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Published in Ashfaq A Marghoob, Ralph Braun, Natalia Jaimes, Atlas of Dermoscopy, 2023
Anna Waśkiel-Burnat, Lidia Rudnicka, Małgorzata Olszewska, Adriana Rakowska, Ralph M. Trüeb, Isabel Kolm
Androgenetic alopecia is the most common reason for hair loss complaints in both women and men.14,59 Trichoscopic features of androgenetic alopecia are hair shaft thickness heterogeneity or diversity (anisotrichosis) (Figure 11e.22), brown perifollicular discoloration (peripilar signs) (Figure 11e.16), empty follicular openings (mainly observed as yellow dots) (Figures 11e.1, 11e.2), increased proportion of thin and vellus hairs, increased number of follicular units with one hair, and decreased number of follicular units with three hairs (Figure 11e.24).33 In general, a predominant presence of these trichoscopic abnormalities in the frontal area compared with the occipital area is highly indicative of androgenetic alopecia.32,33
Summary of Hair Diseases: Cicatricial and Non-Cicatricial
Published in Rubina Alves, Ramon Grimalt, Techniques in the Evaluation and Management of Hair Diseases, 2021
Aurora Alessandrini, Bianca Maria Piraccini, Michela Starace
Clinical manifestations of androgenetic alopecia are different in both sexes. In males, the disease determines a progressive fronto-temporal recession and a vertex loss, while in women the frontal hairline is preserved and hair loss involves more or less uniformly the frontal region, posteriorly to the hairline (Figures 2.1 and 2.2). It's possible to have a female pattern in a male and vice versa.
Geriatric hair and scalp disorders
Published in Robert A. Norman, Geriatric Dermatology, 2020
The diagnosis of androgenetic alopecia in men and women can be made clinically by examining the entire scalp to rule out patchy hair loss or scarring. In women, compare the part width over the vertex with the occipital scalp. The part width will be wider over the vertex. In senescent alopecia, they are the same.
A comprehensive review of platelet-rich plasma for the treatment of dermatologic disorders
Published in Journal of Dermatological Treatment, 2023
Jessica N. Pixley, Madison K. Cook, Rohan Singh, Jorge Larrondo, Amy J. McMichael
Even when studies used the same clinical endpoints, such as the 3 RCTs of alopecia areata that used the SALT scores, there is not consistent benefit from PRP. Only 1 RCT had improvement in the PRP group compared to placebo, with the other 2 RCTs noted similar improvements between the control and PRP treatment groups or greatest improvement in the intralesional corticosteroid group. Similarly, although all the studies we reviewed of androgenic alopecia used hair density and cross-sectional thickness as clinical endpoints, the literature varied widely with some studies showing an increase in both of these endpoints while other studies had no difference or a nonsignificant increase between the treatment and control groups. The inconsistent findings across the androgenic alopecia literature make a case for standardizing the PRP preparation protocol and administration design. In 1 meta-analysis, increased hair density at 6 months was correlated with increased number of sessions, decreased interval between sessions, younger patients, female patients, and whole-head (vs split-scalp) administration (70).
An international expert consensus statement focusing on pre and post hair transplantation care
Published in Journal of Dermatological Treatment, 2023
S. Vañó-Galván, C. N. Bisanga, P. Bouhanna, B. Farjo, V. Gambino, T. Meyer-González, T. Silyuk
The need for adequate medical treatment of alopecia before and after transplant is crucial to prevent or slow deterioration of the non-transplanted hair. This recommendation is especially important for younger patients (less than 30 years) with androgenetic alopecia considering hair restoration surgery, who should be given at least 6 months’ treatment with standard medical therapy to confirm the stabilization of their alopecia. Current options for androgenetic alopecia include oral antiandrogenic therapy (5-α-reductase inhibitors, bicalutamide, spironolactone and oral contraceptives) and oral or topical minoxidil as mainstays of medical treatment (14–16). It is important to rule out common causes of inflammation in patients suffering from hair loss, such as dandruff/seborrheic dermatitis, and treat these causes with approved therapies such as topical ketoconazole prior to transplantation. Other new therapies such as topical finasteride, mesotherapy with antiandrogens, platelet-rich plasma (PRP) and low-level light therapy (LLLT) may be useful as adjuvant treatments prior to transplantation.
EthoLeciplex: a new tool for effective cutaneous delivery of minoxidil
Published in Drug Development and Industrial Pharmacy, 2022
Mohammed Elmowafy, Khaled Shalaby, Nabil K. Alruwaili, Mohammed H. Elkomy, Ameeduzzafar Zafar, Ghareb M. Soliman, Ayman Salama, Elsaied H. Barakat
Alopecia is a case in which hairs are abnormally lost due to different reasons such as genetic problems, healthy condition, stress and aging [1,2]. It has been considered as a public illness that several people are suffering all over the world [3]. Specifically, androgenic alopecia is a genetic disease manifested by thinning of scalp hair due to androgenic effect. US Food and Drug Administration approved two medications for controlling progressive loss the scalp hair associated with androgenic alopecia; administration of finasteride orally (1 mg/day) and topical application of minoxidil (MX) (2% and 5% solutions) [4]. MX, chemically identified as 2,4-diamino-6-piperidinopyrimidine 3-oxide, mechanism of action is not fully understood but it was reported to prolong the anagen stage by stimulating β-catenin through antiapoptotic effect in the dermal papilla cells of hair follicle [5]. As MX is suffering from low solubility, selecting of appropriate vehicle/carrier is a challenge. Commercially, MX topical solution is available in concentrations of 2% and 5% dissolved in mixture of propylene glycol/water/ethanol (Rogaine®, Pfizer). Though the dissolving mixture is capable of dissolving the required dose of MX, it possesses several drawbacks such as skin dryness, skin burning and eye irritation due to presence of organic solvent [6]. Several approaches have been implemented to improve skin/transfollicular delivery of MX such as microemulsion [7], chitosan nanoparticles [8], poly(lactide-co-glycolide)-grafted hyaluronate nanoparticles [9], lecithin-based microparticles [10] and solid effervescent formulations [11].