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Mitochondria are eukaryotic cellular organelles that function in energy metabolism, ROS production, and programmed cell death. Cutaneous epithelial and hair follicle dermal papilla cells are energy-rich cells that thereby may be affected by mitochondrial dysfunction and DNA mutation accumulation. In this review, we aimed to summarize the medical literature assessing dermatologic conditions and outcomes associated with mitochondrial dysfunction. A search of PubMed and Embase was performed with subsequent handsearching to retrieve additional relevant articles. Mitochondrial DNA (mtDNA) deletions, mutation accumulation, and damage are associated with phenotypic signs of cutaneous aging, hair loss, and impaired wound healing. In addition, several dermatologic conditions are associated with aberrant mitochondrial activity, such as systemic lupus erythematosus, psoriasis, vitiligo, and atopic dermatitis. Mouse model studies have better established causality between mitochondrial damage and dermatologic outcomes, with some depicting reversibility upon restoration of mitochondrial function. Mitochondrial function mediates a variety of dermatologic conditions, and mitochondrial components may be a promising target for therapeutic strategies.

ABSTRACT Background Objective Method Results Conclusion Dermal filler‐induced alopecia is a rare yet significant complication of aesthetic procedures primarily associated with vascular occlusion and subsequent tissue ischemia. Hyaluronic acid (HA) fillers, though widely used for facial rejuvenation, can lead to adverse outcomes such as skin necrosis and hair loss, particularly in high‐risk areas like the temples and glabella.This case report aims to highlight the clinical presentation, diagnostic approach, and multidisciplinary management of filler‐induced alopecia, contributing to the existing literature with a comprehensive review of previously reported cases.A 21‐year‐old female presented with localized skin necrosis and alopecia four days after receiving 7 mL of HA filler injections in the temples, tear trough, and eyebrow glabella regions. Trichoscopy revealed follicular dropout and white dots, consistent with ischemic hair loss. Treatment included hyaluronidase injections (1500 units), intralesional corticosteroids, topical minoxidil, and CO2 laser therapy. Over 1 year of follow‐up, the patient achieved complete hair regrowth and resolution of facial scarring.Only 16 cases of filler‐induced alopecia have been documented, predominantly involving HA fillers. This case underscores the importance of early recognition and intervention with hyaluronidase to mitigate ischemic damage. The multidisciplinary management approach employed here demonstrates the potential for full cosmetic recovery.Filler‐induced alopecia, though rare, necessitates heightened awareness among dermatologists and aesthetic practitioners. Adhering to recommended injection techniques and dosages, alongside the judicious use of ultrasound guidance, can minimize risks and improve patient safety. [ABSTRACT FROM AUTHOR]

Background: Patient‐reported outcome measures (PROMs) for hair loss focus mainly on Alopecia Areata. We created a PROM (i.e., HAIR‐Q) that is applicable to any hair loss condition. The HAIR‐Q measures satisfaction with hair. Patients/Methods: Concept elicitation interviews were conducted and analyzed to develop a draft scale. Content validity was established through multiple rounds of patient and expert input. Psychometric properties of the scale were examined in an online sample (i.e., Prolific) using Rasch measurement theory (RMT) analysis. Test–retest reliability and tests of construct validation were examined. Results: Content validity of a 22‐item draft scale was established with input from 11 patients, 12 experts and an online Prolific sample of 59 people who had a variety of hair loss treatments. In the RMT analysis (n = 390), 8 items were dropped. Data for the 14‐item scale fit the Rasch model (χ2 = 89.85, df = 70, p = 0.06). All 14 items had ordered thresholds and good item fit. Reliability was high with person separation index and Cronbach alpha values ≥0.91, and intraclass correlation coefficient of 0.94 based on a sample of 97 participants. Higher (better) scores on the scale were associated with having more hair, looking younger than ones' age, satisfaction with hair overall, being less bothered by hair loss, and for those who had a hair loss treatment in the past year, being more satisfied with their hair now than before treatment (p < 0.001). Conclusion: The HAIR‐Q evidenced reliability and validity and can be used in research and to inform clinical care to measure satisfaction with hair from the patient perspective. [ABSTRACT FROM AUTHOR]

Background: Androgenetic alopecia (AGA) is a prevalent form of hair loss that affects both men and women, severely impacting patients' quality of life. Traditional treatments include oral medications, topical medications, and hair transplantation, but these methods have certain side effects and limitations. How to safely effectively and maximally promote hair growth has been a key issue in the treatment of AGA. In recent years, fractionated laser therapy, as a noninvasive method, has gradually gained attention due to its minimally invasive and highly effective nature. Aims: In this paper, we summarized the studies related to fractional laser treatment of AGA in the past 15 years, and discussed its therapeutic mechanism, clinical effect, future development direction, and advantages and disadvantages compared with traditional treatment methods in the treatment of AGA. Methods: An extensive literature search was conducted using PubMed, Google, Google Scholar, Embase, and Scopus. All available articles studying fractional laser treatment of AGA were compiled in March 2024. Titles and abstracts were then screened for relevance and thoroughly examined for patient clinical outcomes. Prospective clinical trials, retrospective chart reviews, case series, and individual case reports were included in the literature review. Conclusions: Fractional laser treatment of AGA showed remarkable efficacy and high safety. Compared with traditional treatments, fractional laser has the advantages of minimally invasive, quick recovery, fewer side effects, and a wide range of population applicability, providing an effective treatment option for AGA patients. Further large‐scale clinical studies will help optimize the laser parameters and treatment settings to improve the therapeutic effect. [ABSTRACT FROM AUTHOR]

This post‐hoc analysis of the ALLEGRO phase 2b/3 study (NCT03732807) evaluated the efficacy and safety of ritlecitinib, an oral Janus kinase 3/TEC family kinase inhibitor, in patients with alopecia totalis (AT) and alopecia universalis (AU). Patients aged ≥ 12 years with alopecia areata (AA) and ≥50% scalp hair loss received once‐daily ritlecitinib 50 or 30 mg (± 4‐week 200‐mg loading dose) or placebo for 24 weeks. In a subsequent 24‐week extension period, the ritlecitinib groups continued their doses and patients initially assigned to placebo switched to ritlecitinib (200/50 or 50 mg daily). In this analysis, clinician‐ and patient‐reported hair regrowth outcomes were assessed at weeks 24 and 48 in four AA subgroups: AT/AU, AT, AU, and non‐AT/AU. Safety was monitored throughout. Of the 718 randomized patients, 151 (21%) and 147 (20%) were defined as having AT or AU, respectively. At week 24, Severity of Alopecia Tool (SALT) score ≤20 (≤20% scalp hair loss) response rates were higher in the ritlecitinib‐treated AT/AU, AT, and AU groups (7%–14%, 7%–21%, and 4%–10%, respectively) vs the placebo group (0% in the AT/AU, AT, and AU groups). The proportions of patients with a SALT score of ≤20 increased through week 48 (AT/AU, 13%–31%; AT, 11%–27%; AU, 6%–41%). Additionally, at week 24, 25%–43%, 32%–42%, and 12%–50% of patients with AT/AU, AT, and AU, respectively, who received ritlecitinib achieved a moderately or greatly improved response based on the Patient Global Impression of Change scale. Response rates generally increased through week 48 and were similar across AA subgroups. In patients with AT/AU, ritlecitinib was well tolerated with a safety profile consistent with that of the overall AA population. Ritlecitinib demonstrated clinical efficacy, patient‐reported improvement, and an acceptable safety profile in patients with AT and AU through week 48. A plain language summary of this study is available at https://doi.org/10.25454/pfizer.figshare.26879161. Clinicaltrials.gov: NCT03732807. [ABSTRACT FROM AUTHOR]

