Hair Ratio Research Articles

Strip Harvesting Follicular Unit Transplantation Versus Follicular Unit Excision: Comparing the Number of Hairs and the Ratio of Hairs to Follicular Unit.

There are 2 extraction techniques for follicular units (FUs) in hair transplantation: strip harvesting follicular unit transplantation (FUT) and follicular unit excision (FUE). Currently, no extant studies have demonstrated that one technique is superior in extraction and donor area optimization for a dense result. This study compares the FUT and FUE techniques by evaluating the percentage of FUs with 3 or more hairs and the hairs-to-follicular-unit ratio in patients who underwent both procedures at different times. The medical records of patients who underwent at least 1 FUT procedure and at least 1 FUE procedure (with this being the second surgical procedure) were reviewed. The surgeries were performed in the same clinic with the same surgeon and surgical team. There was a higher percentage of FUs with 3 or more hairs and a higher hairs-to-follicular-unit ratio with the FUE technique than with the FUT technique. In FUE, surgeons tend to choose better-looking FUs with thick, plentiful hairs. Even with these results, it is impossible to declare one procedure superior because the correct indication considers multiple factors.

First Insight into Fetal Exposure to Legacy and Emerging Plasticizers Revealed by Infant Hair and Meconium: Occurrence, Biotransformation, and Accumulation.

Epidemiological studies have demonstrated the embryonic and developmental toxicity of plasticizers. Thus, understanding the in utero biotransformation and accumulation of plasticizers is essential to assessing their fate and potential toxicity in early life. In the present study, 311 infant hair samples and 271 paired meconium samples were collected at birth in Guangzhou, China, to characterize fetal exposure to legacy and emerging plasticizers and their metabolites. Results showed that most of the target plasticizers were detected in infant hair, with medians of 9.30, 27.6, and 0.145 ng/g for phthalate esters (PAEs), organic phosphate ester (OPEs), and alternative plasticizers (APs), and 1.44, 0.313, and 0.066 ng/g for the metabolites of PAEs, OPEs, and APs, respectively. Positive correlations between plasticizers and their corresponding primary metabolites, as well as correlations among the oxidative metabolites of bis(2-ethylhexyl) phthalate (DEHP) and 1,2-cyclohexane dicarboxylic acid diisononyl ester (DINCH), were observed, indicating that infant hair retained the major phase-I metabolism of the target plasticizers. While no positive correlations were found in parent compounds or their primary metabolites between paired infant hair and meconium, significant positive correlations were observed among secondary oxidative metabolites of DEHP and DINCH in hair and meconium, suggesting that the primary metabolites in meconium come from hydrolysis of plasticizers in the fetus but most of the oxidative metabolites come from maternal-fetal transmission. The parent compound/metabolite ratios in infant hair showed a decreasing trend across pregnancy, suggesting in utero accumulation and deposition of plasticizers. To the best of our knowledge, this study is the first to report in utero exposure to both parent compounds and metabolites of plasticizers by using paired infant hair and meconium as noninvasive biomonitoring matrices and provides novel insights into the fetal biotransformation and accumulation of plasticizers across pregnancy.

The Value of Trichoscopy in the Follow-up of Treatment Response in Patients With Androgenetic Alopecia.

Although trichoscopy has been used successfully in the diagnosis of androgenetic alopecia (AGA), its utility in monitoring the therapeutic outcome is not clear. To investigate the value of trichoscopy in the follow-up of treatment response in patients with AGA. Ninety-five patients with AGA were included. Trichoscopic images were obtained on a 1 cm2 circular area in the left frontoparietal scalp pre- and post-treatment in all and in 61 patients, respectively. Two doctors evaluated those images who are less experienced (doctor A) and experienced (doctor B) in hair diseases and trichoscopy. Terminal, vellus and total hair count (THC, VHC, ToHC) and terminal to vellus hair (T/V) ratio were determined. These numerical data were also calculated by TrichoScan analysis of the same area. The agreement between trichoscopy and TrichoScan data was assessed. The agreement between doctor A and TrichoScan was moderate for THC and ToHC pre-treatment and good post-treatment; poor for VHC and T/V ratio pre- and post-treatment. The agreement between doctor B and TrichoScan was excellent for THC, VHC and ToHC; good for T/V ratio pre- and post-treatment. Trichoscopy, when performed by a doctor experienced in hair diseases and trichoscopy, can be used as a sensitive method in monitoring the treatment response in patients with AGA which is based on the determination of THC, VHC, ToHC and T/V ratio. If it is to be performed by a less experienced doctor, it can be preferred as a sensitive follow-up method using THC and ToHC.

