Occipital Hair Research Articles

Manganese exposure and association with hormone imbalance in children living near a ferro-manganese alloy plant

It has been suggested that manganese (Mn) plays a fundamental role in the reproductive system through interference with the regulation of the secretion of hormones related to puberty. The objective of this study was to evaluate the environmental exposure to Mn and its effects on the endocrine regulation of hormones related to puberty in school-aged children living near a ferro-manganese alloy plant. Toenails, occipital hair, and blood samples were collected from 225 children, between 7 and 12 years of age, in four elementary schools in Simões Filho, Bahia, Brazil, who were exposed to different Mn levels owing to different Mn dust deposition rates. The Mn content was determined in the toenails (MnTn), hair (MnH), and blood (MnB), in addition to blood lead levels (PbB), by using graphite furnace atomic absorption spectrometry. Luteinizing hormone (LH), prolactin (PRL), estradiol (E2), testosterone (T), and thyroid stimulating hormone (TSH) levels were determined by using a chemiluminescence method. Of the total participants, 50.2% were boys, with an average age of 9 years. PRL values were higher in children attending the school with a higher Mn deposition rate (p < 0.004). We observed that MnTn was positively correlated with PRL levels and exhibited a non-linear association with LH levels. None of the tested Mn biomarkers were associated with E2, T, or TSH levels. To date, despite several animal studies that have focused on the correlation between Mn exposure and the endocrine regulation of hormones and pubertal development, very few studies have reported a similar relationship between environmental Mn effects and the human endocrine system. Our findings support the hypothesis that elevated exposure to Mn in children may be associated with hormonal imbalances that might trigger the early onset of puberty.

Airborne manganese exposure and neurobehavior in school-aged children living near a ferro-manganese alloy plant

Excessive exposure to Mn can lead to its accumulation in the brain with neurotoxic consequences. In children, elevated Mn has been associated with deficits in certain neuropsychological domains such as cognition, motor function, memory and attention, and in some instances, hyperactivity and behavioral problems. The aim of this study was to evaluate behavioral effects in school-aged children living near a ferro-manganese alloy plant and examine their association with Mn exposure. Occipital hair, toenails and blood samples were collected from 225 children (7–12 years old) enrolled in four elementary schools with different levels of exposure to Mn, based on dust Mn deposition rates. Full data set collection was completed and run from 165 children. Mn in hair (MnH), toenails (MnTn), blood (MnB) and blood lead levels (PbB) were determined by graphite furnace atomic absorption spectrometry. Children's behavior was assessed with the Child Behavior Check List (CBCL) reported by parents. Median levels and range of MnH, MnT and MnB were, respectively, 0.73 µg/g (0.16–8.79), 0.84 µg/g (0.15–9.29) and 8.98 μg/L (1.51–40.43). Median and range of PbB were 1.2 µg/dL (0.2–15.6). MnH and MnB were not associated with any scale of the CBCL behavior scores. We found a positive association between logMnTn and raw total CBCL score (β = 10.17, p = 0.034), adjusting for sex, age, maternal IQ and logPbB. Analyses using Generalized Additive Model showed non-linear associations between MnTn and externalizing behavior (p = 0.035), as well as with the related subscales: aggressive behavior (p = 0.045) and rule-breaking behavior (p = 0.024). Further positive associations were observed between MnTn and thought problems (p = 0.031) and social problems (p = 0.027). These findings corroborate previous studies showing an association between Mn exposures and externalizing behavior. Our results suggest that toenail Mn, as a biomarker of environmental exposure, is associated with disruptive behavior in children living near a ferro-manganese alloy plant.

Determinants of Hair Manganese, Lead, Cadmium and Arsenic Levels in Environmentally Exposed Children.

