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Androgenetic alopecia (AGA) is the most common cause of hair loss in both genders with a higher psychological impact on females. Currently, topical minoxidil is the only FDA-approved treatment for female AGA and it needs life-long application and causes side effects. Cetirizine is an antihistamine that may be effective in hair loss treatment. This study aimed to compare the efficacy and safety of topical cetirizine with minoxidil (group 1) versus topical minoxidil with placebo (group 2) in female patients with AGA. This was a double-blind, randomized, controlled, parallel study conducted at Dermatology Clinic, Cairo University Teaching Hospital (Kasr- Al- Ainy), Egypt. Sixty-six patients with female AGA, aged 20–50 years, Sinclair (II–IV), were randomly assigned to one of the 2 groups for 24 weeks. The trichoscopic parameters, patients' self-assessment, side effects and global photographic assessment were evaluated. There was a statistically significant change from baseline in frontal and vertex terminal and vellus hair density (P < 0.0005) with a significant increase in vertex hair shaft thickness and average number of hairs per follicular unit in group 1 (P < 0.05). Patients reported significantly better scores in patient self-assessment in group 1 (P < 0.05). Side effects were not significantly different between groups (P > 0.05). Topical cetirizine increases hair shaft thickness and results in a higher clinical improvement from patients' perspective with a good safety profile (NCT04481412, study start date: July 2020). [ABSTRACT FROM AUTHOR]

Objective: This study explores the applicability and scientific accuracy of instrument measurements in repairing hair products on slightly damaged hair bundles. Materials and method: Sixty hair bundles mildly damaged with hydrogen peroxide and ammonia standards were divided into two groups: the treatment and control groups (30 hair bundles each). The treatment group used commercial hair care essential oil, whereas the control group used tap water to treat the damage. The two groups were measured using an instrument before and after the product application. The objective indicators included the gloss of hair, along with hair cuticle dynamic friction coefficient, and against hair cuticle dynamic friction coefficient. At the same time, two evaluators conducted sensory evaluations on the gloss and frizz levels of the hair bundles. Therefore, data comparison and verification were carried out together with instrumental measurement data. Results: We verified that the instrumental measurement methods could obtain data trends that are consistent with sensory assessment methods; hence, they have the advantages of accuracy, convenience, and quantifiability. Conclusion: Thus, the instrumental measurement methods we verified can provide objective evidence for the efficacy of hair care products in repairing hair. [ABSTRACT FROM AUTHOR]

Background: Platelet‐rich plasma (PRP) has been increasingly accepted as a potential therapy in the treatment of androgenetic alopecia (AGA), However, there remains a dearth of data on the effectiveness of PRP prepared by automatic blood cell separator with a combination of topical minoxidil for the treatment of AGA. Objective: To evaluate the efficacy and safety of PRP prepared by automatic blood cell separator combined with topical 5% minoxidil therapy in male AGA. Methods: Thirty male patients with mild/moderate AGA were enrolled in a randomized double‐blind controlled study. Patients were randomly divided into two treatment arms: (group A) PRP prepared by automatic blood cell separator combined with topical 5% minoxidil group; (group B) PRP prepared by automatic blood cell separator combined with a topical placebo group. Trichoscopic assessments regarding hair density/quantity and mean hair diameter were performed at baseline and follow‐up. Clinical efficacy of global photography and patient satisfaction were conducted to verify the therapeutic efficacy of the treatment, and the occurrence of adverse reactions was recorded. Results: We detected a significant increase in all patients in hair density and quantity after PRP treatment (p < 0.05), and there was no significant difference in mean hair diameter. Although hair density/quantity was more pronounced in group A than in group B, the difference between groups was not statistically significant (p > 0.05). In terms of clinical efficacy and patient satisfaction, group A was superior to group B, and no serious adverse reactions occurred. Conclusion: We hereby conclude that the injections of PRP prepared by an automated method are effective and safe in the treatment of mild‐to‐moderate male AGA patients, and its combination with topical 5% minoxidil therapy was superior to PRP monotherapy with better clinical efficacy and higher patient satisfaction. [ABSTRACT FROM AUTHOR]