Efficacy and safety of diode laser for facial hair reduction in hirsutism-a clinico-trichoscopic evaluation.

Hirsutism is the presence of excessive terminal hair on androgen-dependent sites of the body. Lasers like Alexandrite, diode, and Nd:Yag lasers have been used for hair reduction with varying efficacy. Trichoscopy of hair is a simple noninvasive method of hair assessment. However, it has not been used in the assessment of diode laser hair reduction. This study aimed to assess the efficacy and safety of diode laser hair reduction in skin color with the help of clinical and trichoscopic assessment. This prospective observational study included 73 patients of hirsutism recruited in 18-month period. All participants received sessions of 805 nm diode laser at monthly intervals up to six sessions. Clinical and trichoscopic evaluation along with photographs were obtained at each visit. Side effects, if any, were noted in every sitting. All patients were females of Fitzpatrick skin types III-V. All clinical parameters showed statistically significant hair reduction when compared with baseline. Trichoscopic parameters of hair reduction like total hair count, terminal hair count, and terminal/vellus hair ratio showed reduction compared to baseline which was statistically significant (P < 0.05). The most common side effect noted in our study was pain followed by erythema and perifollicular edema. Diode laser is an effective and safe procedure for the reduction of unwanted facial hair, even in darker skin types. We also wish to emphasize that trichoscopy for the assessment of laser hair reduction is a recent, noninvasive, simple, and underutilized tool. No serious adverse events were noted in our study.

Relationship between Copper, Zinc, and Copper-to-Zinc Ratio in Hair and Severity of Coronary Artery Disease according to the SYNTAX Score.

Coronary artery disease (CAD) continues to be a foremost contributor to global mortality, and the quest for modifiable risk factors could improve prophylactic strategies. Recent studies suggest a significant role of zinc (Zn) and copper (Cu) deficiency in atheromatous plaque formation. Furthermore, hair was previously described as a valuable source of information on elemental burden during the 6-8 week period before sampling. The aim of this study was to investigate the possibility of correlation between the extent of CAD evaluated with the SYNergy Between PCI With TAXUS and the Cardiac Surgery (SYNTAX) score with Cu and Zn content in hair samples, as well as with the Cu/Zn ratio in a cohort of 130 patients. Our findings describe a statistically significant inverse correlation between Cu content and the Cu/Zn ratio in hair samples and the extent of CAD. In contrast, no significant correlation was found between Zn content and the extent of CAD. Considering the scarcity of existing data on the subject, the analysis of hair samples could yield a novel insight into elemental deficiencies and their potential influence on CAD extent.

Within-person associations of cortisol, dehydroepiandrosterone, and testosterone hair hormone concentrations and psychological distress in pregnant and non-pregnant women