Biomarkers of environmental metal exposure in children are important for elucidating exposure and health risk. While exposure biomarkers for As, Cd, and Pb are relatively well defined, there are not yet well-validated biomarkers of Mn exposure. Here, we measured hair Mn, Pb, Cd, and As levels in children from the Mid-Ohio Valley to determine within and between-subject predictors of hair metal levels. Occipital scalp hair was collected in 2009–2010 from 222 children aged 6–12 years (169 female, 53 male) participating in a study of chemical exposure and neurodevelopment in an industrial region of the Mid-Ohio Valley. Hair samples from females were divided into three two centimeter segments, while males provided a single segment. Hair was cleaned and processed in a trace metal clean laboratory, and analyzed for As, Cd, Mn, and Pb by magnetic sector inductively coupled plasma mass spectrometry. Hair Mn and Pb levels were comparable (median 0.11 and 0.15 µg/g, respectively) and were ~10-fold higher than hair Cd and As levels (0.007 and 0.018 µg/g, respectively). Hair metal levels were higher in males compared to females, and varied by ~100–1000-fold between all subjects, and substantially less (<40–70%) between segments within female subjects. Hair Mn, Pb, and Cd, but not As levels systematically increased by ~40–70% from the proximal to distal hair segments of females. There was a significant effect of season of hair sample collection on hair Mn, Pb, and Cd, but not As levels. Finally, hair metal levels reported here are ~2 to >10-fold lower than levels reported in other studies in children, most likely because of more rigorous hair cleaning methodology used in the present study, leading to lower levels of unresolved exogenous metal contamination of hair.

The presence of occipital hair in the pilonidal sinus cavity-a triple approach to proof.

Hair in the pilonidal sinus is not growing within the sinus cavity, as hair follicles are not present there. Not few pilonidal patients do not have intergluteal hair, which is said to be the causative agent of folliculitis and pilonidal genesis. So, what is the real source of the hair forming the typical pilonidal hair nest? A trifold approach was used: First, axial hair strength testing of pilonidal hair and body hair harvested from head, lower back (glabella sacralis), and cranial third of intergluteal fold. Hair strength match was compared clinically. Second, comparative morphological examination by expert forensic biologist of hair from sinus and dorsal body hair. Third, statistical Bayesian classification of every single sinus hair based on its strength was done to determine the most probable region of origin. Using clinical hair strength comparison, in 13/20 patients, head hair is the stiffest hair, followed by intergluteal hair. Only in 6/20 patients, this is the case with hair from the glabella sacralis. According to comparative morphological comparison, a minimum of 5 of 13 hair nests with possible hair allocation examined contain hair from the occiput. In 5/18 nests, hair could not be determined to a specific location though. Statistical classification with correction for multiple testing shows that 2 nests have hair samples that are at least 100 times more probable to originate from head or lower back than from intergluteal fold. We saw our null hypothesis that "hair in the sinus cavity is from the intergluteal region" rejected by each of three different approaches. There is strong evidence that occipital hair is present regularly in pilonidal sinus nests. We should start thinking of occipital hair as an important hair source for the development of the pilonidal hair nest.

Manganese and lead levels in settled dust in elementary schools are correlated with biomarkers of exposure in school-aged children.

Previously, we showed that manganese (Mn) levels in settled dust in elementary schools increased at a rate of 34.1% per km closer to a ferro-manganese alloy plant in the rainy season. In this study, we investigated how this environmental pollution indicator varied in the dry season and if there was an association with Mn biomarker levels in school-aged children. Dust samples were collected with passive samplers (disposable Petri dishes) placed in interior and exterior environments of 14 elementary schools. Occipital hair, toenails and blood samples were collected from 173 students aged 7-12 years from three of these schools, with varying distance from the industrial plant. Mn and lead (Pb) levels were measured by graphite furnace atomic absorption spectrometry. Mn concentration geometric means (GM) in dust fall accumulation in interior environments of schools located at 2, 4, 6 and>6km-radii from the plant were 2212, 584, 625 and 224μg Mn/m2/30 days, respectively. The modelled rate of change of dust Mn levels decreases by 59.8% for each km further from the plant. Pb levels in settled dust varied between 18 and 81μg/m2/30 days with no association with distance from the plant. Blood lead levels median (range) were 1.2μg/dL (0.2-15.6), of which 97.8% were <5μg/dL. Mn in hair and toenails were 0.66μg/g (0.16-8.79) and 0.86μg/g (0.15-13.30), respectively. Mn loading rates were positively associated with log MnH (β=1.42×10-5, p<0.001) after adjusting for children's age; and also with log MnTn (β=2.31×10-5, p<0.001) independent of age. Mn loading rates explained 18.5% and 28.5% of the variance in MnH and MnTn levels, respectively. School-aged children exposure to Mn, independently of age, increases significantly with school proximity to the ferro-manganese alloy plant.

