Hair loss and Regrowth

Skin Pharmacol. 1993;6:170
Potassium channel openers and whole hair follicle cultures.
Harmon CS, Lutz D, Ducote J.

(edited for hair loss blog)

snip.. the extent of stimulation of epidermal keratinocyte DNA synthesis by minoxidil increased as the rate of DNA synthesis in control cultures declined. Minoxidil stimulation of DNA synthesis in cultures required prolonged exposure to the hair growth agent. Pinacidil and diazoxide also stimulated DNA synthesis in mouse epidermal keratinocyte cultures. In addition, minoxidil, pinacidil, diazoxide, and cromakalim stimulated DNA synthesis in whole-organ cultures of mouse hair follicles. That is, K-channel openers retard the loss of proliferative activity of differentiating keratinocytes. This supports the hypothesis that these agents stimulate hair regrowth through a direct effect on hair follicles.

The familial occurrence of universal congenital hair loss conjoined with nonprogressive central nervous system abnormalities in this and other kindreds defines a nosologic group of neurocutaneous disorders in which congenital hair loss is the solitary cutaneous manifestation.

Ann Dermatol Venereol. 1986;113(9):767

Stereology of the dermo-epithelial interface of the matrix-papilla unit of the hair bulb. Computerized processing of tridimensional images

Van Neste D, et al

Images of the spatial relations of the matrix-papilla unit of the human hair bulb are shown. Hair bulbs were reconstructed in 3 dimensions by a computer graphics system from measurements made on horizontal sections parallel to the scalp surface. …snip… As an end result, the hair bulbs appear as wire frame structures in which the boundaries between consecutive segments have been connected to improve rendering of the dermal papilla interacting with the overlying epithelial hair matrix. This computerized method has been used to evaluate dermal-epithelial stereology of the interacting dermal papilla and epithelial hair matrix in hair bulbs. ..snip.. This method could be useful to demonstrate disturbed dermal-epithelial interactions in other types of alopecia and to evaluate potential biological effects of drugs used in the treatment of hair loss.

Am J Dermatopathol.1984;6:553

The recognition of early stages of catagen.

Weedon D, Strutton G.

Several criteria for recognition of follicles in catagen the early stage of the hair-loss phase ) have been advanced, namely, loss of metachromasia in the hair papilla, subsidence of mitotic activity there, retraction of the lower portion of the follicle, and thickening and corrugation of the fibrous root sheath. The presence of scattered apoptotic cells in the outer root sheath is an additional marker of early catagen.

edited

Hair loss blog

Rapidly debilitating disease with generalized lymphadenopathy, skin involvement and interstitial pulmonary infiltration

Haferkamp O, et al
Generalized but well-circumscribed lymphadenopathy and rash-like skin changes were observed in three men, aged 58 to 75 years. There was a reticular appearance in the chest X-ray. Dyspnoea, weakness, marked weight loss, changing but marked lymphopenia, markedly increased blood-sedimentation rate, and an always negative Tine test were present in all three. Despite antibiotics, cytostatic drugs and prednisolone the disease quickly ended fatally with high fever, general debilitation and pneumonia. …snip… Spleen, lung tissue and lymphatics, the skin in the area of the small vessels, hair follicles and sweat glands contained lymphocytes, plasma cells and eosinophilic leucocytes. snip..There was RBC phagocytosis in the macrophages of bone marrow and in Kupffer cells of all three cases.

Hair loss treatment

Am J Dermatopathol. 1991;13(3):248
Cell degeneration in alopecia areata. An ultrastructural study.

Tobin DJ, et al

The morphology and prevalence of different forms of cell degeneration in hair follicles in acute alopecia areata were investigated. In addition to apoptosis and necrosis, a third morphological pattern of cell degeneration, dark-cell transformation, was evident. Fifteen patients with hair loss due to untreated acute alopecia areata and three normal adults without hair loss were studied. Electron microscopy revealed that although apoptosis of outer root sheath keratinocytes produces normal hair follicle involution (catagen), increased levels of apoptosis, necrosis, and dark-cell formation appear to be related to the pathology of alopecia areata. Although cell degeneration was generally restricted to keratinocytes of the lower follicle, melanocytes, Langerhans’ and dermal papilla cells were also affected. Keratinocytic degeneration may affect layers of matrix cells in alopecia areata, unlike the apoptosis of scattered outer root sheath cells in normal catagen. The extent of cell death suggests a pathological rather than a physiological event in alopecia areata.