Prenatal hair cortisol concentration is inconsistently associated with maternal psychological distress. However, prior studies have not often measured hair cortisol and maternal psychological distress prospectively over time, examined within-person associations, nor concurrently considered the complex hormonal milieu in which cortisol operates during pregnancy. We addressed these limitations and tested associations against a similar non-pregnant comparison group. Participants included 68 women (34 pregnant and 34 non-pregnant; Mage = 29.14 and 83 % White) from the Midwestern United States. Pregnant women were assessed each trimester, at 12, 26, and 38 weeks and non-pregnant women were assessed three times on the same schedule. At each assessment, participants completed measures of psychological distress and provided hair samples. The first 3 cm (from the scalp) of hair was assayed using enzyme immune-assay kits to reflect cumulative levels within the given trimester/3-month time period of cortisol, dehydroepiandrosterone (DHEA) and testosterone. Within-person associations of hair cortisol and ratio of hair cortisol-to-DHEA and cortisol-to-testosterone with psychological distress were assessed using multilevel models. There were positive within-person associations of hair cortisol with cumulative psychological distress (γ = 0.01, s.e. = 0.003, p = .049), anxiety (γ = 0.09, s.e. = 0.04, p = .046), and pregnancy-related anxiety symptoms (γ = 0.10, s.e. = 0.05, p = .041) in the pregnant sample such that on occasions when hair cortisol was higher than average so were psychological distress symptoms. No within-person associations of hair cortisol were supported in non-pregnant women although there was a negative within-person association, such that on occasions of having lower testosterone level than typical, depression symptoms were higher. There were no within-person associations of psychological distress and cortisol-to-DHEA ratio or cortisol-to-testosterone ratio in either the pregnant or non-pregnant sample. At the between person-level for pregnant women, lower cortisol levels were associated with higher perceived stress (γ = -0.28, s.e. = 0.09, p = .003) and depression symptoms (γ = -0.11, s.e. = 0.06, p = .039), whereas higher cortisol levels were associated with higher psychological distress (γ = 0.03, s.e. = 0.01, p = .010), state anxiety (γ = 0.33, s.e. = 0.13, p = .010), and depression symptoms (γ = 0.23, s.e. = 0.09, p = .017) in non-pregnant women. Modeling hair cortisol at the within-person and between-person level revealed differential findings in pregnant and non-pregnant women.Hair cortisol concentration, psychological distress, pregnancy, hormone coupling, within-person associations.

Efficacy of autologous dermal sheath cup cell transplantation in male and female pattern hair loss: A Single-Arm, Multi-Center, phase III equivalent clinical study.

A previous, proof-of-concept clinical study suggested that dermal sheath cup cell injections into the affected areas of male/female pattern hair loss (PHL) may have some amelioratory effects, the clinical efficacy of which needs further examination. A phase III equivalent clinical study was conducted to further probe the therapeutic potential of this novel approach and verify its safety and efficacy in improving the appearance of PHL. Thirty-six participants with PHL were injected with dermal sheath cup cell harvested from non-affected occipital hair follicles twice in quarterly intervals. Global photographic assessment and phototrichogram were performed in a blinded manner. Patient-reported outcomes were assessed for 12 months. On global photographic assessment, 30% of the participants showed improvement. The analysis of phototricogram data detected the increases in the cumulative hair diameter, hair cross-sectional area, and mean hair diameter of 107.6 ± 152.6 μm/cm2 , 13069.1 ± 10960.7 μm2 /cm2 , and 0.9 ± 0.9 μm (ratios vs. baseline: +1.4%, +3.4%, and +2.2%), respectively. The female and high terminal hair ratio groups achieved better improvement. Of the total participants, 62.9% noted some degree of improvement. No serious adverse events were detected. This novel approach exhibited visible effects while ensuring safety and patient satisfaction. Therefore, it holds promise as a possible therapeutic option for treating PHL, especially in women.

CLINICO-TRICHOSCOPIC EVALUATION OF HIRSUTISM TREATED WITH INTENSE PULSED LIGHT IN A TERTIARY CARE HOSPITAL IN EASTERN INDIA

Objective: The objective of this study is to determine the effectiveness of Intense Pulsed Light in treating hirsutism after three sittings, as evaluated through clinical and trichoscopic assessments, in patients attending a tertiary care hospital in Eastern India. Methods: This was a Descriptive Longitudinal study conducted at the Dermatology Outpatient Department (OPD), Government Medical College, Kolkata, from March 2019 to February 2020. The study included 40 cases of Dermatology OPD attendees who complained of hirsutism. Trichoscopy was used to evaluate treatment response. Data were analyzed using Medcalc. Results: Seventy percent had functional while 30% had organic hirsutism; 65% patients had PCOD and 27.5% had idiopathic hirsutism. All the patients had significant improvement with intense pulsed light with regard to terminal-vellus hair ratio and Terminal hair density observed with trichoscopy irrespective of their medical treatment. The mean modified visual analog score was 6.75±1.1209. According to the modified visual analog score, 57.5% had good reduction while the rest had a moderate reduction. Conclusions: The majority had functional hirsutism. Polycystic ovarian disease and idiopathic hirsutism are the most common causes of hirsutism. Intense pulsed light is an effective and safe method of hair removal, regardless of medical treatment, and trichoscopy can be used to evaluate treatment response.