ABSTRACT Objective Methods Results Conclusion To investigate the role of miR‐30a‐5p on the proliferation and apoptosis of hair follicle stem cells (HFSCs) and whether the Wnt/β‐catenin signaling pathway is involved.HFSCs derived from the vibrissa of mammary rats were obtained by enzymatic digestion, and subsequently the obtained HFSCs were treated with Lipofectamine 2000 cell transfection and divided into normal cell culture group (control), miR‐30a‐5p overexpression group (miR‐30a‐5p mimic), miR‐30a‐5p empty vector group (miR‐NC), miR‐30a‐5p inhibitor group (in‐miR‐30a‐5p), and in‐miR‐30a‐5p empty vector group (in‐miR‐NC). After transfection, the cell proliferation and apoptosis rates were examined separately. In addition, the mRNA expression of β‐catenin, proliferating cell nuclear antigen (PCNA) and apoptosis‐related genes (Bax and Bcl‐2) were examined.The results of cell proliferation ability showed that in‐miR‐30a‐5p group promoted cell proliferation of HFSCs relative to other groups, along with significant upregulation of gene levels of PCNA. Apoptosis analysis indicated that apoptosis rate was reduced in the in‐miR‐30a‐5p group, and the expression of Bax was suppressed, while that of Bcl‐2 was promoted. Wnt/β‐catenin signaling pathway investigation revealed a significant increase in the levels of β‐catenin in HFSCs in the in‐miR‐30a‐5p group.Downregulation of miR‐30a‐5p levels inhibited HFSCs apoptosis and simultaneously promoted proliferation, furthermore, the increased expression of β‐catenin indirectly confirmed the activation of the Wnt/β‐catenin signaling pathway. [ABSTRACT FROM AUTHOR]

ABSTRACT Background Objectives Methods Results Conclusions Polytrichia is a common clinical and trichoscopic feature in folliculitis decalvans (FD) that morphologically corresponds to compound follicular structures (CFS) of six or more follicles sharing a single infundibulum, surrounded by fibrosis.To characterize the type of follicles in the CFS in scalp biopsy specimens from FD.We retrospectively reviewed 10 scalp biopsy specimens obtained by using the trichoscopy‐guided approach from the affected scalp of patients diagnosed with early‐stage FD between 2018 and 2023. We assessed the number and type of follicles within the CFS on horizontal sections.The total number of assessed follicles was 205, out of which 159 were part of CFS. Of those, 156 were terminal follicles (146 anagen and ten telogen), three intermediate, and zero vellus follicles. Other common findings included dense mixed cell infiltrate consisting of histiocytes, plasma cells, lymphocytes, neutrophils, and eosinophils; psoriasiform hyperplasia; and fragmented hair shafts.We show that CFS in FD are composed largely of terminal anagen follicles. This may help with further understanding of the disease. [ABSTRACT FROM AUTHOR]

Hair loss is a prevalent issue worldwide, which, though not life-threatening, can result in psychological problems, low self-esteem, and social anxiety. Previous studies have shown that ultraviolet radiation can have negative effects on hair follicle cells, leading to hair loss, while the impact of blue light on hair and hair follicle has largely been overlooked. This study aimed to examine the effects of blue light on hair follicle stem cells (HFSCs) and primary dermal papilla cells (DPCs), which are essential components of hair follicles. Human HFSCs and primary DPCs were exposed to blue light (457 nm) at various intensities (1, 4, 8, and 16 mW/cm2) for 3 days. Subsequently, cell viability, cell proliferation, and intracellular reactive oxygen species (ROS) were assessed. The results showed that blue light (457 nm) significantly reduced the cell viability and proliferation of HFSCs and DPCs in vitro, with the inhibition being intensity-dependent. Additionally, blue light triggered the overproduction of ROS in the DPCs. While the exact mechanisms by which blue light affects hair follicle cells remain unclear, these findings suggest that blue light could impede the growth of these cells. This insight may offer a new approach to protecting hair by avoiding exposure to high-intensity blue light. Highlights: 457 nm blue LED light significantly inhibited the cell viability of HFSCs and DPCs. Blue light at comparable high irradiances has toxic effects on hair follicle cells. 16 mW/cm2 blue light significantly induced oxidative stress and inhibited growth of DPCs. [ABSTRACT FROM AUTHOR]

Simple Summary: The dermal papilla (DP) is a specialized mesenchymal compartment that forms at the base of the hair follicle. It acts as a signaling center that regulates hair growth, shape, size, and color. Dermal papilla cells (DPCs) exhibit stem cell properties and show significant potential for use in cell therapy. They can be induced into other functional cells, regenerate skin tissues and new hair follicles when combined with epithelial stem cells, and promote hair growth and wound healing when administered on the skin. This review summarizes the functions of DPs in the hair follicle, shows how DPCs could be used in cell therapy, and discusses the challenges and recent advances in the field, from basic research to translational applications. As an appendage of the skin, hair protects against ultraviolet radiation and mechanical damage and regulates body temperature. It also reflects an individual's health status and serves as an important method of expressing personality. Hair loss and graying are significant psychosocial burdens for many people. Hair is produced from hair follicles, which are exclusively controlled by the dermal papilla (DP) at their base. The dermal papilla cells (DPCs) comprise a cluster of specialized mesenchymal cells that induce the formation of hair follicles during early embryonic development through interaction with epithelial precursor cells. They continue to regulate the growth cycle, color, size, and type of hair after the hair follicle matures by secreting various factors. DPCs possess stem cell characteristics and can be cultured and expanded in vitro. DPCs express numerous stemness-related factors, enabling them to be reprogrammed into induced pluripotent stem cells (iPSCs) using only two, or even one, Yamanaka factor. DPCs are an important source of skin-derived precursors (SKPs). When combined with epithelial stem cells, they can reconstitute skin and hair follicles, participating in the regeneration of the dermis, including the DP and dermal sheath. When implanted between the epidermis and dermis, DPCs can induce the formation of new hair follicles on hairless skin. Subcutaneous injection of DPCs and their exosomes can promote hair growth. This review summarizes the in vivo functions of the DP; highlights the potential of DPCs in cell therapy, particularly for the treatment of hair loss; and discusses the challenges and recent advances in the field, from basic research to translational applications. [ABSTRACT FROM AUTHOR]

