Treatment Of Alopecia Research Articles

Using the follicular unit extraction technique in treatment of male androgenetic alopecia.

The incidence of androgenetic alopecia in males is on the rise annually, with hair transplantation using follicular unit extraction (FUE) gaining increasing acceptance as an appropriate treatment for these individuals. A retrospective study was undertaken, involving 158 male patients diagnosed with androgenetic alopecia, who underwent treatment between January 2016 and December 2020 at the Medical Cosmetology Department of the First Affiliated Hospital of Xi'an Medical University. Demographic data and treatment characteristics were documented and analyzed. Clinical efficacy, operation-related complications, patient satisfaction rates, and quality of life scores were assessed and analyzed. Following FUE hair transplantation, over 90% of the hair follicles survived in 158 patients, with more than 85% of patients achieving a hair follicle survival rate exceeding 95% at 12 months post-operation. Patient satisfaction rates exceeded 98%, while the complication rate was below 6%. Our findings demonstrate that FUE is a minimally invasive hair transplant technique associated with a high hair follicle survival rate and optimal hair density. This approach proves effective in treating male androgenetic alopecia and merits further clinical application.

Revitalizing Effect on the Scalp After Injection with a Mechanically Stabilized Hyaluronic Acid Complex in Subjects with Androgenetic Alopecia

Background: Treatments for androgenetic alopecia (AGA) include different drugs, but a treatment based on stabilized hyaluronic acid has not been tested. The aim of this study is to clinically evaluate the effect of six sessions of injections using a hyaluronic acid compound supplemented with vitamins, ions, and amino acids (CH) on hair density and quality in volunteers. Methods: For this purpose, twenty-six healthy volunteers of both sexes with moderate AGA were injected with 3 mL of CH using the micro-papule technique. All received six CH sessions at two-week intervals. Hair loss, hair thickness, and shine were assessed using macro-photographs. A follow-up questionnaire was given to the volunteers at 40 days and at 90 days after the last treatment to determine their level of satisfaction. In addition, a dermatological control was carried out to assess the tolerance of the treatment applied. Results: The results indicate that, after treatment with CH, there is a significant improvement in the thickness, shine, and density of scalp hair, and that the treatment significantly reduces hair loss on the scalp. On a dermatological level, the tolerability of the treatment was excellent with no complications observed. In total, 88.5% of the volunteers indicated that CH treatment improved their appearance. In summary, it can be said that CH treatment reduces hair loss and promotes hair growth. Conclusions: It is suggested that this treatment is effective in reducing the signs and symptoms of alopecia.

Exploring Mesenchymal Stem Cells versus Minoxidil for Androgenic Alopecia Treatment: A detailed Animal-Based Histological and Morphometric Study.

Androgenic alopecia (AGA), a hair loss condition caused by Dihydrotestosterone (DHT) binding to hair follicle receptors, negatively impacts quality of life for both men and women. Current treatments like minoxidil and finasteride have limitations, highlighting the need for alternative therapies, such as human umbilical cord blood-derived mesenchymal stem cells (HUCB-MSCs). In this study, forty-eight adult male Wistar albino rats (3 months old) were used. The control group (Group I) received no treatment, while the other rats underwent AGA induction via daily subcutaneous testosterone injections (100 mg/kg). These rats developed alopecia and were divided into three groups: AGA (Group II), AGA plus daily minoxidil spray (Group III), and AGA plus a single intradermal injection of HUCB-MSCs (1 ml containing 1x10^5 cells, Group IV). After 4 weeks, the rats were sacrificed, and skin specimens were prepared for histological analysis using H&E, Masson's Trichrome, and immunohistochemical staining for CK 19, VEGF, and TUNEL antibodies. It was shown that HUCB-MSCs treatment reversed structural damage to hair and follicles, normalizing conditions within one week post-injection. The treatment enhanced the anagen phase, suppressed telogen and catagen phases, reduced apoptosis, and increased VEGF and CK 19 immune reactions. Observational follow-up for Groups III and IV revealed that while the minoxidil group experienced significant hair loss after 37 days, the stem cell group exhibited dense and long hair covering the treated area. HUCB-MSC therapy demonstrated superior efficacy over minoxidil with no observed side effects, indicating its potential as a promising alternative for AGA treatment.