Micronutrient Deficiencies and Digital Computerized Phototrichogram Analysis in Telogen Effluvium: a Retrospective Correlation Study in a Tertiary Medical Center.

Telogen effluvium (TE) is a common form of non-scarring alopecia that may manifest as acute or chronic hair shedding. Several studies evaluated a possible relationship between various vitamin and mineral deficiencies and TE, but it is still a controversial topic. This study aimed to investigate the status of vitamin and mineral deficiencies in patients diagnosed with TE and to evaluate their correlation with anagen hair ratios (AHR) calculated with an automated digital phototrichogram (ADCP). Electronic records of 973 TE patients were retrospectively analyzed. Demographic, clinical data, parameters such as ferritin, vitamin B12 (Vit-B12), vitamin D (Vit-D), folic acid, zinc and hemoglobin (HGB) serum levels were evaluated. Anagen to telogen hair ratios were also assessed in forty-two patients via ADCP. The rates of anemia, low ferritin level, and Vit-B12, folate, Vit-D, and zinc deficiencies were 11.9% (N = 109), 44% (N = 332), 1.5% (N = 13), 2.5% (N = 14), 87% (N = 51), and 4.5% (N = 2), respectively. A positive correlation was found between HGB levels and AHR in female patients (Spearman rank, r = 0.417, P = 0.008). No statistically significant relationship was found between ferritin, Vit-B12, folate, zinc serum levels and AHR. The relationship between Vit-D and AHR could not be assessed due to the insufficient number of patients with Vit-D data. HGB value is the only marker that is positively correlated with the AHR of patients with TE. Ordering HGB can be used as an initial test for managing TE patients cost-effectively.

Evaluation of platelet-rich plasma plus basic fibroblast growth factor combined with minoxidil in the treatment of androgenetic alopecia: A randomized controlled trial.

Platelet-rich plasma plus basic fibroblast growth factor (PRPF) has been confirmed to be a safe and valuable therapy for androgenetic alopecia (AGA). However, the efficacy of PRPF combined with minoxidil treatment remains unknown. To assess the efficacy of combined PRPF and minoxidil treatment for AGA. In this prospective, randomized controlled trial, 75 patients with AGA were randomly divided into three groups and were administered the following treatments: Group 1, direct intradermal PRPF injection; Group 2, topical minoxidil 5% twice daily; and Group 3, PRPF injection combined with minoxidil. The PRPF injection was performed three times, 1 month apart. Hair growth parameters were evaluated using a trichoscope until the sixth month of the study. Patient satisfaction and side effects were recorded during the follow-up. All patients showed improvements (p < 0.05) in hair count, terminal hair, and decrease in telogen hair ratio after treatment. The efficacy of PRPF complex therapy revealed significant improvements (p < 0.05) in hair count, terminal hair and growth rate, compared with monotherapy. Small sample size, short follow-up time and lack of quantification of GFs in PRPF. The effect of complex therapy exceed both the effects of PRPF monotherapy and minoxidil treatment, which can be a beneficial AGA treatment strategy.

Comparative histopathological analyses of non-scarring alopecia in systemic lupus erythematosus patients in Lagos Nigeria.

Systemic lupus erythematosus (SLE) is known to cause non-scarring alopecia. However, histopathological evaluation is uncommon. The objective of this study was to document the histopathology of non-scarring alopecia and to compare histopathology of alopecic and normal appearing scalp areas in SLE hair loss patients. A cross-sectional comparative evaluation of scalp biopsies from 23 SLE patients; 12 with hair loss and 11 without was conducted over a 7-month period in 2020. A total of 58 scalp biopsies stained with H and E (23 vertical and 35 cross-sectional) were evaluated. Mucin deposit evaluation was done using Alcian blue (pH 2.5). There were no significant differences in the sociodemographic data between the patients. The SLE hair loss patients demonstrated mucin deposition (91.7%), reduced size/number of sebaceous glands (58.3%), epidermal atrophy (50.0%), naked arrector pili muscles (50.0%), lymphocytic infiltration (33.3%), pigment incontinence (16.7%), fibrous stellae (16.7%), increased telogen percentage, and increased terminal versus vellus hair ratios. On comparing the histopathology of those who had hair loss to those without hair loss, the only significant difference was in the number and size of sebaceous gland. There were no significant differences between scalp areas with and without hair loss in the SLE hair loss patients. There are differences in size and number of sebaceous glands on histopathology between SLE patients who have hair loss and those who do not. Also, there are no histopathological differences between alopecic and non-alopecic scalp areas of SLE patient.