Background: Androgenic alopecia (AGA) is a genetically programmed condition brought on by a woman's disproportionate sensitivity to androgens. The frontal hairline is often spared whereas the crown and top of the head experience diffuse hair loss, which is frequently identified by a broader centre part. For women with AGA, topical minoxidil is a popular and successful therapy for hair loss. By reducing the telogen (resting) phase of hair follicles and activating the anagen (growth) phase, minoxidil encourages hair growth. Carboxytherapy is a noninvasive method that has been shown to affect hair development in a number of ways. Objective: To study the efficacy of combination of both minoxidil 5 % with carboxytherapy versus minoxidil 5 % alone in treatment of female pattern hair loss. Patients and methods: This study included 40 female patients with AGA, who were randomized into two groups (group A and B); Group A included patients who used minoxidil 5% once daily with carboxytherapy session every 3 weeks for 6 months and Group B who used topical minoxidil 5% only once daily for 6 months. Results: There was a statistically significant increase in hair diameter during treatment in group A compared to group B (at 3 months and 6 months) (p=0,012, 0.001 respectively). There was a statistically significant increase in hair density during treatment in group A compared to group B (at 3 months and 6 months) (p = 0.004, < 0.001 respectively). There was a statistically significant increase in hair count during treatment in group A compared to group B (at 3 months and 6 months) (P=0.048, 0.002 respectively). Higher satisfaction was recorded in group A compared to group B with a statistically significant difference (P=0.049). Conclusion: In the context of female pattern hair loss, carboxytherapy seems to be a promising therapeutic modality and it could be used as a helpful adjuvant therapy of AGA in association with minoxidil. In addition, it is recommended for maintenance of the results with minimal side effects. [ABSTRACT FROM AUTHOR]

Background: 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. Objective: To assess the efficacy of combined PRPF and minoxidil treatment for AGA. Methods: 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. Results: 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. Limitations: Small sample size, short follow‐up time and lack of quantification of GFs in PRPF. Conclusion: The effect of complex therapy exceed both the effects of PRPF monotherapy and minoxidil treatment, which can be a beneficial AGA treatment strategy. [ABSTRACT FROM AUTHOR]

Objective: To describe the successful management of 2 cats following ingestion of minoxidil 5%. Series Summary: Two 2‐year‐old neutered male Savannah cats were presented following suspected minoxidil 5% ingestion. Both cats developed significant myocardial injury, and clinical signs were consistent with congestive heart failure, supported by cardiac troponin I concentrations, echocardiogram, and thoracic radiographs. They required vasopressor therapy and were decontaminated with intravenous lipid emulsion therapy. Following decontamination, both cats were successfully discontinued from vasopressor therapy, and their clinical signs resolved within 24 hours. The cats were successfully discharged without long‐lasting cardiac compromise. Their echocardiograms and cardiac troponin concentration 7 weeks after discharge were within reference intervals. New or Unique Information: This is the first detailed report of the successful management of cats following minoxidil 5% ingestion. [ABSTRACT FROM AUTHOR]

Female pattern hair loss (FPHL) isahereditary form ofhair loss in women and themost common patterned progressive hair loss infemale patients with androgenetic alopecia (AGA). One of thebest methods for treating hair loss inwomen isthefinasteride treatment. This systematic review includes asummary of thepharmacology offinasteride and theeffect of thedrug on women, especially those inthe menopausal age group, and is aimed at elucidating methods of preventing systematic side effects. A search of all published literature from 1999 to2020has been conducted with theuse ofPubMed/MEDLINE, Embase, PsycINFO, TRIP Cochrane, as well asCochrane Skin databases. A total of380articles were found, of which 260articles were removed and 87review studies were excluded. Lastly, full texts of33original articles were reviewed and 14articles that met the inclusion criteria were selected. Ten out of the 14 articles reported a high rate of alopecia recovery in women taking finasteride. Based on the results, it can be stated that 5 mg of oral finasteride per day could be aneffective and safe treatment innormoandrogenic women with FPHL, especially when used in combination with other drugs, such as topical estradiol and minoxidil. We also found that topical finasteride is more effective than other topical formulas for treating hair loss. [ABSTRACT FROM AUTHOR]

Androgenetic alopecia (AGA), also known as male pattern hair loss (MPHL) or female pattern hair loss (FPHL), is the most common form of alopecia worldwide, and arises from an excessive response to androgens. AGA presents itself in a characteristic distribution unique to both sexes. Despite its prevalence, AGA can be quite challenging to treat. The condition is chronic in nature and stems from an interplay of genetic and environmental factors. There are only two US Food and Drug Administration (FDA)-approved drugs for the condition: topical minoxidil and oral finasteride. However, numerous non-FDA-approved treatments have been shown to be effective in treating AGA in various studies. Some of these treatments are relatively new and still to be explored, thus emphasizing the need for an updated review of the literature. In this comprehensive review, we discuss the evaluation of AGA and the mechanisms of action, costs, efficacies, and safety profiles of existing, alternative, and upcoming therapeutics for this widespread condition. [ABSTRACT FROM AUTHOR]

Background: Dermatologic signs and symptoms can be the manifestations of a single disease or different diseases, and it is proven that some are associated with one another. These connections are not fully understood, but the answer lies in the pathophysiology of each disease. Case presentation: We report the case of a 6-year-old Middle-Eastern girl who presented with two skin lesions on the dorsum of her foot, along with scaling of her soles and palms, face skin discoloration, and areas of patchy alopecia on her scalp. She was diagnosed as a case of acute onset of granuloma annulare with alopecia areata and dermatitis. The treatment regimen for the patient's scalp consisted of topical minoxidil and betamethasone and three sessions with 1-month intervals of triamcinolone acetonide intralesional injections, which demonstrated modest effectiveness in treating alopecia areata. Conclusion: Granuloma annulare is a benign inflammatory illness with no known cause that might be difficult to cure. The clinical course and prognosis might vary greatly depending on the disease subtype, and associating symptoms and diseases, such as alopecia areata, should be considered. [ABSTRACT FROM AUTHOR]