Current Landscape and Emerging Therapies in Hair Loss Treatment for Androgenetic Alopecia

Current Landscape and Emerging Therapies in Hair Loss Treatment for Androgenetic Alopecia

Exosomes derived from Umbilical cord mesenchymal stem cell promote hair regrowth in C57BL6 mice through upregulation of the RAS/ERK signaling pathway.

Androgenetic alopecia is one of the common types of hair loss and has become a medical and social problem due to its increasingly young onset. Existing therapies, although effective, have serious side effects and therefore better treatments need to be sought. The aim of this study was to evaluate the efficacy of umbilical cord mesenchymal stem cell-derived exosomes in the treatment of androgenetic alopecia and to investigate the mechanism of exosome regulation of hair growth. First, we randomly divided 20 C57BL/6J mice into blank group, model group, positive control group and exosomal hydrogel group, and mice were treated with hair removal on the back. The mice were injected intraperitoneally with dihydrotestosterone solution except for the blank group. At the end of the experiment, new hairs were collected and the differences in length, diameter and number of hair follicles were compared among the groups; the histopathological changes of hair follicles were observed by HE staining; the expression of androgen receptor mRNA and protein in skin tissues were compared; and the skin tissues were analyzed by real-time PCR, western blotting, immunofluorescence staining and transcriptome sequencing. Finally, the results of transcriptome sequencing experiments were verified by real-time PCR, western blotting and other techniques for the corresponding genes and proteins. Compared with the blank group, mice in the model group had shorter hair length and reduced hair diameter, and pathological observation showed that the total number of hair follicles was significantly reduced and the hair follicles were miniaturized; compared with the model group, mice in the positive control and exosome groups had longer hair length, larger hair diameter and more hair follicles; the androgen receptor mRNA content and protein expression in the skin tissue of mice in the model group were significantly higher than those in the blank group, and the protein expression in the exosome gel group was lower than that in the model group. Similarly, compared with the model group, the expression of stemness-related proteins K15 and CD200 in the skin tissues of mice in the exosome group increased, and the expression of PCNA, a protein related to cell proliferation, increased. The KEGG data showed that the differential genes were mainly enriched in the RAS/ERK pathway. In this study, we demonstrated the therapeutic effect of umbilical cord MSC-derived exosomes on androgenetic alopecia and verified that exosomes regulate hair follicle stem cell stemness through the RAS/ERK pathway to promote hair proliferation and thus hair growth in mice with androgenetic alopecia, providing a potential therapeutic strategy for androgenetic alopecia.

Multistage Transdermal Nitric Oxide Delivery System for the Efficient Treatment of Androgenic Alopecia

Multistage Transdermal Nitric Oxide Delivery System for the Efficient Treatment of Androgenic Alopecia

An Overview of Commonly Used Natural Alternatives for the Treatment of Androgenetic Alopecia, with Special Emphasis on Rosemary Oil.

Androgenetic alopecia is a chronic dermatological condition in which genetically predisposed individuals undergo progressive hair loss secondary to the effects of circulating androgens. It has been well documented that dihydrotestosterone binds to the androgenic receptors prevalent in the scalp, thus inducing miniaturization of the hair follicle. To date, the only FDA approved medications for the treatment of androgenetic alopecia are finasteride and minoxidil. A plethora of studies have been conducted testing the efficacy of various herbal compounds, but additional research is needed to further establish the concrete efficacy of such natural remedies in treating androgenetic alopecia. Of late, rosemary oil has gained mass popularity as a promising natural alternative. This review article will not only provide a detailed background on this ancient herbal component but will additionally overview all other major herbal alternatives including peppermint oil, tea tree oil, green tea, pumpkin seed oil, saw palmetto, and lavender oil and will summarize the latest clinical studies, which have tested their efficacy for the management of androgenetic alopecia.

Efficacy and Safety of Laser Therapy and Phototherapy in Cicatricial and NonCicatricial Alopecia: A Systematic Review Study.