Trichoscopic Patterns of Scalp Dermatoses: An Observational Cross-sectional Study

Introduction: Trichoscopy is a well-acclaimed diagnostic tool for numerous dermatoses. Scalp disorders contribute to a significant percentage of daily visits to the outpatient dermatology department, and a multitude of trichoscopic signs have been documented in the literature. The consistency and repeatability of these signs add weight to their diagnostic value. Aim: To determine the various trichoscopic patterns observed in classical cases of scalp dermatoses and to differentiate between different scalp disorders. Materials and Methods: The present observational crosssectional study included 100 newly diagnosed cases of scalp dermatoses attending the Dermatology Outpatient Department at Sree Balaji Medical College and Hospital, Chennai, India. The study was conducted over a period of six months (180 days) from December 2021 to May 2022. After obtaining a thorough history and conducting clinical examinations, patients underwent trichoscopy. Photographs were taken, and the data obtained were systematically tabulated. The scalp disorders studied included Androgenetic Alopecia (AGA), Alopecia Areata (AA), Telogen Effluvium, Tinea Capitis, Trichotillomania (TTM), Seborrhoeic Dermatitis, Scalp Psoriasis, Discoid Lupus Erythematosus (DLE), Lichen Plano-Pilaris (LPP), and scalp verruca. All data were entered into Microsoft excel and analysed using Statistical Package for Social Sciences software. Results: Trichoscopic findings from the 100 cases were categorised and tabulated according to pattern and condition for better understanding and comparison. Trichoscopic patterns observed were categorised as dots, vessels, shaft patterns, and changes in the inter and perifollicular areas. Out of the 100 patients, 67 presented primarily with alopecia, of which 56 patients (83.5%) had non scarring alopecia and 11 patients (16.4%) had scarring alopecia. The highest number of cases was observed in alopecia areata (n=20), where exclamation mark hairs were seen in all individuals, followed by coudability sign, yellow dots, and black dots. Among the androgenetic alopecia cases (n=18), anisotrichosis, pearly white dots, yellow dots, and an increased vellus-to-terminal hair ratio were observed in 100% of cases. Conclusion: While certain signs/findings are specific, most trichoscopic patterns overlap in various skin conditions. Therefore, dermatologists should be aware of the patterns observed in trichoscopy and the need to stay updated with the latest findings.

Comparison of a New 5% Minoxidil Foam and Rogaine® in the Treatment of Androgenetic Alopecia in Chinese Men: A Randomized, Double‐Blind, Phase III, Equivalence Trial

Androgenetic alopecia (AGA) is a common cause of hair loss in adults. We aimed to compare the efficacy and safety of topical generic 5% new minoxidil foam (NMF) versus 5% minoxidil Rogaine® foam in male patients with AGA. A randomized, double‐blind, controlled, phase III, equivalence trial in 10 centers in China between December 25, 2019, and June 28, 2021, was performed. In total, 417 men patients (≥18 years) with AGA were randomized to receive 5% NMF (211 patients) or 5% Rogaine® foam (206 patients) 1 g two times daily for 24 weeks. The primary outcome was the changes in nonvellus target area hair counts (TAHC) from baseline to week 24. Equivalence was concluded if the 95% confidence interval (CI) for the treatment difference between the 5% NMF and Rogaine® groups was within (−8.00, 8.00). After 24 weeks of treatment, the mean difference in the change of nonvellus TAHC between the 5% NMF group and the Rogaine® group was −3.85 ± 1.62 hair/cm2 in full‐analysis set (FAS) and −3.96 ± 1.68 hair/cm2 in per‐protocol set (PPS), and the 95% CI of mean difference was (−7.03, −0.67) in FAS and (−7.26, −0.66) in PPS. No significant differences were found between the two groups in hair diameter, the ratio of terminal hair to vellus hair, the global photographic assessment by investigators, and adverse events (all P &gt; 0.05). 5% NMF is as effective as Rogaine® in increasing hair density and hair diameter in AGA patients and was found to be safe. This trial is registered with CTR20191708.