Optimizing Exposure for the Occipital Nerve in Migraine Surgery while Maintaining Hair Length.

Summary:Surgical decompression of the greater occipital nerve is used in the treatment of migraine headaches. Generally, hair is removed from the posterior scalp to aid with exposure and minimize interference. The securing of occipital hair with surgical tape and rubber bands instead of preoperative hair removal is a viable alternative. The preservation of hair length can lead to better patient satisfaction by avoiding the hair length discrepancies and has demonstrated a low risk of surgical-site infection.

Strength of Occipital Hair as an Explanation for Pilonidal Sinus Disease Caused by Intruding Hair.

Pilonidal sinus disease is thought to be caused by intrusion of hair into healthy skin; loose hair in the intergluteal fold is thought to promote disease. However, compelling evidence to support these postulates is lacking; the cause of pilonidal sinus disease remains uncertain. To determine whether particular properties of hair are associated with susceptibility to pilonidal sinus disease, we compared physical properties of hairs of patients with pilonidal sinus disease with hairs from control subjects who were matched for sex, BMI, and age. This was an experimental study with establishment of a mechanical strength test for single hairs to quantify the maximum vertical force that a hair could exert, following tests of strength of occipital, lumbar, and intergluteal hair. Hair from patients with pilonidal sinus disease and matched control subjects were harvested from patients of the St. Marienhospital Vechta Department of Procto-Surgery. A total of 17 adult patients with pilonidal sinus disease and 217 control subjects were included. ANOVA and intraclass and interclass variations of data gained from mechanical strength tests of occipital, lumbar, and intergluteal hair were included. Vertical hair strength was significantly greater in patients with pilonidal sinus disease. Occipital hair exhibited 20% greater, glabella sacralis 1.1 times greater, and intergluteal hair 2 times greater strength in patients with pilonidal sinus disease than in matched control subjects (all p = 0.0001). In addition, patients with pilonidal sinus disease presented with significantly more hair at the glabella sacralis and in the intergluteal fold. The study was limited by its relatively small number of patients from a specific cohort of European patients. Occipital hair exhibited considerable vertical strength. Because occipital hair exerted the greatest force and cut hair fragments were found in the pilonidal nest in large quantities, these data suggest that pilonidal sinus disease is promoted by occipital hair. See Video Abstract at http://links.lww.com/DCR/A435.

Cyberspace Chat: Ethics, the Impermanence of Occipital Donor Hair, and Other Topics from a Cyber Chat

1. Bradley R. Wolf, MD, FISHRS (wolfmedinc{at}gmail.com) 1. Cincinnati, Ohio, USA </br>![][1]</img> Dr. Bill Rassman began a recent internet discussion with the following post, titled “Unethical hair transplantation.” Bill Rassman (in a letter to a patient): You have had previous

Hair concentration of essential trace elements in adult non-exposed Russian population.

Appropriate reference values of hair trace element content are required for correct interpretation of biomonitoring data. The primary objective of the current study was to estimate the reference values of selected essential trace elements in hair of adult Russian population. Involved in current investigation were 7256 occupationally non-exposed adults aged from 20 to 60 years and living in the European part of Russia. Occipital hair essential metal and metalloid (Co, Cr, Cu, Fe, Mn, Se, V, Zn) content was estimated using inductively coupled plasma mass spectrometry. The reference ranges were calculated in accordance with the International Union of Pure and Applied Chemistry (IUPAC) recommendations. Women were characterized by 55, 18, 58, and 7% higher values of hair Co, Cu, Mn, and Zn content as compared to the values observed in men. At the same time, hair Cr, Fe, Se, and V concentration in men significantly exceeded the respective female values by 65, 13, 20, and 56%. Consequently, the reference ranges of essential hair trace elements content should be separately calculated for both men and women. The obtained reference ranges for hair Co, Cr, Cu, Fe, Mn, Se, V, and Zn in men were 0.11-0.67, 0.007-0.045, 10.4-22.6, 11.1-40.5, 0.24-1.05, 0.089-0.480, 0.014-0.083, and 125.7-262.8 μg/g, respectively. The respective values estimated for women were 0.06-0.40, 0.011-0.085, 12.1-44.5, 8.9-25.6, 0.32-2.05, 0.094-0.504, 0.010-0.056, and 140.0-315.1 μg/g. The reference ranges for hair Co (0.07-0.50), Cr (0.009-0.073), Cu (11.8-29.2), Fe (9.6-31.5), Mn (0.29-1.76), Se (0.093-0.482), V (0.011-0.069), and Zn (134.7-301.9) content (μg/g) in the general cohort were also calculated.