Patterned hair loss is a common type of non-scarring alopecia, characterized by miniaturization of hair follicles. The etiology of female pattern hair loss (FPHL) is not clearly linked to androgens or other hormones thereby making it a challenging condition to treat. Various treatment modalities, like minoxidil (topical or oral), spironolactone, finasteride, have been tried alone or in combination with variable results. Combination therapy is superior to the monotherapy, since these multiple treatment modalities act by targeting different pathogenetic pathways, making the treatment aggressive and more effective. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To evaluate the efficacy and safety of 5% minoxidil combined with finasteride in the treatment of androgenic alopecia (AGA), so as to provide evidence-based reference for clinical application of 5% minoxidil. METHODS: PubMed, the Cochrane Library, CNKI, VIP, CBM and Wanfang Data were retrieved for randomized controlled trials (RCT) on 5% minodil combined with finasteride in the treatment of AGA published before Jun. 1st, 2022. Literature was screened by title, abstract and full text in turn, and Meta-analysis was performed by using RevMan 5. 4 statistical software. RESULTS: After screening, 7 RCT were included. Results of Meta-analysis showed that after 3, 6 and 12 months of treatment, the efficacy of AGA in the combined treatment group was better than that in the 5% minoxidil group or finasteride group, the differences were statistically significant (P<0. 01). The incidence of adverse drug reactions of topical 5% minoxidil was significantly higher than that of oral finasteride, the difference was statistically significant ( P < 0. 01). CONCLUSIONS: For patients with AGA, topical 5% minoxidil combined with oral finasteride is the most effective. However, local itching, increased dandruff or dermatitis may occur during medication, and attention should be paid to the occurrence of adverse reactions on the skin and its accessories. Adverse drug reactions such as sexual dysfunction may occur and should be given attention, patient’ s liver function should be promptly monitored during drug medication. [ABSTRACT FROM AUTHOR]

Introduction: This study assessed the levels of compliance to topical minoxidil (TM) among male and female patients with androgenetic alopecia (AGA) and analyzed the factors associated with minoxidil discontinuation. Method: A retrospective study was conducted among 400 consecutive patients with AGA who presented to a dermatology clinic and who were prescribed minoxidil 2% or 5% in the past 5 years. Demographic factors, other previous treatments, and minoxidil parameters including the dose (2% or 5%), total duration of use, treatment results, and side effects were collected. Result: The mean age of the patients was 32.41 years [standard deviation (SD) 8.18], and 66.5% were female. The majority of patients (82.5%) did not receive any previous treatment for AGA. Of the total patients, 345 (86.3%) have discontinued minoxidil. Discontinuation rate showed no association with sex (p = 0.271), age category (p = 0.069), or previous treatment (p = 0.530). Furthermore, the likelihood of minoxidil discontinuation decreased with the increase in treatment duration (p < 0.001) and was significantly lower among patients who reported improvement (69.3%) or stabilization of hair shedding (64.1%) compared with those who reported baby hair (88.9%) or no efficacy (95.3%) (p < 0.001). Furthermore, having experienced an adverse effect of minoxidil was associated with 93.6% discontinuation rate compared with 75.8% in the case of no side effects (p < 0.001). Adjusted analysis showed that minoxidil discontinuation was independently association with longer duration of use [> 1 year; odds ratio (OR) 0.22; p < 0.001], perceived improvement (OR 0.17; p < 0.001) or stabilization (OR 0.14; p < 0.001), and the occurrence of side effects (OR 3.06; p = 0.002). Conclusions: The clinical use of TM in AGA is limited by a substantially low compliance even in absence of adverse effects. We emphasize the importance of educating patients regarding the treatment's side effects and the need to use minoxidil for a minimum of 12 months to assess treatment efficacy. [ABSTRACT FROM AUTHOR]

Background: Alopecia areata (AA) is characterized by limited non‐scarring patchy alopecia, which appears as round or oval patches and is prone to recurrence, causing severe psychological burdens to patients. No specific device has been approved by the FDA for the treatment of baldness, but new treatments are being investigated and treatments such as the excimer laser, He‐ Ne laser, and excimer lamp have been proposed. A growing number of studies have found that fractional lasers also have great potential in the treatment of AA. Methods: A literature search and meta‐analysis using Review Manager 5.4 software to investigate the efficacy of fractional laser treatment for AA. Results: Fractional laser combined with minoxidil (RR 1.32, 95% CI 1.17–1.49, p < 0.00001) or cortisol (RR 1.39, 95% CI 1.15–1.67, p = 0.00006) was more effective than either drug alone in the treatment of AA. Of course, the fractional laser alone was also effective in the treatment of AA (RR 10.33, 95% CI 2.07–51.36, p = 0.004) and more effective than cortisol alone (RR 1.86, 95% CI 1.36–2.52, p < 0.00001), and there was no effect on the occurrence of adverse effects (p = 0.49 > 0.05). When compared to other physical treatments of a comparable kind, fractional laser therapy's effectiveness was not significantly different (p = 0.15 > 0.05). Conclusion: Our results show that the use of fractional lasers can effectively treat alopecia areata. [ABSTRACT FROM AUTHOR]