Acta Derm Venereol. 1994 Jan;74(1):28-32.

Cytokeratin expression in alopecia areata hair follicles.

Van Baar HM, et al

Alopecia areata is a human hair-loss disease of unknown etiology. Immunological mechanisms, alterations in the extracellular matrix and follicular growth abnormalities have been suggested as a possible cause. Here we compare the expression of cytokeratins in normal hair follicles to that of alopecia areata using immunohistology with monoclonal antibodies. A number of cytokeratins were specifically expressed in defined anatomical parts of the follicle; however, no gross qualitative or quantitative differences were found between normal and diseased scalp. Interestingly, the expression of cytokeratin 16, which is modulated by conditions that affect the rate of keratinocyte proliferation, was found to be unchanged in the outer root sheet of alopecia areata follicles. This is in contrast with earlier observations of a decrease in the expression of the proliferation-associated, Ki-67 nuclear antigen.

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Z Hautkr. 1985 Apr 1;60(7):576-8.Links

Female pattern androgenic alopecia in the male

Kuhlwein A.

The schematic description of male pattern hair loss neglects the fact that special forms of baldness in males have a rather female pattern aspect. Here we report on a man with female pattern alopecia.

PMID: 3923725

Am J Dermatopathol. 1991 Jun;13(3):248-56.

Cell degeneration in alopecia areata. An ultrastructural study.
Tobin DJ, et al.

The morphology and prevalence of different forms of cell degeneration in hair follicles in acute alopecia areata were investigated. In addition to apoptosis and necrosis, a third morphological pattern of cell degeneration, dark-cell transformation, was evident. Fifteen patients with untreated hair loss due to alopecia areata and three normal adults without hair loss were studied. Electron microscopy revealed that although apoptosis of outer root sheath keratinocytes produces normal hair follicle involution (catagen), increased levels of apoptosis, necrosis, and dark-cell formation appear to be related to the pathology of alopecia areata. Although cell degeneration was generally restricted to keratinocytes of the lower follicle, melanocytes, Langerhans’ and dermal papilla cells were also affected. Keratinocytic degeneration may affect layers of matrix cells in alopecia areata, unlike the apoptosis of scattered outer root sheath cells in normal catagen. The extent of cell death suggests a pathological rather than a physiological event in alopecia areata.

Australas J Dermatol. 1995 May;36(2):51-5; quiz 56-7.

Female pattern hair loss
Callan AW, Montalto J.

Pattern hair loss is an androgen dependent disorder occurring in genetically susceptible individuals. The pattern of hair loss in women differs from that of classical male pattern hair loss, being more diffuse and with retention of the frontal hair line in most cases. snip.. Although research has shown subtle alterations in the androgen status of women with androgenetic alopecia, most patients presenting with this disorder are normal endocrinologically. Anti-androgen therapy will result in some improvement in up to 50% of patients after 6 to 12 months of therapy, but in practice will usually only decrease the rate of hair loss and not result in new hair growth.

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Plast Reconstr Surg. 1978 Sep;62(3):447-51.

Successful replantation of totally avulsed scalp, with profuse regrowth of hair: case report.

Spira M, Daniel RK, Agris J.

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Arch Dermatol. 1982 Aug;118(8):542-5.

Dinitrochlorobenzene treatment of alopecia areata.

de Prost Y, Paquez F, Touraine R.

Forty-two patients with alopecia areata were treated with local applications of dinitrochlorobenzene (DNCB); We used DNCB in two forms, an acetone solution applied weekly or a cream used every day, employing a wide range of DNCB concentrations. The concentration used was varied at the time of each application to produce a contact dermatitis. Seven patients experienced complete and lasting hair regrowth, 17 had poor results, and in 18 patients the treatment was a failure. Acquired tolerance to DNCB was observed in six patients; in five it was abolished by the administration of cimetidine. Certain factors such as the delay in appearance and the intensity of the sensitization reaction influence the hair regrowth. Poor prognostic criteria for treatment effect included a history of previous systemic corticosteroid therapy, atopy, and the presence of alopecia areata in close relatives.