Chronic stress is a common cause of hair loss, involving inflammatory responses and changes in cellular signaling pathways. This study explores the mechanism of action of the SDF-1/CXCR4 signaling axis in chronic stress-induced hair loss. The research indicates that SDF-1 promotes hair follicle growth through the PI3K/Akt and JAK/STAT signaling pathways. Transcriptome sequencing analysis was conducted to identify differentially expressed genes in the skin of normal and stressed mice, with key genes SDF-1/CXCR4 selected through machine learning and a protein-protein interaction network established. A chronic stress mouse model was created, with injections of SDF-1 and AMD3100 administered to observe hair growth, weight changes, and behavioral alterations and validate hair follicle activity. Skin SDF-1 concentrations were measured, differentially expressed genes were screened, and pathways were enriched. Activation of the PI3K/Akt and JAK/STAT signaling pathways was assessed, and siRNA technology was used in vitro to inhibit the expression of SDF-1 or CXCR4. SDF-1 promoted hair follicle activity, with the combined injection of SDF-1 and AMD3100 weakening this effect. The activation of the PI3K/Akt and JAK/STAT signaling pathways was observed in the SDF-1 injection group, confirmed by Western blot and immunofluorescence. Silencing SDF-1 through siRNA-mediated inhibition reduced cell proliferation and migration abilities. SDF-1 promotes hair growth in chronic stress mice by activating the PI3K/Akt and JAK/STAT pathways, an effect reversible by AMD3100. The SDF-1/CXCR4 axis may serve as a potential therapeutic target for stress-induced hair loss. [ABSTRACT FROM AUTHOR]

Background: Disruption of ALX4 causes autosomal dominant parietal foramina and autosomal recessive frontonasal dysplasia with alopecia, but the mechanisms involving ALX4 in craniofacial and other developmental processes are not well understood. Although mice carrying distinct mutations in Alx4 have been previously reported, the perinatal lethality of homozygous mutants together with dynamic patterns of Alx4 expression in multiple tissues have hindered systematic elucidation of the cellular and molecular mechanisms involving Alx4 in organogenesis and disease pathogenesis. Results: We report generation of Alx4f/f conditional mice and show that tissue‐specific Cre‐mediated inactivation of Alx4 in cranial neural crest and limb bud mesenchyme, respectively, recapitulated craniofacial and limb developmental defects as found in Alx4‐null mice but without affecting postnatal survival. While Alx4‐null mice that survive postnatally exhibited dorsal alopecia, mice lacking Alx4 function in the neural crest lineage exhibited a highly restricted region of hair loss over the anterior skull whereas mice lacking Alx4 in the cranial mesoderm lineage exhibited normal hair development, suggesting that Alx4 plays partly redundant roles in multiple cell lineages during hair follicle development. Conclusion: The Alx4f/f mice provide a valuable resource for systematic investigation of cell type‐ and stage‐specific function of ALX family transcription factors in development and disease. Key Findings: We report successful generation and analysis of Alx4 conditional mice.We demonstrate lineage‐specific requirements of Alx4 in craniofacial, limb, and hair development.Our results demonstrate that Alx4 functions in multiple lineages to control hair follicle development.The Alx4 conditional mice provide a valuable and unique resource for systematic characterization of the cellular and molecular mechanisms involving the ALX family transcription factors in development and disease. [ABSTRACT FROM AUTHOR]

Background Chemotherapy-induced alopecia is a common consequence of cancer treatment with a high psychological impact on patients and can be prevented by scalp cooling (SC). With this multi-center patient series, we examined the results for multiple currently used chemotherapy regimens to offer an audit into the real-world determinants of SC efficacy. Materials and methods The Dutch Scalp Cooling Registry collected data on 7424 scalp-cooled patients in 68 Dutch hospitals. Nurses and patients completed questionnaires on patient characteristics, chemotherapy, and SC protocol. Patient-reported primary outcomes at the start of the final SC session included head cover (HC) (eg, wig/scarf) use (yes/no) as a surrogate for patient satisfaction with SC and WHO score for alopecia (0 = no hair loss up to 3 = total alopecia) as a measure of scalp cooling success. Exhaustive logistic regression analysis stratified by chemotherapy regimen was implemented to examine characteristics and interactions associated with the SC result. Results Overall, over half of patients (n  = 4191, 56%) did not wear a HC and 53% (n  = 3784/7183) reported minimal hair loss (WHO score 0/1) at the start of their final treatment. Outcomes were drug and dose dependent. Besides the chemotherapy regimen, this study did not identify any patient characteristic or lifestyle factor as a generic determinant influencing SC success. For non-gender specific cancers, gender played no statistically significant role in HC use nor WHO score. Conclusions Scalp cooling is effective for the majority of patients. The robust model for evaluating the drug and dose-specific determinants of SC efficacy revealed no indications for changes in daily practice, suggesting factors currently being overlooked. As no correlation was identified between the determinants explaining HC use and WHO score outcomes, new methods for evaluation are warranted. [ABSTRACT FROM AUTHOR]

Prostaglandin D2 (PGD2) levels are high in the balding areas of human scalps, and PGD2 has been found to inhibit hair growth. It is known that the inhibition of the PGD2 receptor can promote hair growth by preventing hair follicles from entering the catagen phase. Thus, we identified an antagonist of DP2, the receptor for PGD2, as a potential treatment for hair loss using an AI-based DeepZema® drug development program. In this study, we identified that the DP2 antagonist (DP2A) could ameliorate alopecia in human follicle dermal papilla cells (HFDPCs) that were stimulated by dihydrotestosterone (DHT), a known molecule related to hair loss. We observed that the DP2A promoted wound healing efficiency and increased alkaline phosphatase levels in the HFDPCs that were damaged with DHT. In addition, we found that the DP2A diminished the reactive oxygen species (ROS) levels generated in the DHT-damaged HFDPCs. We confirmed that the DP2A effectively recovered the membrane potential of mitochondria in these cells. We also demonstrated that the DP2A enhanced the phosphorylation levels of both Akt and ERK in the HFDPCs that were damaged with DHT. Notably, we revealed that the DP2A slightly enlarged the three-dimensional spheroid size in these cells and confirmed that the DP2A improved hair growth in the organ culture of human hair follicles. Taken together, we suggest that DP2A has therapeutic effects on HFDPCs that are damaged by DHT and holds promise as a potential treatment for treating hair loss. [ABSTRACT FROM AUTHOR]