Background: Androgenetic alopecia leads to progressive hair loss in susceptible individuals if left untreated. Topical minoxidil represents an evidence-based treatment for female androgenetic alopecia, though with variable success. Aims and Objectives: Treatment of minoxidil non-responders remains challenging, as does treatment of patients with propylene glycol sensitivity or irritable scalp syndrome. Materials and Methods: Single-center, retrospective cohort of 50 female patients with androgenetic alopecia failing to respond to a minimum of 6 months of standard 5% topical minoxidil solution either once daily or b.i.d. depending on the severity of the alopecia. Patients were switched to propylene glycol-free, North American Witch Hazel (Hamamelis virginiana)-based solution of 5% minoxidil sulfate (5% minoxidil sensitive solution). Efficacy and safety of treatment were evaluated, including stereotactic global photography and epiluminiscence microscopy with digital imaging taken at baseline, at 3, and at 6 months of treatment. Results: 70% of patients showed observable clinical improvement with combined global photographic and epiluminiscence microscopic assessment with digital imaging, and 22% epiluminiscence microscopic-only improvement as evidence of treatment efficacy. The treatment was well tolerated, particularly in patients with propylene glycol sensitivity and patients with irritable scalp syndrome. Conclusions: These results suggest that propylene glycol-free, North American witch hazel (Hamamelis virginiana)-based solution of 5% minoxidil is effective and safe for treatment of female androgenetic alopecia, specifically in minoxidil non-responders and patients with propylene glycol sensitivity or irritable scalp syndrome. [ABSTRACT FROM AUTHOR]

Alopecia is a highly prevalent condition worldwide including in India. There are different types of alopecia with differing etiology, presentation, and hence treatment. Androgenetic alopecia represents the most common form of hair loss affecting male as well as female population termed as male and female pattern hair loss, respectively. Several treatment options are available for the treatment of alopecia with often unsatisfactory results resulting in psychological distress among such patients. Topical minoxidil is known to be effective in the treatment of alopecia. However, oral minoxidil is not currently approved for the treatment of alopecia. This expert consensus is prepared to provide guidance to the clinicians regarding the use of oral minoxidil in the treatment of alopecia. Extensive literature review was performed to prepare the draft consensus which was then revised based on the suggestions and comments from the experts. The final draft was circulated to the experts for review and approval. This consensus document provides overview of evidence related to oral minoxidil and consensus from the experts for its use in the treatment of minoxidil. [ABSTRACT FROM AUTHOR]

Androgenetic alopecia is a widespread problem in contemporary dermatology, as it may also affect many young patients, in particular males, making them more prone to anxiety and depression which may be caused by a distorted body image. These behavioural problems may occur in older individuals as well. That is why, there is an obvious need for further development in that area of dermatology, which should also include discovering new therapies. In men, the diagnosis of androgenetic alopecia is quite simple, and the treatment usually involves incorporating minoxidil and/or finasteride. Switching from topical minoxidil to its systemic form as well as from finasteride to dutasteride may give better results in some patients. In general, male pattern hair loss (MPHL) is a chronic disease that may demand pharmacological treatment in the long term, which is often unlimited. Therefore, and also considering the patients’ concerns involving the systemic usage of 5α-reductase inhibitors as well as the limitations of current therapies, some specialists use topical finasteride, dutasteride in mesotherapy and many other additional modalities. When it comes to female pattern hair loss (FPHL), in most cases it is also a chronic entity, which especially in younger women demands performing extended lab testing in the search for potential hyperandrogenism. It is necessary to remember that especially in women the condition may be triggered by many environmental and other additional factors, so taking that into consideration may be helpful in some patients. [ABSTRACT FROM AUTHOR]

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 > 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. [ABSTRACT FROM AUTHOR]

Millions of new cancer patients receive chemotherapy each year. In addition to killing cancer cells, chemotherapy is likely to damage rapidly proliferating healthy cells, including the hair follicle keratinocytes. Chemotherapy causes substantial thinning or loss of hair, termed chemotherapy-induced alopecia (CIA), in approximately 65% of patients. CIA is often ranked as one of the most distressing adverse effects of chemotherapy, but interventional options have been limited. To date, only scalp cooling has been cleared by the US Food and Drug Administration (FDA) to prevent CIA. However, several factors, including the high costs not always covered by insurance, preclude its broader use. Here we review the current options for CIA prevention and treatment and discuss new approaches being tested. CIA interventions include scalp cooling systems (both non-portable and portable) and topical agents to prevent hair loss, versus topical and oral minoxidil, photobiomodulation therapy (PBMT), and platelet-rich plasma (PRP) injections, among others, to stimulate hair regrowth after hair loss. Evidence-based studies are needed to develop and validate methods to prevent hair loss and/or accelerate hair regrowth in cancer patients receiving chemotherapy, which could significantly improve cancer patients' quality of life and may help improve compliance and consequently the outcome of cancer treatment. [ABSTRACT FROM AUTHOR]