In recent years, the application of various light and laser devices in the treatment of different types of alopecia has been established. This systematic review aims to assess the efficacy and safety of laser therapy and phototherapy in cicatricial and non-cicatricial alopecia. A comprehensive search was conducted on PubMed, Scopus, Science Direct, and Google Scholar. Articles were evaluated across four subgroups: alopecia areata, androgenic alopecia, telogen effluvium, and cicatricial alopecia. Included studies were published in English or Persian between January 2010 and September 2023, focusing on interventional, cohort, or case series research that achieved a minimum score of 75% on the EBL checklist. Exclusion criteria encompassed animal and in vitro studies, review articles, case reports, duplicated or irrelevant research, as well as studies that did not meet the designated EBL score. Editorial letters and case studies were also excluded. Initially, 965 records were collected, resulting in the inclusion of 58 studies in the final review: 26 on alopecia areata, 26 on androgenic alopecia, five on cicatricial alopecia, and one on telogen effluvium. Narrow-band ultraviolet B, 308-nm excimer laser, and psoralen ultraviolet A therapy showed varying effectiveness; specifically, the excimer laser was notably effective for patients with shorter disease duration. In androgenic alopecia, erbium-glass and thulium lasers effectively increased hair density but showed a gradual decline posttreatment. Low-level light/laser therapy also increased hair density and diameter and exhibited potential benefits when used alongside minoxidil, but did not significantly enhance outcomes in telogen effluvium treatment. Light/laser therapy can serve as an additive treatment for cicatricial alopecia, particularly lichen planopilaris, but has limited efficacy in treating telogen effluvium. Overall, light/laser therapies exhibit a significant positive effect on increasing hair density and diameter across various alopecia types.

Low Dose Oral Minoxidil does not significantly affect blood pressure: A systematic review and meta-analysis

IntroductionMinoxidil, traditionally used as an anti-hypertensive, is now widely used for treating various forms of alopecia due to its vasodilatory effects. While topical minoxidil has been the standard treatment, low-dose oral minoxidil (LDOM) is emerging as an effective alternative. This study investigates LDOM’s potential hypotensive effects. MethodsStudies were selected based on criteria such as the use of LDOM (≤5 mg/day) and reporting on blood pressure changes. Mean differences (MD) were calculated for mean arterial pressure (MAP), systolic blood pressure (SBP), diastolic blood pressure (DBP), and heart rate (HR). ResultsLDOM did not significantly alter SBP (MD: -0.13, 95% CI: -2.67-2.41) or DBP (MD: -1.25, 95% CI: -3.21-0.71). Though MAP was not significantly altered, there was a strong tendency towards decreased MAP (MD: -1.92, 95% CI: -4.00-0.17). There was a significant increase in HR (MD: 2.67, 95% CI: 0.34-5.01). Hypotensive symptoms were reported in 119 patients (5.0%), but no hypotensive episodes were observed. Hypertrichosis was the most frequent side effect, leading to 34.6% of discontinuations. LimitationsStudies lacked control groups and showed variability in dosing regimens and blood pressure monitoring. ConclusionLDOM appears to be a safe treatment for alopecia with no significant impact on blood pressure.

The Impact of Smoking and Lifestyle Factors on Hair Transplant Outcomes in Patients with Androgenic Alopecia

Background: Hair transplantation is a popular treatment for androgenic alopecia, a common form of hair loss that significantly affects self-esteem and quality of life. However, it is important to note that smoking can potentially have a detrimental impact on the efficacy of this procedure. Objectives: The objective of this study is to examine the influence of smoking, alcohol consumption, and water pipe usage on hair density and growth rate in individuals with alopecia who have undergone hair transplantation at the Jordan Clinic in Tehran, Iran. Methods: A retrospective analysis was conducted on 23 smoker and 97 non-smoker patients who underwent hair transplantation at the Jordan Clinic between 2011 and 2013. A convenience sampling method was employed in the study. Data on smoking status, hair growth, and complications were collected and analyzed. The study included 94.2% male and 5.8% female patients. Data analysis was performed using SPSS software, version 13. The repeated measures ANOVA test was used for statistical analysis, with a significance level of five percent. Results: The results showed that smokers experienced spontaneous bleeding at the implant site after surgery, resulting in hairless areas following crust formation, a complication not observed in non-smokers (P > 0.05). Smokers also had significantly lower hair density and growth compared to non-smokers (P > 0.05). Additionally, alcohol users demonstrated significantly less hair growth than non-drinkers. Conclusions: Smoking—including cigarettes, hookah, and combined smoking—and alcohol consumption negatively impacted hair transplant outcomes in patients with androgenic alopecia treated at the Jordan Clinic. These findings underscore the importance of addressing lifestyle factors, such as smoking and alcohol consumption, in the management of androgenic alopecia and hair transplantation.