Efficacy of autologous stromal vascular fraction injection in the treatment of androgenic alopecia

Androgenic alopecia (AGA) is a common condition associated with loss of terminal hair on the scalp in a specific pattern in both males and females. Management of AGA is usually challenging as the approved therapeutic options are limited. Our aim was to evaluate the efficacy of non-enzymatic stromal vascular fraction (SVF) as a new promising treatment for AGA. From April to December 2021, this prospective study included 30 patients with AGA who were enrolled from the University Hospitals' dermatology outpatient clinics. Patients received a single session of autologous SVF injection and were then followed up for 6 months. There was an increase in hair shaft caliber from 0.037 ± 0.01 mm before treatment with SVF to 0.056 ± 0.02 mm after 6 months of treatment. Also, hair count/cm2 increased from 130.87 ± 14/cm2 to 151.93 ± 22.36/cm2 and terminal to vellus hair ratio increased from 77.06 ± 10.47% to 81.45 ± 11.98% at the end of the study. No significant difference was recorded between male and female groups as regard response to treatment. We concluded that SVF is an effective line of treatment for AGA with significant improvement regarding hair density, hair diameter, global photography, and patient satisfaction.

Videodermoscopic Changes of the Hair in Vitiligo Lesions in Relation to Disease Duration.

Vitiligo is an acquired disease of complex pathogenesis, in which the immunologic attack to the skin and hair follicle melanocytes leads to areas of depigmentation and leukotrichia, respectively. To study the dermoscopic features of the hair changes in vitiligo lesions in comparison to perilesional control areas and in relation to disease duration. Forty-seven patients with both old and recent vitiligo lesions were included. Dermoscopic features of hair within the lesions were examined and compared to those in perilesional non depigmented skin of the same patient. Hair density (P < 0.001), terminal hair rate (P = 0.011), terminal to vellus hair ratio (P = 0.029) and mean hair shaft thickness (P = 0.031) were significantly decreased, whereas vellus hair rate (P = 0.011) was significantly increased in old vitiligo lesions compared to their respective control areas. The frequency of broken hair was significantly higher in old lesions (P < 0.001), while that of upright re-growing hair was significantly higher in recent lesions (P = 0.016). Hair involvement in vitiligo lesions is not only limited to the development of leukotrichia. Other subtle changes in hair density, anagen and telogen hair rates, and mean hair thickness can be detected. These changes may serve as objective clues to the duration of the lesions.

Traditional Chinese Medicine Treatment for Androgenetic Alopecia Based on Animal Experiments: A Systematic Review and Meta-Analysis.

Background In the present study, we systematically evaluated the effects of Traditional Chinese Medicine (TCM) on androgenetic alopecia (AGA) in rodent models (rats and mice) to provide potential evidence for the treatment of AGA by TCM. Methods Previous research papers focusing on the treatment of AGA by TCM were retrieved from various electronic databases (PubMed, Embase, The Cochrane Library, CNKI, Vip, Wanfang data, and CBM) up to October 30, 2021. Screening of the literature was performed independently, and data were extracted and assessed. A meta-analysis was performed using RevMan 5.3 software. Results When compared with the model groups, a group of C57BL/6 mice treated with TCM showed an increase in the total number of hair follicles (mean difference [MD] = 11.99, 95% confidence interval [CI] [5.94,18.03], P=0.0001), as well as a decrease in serum testosterone (T) level (MD = −1.10, 95% CI [−1.43, −0.78], P < 0.00001), skin discoloration time (MD = −2.93, 95% CI [−4.03, −1.84], P < 0.00001), and skin hair growth time (MD = −3.16, 95% CI [−4.16, −2.16], P < 0.00001). Terminal hair/vellus hair also increased in TCM-treated AGA animals (MD = 3.02, 95% CI [2.05, 3.98], P < 0.00001). No significant difference was found in serum estradiol (E2) level, skin tissue E2 level, or skin tissue T level between the TCM-treated group and the model group. Conclusion TCM can increase the total number of hair follicles and terminal hair/vellus hair ratio, and reduce skin discoloration time and skin hair growth time in AGA animal models. These effects may be related to the reduction of the serum T level in AGA animals. These conclusions need to be verified by high-quality studies as the current analysis may be affected by the number and quality of the studies identified.