Resveratrol has been found to stimulate the growth of human dermal papilla cells (hDPCs) and protect them from oxidative damage. The topical application of resveratrol effectively enhanced hair growth and stimulated the transition of the hair cycle from the resting phase (telogen) into the active growth phase (anagen phase). The aim of this study was to examine the effects of resveratrol-rich peanut callus and sprout extracts on promoting hair growth and anti-hair loss effects in hDPCs and then select the most effective extract (callus) for further assessment in clinical applications. The peanut sprout and callus were produced from plant seeds and extracted with ethanol. Resveratrol was identified as the major constituent in the extracts obtained using the HPLC approach, although no resveratrol was found in the original seed extract. Hair cell proliferation, growth factor expression, and 5α-reductase (5-AR) inhibition assays were used to examine the extracts' promotion of hair growth and inhibition of anti-hair loss in an in vitro hDPCs model, and standard resveratrol served as a positive reference. Initially, the cytotoxicity of the samples was assessed, revealing that 2.5% of all extracts and 0.02% of resveratrol exhibited a non-cytotoxic effect to hDPCs. The 50% cytotoxic concentration of peanut callus extract (15.50 ± 0.05%) was significantly less cytotoxic to hDPCs than sprout (12.30 ± 0.14%) and seed (11.69 ± 0.26%) extracts (p < 0.05). In vitro experiments indicated that peanut callus extract had the greatest proliferated hDPCs (20.44 ± 0.78%), increased the expression of growth factors (IGF-1, KGF, and HGF) and inhibited 5AR (27.83 ± 2.48%). Then, the callus extract and resveratrol as the positive standard were separately incorporated into a hair serum base and assessed for anti-hair loss effect in a randomized, double-blind, placebo-controlled clinical trial on 60 subjects, and the daily hair shedding count, one-minute combing, and forcible hair pluck tests were monitored for 12 weeks. The clinical study showed that the hair serum containing peanut callus extract and resveratrol were effective in reducing hair shedding (66.98% and 61.47%), decreased hair fall from combing by (83.92% and 68.19%), and increased the ratio of the anagen/telogen by (3.3 and 2.8, respectively). The results suggest that peanut callus extract has a significant amount of resveratrol and the potential to stimulate hair growth and prevent hair loss, making it an alternative bioactive option for cosmetic applications. [ABSTRACT FROM AUTHOR]

Alopecia is a common adverse effect of neoadjuvant or adjuvant chemotherapy in patients with early breast cancer. While hair typically regrows over time, more than 40% of patients continue to suffer from permanent partial alopecia, significantly affecting body image, psychological well-being, and quality of life. This concern is a recognized reason why some breast cancer patients decline life-saving chemotherapy. It is critical for healthcare professionals to consider the impact of this distressing side effect and adopt supportive measures to mitigate it. Among the various strategies investigated to reduce chemotherapy-induced alopecia (CIA), scalp cooling has emerged as the most effective. This article reviews the pathophysiology of CIA and examines the efficacy of different scalp cooling methods. Scalp cooling has been shown to reduce the incidence of CIA, defined as less than 50% hair loss, by 50% in patients receiving chemotherapy. It is associated with high patient satisfaction and does not significantly increase the risk of scalp metastasis or compromise overall survival. Promising new scalp cooling technologies, such as cryogenic nitrogen oxide cryotherapy, offer the potential to achieve and maintain lower scalp temperatures, potentially enhancing therapeutic effects. Further investigation into these approaches is warranted. Research on CIA is hindered by significant heterogeneity and the lack of standardised methods for assessing hair loss. To advance the field, further interdisciplinary research is crucial to develop preclinical models of CIA, establish a uniform, internationally accepted and standardised classification system, and establish an objective, personalised prognosis monitoring system. [ABSTRACT FROM AUTHOR]

Purpose: Hair loss is often overlooked but psychologically challenging. However, the emergence of online health communities provides opportunities for hair loss patients to seek social support through self-disclosure. Nevertheless, not all disclosures receive the desired support. This research explores what patients disclose within the community and how their health narrative (content, form and linguistic style) regarding self-disclosure influences the social support they receive. Design/methodology/approach: This study investigated a 13-year-old online support group for Chinese hair loss patients with nearly 240,000 members. Using structural topic modeling, Linguistic Inquiry and Word Count, and a negative binomial model, the research analyzed the content of self-disclosure and the interrelationships between social support and three narrative dimensions of self-disclosure. Findings: Self-disclosures are classified into 14 topics, grouped under analytical, informative and emotional categories. Emotion-related self-disclosures, whether in content or effective word use, receive deeper social support. Longer and image-rich posts attract more support in quantity, but not necessarily in quality, while cognitive words have a limited impact. Originality/value: This study addresses the previously overlooked population of hair loss patients within online health communities. It employs a more comprehensive health narrative framework to explore the relationship between self-disclosure and social support, utilizing unsupervised structural topic modeling methods to mine text. The research offers practical implications for how patients seek support and for healthcare professionals in developing doctor-patient communication strategies. [ABSTRACT FROM AUTHOR]

Background: Pattern hair loss, the most common form of hair loss, affects millions in the United States. Americans are increasingly seeking health information from social media. It would appear that healthcare professionals contribute relatively minimally to pattern hair loss content, thereby posing serious concerns for credibility and quality of information available to the general public. Objectives: This study evaluates popular pattern hair loss‐related content on Instagram, TikTok, and YouTube, aiming to understand effective engagement strategies for healthcare professionals on social media. Methods: The top 60 short‐form videos were extracted from Instagram, TikTok, and YouTube, using the search term "pattern hair loss" and inclusion of USA‐based accounts only. Videos were categorized by creator type (healthcare vs. non‐healthcare professional), content type (informational, interactional, and transactional), and analyzed for user engagement and quality, using engagement ratios and DISCERN scores, respectively. Conclusions: Healthcare professionals, especially dermatologists, play a crucial role in delivering credible information on social media, supported by higher DISCERN scores. Multi‐platform presence, frequent activity, and strategic content creation contributes to increased reach and engagement. Duration of short‐form videos does not impact engagement. The "Duet" or "Remix" options on TikTok, Instagram, and YouTube serve as a valuable tool for healthcare professionals to counter misinformation. Our study underscores the importance of optimizing educational impact provided by health care professionals at a time when the public increasingly relies on social media for medical information. [ABSTRACT FROM AUTHOR]

Background: Hair loss is a widespread health problem that affects numerous individuals and is associated with age, lack of sleep, stress, endocrine problems, and other problems. Caffeine exerts various pharmacological effects, particularly after ingestion. The caffeine‐induced inhibition of phosphodiesterases can increase intracellular cAMP concentrations, ultimately resulting in stimulatory effects on cell metabolism and proliferation. Hence, caffeine has been confirmed to inhibit hair loss caused by premature termination of the hair growth phase. Adenosine also improves hair loss by stimulating hair growth and thickening hair shafts. However, further empirical evidence is required to comprehensively assess the efficacy of hair loss treatment and prevention using a formulation of caffeine and adenosine in specific proportions in shampoos. Objectives: This study aimed to evaluate a shampoo with caffeine and adenosine as a daily scalp care product for hair loss in 77 subjects aged 18–60 years. Methods: The overall and local hair densities were assessed using professional cameras and dermoscopes at different magnifications and distances. Five hairs that came off the participant's head were randomly selected to measure hair diameter. The self‐assessment questionnaires were filled on third month of product use. Results: The combination of caffeine and adenosine in the shampoo significantly enhanced hair density compared to that of the baseline. The results revealed a significant reduction in hair loss. The hair diameters of the subjects did not change significantly. Most of the participants (71.05%) were satisfied with their hair after using the product. Conclusions: Shampoos containing caffeine and adenosine have been demonstrated to exert therapeutic benefits for reducing hair loss. [ABSTRACT FROM AUTHOR]