Role of Autologous Micrografting Technology through Rigenera® System in the Treatment of Androgenetic Alopecia

Introduction: Androgenetic alopecia (AGA) is a common form of baldness, affecting 60–70% of the adult population worldwide, and may have a negative effect on quality life. AGA leads to a progressive thinning of scalp hair and is characterized by a progressive miniaturization of the hair follicle with a specific pattern distribution. Although AGA is a very frequent condition, compelling therapeutic options are still limited. Methods: Herein, we present the protocol of autologous micrografting technology through Rigenera® system allowing to obtain a suspension of autologous micrografts ready to be injected on scalp. This paper combines the results of two studies that evaluated the effects of micrografts in patients with AGA. The first study involved 17 patients who received one micrografts session with a 6-month follow-up. The second study 13 patients who received two micrografts sessions 6 months apart with a follow-up of 6 months after the second session. Clinical assessment involved global photography evaluation and patient’s satisfaction before and after the treatment. Hair measures using TrichoLab were also performed. Results: Most of the patients had a moderate improvement after investigator’s assessment in terms of hair loss reduction and hair density improvement. The assessment of patients was satisfactory in terms of hair improvement and treatment tolerability. Conclusion: In summary, we conclude that this new regenerative approach can be a promising tool for clinicians to obtain a viable, sterile and ready to use micrografts that can be immediately injected into the scalp to improve AGA condition.

Platinum Nanozyme-Loaded Dissolving Microneedles Scavenge ROS and Promote Lineage Progression for Androgenetic Alopecia Treatment.

Androgenetic alopecia (AGA) is a prevalent issue affecting the physical and mental health of individuals but with fewer current treatments. Platinum nanozymes (PtNZs) are known for their excellent ability to reduce and modulate the high oxidative stress environment in AGA pathology. And microneedles are used to overcome the skin barrier due to the poor permeability of PtNZs. Herein, dissolving microneedles loaded with PtNZs (Pt-MNs) are designed and successfully induced hair regeneration in the AGA model. Pt-MNs possessed adequate mechanical strength to breach the skin barrier for effective PtNZs delivery. In vivo, PtNZs first reduced reactive oxygen species (ROS) to oxygen, which recovered the AGA pathological environment. And the oxygen then increased oxidative phosphorylation, promoting the differentiation of hair follicle stem cells to achieve hair regeneration. The group treated with Pt-MNs with a dosing frequency of once every three days achieved faster hair growth than the daily application of the positive drug minoxidil. Further safety experiments showed that the application of Pt-MNs locally opened temporary and recoverable skin channels, with no retention of Pt in major organs, indicating high safety. In conclusion, this study indicated the potential of Pt-MNs as an effective method for treating AGA.

The role of salivary vitamin D and interleukin-6 on non-scarring Alopecia.

Alopecia, or hair loss, is an emerging global disease. Its etiopathogenesis includes nutritional deficiencies, oxidative stress, and deficiency of physiological factors. Around 2% of the general population has the probability of developing alopecia at any one period. Vitamin D and interleukin-6 (IL-6) have a major role in alopecia. The present goal of research is to investigate the role of vitamin D and IL-6 in the saliva of patients with non-scarring alopecia. The study involved 51 cases of non-scarring alopecia and 50 healthy controls with an age range between 18 and 40 years. A detailed history and clinical examination were done. Salivary vitamin D and IL-6 were determined to compare within the groups. The average vitamin D level in cases (104.64 ± 46.95 pmol/L) was significantly lower as compared to controls (223 ± 12.03 pmol/L) (p < 0.001). Whereas the average amount of IL-6 was significantly higher (170.54 ± 63.68 ng/L) than the control group (56.38 ± 46.52 ng/L) (p < 0.001). No correlation of vitamin D level with IL-6 was detected in study subjects. Vitamin D significantly influences the development of non-scarring alopecia. Patients with non-scarring alopecia had low amount of vitamin D indicate its role in etiology of hair loss. IL-6 may cause a collapse of the hair bulb, having a significant part in the pathogenesis of alopecia indicating chronic inflammatory or autoimmune condition. This research will aid in diagnosing scalp disease using salivary biomarkers and improve the treatment of alopecia.

