improvement in 93% (25/27) patients in the combined group and 52% (14/27) patients in the minoxidil group. Poly-l-lactic acid microthread therapy combined with minoxidil may improve hair density, hair thickness, and hair appearance better than minoxidil alone.

Stromal vascular fraction‐enriched platelet‐rich plasma therapy reverses the effects of androgenetic alopecia

Since antiquity, humans have been trying to devise remedies to cure androgenetic alopecia (AGA). These efforts include use of oral and topical concoctions and hair transplant strategies.As AGA affects people of all colors and creed, there has been a continuous effort to find a magic bullet against AGA.Unfortunately, to date, all the strategies to negate AGA effects have limitations and thus require new treatment options. To evaluate the efficacy of use of stromal vascular fraction (SVF) in androgenetic alopecia patients. Stromal vascular fraction was obtained by enzymatic digestion of autologous adipose tissue. The patients were divided into two groups, that is, platelet-rich plasma (PRP) group and SVF-PRP group. In PRP group, only PRP was injected, while in SVF-PRP group a mixture of PRP and SVF was injected in affected scalp areas. After two sessions (4weeks apart), the patients in both groups were assessed and analyzed using various parameters. Mean hair density in PRP group was increased from 52.44hair/cm2 to 63.72hair/cm2 (21.51% increase); while in SVF-PRP group, it was 37.66hair/cm2 before treatment and 57.11hair/cm2 after SVF-PRP therapy (51.64% increase). Percentage reduction in pull test was more significant in SVF-PRP group (80.78±5.84) as compared to PRP group (34.01±22.44). The physician and patient assessment scores also indicated a significant improvement in SVF-PRP group. A combined SVF-PRP therapy reversed effects of AGA more efficiently as compared to PRP therapy alone.

Impact of a topical lotion, CG428, on permanent chemotherapy-induced alopecia in breast cancer survivors: a pilot randomized double-blind controlled clinical trial (VOLUME RCT).

This study aimed to evaluate the impact of a topical lotion (CG428) on hair thickness and density in breast cancer survivors with permanent chemotherapy-induced alopecia (PCIA). The study was a double-blind, randomized controlled trial which conducted from February 2016 to December 2016 at the Samsung Comprehensive Cancer Center in Seoul, South Korea. Breast cancer patients with PCIA were randomized on average of 3.5years after chemotherapy. Topical lotion (Batch DT023) is a botanical drug under development containing a novel patented blend of 4 botanical ingredients: citrus, cocoa, guarana, and onion. Participants were asked to self-apply the study product or placebo twice per day for 6months. Changes in hair density and thickness were assessed using a noninvasive bioengineering device, and patient-reported outcomes were evaluated at 3 and 6months after randomization. A total of 35 patients were randomized to intervention (N = 18) or placebo (N = 17). Patients in the intervention group were older than those in the placebo group (52.1 vs. 41.6years; P < 0.001). The mean hair density (SD) at baseline was 97.6 (6.4) and 126.8 (30.3) hairs/cm2 in the intervention and placebo group, respectively (P = 0.005). The corresponding values for hair thickness were 49.9 (12.7) and 48.1 (8.4) μm, respectively. After 6months, hair density had increased by 34.7 and 24.9% compared with baseline in the intervention and control groups, respectively (P = 0.37). Corresponding values for hair thickness were 19.8 and 35.6%, respectively (P = 0.23). Similar findings were observed after age adjustment. In this pilot randomized clinical trial, we observed safety, tolerability, and a trend toward the efficacy of CG428 vs. placebo, especially regarding hair density and self-reported improvement.

Platelet-Rich Plasma and Micrografts Enriched with Autologous Human Follicle Mesenchymal Stem Cells Improve Hair Re-Growth in Androgenetic Alopecia. Biomolecular Pathway Analysis and Clinical Evaluation.