Background: Androgenetic alopecia (AGA) is a prevalent hair loss disorder with psychological repercussions. Traditional treatments have limitations, leading to the exploration of regenerative therapies such as exosomes derived from adipose tissue stem cells (ASC‐Exosomes). Methods: First, using human hair follicle (HF) dermal papilla cells (hDPCs) treated with ASC‐Exosomes, ALP, VCAN, β‐catenin, and LEF‐1 levels with RT‐PCR and p‐GSK3β, GSK3β, β‐catenin, ALP, and β‐actin levels with western blot analysis were assessed. Hair shaft elongation test and assay for ALP, Ki‐67, and β‐catenin were done using human HF organ culture. Patients with AGA had ASC‐Exosomes treatment and were evaluated for hair counts, photographic assessments, subjective satisfaction, and safety profiles. Results: ASC‐Exosomes impact hDPCs, increasing proliferation and the upregulation of hair growth‐related genes, including ALP, VCAN, β‐catenin, and LEF‐1. The Wnt/β‐catenin pathway was activated, indicating their role in promoting hair growth. ASC‐Exosomes also promoted hair shaft elongation and ALP activity, suggesting a potential for hair regeneration. Thirty participants with AGA enrolled and treated over 24 weeks. The subjects experienced a significant increase in total hair density, improved global photographic assessments, and reported higher subjective satisfaction without severe adverse reactions. Conclusion: This research contributes to the growing body of evidence supporting the use of exosomes in hair loss treatment, offering a safe and effective alternative for individuals with AGA. [ABSTRACT FROM AUTHOR]

Purpose/Background: Hair loss is a common presentation in primary care. This condition is caused by telogen effluvium and alopecia, among others. Several factors such as drugs, trauma, and emotional and physiological stress can lead to the development of hair loss in addition to vitamin and mineral deficiency. This study aimed to assess the knowledge and practice of primary health physicians in Saudi Arabia on the use of vitamins and minerals for the treatment of hair loss with the research question of what is the knowledge and practice level among primary physicians in Kingdom of Saudi Arabia regarding hair loss. Methods: This cross-sectional study was carried out in primary health care centers in Saudi Arabia. Data were collected by a self-administered online questionnaire. The questionnaire included two parts; the first one is the personal information such as age, sex, year of experience, and current medical ranking. The second part included questions assessing the knowledge and practice of using vitamins and minerals for treatment of hair loss. Data were analyzed by using Statistical Package for Social Sciences (SPSS). Results: A total of 146 physicians were included in the final analysis with a mean age of 41.65 (SD = 12.71). Slightly over half (54.1%) were juniors being general practitioners or residents. The mean knowledge score was 12.6 (SD = 2.83), and the mean practice score was 8 (SD = 3.43), with no difference between the total score between the senior and junior physicians, while some significant differences were noted in some items of both scores. No significant association was noted between knowledge and practice scores. Conclusion: The findings show the low scores of knowledge and practice among doctors about the causes and treatment of hair loss. Guidelines should guide practice regardless of seniority. Future studies should address each group separately.

Abstract Background The Severity of Alopecia Tool (SALT) is a clinician‐reported outcome measure of scalp hair loss in alopecia areata (AA). Objectives To characterise the magnitudes of change in SALT scores corresponding to meaningful treatment benefits from the patient's perspective. Methods Anchor‐based methods for the estimation of meaningful within‐patient change thresholds were applied to pooled data from a randomised, double‐blind trial of ritlecitinib. Anchors included a patient‐reported measure of change in AA severity, the Patient Global Impression of Change (PGI‐C) and three items comprising the Patient Satisfaction with Hair Growth (P‐Sat) questionnaire. After reviewing Pearson correlations between change‐from‐baseline SALT scores and each anchor to confirm adequate association, potential thresholds were computed as mean change‐from‐baseline SALT scores among patients who reported moderate improvement on the PGI‐C and/or moderate satisfaction on each of three P‐Sat items at week 24. Results Six hundred and fifty participants (86% adults, 14% adolescents) had mean (standard deviation) SALT scores of 90.6 (14.3) at baseline, suggesting a sample with primarily severe AA. Correlations between SALT change‐from‐baseline scores and the patient‐reported items supported their use as anchors. Estimates based on patients reporting moderate improvement in AA (n = 102) on the PGI‐C and those reporting moderate satisfaction on the P‐Sat item related to the amount of hair growth at week 24 (n = 122) were −42.2 (26.1) and −43.1 (26.8), respectively. Supportive estimates based on the remaining P‐Sat items were similar in magnitude. Conclusions Among patients with severe AA, SALT change‐from‐baseline scores of 42 or 43 represent meaningful improvements. While the achievement of low SALT scores of ≤10–≤20 have been used to characterise efficacy in clinical trials, the amount of change required to meet this endpoint far exceeds the estimates in this study. The treatment goals of individual patients must be considered when evaluating benefit in both clinical trials and clinical practice.

What is this summary about?This is a summary of the results of the ALLEGRO phase 2b/3 clinical trial, originally published in The Lancet. ALLEGRO-2b/3 looked at how well and safely the study medicine, ritlecitinib, works in treating people with alopecia areata ('AA' for short). The immune system protects your body from outside invaders such as bacteria and viruses. AA is an autoimmune disease, meaning a disease in which one's immune system attacks healthy cells of the body by mistake. In AA, the immune system attacks hair follicles, causing hair to fall out. AA causes hair loss ranging from small bald patches to complete hair loss on the scalp, face, and/or body. Ritlecitinib is a medicine taken as a pill every day, by mouth, that is approved for the treatment of severe AA. It blocks processes that are known to play a role in causing hair loss in patients with AA.What were the results of the study?Adults and adolescents (12 years and older) took part in the ALLEGRO-2b/3 study. They either took ritlecitinib for 48 weeks or took a placebo (a pill with no medicine) for 24 weeks. Participants taking placebo later switched to taking ritlecitinib for 24 weeks. The study showed that participants taking ritlecitinib had more hair regrowth on their scalp after 24 weeks than those taking the placebo. Hair regrowth was also seen on the eyebrows and eyelashes in participants taking ritlecitinib. Hair regrowth continued to improve to week 48 with continued ritlecitinib treatment. In addition, more participants taking ritlecitinib reported that their AA had 'moderately' or 'greatly' improved after 24 weeks than those taking the placebo. Similar numbers of participants taking ritlecitinib or placebo had side effects after 24 weeks. Most side effects were mild or moderate.What do the results of the study mean?Ritlecitinib was an effective and well-tolerated treatment over 48 weeks for people with AA. Clinical Trial Registration: NCT03732807 (phase 2b/3 ALLEGRO study).