Ann Dermatol Venereol. 1997;124(1):7-11.

Androgenetic alopecia

Esteve E, Aubin F.
Service de Dermatologie, Centre Hospitalier Régional, Orléans.

PMID: 9686040
hai rloss and hair loss treatment

Hautarzt. 2002 Dec;53(12):798-804.

TrichoScan for hair analysis

Hoffmann R.
Universitäts-Hautklinik, Marburg, Germany.

BACKGROUND/OBJECTIVE: Hair loss or hair thinning is a common complaint in clinical dermatology. Patients seeking advice for hair loss treatment are not necessarily bald. Consequently, there is a need for a sensitive tool to monitor hair loss and treatment response. Such a method must be able to analyze the biological parameters of hair growth…..

PATIENTS/METHODS: We present the TrichoScan as a method which combines epiluminescence microscopy (ELM) with automatic digital image analysis for the measurement of human, and potentially animal hair, in situ. The TrichoScan is able to analyze all biological parameters of hair growth with a so called intraclass correlation of approximately 91% within the same operator and an intraclass correlation of approximately 97% for different operators.

RESULTS: The application of the technique is demonstrated by comparison of the hair parameters in individuals without apparent hair loss with men with untreated AGA and men after treatment with finasteride (1 mg/day), and women who were treated with minoxidil. We were able to detect a significant increase in hair counts and cumulative hair thickness 3 and 6 months after treatment. CONCLUSION: The advantage of the TrichoScan is that it can be used for clinical studies to compare placebo versus treatment or to compare different hair regrowth promoting substances, it can be used for studying AGA or other forms of diffuse hair loss, and it can be adopted to study the effect of drugs or laser treatment on hypertrichosis or hirsutism.

Praxis (Bern 1994). 2001 Nov 29;90(48):2087-93.

Photographic documentation of the effectiveness of 1 mg. oral finasteride in treatment of androgenic alopecia in the man in

Trüeb RM, Itin P; Itin und Schweizerische Arbeitsgruppe für Trichologie.
Dermatologische Klinik, Universitätsspital Zürich. ramitru@derm.unizh.ch

A 6-month, prospective, open, multicenter cohort study in 265 men with male pattern hair loss treated with oral finasteride 1 mg/day (Propecia) was conducted in the office of 52 Swiss dermatologists. The patient’s head was placed in a stereotactic device, and Polaroid photographs were taken of the vertex and frontal areas. Endpoints used to determine treatment efficacy were patient self-assessment, investigator clinical assessment, and blinded assessment of the serial Polaroid photographs by a panel of 2 experienced dermatologists. Significant improvements were stated on the photographs by both clinical investigators and the blinded expert panel: 54% of patients showed improvement of hair growth at 6 months of treatment in the vertex region, and 48.7% in the frontal area. No progression of hair loss was found in an additional 38% (vertex) and 47% (frontal region), respectively. Clinical investigator and expert assessment yielded comparable results. Independently, patient self-assessment and investigator clinical assessment confirmed the progress. Propecia was well-tolerated, and no significant safety concerns were identified during the study. The photographic method was well accepted by the physicians. The office-based Polaroid photographic system allowed reliable assessment of change during treatment of male pattern hair loss with Propecia. The data generated in this manner corresponded to the antecedent results of the multicenter, placebo-controlled studies with oral finasteride.

Cleve Clin J Med. 1989 Mar-Apr;56(2):149-54.

Extensive alopecia areata. Results of treatment with 3% topical minoxidil.

Ranchoff RE, Bergfeld WF, Steck WD, Subichin SJ.

A 3% topical minoxidil solution was used to treat 31 normotensive persons (13 male, 18 female) with extensive alopecia areata. After 15 months, three patients (14%) had 75%-100% regrowth, 13 (59%) had some form of regrowth, and nine (41%) had no regrowth. In the initial three-month double-blind portion of the study, minoxidil was not shown to be more effective than placebo. Biopsy specimens from eight patients who underwent biopsy prior to treatment, after three months, and posttreatment showed no significant change in peribulbar or perivascular inflammation. Prominent, new anagen follicles were observed. The 3% topical minoxidil was generally well tolerated and skin irritation was minimal. Blood pressure monitoring revealed no significant changes in diastolic or systolic pressures. Minoxidil is a relatively safe treatment for extensive alopecia areata and may be effective in the treatment of some cases of recalcitrant disease.