CGF therapy: bridging androgenetic alopecia observations to psoriasis treatment via IL-17 pathway.

Concentrated Growth Factor (CGF), rich in CD34 + stem cells, is widely used in treatments for androgenetic alopecia and skin rejuvenation due to its immune-modulating properties. Psoriasis, a chronic inflammatory skin condition, presents significant treatment challenges, particularly for patients who cannot use biologics due to conditions such as cancer and lesions resistant to treatments. The potential of CGF in treating psoriasis is promising, given its broad immunoregulatory effects which confirmed in our previous androgenetic alopecia work. We evaluated the impact of CGF on IL-17 levels in two contexts: patients treated for androgenetic alopecia and a psoriasis mouse model. Twelve patients received three monthly injections of CGF, with serum IL-17 levels measured before and after treatment. In the psoriasis mouse model, groups were treated with CGF, and outcomes were assessed using the Psoriasis Area and Severity Index (PASI), skin barrier scores, histological analysis, and RNA sequencing. Additionally, in vitro experiments applied CD34 + cells from CGF to keratinocytes to measure levels of TNF-α, IFN-γ, IL-23, and IL-17. In patients with androgenetic alopecia, three monthly CGF injections resulted in significantly reduced serum IL-17 levels. In the psoriatic mouse model, CGF-treated groups exhibited lower PASI scores and improved skin barrier scores compared to controls. Histological analysis revealed enhanced skin characteristics, while RNA sequencing demonstrated downregulated IL-17 and upregulated CD34 expression, as well as improved expression of barrier-related genes. In vitro, the application of CD34 + cells from CGF to keratinocytes led to a significant reduction in TNF-α, IFN-γ, IL-23, and IL-17 levels, indicating strong anti-inflammatory effects. A clinical case of a psoriasis patient unresponsive to IL-23 therapy (Guselkumab) showed significant improvement following CGF treatment. These findings indicate that CGF could serve as an effective and versatile treatment for psoriasis, especially for patients who have already undergone biologic therapies but continue to experience resistant lesions.

Platycladus orientalis Leaf Extract Promotes Hair Growth via Non-Receptor Tyrosine Kinase ACK1 Activation.

Platycladus orientalis is a traditional oriental herbal medicinal plant that is widely used as a component of complex prescriptions for alopecia treatment in Eastern Asia. The effect of PO on hair growth and its underlying mechanism, however, have not been demonstrated or clarified. In this study, we investigated the hair-growth-promoting effect of PO in cultured human dermal papilla cells (hDPCs). Platycladus orientalis leaf extract (POLE) was found to stimulate the proliferation of hDPCs. POLE with higher quercitrin concentration, especially, showed a high level of cellular viability. In the context of cellular senescence, POLE decreased the expression of p16 (CDKN2A) and p21(CDKN1A), which resulted in enhanced proliferation. In addition, growth factor receptors, FGFR1 and VEGFR2/3, and non-receptor tyrosine kinases, ACK1 and HCK, were significantly activated. In addition, LEF1, a transcription factor of Wnt/β-catenin signaling, was enhanced, but DKK1, an inhibitor of Wnt/β-catenin signaling, was downregulated by POLE treatment in cultured hDPCs. As a consequence, the expression of growth factors such as bFGF, KGF, and VEGF were also increased by POLE. We further investigated the hair-growth-promoting effect of topically administered POLE over a 12-week period. Our data suggest that POLE could support terminal hair growth by stimulating proliferation of DPCs and that enhanced production of growth factors, especially KGF, occurred as a result of tyrosine kinase ACK1 activation.