Commentary on: use of nape and peri-auricular hair by follicular unit extraction to create soft hairlines and temples: my experience with 128 patients.

For many professionals, as well as the lay public, the results of hair transplantation still evoke images of a pluggy or doll's hair appearance. However, the standard of care today is to create a hairline that appears completely natural and not surgically created. Advances which have led to this current expected level include improved instrumentation, clinical observation of normal hairlines, and recognition of the different qualities of hair that reside in the safe donor area (SDA). Another recent advance in the field of hair restoration surgery is the donor harvest technique known as follicular unit transplantation (FUE).1-4 The primary advantage of FUE is the absence of a donor site scar following traditional strip excision. While there are several additional advantages to the FUE technique, the ability of a patient to wear a short hair style without a concern for donor scar visibility is the major reason patients choose this approach. Another important concept of hair restoration surgery which is germane to this article is the “variable” permanence of the most inferior aspect of the SDA. The concept of donor dominance, which is the principle reason transplants work, was originally described by Oreintreich,5 who demonstrated the “permanence” of occipital and temporal hair (ie, the donor fringe or SDA) when transplanted into areas of alopecia. Not recognized at the time of Orentreich's original description, but addressed by Unger and Cole6 and recognized by others subsequently, is the often progressive nature of hair loss in the SDA from the bottom up. Dr Umar7 has focused this article on the use of nape and …

Characteristics of nonbalding scalp zones of androgenetic alopecia in East Asians.

Hair is known to persist on the occipital and part of the temporal scalp in patients with androgenetic alopecia (AGA), but no quantified data about the follicular changes in such areas exist. To evaluate the hair characteristics in nonbalding scalp areas in East Asian patients with AGA. In total, 265 participants [211 patients with AGA and 50 healthy controls (HCs)] were enrolled. The patients were divided by the Basic and Specific (BASP) classification [four basic types (L, M, C, and U) and two special types (V and F)], and the hair in the occipital region and two sites of the temporal region were analysed by computer-assisted phototrichography. Hair density, hair width, number of each follicular unit, ratio of single to compound hairs and ratio of terminal to vellus hairs were examined. In the temporal region, a statistically significant (P<0.05) decrease in hair density was observed in patients with C, U or F subtypes, and a significant (P<0.05) decrease in hair thickness was observed in patients with the U subtype compared with HCs. In the mastoid and occipital areas, both hair density and hair thickness was significantly (P<0.05) decreased in patients with the U subtype compared with HCs. Within each classification, hairs became generally thinner as the hair loss progressed. Hair density and hair thickness of known nonbalding scalp regions showed some differences depending on the severity and the BASP subtypes in East Asian people with male pattern baldness.

Effects of Dietary Factors on Selenium Levels of Children to Prevent Kashin–Beck Disease During a High-Prevalence Period in an Endemic Area: a Cohort Study

Selenium (Se) supplements have been used to control Kashin-Beck disease (KBD) for decades, but the effect of diet without Se supplements is unclear because the prevalence of KBD has decreased. This matched cohort study was undertaken to determine dietary factors affecting selenium nutrition status of children living in KBD areas and the effects of Se supplements in preventing KBD. A total of 593 children aged 5-12years were randomly selected during the high prevalence period of KBD from 1992 to 1995. Children in one village received Se supplemented (Se+) salt and were matched with three children in 16 other villages who did not receive Se supplemented (Se-) salt. A questionnaire and determinations of occipital hair Se to reflect body Se status were obtained at baseline (April 1992), at 6months (October 1992), and yearly each April through 1995. Hair Se content in the Se+ group was significantly higher than in the Se- group (P < 0.001) at all time-points and was significantly related to the incidence of suspected KBD symptoms (P = 0.018). Four dietary factors significantly affected hair Se contents. Se levels were increased by consumption of Se+ salt (P < 0.001) and eating meat/egg often (P = 0.019) or occasionally (P = 0.001). Se levels were decreased by consumption of grain mildewed at harvest or in storage (P < 0.001 for each) and drinking ditch, river, or cellar water (P < 0.001; P = 0.002; P < 0.001, respectively). These results show that Se+ salt had a significant effect in maintaining the Se nutrition status of children in this cohort study but that dietary factors in those without Se supplements contributed as well.