OBJECTIVE: This review examines the current literature on the gut-skin connection in alopecia and summarizes interventions that impact hair growth by modulation of the gut or skin microbiome. METHODS: PubMed searches were done to assess studies of the gut and skin microbiome and forms of alopecia including, alopecia areata (AA), androgenic alopecia (AGA), alopecia universalis (AU), central centrifugal cicatricial alopecia (CCCA) and lichen planopilaris (LPP). Filters were applied for human and animal studies. Articles not translated to English and studies assessing supplemental therapies on alopecia were excluded. RESULTS: There is evidence that scalp, hair follicle, and gut microbiome alterations are associated with various types of alopecia. There is potential in the use of interventions targeting microbiome dysbiosis, including fecal transplants and probiotics. LIMITATIONS: This field of study still requires more high-quality research and studies with larger participant populations. CONCLUSION: Dysbiosis on the scalp, within the hair follicle and the gut seem to have a role in the pathophysiology of various forms of alopecia. There is evidence that interventions targeting dysbiosis may have potential in the treatment and management of hair loss. Further studies are needed to establish a direct connection and to clarify specific effects of these interventions.

Lipedematous scalp (LS) and lipedematous alopecia (LA) are uncommon conditions with an unclear cause. Over the past century, about 115 cases have been documented in the literature. It is unknown if these disorders are indeed so uncommon or if cases that accept the illness as a structural alteration or are asymptomatic make the disease appear more uncommon than it is. Despite the fact that the majority of cases are seen in young and middle-aged people, the cases involving congenital, elderly, and children have also been reported. In the reported cases, female gender was observed to be dominant. The most significant clinical characteristics include felty swelling of the scalp in both disorders, diffusely or locally enlarged subcutaneous tissue with a swampy, spongy feel, and varied degrees of alopecia in LA. There is still much to learn about the pathogenetic mechanisms and therapeutic approaches for LA and LS. In this article, I review the general clinical characteristics, supposed pathogenetic mechanisms, histopathologic characteristics, diagnostic procedures, and management strategies for LS and LA. [ABSTRACT FROM AUTHOR]

In recent years, both domestic and international studies have demonstrated therapeutic benefits of microneedles with various depth in the treatment of androgenetic alopecia, alopecia areata, and telogen effluvium. The mechanisms of microneedle therapy for alopecia may be related to the enhancement of transdermal drug delivery. In addition, various growth factors generated during microneedling participate in multiple hair loss-related signaling pathways, thereby promoting the formation of hair follicles during the growth phase. This article introduces microneedle treatments for different types of hair loss diseases and the selection of microneedle depth, aiming to provide reference for clinical treatment.

Background: Hair loss can occur in pediatric and adult populations and may have different patterns. The causes of hair loss in pediatric patients include tinea capitis, alopecia areata, telogen effluvium, traction alopecia, anagen effluvium, androgenetic alopecia, loose anagen syndrome, short anagen syndrome, congenital aplasia cutis, congenital triangular alopecia, atrichia congenita, congenital hypotrichosis, and transient neonatal hair loss.Purpose: to understand etiologies of hair loss in pediatrics, and to determine the appropriate examinations for diagnosing and managing hair loss in children.Review: Hair loss in children can be categorized as congenital or acquired. Congenital hair loss is classified based on distribution, while acquired hair loss is classified as either scarring or non-scarring. Hair loss complications in children can be irreversible. The diagnosis of hair loss in pediatric patients includes anamnesis, physical examination, and supporting examinations. The supporting examinations used for diagnosis include fungal cultures, hair pull tests, hair tug tests, light microscopy, and trichoscopy. Conclusion: There are numerous causes of hair loss in pediatric patients that need to be identified before appropriate management can be implemented. The management of hair loss requires a holistic approach, including psychosocial support. Correct diagnosis and treatment of pediatric hair loss can prevent a decrease in the patient's quality of life.

Because hair loss is a common concern for many individuals, potential regenerative therapies of hair follicles have been extensively researched. Induced pluripotent stem cells (iPSCs) are a promising avenue for hair follicle regeneration. This review explores current iPSC-based approaches and highlights their potential applications and challenges in hair restoration. The principles of iPSC technology, iPSC differentiation into hair follicle precursor cells, and potential clinical implications for hair follicle regeneration are also discussed. This overview of iPSCs and their applications aims to contribute to our understanding of their role in hair restoration and potential future therapeutic applications.

Abstract The minimal adverse-effect profile and positive clinical response of low-dose oral minoxidil (LDOM) have recently caused the drug to gain popularity for the treatment of hair disorders in adults. However, in the pediatric population, hesitancy still surrounds the use of oral minoxidil given the wide profile of potential side effects the drug offers. This review aims to characterize the safety and use of oral minoxidil in children for the treatment of all disorders to equip physicians with ample knowledge when prescribing oral minoxidil in the pediatric population. A total of 41 studies (19 case reports, 10 cohort studies, 7 retrospective chart reviews, and 5 case series) that reported data on 442 pediatric patients for whom oral minoxidil was used for treatment were included. Conditions for which treatment with minoxidil was described were hair disorders (83.9%, 371/442) and hypertension (11.3%, 50/442); accidental usage (4.8%, 21/442) was also noted in the literature and included in this review. This review is broken down by dosage and describes the safety and efficacy of oral minoxidil in pediatric patients aged 0 to 18 years old for the treatment of hair disorders. This review found that LDOM may represent a safe option for the treatment of hair disorders in children. This study also suggests moderate and high doses of oral minoxidil may not be safe for use in children. Additional studies are needed to further understand this drug’s efficacy and safety in children.

Abstract Introduction Recent advancements in androgenetic alopecia (AGA) treatment have highlighted the efficacy of botulinum toxin (BoNT). However, inconsistencies in injection sites and depths warrant attention. It remains unclear which injection strategy is most beneficial for patients. Methods This split-scalp randomized controlled trial divided each enrolled participant’s scalp along the midline: one side was randomized to receive intramuscular BoNT injections in the surrounding muscles, while the other side received intradermal BoNT injections directly into the balding areas. This study evaluated the impact of treatment on hair density and diameter through trichoscopic examinations conducted at baseline and 12 weeks post treatment. Additionally, assessments of pain and overall safety were integrated into the study protocol. Results Twenty-nine patients completed the study, with significant improvements in hair density observed in the intramuscular injection group compared to the intradermal group (p

Abstract Background The Severity of Alopecia Tool (SALT) is a standardized method for quantifying scalp hair loss in alopecia areata (AA). SALT scores can be used to guide treatment decisions and are widely used as eligibility criteria and endpoints for clinical trials in AA. However, clinicians may be unfamiliar with assessing and envisioning SALT scores in practice. Objectives To aid clinicians in the determination and application of SALT scores in a clinical setting, this manuscript seeks to contextualize SALT scores using patient images from a clinical trial of adults with severe AA. Methods Images from 722 patients enrolled in BRAVE‐AA1, a phase 2/3 study of baricitinib in adults with severe AA (SALT score ≥50; ≥50% scalp hair loss), were obtained at baseline and Weeks 12, 36, and 52 and compiled into a repository. Photographs were selected to represent SALT scores across the full range of disease (SALT scores 0–100) and to demonstrate the progression of SALT scores during the course of treatment. Results Images of six patients depict the range of SALT scores (0–100). Photographs are of male and female patients of different ages (21–69) and races (Asian, Black, White) with varying extent, density, and patterns of hair loss. Images of two additional patients demonstrate the use of SALT to monitor treatment progress, showing distinct patterns and timing of clinical response over 52 weeks of therapy. Conclusions The SALT is widely used in clinical trials for AA, but clinicians may lack familiarity. Presented patient images show SALT scores commonly used as eligibility criteria and endpoints in clinical trials, which may be useful in identifying patients eligible for systemic treatment and in visualizing therapeutic response.