A finasteride patch for the treatment of androgenetic alopecia: A study of promoting permeability strategy using synthetic novel O-acylmenthols combined with ion-pair

Currently, finasteride (FIN) is approved to treat androgenetic alopecia only orally, and the application of FIN in transdermal drug delivery system (TDDS) has introduced a new approach for treating the disease. This study was aimed to develop a FIN transdermal patch for the treatment of androgenetic alopecia（AGA） by combing ion-pair and O-acylmenthols (AM) as chemical permeation enhancers (CPEs). The formulation of patch was optimized though single-factor investigation and Box-Behnken design. The pharmacokinetics and androgenetic alopecia pharmacodynamics of the patch were evaluated. Additionally, the permeability enhancement mechanisms of ion-pair and AMs were explored at both the patch and skin levels. The effects of ion-pair and AMs on the patch were characterized by rheology study, FTIR, and molecular docking, and the effects on the skin were assessed through ATR-FTIR, Raman study, DSC, CLSM and molecular dynamics. The finalized formulation of FIN patches was consisted of 5 % (w/w) synthetic FIN-CA (Citric Acid), 6 % MT-C6 as CPEs, 25-AAOH as a pressure-sensitive adhesive (PSA), with a patch thickness of 80 ± 5 μm. The final Q24 h is 78.22 ± 5.18 μg/cm2. Based on the high FIN permeability, the pharmacokinetic analysis revealed that the FIN patch group exhibited a slower absorption rate (tmax = 7.3 ± 2.7 h), lower peak plasma concentration and slower metabolic rate (t1/2 = 6.2 ± 0.8 h, MRT0-t = 26.0 ± 7.8 h) compared to the oral group. Moreover, the FIN patch also demonstrated the same effect as the oral group in promoting hair growth in AGA mice. The results indicated that both FIN-CA and AMs could enhance the fluidity of the PSA and weaken the interaction between FIN-CA and PSA, thereby promoting the release of the FIN from the patch. The interaction sites on the skin for ion-pair and the four AMs were found in the stratum corneum (SC) of the skin, disrupting the tight arrangement of stratum corneum lipids. This study serves as a reference for the multi-pathway administration of FIN and the combination of ion-pair with AMs to enhance drug permeation.

Novel natural lipids based NLC containing finasteride improved androgenetic alopecia treatment in rats

Androgenetic alopecia (AGA) is the most common hair loss disorder, affecting millions of men and women worldwide. Current formulations used to treat this condition often lead to a wide variety of side effects, ranging from allergies to sexual disfunction, especially when those drugs are administered orally. In this study, we developed and tested unique formulations containing nanostructured lipid carriers (NLC) composed of lipids extracted from fruit seeds, carrying finasteride to enhance efficacy of AGA treatment. By stabilizing the hydrophobic compounds in the solid matrix, three formulations of NLC were engineered and successfully prepared. Further an in vivo model of AGA was induced in rats by the administration of testosterone, as a platform to evaluate the efficiency of the formulations. The chosen formulation exhibited high bioavailability, medium size of 124.5 nm and PdI of 0.143, without systemic absorption. In addition, it promoted efficient and significant follicle restoration in AGA induced rats by increasing number of active bulbs and showed to be a safe formulation for topical application. The results of this research indicate that the presented formulation has significant potential to yield improved outcomes in AGA treatment.

Vitamin D deficiency in non-scarring and scarring alopecias: a systematic review and meta-analysis.