Use of Urinary Bladder Matrix, a Bioactive, Acellular Scaffold, in Transplant Donor Scars and Androgenetic Alopecia: Initial Clinical Experience

Introduction: Emerging regenerative medicine technologies have yet to be utilized in hair restoration surgery. Urinary bladder extracellular matrix (UBM) has shown promise in a wide variety of applications, inducing site-specific remodeling of injured tissue. This case series describes one clinician's experience in the first use of this regenerative material in hair restoration surgery. Materials and Methods: Twenty subjects underwent one of several protocols: (1) Treatment of 3-mm biopsies within donor site scars with UBM versus untreated controls, (2) Removal of a strip of donor site scar tissue and treatment of the site with UBM, (3) Soaking of occipital hair follicle grafts in a solution of UBM, or (4) Soaking of beard or temple hair follicle grafts. Results: At 6 months, hair was observed in biopsy sites that contained UBM, including donor scar areas that would not normally regrow hair, in contrast to the control biopsy sites. Similar results were observed for the strip excisions. UBM-soaked occipital, beard, and temple hair grafts consistently yielded higher than expected numbers of hair follicles. Conclusions: These cases provide anecdotal support for the hypothesized benefits of UBM regenerative technology in restoration therapy for men and women with androgenetic hair loss.

Epigenetic modifications may explain the relative protection of occipital hair follicles from androgenetic alopecia in men

Epigenetic modifications may explain the relative protection of occipital hair follicles from androgenetic alopecia in men

Evidence of increased DNA methylation of the androgen receptor gene in occipital hair follicles from men with androgenetic alopecia

Evidence of increased DNA methylation of the androgen receptor gene in occipital hair follicles from men with androgenetic alopecia

Determinants of lead exposure in children on the outskirts of Salvador, Brazil

Lead (Pb) is a toxic heavy metal that is widely distributed throughout the environment. Pb is an important neurotoxic metal and children are more susceptible to its effect due to their higher absorption rate and greater susceptibility of the developing nervous system. In this work, we evaluated the lead exposure levels in children living near a metallurgical plant and identified risk factors associated with its internal dose. All children, aged 1-10 years and 11 months, living near a metallurgical plant in the great Salvador area, Brazil were evaluated in this cross-sectional study and compared with children from a non exposed area. Occipital hair and blood were used to assess exposure. Air lead levels in the respirable fraction (PM(2.5)) were also measured in both areas. Blood lead levels (BLL), hair lead levels (PbH) and air lead were determined by graphite furnace atomic absorption spectrometry. Spearman correlations analysis was used to evaluate correlations between BLL, PbH and descriptors. Significant risk factors were modeled using multivariate linear regression analysis. Air lead levels were approximately ten-folds lower than EPA reference concentration (0.15 μg/m(3)). Median BLL and PbH were 1.65 ± 1.45 μg/dL and 1.26 ± 3.70 μg/g, respectively, in exposed children. In the referents, medians were BLL 1.20 ± 1.20 μg/dL; PbH 2.09 ± 2.06 μg/g. No significant difference was observed in biomarkers levels between boys and girls. It was observed a positive weak correlation (Spearman rho = 0.197, p = 0.033) between BLL and PbH. Our data show that children's lead body burden measured as BLL or PbH are low when compared with the recommended reference values. Despite that, we were able to identify four risk factors associated with increased biological lead levels: age, living near industrial site, environmental tobacco smoking and, above all, domestic waste burning. In order to prevent such avoidable exposure, environmental education and proper waste management should be implemented, especially in developing countries.

Hair transplantation for therapy‐resistant alopecia areata of the eyebrows: Is it the right choice?