Introduction: Hair loss is one of the common clinical conditions in modern society. Although it is not a serious disease that threatens human life, it brings great mental stress and psychological burden to patients. This study investigated the role of dendrobium officinale polysaccharide (DOP) in hair follicle regeneration and hair growth and its related mechanisms. Methods: After in vitro culture of mouse antennal hair follicles and mouse dermal papilla cells (DPCs), and mouse vascular endothelial cells (MVECs), the effects of DOP upon hair follicles and cells were evaluated using multiple methods. DOP effects were evaluated by measuring tentacle growth, HE staining, immunofluorescence, Western blot, CCK-8, ALP staining, tube formation, scratch test, and Transwell. LDH levels, WNT signaling proteins, and therapeutic mechanisms were also analyzed. Results: DOP promoted tentacle hair follicle and DPCs growth in mice and the angiogenic, migratory and invasive capacities of MVECs. Meanwhile, DOP was also capable of enhancing angiogenesis and proliferation-related protein expression. Mechanistically, DOP activated the WNT signaling and promoted the expression level of β-catenin, a pivotal protein of the pathway, and the pathway target proteins Cyclin D1, C-Myc, and LDH activity. The promotional effects of DOP on the biological functions of DPCs and MVECs could be effectively reversed by the WNT signaling pathway inhibitor IWR-1. Conclusion: DOP advances hair follicle and hair growth via the activation of the WNT signaling. This finding provides a mechanistic reference and theoretical basis for the clinical use of DOP in treating hair loss.

Background: Low dose oral minoxidil (LDOM) is a preferred treatment for alopecia due to ease of use and efficacy. While LDOM is typically well tolerated, patients may experience a temporary increase in hair shedding starting treatment, colloquially regarded as “dread shed”. One proposed method to combat this is to overlap therapies by maintaining use of topical minoxidil when initiating LDOM. Objective: To evaluate the impact of maintaining topical minoxidil when initiating LDOM on “dread shed”. Methods: We performed a retrospective chart review of patients seen at New York University Langone Health Dermatology from January 1, 2008 to August 1, 2023 prescribed LDOM. Results: A total of 115 patients met inclusion criteria, of whom 37 maintained use of topical minoxidil when initiating LDOM. Six patients experienced “dread shed” when initiating LDOM, 2 of whom overlapped therapies. We did not find that overlapping therapies had a significant impact on decreasing rates of “dread shed”. Limitations: Limitations include retrospective design, sample size, and subjective patient-reported assessment of hair shedding. Conclusions: A total of 5.2% of patients experienced dread shed, which is lower than previously reported in literature. Maintaining topical minoxidil during LDOM initiation does not significantly impact “dread shed”. This remains a significant side effect deserving of further research.

Objective Methods Results Conclusions This study was designed to evaluate the safety and efficacy of injections of concentrated growth factors (CGF) for hair growth promotion in androgenetic alopecia (AGA) patients.A retrospective review of AGA patients treated with injections of CGF at our center from October 2021 to April 2023 was performed. A total of 3 injections were administered every 3–4 weeks apart, and evaluation were performed before the first injection and at 3 months, 6 months later. The outcomes were assessed by trichoscopy photomicrographs and the Global Aesthetic Improvement Scale (GAIS).At 3 months after the first injection, the hair density and hair growth ratio were significantly improved. Significant improvements were found in GAIS score by both patients and independent doctors and the hair growth promotion was sustained for 6 months after first treatment.According to this tiny single‐arm trial, the use of CGF injection may help AGA by increasing terminal hair density and hair density. No severe topical or systemic adverse events occurred during the treatment. [ABSTRACT FROM AUTHOR]

Androgenetic alopecia, the most common cause of hair loss affecting both men and women, is typically treated using pharmaceutical options, such as minoxidil and finasteride. While these medications work for many individuals, they are not suitable options for all. To date, the only non-pharmaceutical option that the United States Food and Drug Administration has cleared as a treatment for androgenetic alopecia is low-level laser therapy (LLLT). Numerous clinical trials utilizing LLLT devices of various types are available. However, a myriad of other physical treatments for this form of hair loss have been reported in the literature. This review evaluated the effectiveness of microneedling, pulsed electromagnetic field (PEMF) therapy, low-level laser therapy (LLLT), fractional laser therapy, and nonablative laser therapy for the treatment of androgenetic alopecia (AGA). It also explores the potential of multimodal treatments combining these physical therapies. The majority of evidence in the literature supports LLLT as a physical therapy for androgenetic alopecia. However, other physical treatments, such as nonablative laser treatments, and multimodal approaches, such as PEMF-LLLT, seem to have the potential to be equally or more promising and merit further exploration. [ABSTRACT FROM AUTHOR]

OBJECTIVE: Biotin has widespread popularity as a hair supplement. We sought to review the literature regarding biotin's efficacy as a hair supplement. METHODS: We conducted a literature search of PubMed for articles specifically studying the use of oral biotin for hair growth or quality. Case reports and case series were excluded. RESULTS: Three studies met our inclusion criteria. The first study was the highest quality, with a double-blind and placebo-controlled study design, but their results found no difference between the biotin and placebo groups for hair growth. The other two studies investigated specific patient populations (patients on isotretinoin and female patients post-sleeve gastrectomy). Both studies were susceptible to multiple potential biases and neither had striking results in favor of biotin. LIMITATIONS: Our review is limited by lack of available studies. CONCLUSION: Given the widespread popularity of biotin as a hair supplement, one would presume that this claim must be grounded in strong evidence; however, there is a large discrepancy between the public's perception of its efficacy and the scientific literature. The utility of biotin as a hair supplement is not supported by high-quality studies. [ABSTRACT FROM AUTHOR]