Numerous studies have linked vitamin D deficiency (VDD) to the pathogenesis of various alopecia disorders. This study aimed to investigate whether patients with alopecia are more likely to have VDD or lower vitamin D levels than controls, and the prevalence of VDD among patients with certain alopecia disorders. Electronic searches were conducted using PubMed, Embase, Scopus, and Cochrane Library databases from the dates of their inception until September 2024. Studies that reported data allowing for the calculation of odds ratios, mean differences, or correlation coefficients related to vitamin D levels and alopecia were included, while studies without a confirmed diagnosis of alopecia or those involving patients taking vitamin D supplements were excluded. It was found that 51.94% of patients with alopecia areata (AA), 50.38% of patients with female pattern hair loss (FPHL), 47.38% of patients with male androgenic alopecia (MAGA), 53.51% of patients with telogen effluvium (TE), and 38.85% of patients with primary scarring alopecia had VDD. Compared to controls, AA patients had a pooled odds ratio (OR) of VDD of 2.84 (95% confidence interval: 1.89-4.26, I2 = 84.29%, p < 0.01) and a pooled unstandardized mean difference (UMD) of vitamin D levels of -8.20 (-10.28 - -6.12, I2 = 74.25%, p < 0.01) ng/mL. For FPHL patients, a pooled OR of VDD of 5.24 (1.50-18.33, I2 = 81.65%, p < 0.01) and a pooled UMD of vitamin D levels of -15.67 (-24.55 - -6.79, I2 = 91.60%, p < 0.01) ng/mL were found. However, for MAGA, a pooled VDD OR of 4.42 (0.53-36.61, I2 = 88.40%, p < 0.01), and a pooled UMD of vitamin D levels of -2.19 ng/mL (-4.07 - -0.31 ng/mL, I2 = 7.64%, p = 0.37) were found. For TE patients, pooled UMD of vitamin D levels of -5.71 (-10.10 - -1.32) ng/mL were found. People with alopecia frequently have VDD; however, only in patients with AA or FPHL was the association of VDD and decreased vitamin D levels statistically significant compared to control. The findings indicate screening for vitamin D could benefit patients with AA or FPHL, potentially addressing vitamin D deficiency. Further study on vitamin D supplementation as a treatment for alopecia is recommended.

Efficacy of Topical Finasteride 0.25% With Minoxidil 5% Versus Topical Minoxidil 5% Alone in Treatment of Male Pattern Androgenic Alopecia.

Androgenetic Alopecia (AGA) (male pattern hair loss) is the most common form of alopecia in men, affecting 30% of men by the age of 30 years and 50% by the age of 50 years. To compare the efficacy of topical finasteride 0.25% with minoxidil 5% versus topical minoxidil 5% alone in the treatment of male pattern androgenic alopecia. A total of 164 male patients aged between 30 and 60 years, presenting with androgenic alopecia of more than 2 months duration, were included in this single-blind study conducted at the Department of Dermatology, JPMC, Karachi. The patients were randomly divided into two groups: Group A (topical finasteride 0.25% with minoxidil 5%) and Group B (topical minoxidil 5% alone). Patients were followed up for 12 weeks, and hair regrowth was assessed at each visit. The mean age in Group A was 33.99&plusmn;5.97 years, and in Group B, it was 33.91&plusmn;5.71 years. At baseline, the mean salt score was 1.8&plusmn;0.7 in both groups. The efficacy of the treatment was significantly higher in Group A (86.7%) compared to Group B (69.1%; P=0.006). The combination of topical finasteride 0.25% with minoxidil 5% provides superior efficacy in the treatment of male pattern androgenic alopecia compared to topical minoxidil 5% alone. These findings support the use of this combination therapy as a potential treatment option for patients with androgenic alopecia. J Drugs Dermatol. 2024;23(11):1003-1008. doi:10.36849/JDD.7826.

Tissue Expanders for Hair Restoration in the Scalp: Overexpansion Does Matter.

Tissue expansion to treat of alopecia of the scalp is the corner stone to restore a hairy scalp, although the process of expansion takes time to achieve a satisfactory result. Overexpansion could help in managing limited areas of donor sites or inadequate supply of tissue expanders. Meticulous patient selection and follow-up is the key to avoid complications and to obtain good results. Tissue expanders were used to restore the hairy scalp after burns or direct trauma. More than one tissue expander could be used simultaneously or after the first stage; the expander could be reused for the same patient for further expansion in another part of the hairy scalp to complete hair restoration and removal of all scar tissue. Twenty-five patients with alopecia underwent hair restoration with 28 expanders, all of which were overexpanded. Three pairs of expanders were used simultaneously in three patients. Three expanders were reused in the other three patients after removal to complete the second stage. All patients showed complete restoration of their hairy scalp with minimal complications and a high rate of satisfaction. Tissue expansion is a cornerstone in the treatment of scalp alopecia. Meticulous patient selection and follow-up provided the most satisfactory results, with fewer postoperative complications. Overexpansion can be safely used.