There is a growing interest in innovative products for eyebrow hair loss treatment with fewer adverse effects. Nevertheless, a fundamental formulation aspect of preventing the fragile skin from the ocular region from being irritated is that the formulations remain restricted to the application region and do not run off. Consequently, the methods and protocols in drug delivery scientific research must be adapted to fulfill such performance analysis demand. Thus, this work aimed to propose a novel protocol to evaluate the in vitro performance of a topical gel formulation with a reduced runoff for minoxidil (MXS) delivery to eyebrows. MXS was formulated with 16% poloxamer 407 (PLX) and 0.4% of hydroxypropyl methylcellulose (HPMC). The sol/gel transition temperature, viscosity at 25 °C, and formulation runoff distance on the skin were evaluated to characterize the formulation. The release profile and skin permeation were evaluated in Franz vertical diffusion cells for 12 h and compared to a control formulation (4% PLX and 0.7% HPMC). Then, the formulation's performance at promoting minoxidil skin penetration with minimum runoff was evaluated in a vertical custom-made permeation template (divided into three areas: superior, middle, and inferior). The MXS release profile from the test formulation was comparable to that from the MXS solution and the control formulation. There was also no difference in the MXS amount that penetrated the skin in the permeation experiments in Franz diffusion cells using the different formulations (p > 0.05). However, the test formulation demonstrated a localized MXS delivery at the application site in the vertical permeation experiment. In conclusion, the proposed protocol could differentiate the test formulation from the control, attesting to its better performance in efficiently delivering MXS to the site of interest (middle third of application). The vertical protocol can be easily employed to evaluate other gels with a drip-free appeal. [ABSTRACT FROM AUTHOR]

Platelet-rich plasma (PRP) has become an increasingly popular alternative or additional method in treating androgenic alopecia (AGA). AGA is a multifactorial disease, in which testosterone plays a significant role in influencing hair growth. The aim of this study was to evaluate the effectiveness of PRP treatment in AGA affecting men and women. The research was performed using the following databases: PubMed, Embase, and Cochrane Library. The effects were measured with a TrichoScan by comparing the initial and final hair density. A significant difference was observed between the areas of the scalp where PRP injections were made and those where saline was administered. Compared to conventional minoxidil 5% topical PRP, PRP is more effective in treating alopecia. A beneficial outcome of combined therapy with PRP and minoxidil 5% was observed. Therefore, PRP is not only an excellent alternative for patients in whom the minoxidil 5% topical monotherapy did not bring the expected effects or who experienced unacceptable side effects, but can also be used as a complementary therapy. [ABSTRACT FROM AUTHOR]

While current studies have supported oral minoxidil as a novel, adjunctive therapy in non-scarring forms of alopecia, there continues to be limited data on oral minoxidil for these conditions. To assess oral minoxidil use in the treatment of androgenetic alopecia and telogen effluvium, a multi-center, retrospective analysis was conducted in 105 adult patients treated for androgenetic alopecia and/or telogen effluvium with oral minoxidil (dose range 0.625–2.5 mg) once daily for ≥ 52 weeks, case matched by age (± 5 years) and gender with 105 controls with androgenetic alopecia and/or telogen effluvium who were not treated with oral minoxidil. 80 women (76.2%) with a mean age of 57.5 ± 13.56 (range 24–80) and 25 men (23.8%) with a mean age of 40.4 ± 13.79 (range 19–63) were included. Efficacy was evaluated based on provider assessment of clinical response and clinical photographic evaluation using a 3-point scale (worsening, stabilization, and improvement). 52.4% of patients demonstrated clinical improvement and 42.9% demonstrated stabilization. There was a significant difference in clinical response between the patient and control group, p < 0.001. Retrospective study design. These results suggest that oral minoxidil can be an effective treatment in androgenetic alopecia and telogen effluvium. [ABSTRACT FROM AUTHOR]