Identification and determination of the relationship between elemental compounds of hair and fingernail by PIXE technique in Hamadan urban community, Iran

The measurement of trace elements in nails and hairs has advantages relative to other body tissues and they have been increasingly used in forensic and clinical toxicology as a complementary test. Complementary hair and nail analysis can indicate the amount of elements in the body for long periods of time. In this study, hair and nail samples were collected from the city of Hamedan and the quantitative elemental concentration of samples was measured by PIXE technique. In hair samples of females, P had a significant difference with Cr and Ni, and a moderate difference with Co. The average amounts of Si, K, Cl, Al and Ca of hair samples in athletes were higher than normal people, in turn higher than addicted group. Ca content had a moderate difference between athlete and addicted groups. There was a weak difference between P-Ni and P-Co only for age ranges of 30-40 year. In female nail samples, P had a significant difference with Ca, Cr and Al. The existence of the meaningful difference in the Ca ratio in hair to nail samples can be used as a biomarker in forensic medicine.

Hormonal profile changes induced by pesticide mixture exposure in female rats revealed by hair analysis.

Pesticide exposure has been associated with hormonal disruption in both animals and humans. However, there is limited knowledge of the combined effects of complex mixtures of pesticides on endogenous hormone levels. Here, we used hair analysis to assess the impact of a pesticide mixture comprising 19 components from multiple chemical classes at eight doses of 0-400μg/kg body weight (bw) three times per week per component on concentrations of 36 steroid and thyroid hormones in female rats over a 90-day exposure period. We detected 13 hormones in rat hair, namely estradiol (E2), androstenedione (AD), testosterone (T), dehydroepiandrosterone (DHEA), dehydroepiandrosterone sulfate (DHEAS), pregnenolone (P5), progesterone (P4), 11-deoxycorticosterone (11-DOC), corticosterone (CORT), 3,3'-l-diiodothyronine (T2), 3,5,3'-l-triiodothyronine (T3), 3,3',5'-l-triiodothyronine (rT3), and 3,5,3',5'-l-tetraiodothyronine (T4). In comparison to the control group, hair E2 concentration was significantly lower in the two highest (200 and 400μg/kg bw) exposure groups, whereas hair DHEAS and CORT concentrations were significantly higher in the 40μg/kg bw and the highest exposure groups, respectively. Results from generalized additive models suggest that pesticide exposure resulted in monotonic dose responses in hair E2 concentration, CORT concentration and DHEA/CORT molar ratio but nonmonotonic dose responses in hair T concentration, DHEAS concentration, P4/P5 and DHEA/DHEAS molar ratios. The associations of E2, CORT and DHEA/CORT ratio with exposure intensity were confirmed by their significant linear relationships with hair concentrations of at least 23 of the 25 exposure biomarkers analyzed. Our results demonstrate that exposure to low levels of the pesticide mixture evaluated here can alter hair reproductive and adrenal hormones levels.

Citalopram and escitalopram in hair segments from deceased individuals with mental illnesses