Platelet rich plasma (PRP) and Micrografts containing human follicle mesenchymal stem cells (HF-MSCs) were tried as a potential treatment for androgenetic alopecia (AGA). However, little to no work has yet to be seen wherein the bio-molecular pathway of HF-MSCs or PRP treatments were analyzed. The aims of this work are to report the clinical effectiveness of HF-MSCs and platelet-rich plasma evaluating and reviewing the most updated information related to the bio-molecular pathway. Twenty-one patients were treated with HF-MSCs injections and 57 patients were treated with A-PRP. The Wnt pathway and Platelet derived-growth factors effects were analyzed. 23 weeks after the last treatment with mean hair thickness increments (29 ± 5.0%) over baseline values for the targeted area. 12 weeks after the last injection with A-PRP mean hair count and hair density (31 ± 2%) increases significantly over baseline values. The increment of Wnt signaling in Dermal Papilla Cells evidently is one of the principal factors that enhances hair growth. Signaling from mesenchymal stem cells and platelet derived growth factors positively influences hair growth through cellular proliferation to prolong the anagen phase (FGF-7), inducing cell growth (ERK activation), stimulating hair follicle development (β-catenin), and suppressing apoptotic cues (Bcl-2 release and Akt activation).

The effectiveness of adding low-level light therapy to minoxidil 5% solution in the treatment of patients with androgenetic alopecia.

Androgenetic alopecia is the commonest type of alopecia affecting over half of men and women. Low-level light therapy is a new technique for stimulating hair growth in both genders. To overcome the shortcomings of previous epidemiological studies and a lack of controlled clinical trials on the subject, this study compared the effectiveness of adding low-level light therapy to minoxidil topical solution in the treatment of androgenetic alopecia in patients presenting to two skin clinics in Isfahan, Iran during 2014-2015. This clinical trial included 50 patients aged 17-45 presenting to Khorshid and Alzahra educational centers and skin diseases research center for androgenetic alopecia during 2014-2015. The patients were randomly divided into a control and a case group. The case group received topical minoxidil 5% solution plus low-level light therapy twice per day. The control group was given the same topical solution and a laser comb system that was turned off to act as a placebo. Changes in patients' hair density and diameter and its overall regrowth as well as their satisfaction with the treatment were assessed at months 0 (baseline), 3, 6, 9 and 12. The percentage of recovery from androgenetic alopecia and the patients' satisfaction with their treatment were significantly higher in the case group compared to the control group. The patients' mean hair density and diameter were found to be higher in the case group after the intervention compared to the control group. The study limitations included patient compliance, small sample size, patient insight due to novelty of the method and clinical judgement. As a new method of treatment, low-level light therapy can help improve the percentage of recovery from androgenetic alopecia and increase patients' satisfaction with their treatment.

Stem cells from human hair follicles: first mechanical isolation for immediate autologous clinical use in androgenetic alopecia and hair loss.

Hair follicles are known to contain a well-characterized niche for adult stem cells: the bulge, which contains epithelial and melanocytic stem cells. Stem cells in the hair bulge, a clearly demarcated structure within the lower permanent portion of hair follicles, can generate the interfollicular epidermis, hair follicle structures, and sebaceous glands. The bulge epithelial stem cells can also reconstitute in an artificial in vivo system to a new hair follicle. In this study, we have developed a new method to isolate human adult stem cells by mechanical centrifugation of punch biopsy from human hair follicles without culture condition. Here, we used human follicle stem cells (HFSCs), to improve the hair density in 11 patients (38 to 61 years old) affected by AGA in stage 3-5 as determined by the Norwood-Hamilton classification scale. The primary outcomes were microscopic identification and counting of HFSCs. The secondary outcomes were clinical preliminary results and safety and feasibility in HFSCs-treated scalp. Each scalp tissue suspension contained about 3,728.5±664.5 cells. The percentage of hair follicle-derived mesenchymal stem cells CD44+ [from dermal papilla (DP)] was about 5%+0.7% whereas the percentage of hair follicle epithelial stem cells CD200+ (from the bulge) was about 2.6%+0.3%. In total, 23 weeks after the last treatment with HFSCs mean hair count and hair density increases over baseline values. In particular, a 29%±5% increase in hair density for the treated area and less than a 1% increase in hair density for the placebo area. We have shown that the isolated cells are capable to improve the hair density in patients affected by androgenetic alopecia (AGA). These cells appear to be located in the bulge area of human.