Introduction: Androgenetic Alopecia (AGA) is a progressive loss of hair in a patterned distribution for which treatment selection is limited. Long-term efficacy, safety, cost leads to low compliance rate. Among various treatment modalities (medical and surgical) available, microneedling and Platelet Rich Plasma (PRP) are emerging as a newer, useful and safe non surgical treatment regime. Aim: To evaluate the effectiveness and safety of microneedling with PRP versus minoxidil (5%) + finasteride (0.1%) topical therapy in AGA. Materials and Methods: This randomised controlled trial was done at Department of Dermatology, Venereology and Leprology (DVL), Hind Institute of Medical Sciences, Safedabad, Barabanki, Uttar Pradesh, India, from November 2021 to November 2022. Total of 60 adult males clinically diagnosed with AGA were enrolled and randomised into group 1 and group 2. Subjects in group 1 were treated with microneedling+PRP and group 2 were advised minoxidil+finasteride topical therapy. Microneedling alongwith intradermal injection of autologous PRP was done every month for four consecutive months in group 1 (n=30) while 1 mL of minoxidil (5%)+finasteride (0.1%) lotion was advised to be applied over dry scalp twice daily for four months in group 2 (n=30) patients. Both groups were followed for next two months. Hair density was assessed by Hamilton Norwood Scale using photographic and dermoscopic images and patient's self-assessment scores. Data assessment was done by Chi-square test. Statistical Package for the Social Sciences (SPSS) version 26.0 was used to analyse data and p-value for significance was established at <0.05. Results: Patients in group 1 with mean age 27.9±4.15 years showed almost similar increase in hair density compared to group 2 with mean age 25.8±3.94 years, as assessed by patient assessment score, photography, dermoscopy, Hamilton Norwood scale at six months of study (p-value >0.05), however onset of action was quicker in group 1. Investigator assessment on improvement in hair density using Hamilton Norwood Scale at three months (p-value=0.920) and six months (p-value=0.995) showed that microneedling+PRP therapy is as effective as minoxidil+finasteride lotion since the difference between results of both groups was not statistically significant. Conclusion: Microneedling and PRP although safe, effective and promising treatment modality in AGA is comparable to minoxidil+finasteride topical therapy. [ABSTRACT FROM AUTHOR]

Background: Androgenetic alopecia (AGA) is the most common cause of hair loss in males which remains a therapeutic challenge. Objectives: To compare the efficacy of topical 5% minoxidil and 0.25% finasteride combination (MNF) over 5% minoxidil (MNX) or 0.25% finasteride (FNS) alone by assessing hair count, physician assessment score (PAS), and patient satisfaction score (PSS). Materials and Methods: Pilot randomized open-label study where 60 male patients with AGA = III grade were randomized into three treatment groups and evaluated over 24 weeks. Improvement in hair count was assessed manually using dermoscopy. Global photographs were used to assess PAS. Side effects were evaluated using relevant laboratory investigations. Results: At the 12th and 24th week, all three groups showed significant improvement in total hair density as compared to baseline (P < 0.001). None of the groups was superior to the other (P > 0.05) at the 12th week but at 24th week, MNF was comparatively superior (P < 0.02). At the 12th week and 24th week, all three groups showed significant improvement in terminal hair density as compared to baseline (P < 0.001). In the 12th week, MNF was comparatively superior (P = 0.028) and at the 24th week, MNF was comparatively superior (P < 0.02). PAS and PSS were significantly better with MNF and MNX compared to FNS (P < 0.004). Side effects such as scaling and itching were reported with MNF and MNX. Conclusion: Topical minoxidil 5% and finasteride 0.25% had an overall better efficacy compared to monotherapy without significant side effects. [ABSTRACT FROM AUTHOR]

Minoxidil is a widely utilized medication for various hair conditions, such as androgenic alopecia. The current literature lacks an original study that reports the possibility of this medication causing a well-noticed side effect, hair discoloration, among the treated patients. We conducted an observational study utilizing two face-validated questionnaires that experts, in dermatology, revised to assess the possibility of Minoxidil in inducing hair discoloration. This study was done in Saudi Arabia, and the data collection spanned October and November 2022. The first questionnaire was targeting the population, while the second was targeting practicing dermatologists. In survey 1, of 453 included patients, 56.7% of the participants were between the ages of 18-24, most of whom were females. Interestingly, 26% (n=118) noticed greying of hair and 14.8% (n=67) noticed other hair color changes. The hair discoloration was more prevalently noticed among the groups who used Minoxidil for a longer duration and among those with a family history of hair greying, with a p-value of 0.0001 for each group. Survey 2 was targeting dermatologists and was answered by 57 participants. Almost 60% of the physicians have ten years or more experience in Dermatology. 42.1% of the dermatologists noticed greying of hair on their patients after using Minoxidil. 17.5% of the physicians think Minoxidil caused hair greying. This observational study analyzed the data of more than 400 patients to assess the possibility of Minoxidil inducing hair discoloration; based on the data presented, we hypothesize that Minoxidil could be classified as a drug that potentially induces hair discoloration with more extended periods of usage and among those who have familial history of hair greying. Further confirmatory data are warranted to support such statement.