Alopecia areata is a common skin disorder of presumed autoimmune etiology and it usually shows an unpredictable course. Treatment of alopecia areata is challenging. There is very little information on the use of surgical therapies for the treatment of alopecia areata in the medical published work. A 24-year-old male patient was referred to a private hair transplantation clinic owned by one of the authors for the treatment of therapy-resistant alopecia areata affecting both eyebrows. He had quickly lost all body hair 4 years prior beginning from the scalp. He received psoralen and ultraviolet A (PUVA) therapy for alopecia universalis and all body hair re-grew except his eyebrows. Alopecia areata was stable for the 18 months following the last medical treatment he received. Because there was no response to various medical therapeutic agents, we decided to transplant occipital hairs to the eyebrow area. After the patient understood and accepted all risks, occipital hairs were transplanted to the eyebrows by using the follicular unit extraction technique. Postoperatively, the patient did not receive any topical or systemic therapies for alopecia areata. Although 40% hair re-growth was detected in his eyebrows at 1 year postoperation, this rate was 80% by 2 years postoperation. However, there was resistance to re-growth in the medial eyebrow regions. New eyebrows grew as occipital hairs and required trimming. His satisfaction from the surgical procedure was 90% at the end of the 24th postoperative month. Surgical treatment of diseases like alopecia areata is still controversial. Our case report offers an additional contribution to the published work on the surgical methods used in the treatment of stable alopecia areata.

Replacing Facial Hair

The face is the second most common area for hair transplantation after the scalp. Areas that are transplanted include eyebrows, eyelashes, moustaches, beards, temples and temporal points, as well as scars either traumatic or the side effect of cosmetic procedures such as rhytidectomies or brow lifts. The hair is harvested from the same area as the hair that is transplanted to the head. For this reason, it grows longer than nongrafted facial hair and must be trimmed regularly. Occasionally, hair lower in the neck region is harvested, which is finer than occipital hair; however, because of movement in the neck area, the scars are often larger. Body hair has been suggested as donor hair but is not recommended because it spends as much as 85% of its time in the telogen phase.

Pressure Ulcers and Occipital Alopecia in Operation Iraqi Freedom Polytrauma Casualties

Several of the casualties from Operation Iraqi Freedom arriving at one Veterans Administration (VA) polytrauma rehabilitation center (PRC) were noted to have occipital pressure ulcers or hair loss. The objective of this study was to determine the prevalence and severity of pressure-related injuries in VA PRC admissions. A retrospective review of admissions from active duty from 2004 to 2006 was performed. Thirty-eight percent of admissions to this VA PRC had pressure-related injuries on the day of admission. Casualties from Iraq had a higher rate of pressure ulcers (53%) than did those from elsewhere (22%). Occipital lesions constituted 50% of non-stage I pressure ulcers and were more severe than those of the sacrum or extremities. Further epidemiological research should be performed to identify risk factors for pressure injury in the military continuum of care, by linking specific military medical evacuation and treatment processes and characteristics of casualties with outcomes.

Cicatricial marginal alopecia: is it all traction?

In a specialized hair loss clinic, a group of patients was identified with focal or complete hair loss at the scalp periphery, with a normal scalp surface. Biopsy revealed complete loss of individual hair follicles, indicative of scarring alopecia. Not all patients had a history supportive of a diagnosis of traction alopecia. To identify and characterize further patients with scarring alopecia of the scalp margin using a retrospective review. All biopsies of scarring alopecia carried out by a single clinician between 1 January 1999 and 29 September 2006 were reviewed. Patients in whom the hair loss was located at the periphery of the scalp were selected for retrospective chart review. A total of 15 patients met the study criteria, which included histological scarring alopecia and hair loss of the scalp margin. Six of the patients gave a history of relaxing or straightening their hair. Six denied hair care practices sufficient to cause traction alopecia. In three patients, the hair care history was unknown. Occipital hair loss was a common clinical finding, mimicking alopecia areata. The presence of scarring was often subtle histologically. A group of patients with moderate to severe cicatricial alopecia of the scalp margin is described. The presence of scarring is difficult to diagnose both clinically and histologically. The lack of a history of severe traction or harsh styling practices in half the patients casts doubt on whether or not traction is the only pathogenic factor.