To aim of the study was determine concentrations of citalopram, escitalopram and their primary metabolite in hair segments from individuals with mental illnesses and correlate them to an estimated daily dose. Citalopram is a commonly sold antidepressant. It contains a chiral center and is used in therapy as the racemic mixture (RS-citalopram) or as the pure enantiomer (S-citalopram), escitalopram. The use of pharmaceuticals, polypharmacy and drug abuse can all been linked to elevated death rate among individuals with mental illnesses. Therefore, information on previous drug intake is important and can be obtained by hair analysis. Monthly drug intake before death is investigated using an average hair growth rate of 1 cm/month and analysis of 1 cm hair segments. Investigations on drug distribution in the hair and its relationship to the estimated dose provide insight into the interpretation of forensic cases. Hair samples were collected from 44 deceased individuals included in the autopsy-based study “SURVIVE” and had a presumed history of citalopram use based on results in the postmortem blood sample or the case history. Citalopram and N-demethylcitalopram were quantified using a previous method optimized to cover long-term drug intake. The method was successfully validated according to international guidelines with a measurement range of 0.005 to 100 ng/mg by using 12 C and 13 C isotopes. Depending on the length of the hair, hair samples were cut into 6 × 1 cm segments corresponding to six months before death. The segments were weighted, washed, pulverized, and incubated over night at 37 °C in an extraction medium of methanol, acetonitrile and 2 mM ammonium formate (25:29:46, v/v/v). After filtration, the extract was injected into an LC–MS/MS system. Soaked QCs in hair at three concentrations levels were included. After quantification, R- and S-citalopram were identified using a method adapted from chiral determination of citalopram in blood. Prescription data was used to estimate daily doses. We found citalopram concentrations in hair ranging from 0.12 to 67 ng/mg (10th–90th percentile) with a median of 8.2 ng/mg ( N = 40 individuals, n = 182 segments) and escitalopram concentrations ranging from 0.027 to 7.0 ng/mg (10th–90th percentile) with a median of 3.9 ng/mg ( N = 4, n = 23). Similar or decreasing concentrations throughout the segments were often detected, indicating a probable wash out of citalopram over time. The daily doses calculated varied from 1.3 to 69 mg/day (median 27 mg/day). We found no correlations between the hair concentrations and the estimated daily dose ( N = 30, P = 0.1). However, after accounting for the calculated daily doses, our findings revealed a propensity for dark hair to have higher citalopram concentrations than light hair, indicating a possible effect of hair color on the hair concentration. The 10th–90th percentile metabolite-to-drug ratios in hair were 0.053–0.63 ( N = 39, n = 166) with intraindividual variability of <25% for most individuals. Citalopram concentrations >30 ng/mg were found in 13 individuals suggesting very high levels in hair. The chiral analysis revealed that racemic citalopram had a median R/S ratio of 1.5 ( N = 27), which is consistent with blood ratios. This study determined concentrations of citalopram, escitalopram and N-demethylcitalopram in 1 cm segments from 44 deceased individuals with mental illnesses applying chiral separation of R- and S-citalopram. This is the first study reporting chiral separation of citalopram in hair samples. No correlations were found between the concentrations in hair and the estimated daily dose. However, our findings suggest that hair color has an impact on this. This research contributes to the establishment of reference values for citalopram in hair for future forensic investigations.

Efficacy of intramuscular injections of biotin and dexpanthenol in the treatment of diffuse hair loss: A randomized, double-blind controlled study comparing two brands.

Combination therapy with biotin and dexpanthenol is a well-known practice in preventing and treating hair loss, however, it is not well studied. In this study, we compared the efficacy of the 6-week treatment with two brands of biotin and dexpanthenol for the treatment of diffuse hair loss. Fifty eligible patients with diffused pattern hair loss, (41 women and 9 men) were randomized in a 1:1 ratio to receive either 6 weekly injections of dexpanthenol ampoule 250 mg/2ml and biotin ampoule 5mg/1ml, manufactured by Pars Behvarzan or Bayer Company. Combing test, Standard scalp photography and trichoscan assessment were performed before the first treatment session and one and 8 weeks after the last one. Patients' satisfaction and drug adverse reactions were also recorded. One and eight weeks after the last treatment session, hair fall count and total hair density significantly improved in both groups (p-value <0.01 for hair fall count and 0.04 and 0.02, for hair density in Pars and Bayer groups, respectively). There was no significant difference between the two groups in any other trichoscan parameter, except for improvement in terminal/vellus hair ratio in the Bayer group in both follow up visits, compared to the Pars group (p-value=0.02 and 0.033 for weeks one and eight). Six-week treatment with both brands of biotin and dexpanthenol was effective and safe in people with diffused pattern hair loss.