β-Nicotinamide mononucleotide (NMN) has shown promising effects on intestinal health, and it is extensively applied as an anti-aging and Alzheimer’s disease therapeutic, due to its medicinal properties. The effects of NMN on the growth of mouse hair were observed after hair removal. The results indicated that NMN can reverse the state of hair follicle atrophy, hair thinning, and hair sparsity induced by dihydrotestosterone (DHT), compared to that of minoxidil. In addition, the action mechanisms of NMN promoting hair growth in cultured human dermal papilla cells (HDPCs) treated with DHT were investigated in detail. The incubation of HDPCs with DHT led to a decrease in cell viability and the release of inflammatory mediators, including interleukin-6 (IL-6), interleukin-1Beta (IL-1β) and tumor necrosis factor Alpha (TNF-α). It was found that NMN can significantly lower the release of inflammatory factors induced by DHT in HDPCs. HDPCs cells are protected from oxidative stress damage by NMN, which inhibits the NF-κB p65 inflammatory signaling pathway. Moreover, the levels of androgen receptor (AR), dickkopf-1 (DKK-1), and β-catenin in the HDPCs were assessed using PCR, indicating that NMN can significantly enhance the expression of VEGF, reduced IL-6 levels and suppress the expression of AR and DKK-1, and notably increase β-catenin expression in DHT-induced HDPCs.

Purpose: The aim of this research was to prepare adhesive nanoparticles for the topical application of Minoxidil (MXD). Methods: Thiolated β-CDs were prepared via conjugation of cysteamine with oxidized CDs. MXD was encapsulated within thiolated and unmodified β-CDs. Ionic gelation method was used to prepare nanoparticles (Thio-NP and blank NP) of CDs with chitosan. Nanoparticles were analyzed for size and zetapotential. Inclusion complexes were characterized via FTIR. Drug dissolution studies were carried out. An in vitro adhesion study over human hair was performed. An in vivo skin irritation study was performed. Ex vivo drug uptake was evaluated by using a Franz diffusion cell. Results: Thiolated β-CDs presented 1804.68 ± 25 μmol/g thiol groups and 902.34 ± 25 μmol/g disulfide bonds. Nanoparticles displayed particle sizes within a range of 231 ± 07 nm to 354 ± 13 nm. The zeta potential was in the range of −8.1 ± 02 mV, +16.0 ± 05 mV. FTIR analyses confirmed no interaction between the excipients and drug. Delayed drug release was observed from Thio-NP. Thio-NP retained over hair surfaces for a significantly longer time. Similarly, drug retention was significantly improved. Thio-NP displayed no irritation over rabbit skin. Conclusion: Owing to the above results, nanoparticles developed with MXD-loaded thiolated β-CDs might be a potential drug delivery system for topical scalp diseases.

Although topical minoxidil is successful for management of persistent chemotherapy-induced alopecia (pCIA) and endocrine therapy-induced alopecia (EIA), practical challenges related to frequency and consistency of application have increased interest in low-dose oral minoxidil (LDOM) as an alternative [[1]-[4]]. In conclusion, LDOM is a successful and well-tolerated alternative for cancer-treatment-induced hair loss that may improve outcomes in patients with higher baseline alopecia severity or poor compliance to topical therapy. Primary outcome measure was degree of alopecia improvement by the Dean Scale (grades 1-4: where grade 1 is defined as > 0 to <= 25% alopecia and grade 4 is defined as > 75% alopecia). [Extracted from the article]

Interestingly, in our sample nine patients with onychomadesis and eight patients with nail growth arrest claimed no need to cut their nails for 12 months or more. Nail growth disorders characterize a spectrum of diseases in which nail matrix activity slows down or completely stops. It is possible to appreciate complete nail regrowth and reappearance of the cuticle. gl We enrolled 50 patients with the diagnosis of toenail growth arrest (48%) or onychomadesis (52%), with a total of 84 affected toenails. [Extracted from the article]

Alopecia universalis (AU) is a rare form of hair loss characterized by the complete absence of hair on the scalp and body. It is an advanced form of alopecia areata. There is currently no definitive treatment for this condition, and management options are limited. This case report describes the successful treatment of a 37-year-old female patient with AU using oral tofacitinib 5 mg BID, an oral Janus kinase inhibitor. The patient experienced clinically significant hair regrowth on the scalp and eyebrows after 6 months of treatment with tofacitinib, along with the concurrent use of oral mini-pulse betamethasone, topical minoxidil 5%, and clobetasol lotion. This case highlights the potential efficacy of tofacitinib as a promising therapeutic option for AU, without notable safety concerns. Moreover, it is also well tolerated in this patient. [ABSTRACT FROM AUTHOR]

INTRODUCTION: Classic treatment options for patients with alopecia areata (AA) include intralesional and topical steroids as well as oral immunotherapy. Although these options can be effective for some patients, topical therapies are often inconvenient, and there can be many side effects with oral medications. Platelet-rich plasma (PRP) is an autologous preparation of concentrated platelets that is an emerging therapy for various conditions such as chronic nonhealingwounds, muscle injuries, and, more recently, hair loss. CASE PRESENTATION: A 71-year-old woman with diffuse hair loss diagnosed previously as AA presented to our clinic after nonresponse to topical steroids and adverse events with topicalminoxidil use. At our clinic, the patient underwent three treatments with PRP injections. Total hair regrowth without relapse was noted 6 months after treatment cessation. DISCUSSION/CONCLUSION: Our case illustrates a situation in which PRP served as an effective, rapid, and safe treatment option in a patient with AA who was unresponsive to previous standard therapies and feared side effects of oral medications. [ABSTRACT FROM AUTHOR]