Hair loss treatment and regrowth blog

Facial Plast Surg Clin North Am. 2004 May;12(2):181-9.

Pharmacologic management of pattern hair loss.
Haber RS.
Dermatology and Pediatrics, Case Western Reserve University School of Medicine, Cleveland, OH 44106, USA.

Hair Loss Treatment Blog

Pharmacologic management of pattern hair loss is an active area of research, and clinicians should be aware of new data and new treatment modalities. Under-standing the proper role of pharmacology as it relates to surgical hair restoration and nonmedical options is crucial to provide patients with the best clinical, aesthetic, and psychological benefits or hair regrowth.

J Am Acad Dermatol. 2002 Sep;47(3):377-85.

A randomized clinical trial of 5% topical minoxidil versus 2% topical minoxidil and placebo in the treatment of androgenetic alopecia in men.
Olsen EA, Dunlap FE, Funicella T, Koperski JA, Swinehart JM, Tschen EH, Trancik RJ.
Duke Dermatopharmacology Study Center, Durham, North Carolina, USA.

BACKGROUND: Topical minoxidil solution 2% stimulates new hair growth and helps stop the loss of hair in individuals with androgenetic alopecia (AGA). Results can be variable, and historical experience suggests that higher concentrations of topical minoxidil may enhance efficacy. OBJECTIVE: The purpose of this 48-week, double-blind, placebo-controlled, randomized, multicenter trial was to compare 5% topical minoxidil with 2% topical minoxidil and placebo in the treatment of men with AGA. METHODS: A total of 393 men (18-49 years old) with AGA applied 5% topical minoxidil solution (n = 157), 2% topical minoxidil solution (n = 158), or placebo (vehicle for 5% solution; n = 78) twice daily. Efficacy was evaluated by scalp target area hair counts and patient and investigator assessments of change in scalp coverage and benefit of treatment. RESULTS: After 48 weeks of therapy, 5% topical minoxidil was significantly superior to 2% topical minoxidil and placebo in terms of change from baseline in nonvellus hair count, patient rating of scalp coverage and treatment benefit, and investigator rating of scalp coverage. Hair count data indicate that response to treatment occurred earlier with 5% compared with 2% topical minoxidil. Additionally, data from a patient questionnaire on quality of life, global benefit, hair growth, and hair styling demonstrated that 5% topical minoxidil helped improve patients’ psychosocial perceptions of hair loss. An increased occurrence of pruritus and local irritation was observed with 5% topical minoxidil compared with 2% topical minoxidil. CONCLUSION: In men with AGA, 5% topical minoxidil was clearly superior to 2% topical minoxidil and placebo in increasing hair regrowth, and the magnitude of its effect was marked (45% more hair regrowth than 2% topical minoxidil at week 48). Men who used 5% topical minoxidil also had an earlier response to treatment than those who used 2% topical minoxidil. Psychosocial perceptions of hair loss in men with AGA were also improved. Topical minoxidil (5% and 2%) was well tolerated by the men in this trial without evidence of systemic effects.

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J Dermatol Surg Oncol. 1989 Jan;15(1):50-3.

Topical minoxidil used before and after hair transplantation.
Bouhanna P.

A 2% solution of topical minoxidil was applied on the recipient bald scalp of 16 patients aged 25 to 52 years with Hamilton classifications of androgenetic alopecia from III to VI. Therapy was begun 4 weeks before surgery, was interrupted for 3 weeks, and was started again and continued for 3 months. Four-millimeter donor grafts were inserted into 3.5-mm recipient sites. Follow-up utilizing macrophotography was done for 3 months on 4 grafts near a tattooed area. In 71% of the 64 grafts, partial or total hair is still growing without the shedding that usually occurs 2-4 weeks after transplantation. Topical minoxidil seems to be an adjunct for a better evolution of grafts after hair transplantation surgery.