Platelet-rich plasma, which contains numerous growth factors that promote hair growth, is a nonsurgical treatment available for patients with androgenetic alopecia. However, neither the quantity nor the location and depth of platelet-rich plasma placement in the scalp is uniform; in addition, multiple painful injections are required. Vertical uniform channels from the skin surface into the dermis, created by ablative laser fractional photothermolysis, can be used to enhance the cutaneous delivery of medications. This technique — referred to as laser assisted drug delivery — may provide an efficacious means for the administration of platelet-rich plasma to the scalp. It would not only enable the uniform placement of platelet-rich plasma in the dermis (instead of inadvertently in the subcutaneous fat) of androgenetic alopecia patients' scalps, but also eliminate the injection-associated pain. In addition, the topical application of either bimatoprost or minoxidil or both could also be enhanced with laser assisted drug delivery. In conclusion, to potentially maximize the stimulation of hair growth, laser assisted drug delivery of platelet-rich plasma — with or without bimatoprost and/or minoxidil — should be considered in patients with androgenetic alopecia in order to effectively deliver the agents to the dermis where the bulge area of the hair follicles is located.

Objective To observe the clinical efficacy and safety of microneedling at different depths combined with minoxidil tincture in the treatment of male androgenetic alopecia. Methods From June 2020 to June 2021, 90 male patients with androgenetic alopecia were enrolled in the department of dermatology clinic of the first affiliated hospital of Henan university of science and technology, and they were randomly divided into the group A (n=30), the group B (n=30) or the group C (n=30). Patients in the group A were treated with external application of minoxidil tincture only, patients in the group B were treated with 0.5 mm deep electrodynamic microneedling combined with external application of minoxidil tincture, and patients in the group C were treated with 1 mm deep electrodynamic microneedling combined with external application of minoxidil tincture drug treatment. The clinical efficacy and adverse reactions were observed after 12 weeks treatment. Results After 12 weeks treatment, the hair densities and the hair diameters of patients in all three groups were significantly improved compared with those before treatment (all P

This article discusses the use of low dose oral minoxidil as a potential treatment for female pattern hair loss (FPHL). FPHL is a common form of hair loss that affects both men and women. While topical minoxidil and oral finasteride are commonly used treatments, their effectiveness in treating FPHL is debated. The article presents a case study of a 63-year-old woman with FPHL who underwent a 3-month regimen of 1.25 mg oral minoxidil daily. Hair density measurements before and after treatment showed an increase in hair growth. However, further research is needed to determine the clinical efficacy and safety profile of oral minoxidil for FPHL. [Extracted from the article]

This article, published in the Journal of Cosmetic Dermatology, compares the activity of the sulfotransferase enzyme SULT1A1 in scalp hair, eyebrows, and eyelashes. The study found that the SULT1A1 activity in scalp hair follicles was significantly higher than in eyebrow and eyelash hair follicles. The researchers suggest that supplementing eyebrow and eyelash hair follicles with sulfotransferase enzymes may improve treatment outcomes for hair loss in these areas. However, they caution against using 5% minoxidil for off-label use on the face due to the potential for undesired hair growth, hypertrichosis, and dryness. [Extracted from the article]

Pigmentary and hair disorders have a significant cosmetic and psychological impact. In the August issue of the Journal, we highlight the use of reflectance confocal microscopy in diagnosing and monitoring treatment responses in patients with melasma. We will also discuss new therapeutic approaches involving oral melatonin and a combination of glutathione and resveratrol for melasma. Additionally, the ongoing revolution in alopecia treatment with oral low‐dose minoxidil will be spotlighted, including the circumstances under which media attention has contributed to the growing interest in oral minoxidil prescriptions. [ABSTRACT FROM AUTHOR]

This article examines the impact of media attention on the interest in oral minoxidil (OM) as a treatment for hair loss among English and non-English speaking patients. The study conducted a retrospective chart review of prescription orders for hair loss patients seen at dermatology clinics affiliated with the University of Miami. The results showed a significant increase in the proportion of OM prescriptions for English language preferring (ELP) patients 6 months after the media attention, but no significant increase for non-English language preferring (NELP) patients. The study suggests that media influence on patient education may vary based on language preferences. [Extracted from the article]

This article discusses the use of low-dose oral minoxidil (LDOM) as a treatment for traction alopecia (TA) in women. TA is a condition that primarily affects women of African descent and is caused by prolonged tension on the hair follicles due to certain hair grooming practices. The study presents a case series of four patients who experienced significant hair regrowth after using oral minoxidil. The treatment was found to be effective and safe, with improvements in hair thickness and volume observed after just three months of therapy. The article suggests that oral minoxidil may be a viable option for treating TA in both the early and late stages. [Extracted from the article]