Background: One common problem in various patient groups is excessive hair loss on the head. One such group is people struggling with hypothyroidism. The market for preparations for hair growth and hair loss prevention includes betulin. Purpose: This pilot study investigated its effect on hair loss in hypothyroid patients. Study design: The study included a group of hypothyroid patients and a control group of people without hypothyroidism. Participants were randomly divided into a group taking placebo and betulin. Methods: Results were investigated using photographic assessment of hair, trichoscopy and subjective evaluation of participants. Conclusion: The study did not conclusively prove that betulin would contribute to the inhibition of hair loss or regrowth. [ABSTRACT FROM AUTHOR]

Although there are now two Food and Drug Administration (FDA)-approved treatments for severe alopecia areata (AA), many patients still resort to non-medical therapies and lifestyle modifications such as diet and nutrition. The goal of this study was to evaluate the sources and types of dietary and nutritional advice for patients with AA. We distributed a cross-sectional national survey using the National Alopecia Areata Foundation’s email list-serv between August 2022 and January 2023. Most respondents were White (76.3%), employed (58.3%) females (84.4%) with a mean age of 52 years. 163 (19.1%) respondents reported receiving diet and/or nutritional advice and 418 (49.5%) respondents reported searching for diet and/or nutritional advice to help with their AA; the most common source of advice was online. The most common dietary changes were the use of vitamins or supplements (30.6%), adherence to diets (23.2%), and the addition of specific foods (21.4%). 209 (50.2%) respondents reported no change in their disease and 197 (47.4%) respondents reported no change in how they felt about their disease compared to before they tried the change. Many AA patients search for or receive unsolicited dietary and nutritional advice and subsequently modify their behavior to manage their disease. However, the efficacy of these changes is unclear. Providers should be mindful of the sources through which patients obtain treatment information as well as the lifestyle changes patients make to counsel patients with evidence-based information. Further investigation is needed to better characterize the direct and indirect costs of dietary and nutritional modification in the treatment of AA. [ABSTRACT FROM AUTHOR]

Hair loss affects men and women of all ages. Myokines, which are mainly secreted by skeletal muscles during exercise, have numerous health benefits. VEGF, IGF‐1, FGF and irisin are reprehensive myokines. Although VEGF, IGF‐1 and FGF are positively associated with hair growth, few studies have researched the effects of irisin on hair growth. Here, we investigated whether irisin promotes hair growth using in vitro, ex vivo and in vivo patch assays, as well as mouse models. We show that irisin increases proliferation, alkaline phosphatase (ALP) activity and mitochondrial membrane potential in human dermal papilla cells (hDPCs). Irisin activated the Wnt/β‐catenin signalling pathway, thereby upregulating Wnt5a, Wnt10b and LEF‐1, which play an important role in hair growth. Moreover, irisin enhanced human hair shaft elongation. In vivo, patch assays revealed that irisin promotes the generation of new hair follicles, accelerates entry into the anagen phase, and significantly increases hair growth in C57BL/6 mice. However, XAV939, a Wnt/β‐catenin signalling inhibitor, suppressed the irisin‐mediated increase in hair shaft and hair growth. These results indicate that irisin increases hair growth via the Wnt/β‐catenin pathway and highlight its therapeutic potential in hair loss treatment. [ABSTRACT FROM AUTHOR]

Central centrifugal cicatricial alopecia (CCCA) nomenclature describes a typical clinical presentation of cicatricial hair loss that begins on the vertex scalp with progressive, symmetric, and centrifugal evolution. However, atypical presentations have been noted clinically by the authors and reported in the literature. We sought to characterize the distribution of hair loss in published cases of adult patients with CCCA. A 3-step search process was used to evaluate research articles in Cumulative Index to Nursing & Allied Health, EMBASE, Google Scholar, MEDLINE, Scopus, and Web of Science databases. Studies with scalp photography or description of hair loss distribution were included. Three researchers evaluated eligible studies for clinical subtypes. Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Review was used to report results. Ninety-nine studies consisting of 281 cases of CCCA were included. Hair loss distributions included variants of the classic presentation along with distinct subtypes such as patchy, occipital, parietal, frontal, temporal, and trichorrhexis. Studies had significant homogeneity, as the classic distribution of CCCA was commonly reported. Additionally, clinically diagnosed cases may have concurrent diagnoses, and numerous studies did not report trichoscopy findings. CCCA terminology may not always be reflective of clinical presentation. Understanding atypical presentations is essential to inform appropriate and targeted treatment. [ABSTRACT FROM AUTHOR]

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Background/Objectives: Chronic systemic inflammation is a risk factor that increases the development of atherosclerosis and predisposes to cardiovascular diseases (CVDs). The systemic inflammatory profile of alopecia areata (AA) regarding IFNγ and Th1 cytokine dysregulation has previously been described, suggesting an increased incidence of CVDs in this population. No previous studies investigated the possible relationship between atherosclerosis and AA by cardiovascular imaging techniques. To determine the prevalence, distribution and burden of subclinical atherosclerosis in AA. Methods: We conducted a case–control study in 62 participants, including 31 patients with severe AA (SALT > 75) and 31 healthy controls, matched for age, sex and body mass index (BMI). The participants underwent a detailed history assessment and were subjected to the measurement of weight, height, abdominal circumference and blood pressure. A fasting blood sample was also collected. Subclinical atherosclerosis was evaluated by ultrasonography of the bilateral femoral and carotid arteries. Results: The AA patients had an increased prevalence of subclinical atherosclerosis (54.7%) compared to the healthy controls (22.6%, p = 0.010). The prevalence of atheroma plaques was significantly higher in the carotid arteries (41.90% vs. 12.9%, p = 0.009), while no significant differences were found in femoral plaque prevalence. The AA patients with atherosclerotic plaques were older (p < 0.001) and had a longer time since AA diagnosis (p = 0.11) and increased serum levels of glycated hemoglobin (p = 0.029) and triglycerides (p = 0.009). In a regression analysis, duration of disease and neutrophil/lymphocyte ratio were the main predictors of atherosclerosis. Conclusions: AA patients have an increased prevalence of carotid subclinical atherosclerosis. The duration of AA, systemic inflammation and insulin resistance appear to play a role in the development of subclinical atherosclerosis in this population. [ABSTRACT FROM AUTHOR]

Therapeutic needs for hair loss are intended to find small interfering ribonucleic acid (siRNA) therapeutics for breakthrough. Since naked siRNA is restricted to meet a druggable target in clinic,, delivery systems are indispensable to overcome intrinsic and pathophysiological barriers, enhancing targetability and persistency to ensure safety, efficacy, and effectiveness. Diverse carriers repurposed from small molecules to siRNA can be systematically or locally employed in hair loss therapy, followed by the adoption of new compositions associated with structural and environmental modification. The siRNA delivery systems have been extensively studied via conjugation or nanoparticle formulation to improve their fate in vitro and in vivo. In this review, we introduce clinically tunable siRNA delivery systems for hair loss based on design principles, after analyzing clinical trials in hair loss and currently approved siRNA therapeutics. We further discuss a strategic research framework for optimized siRNA delivery in hair loss from the scientific perspective of clinical translation. [ABSTRACT FROM AUTHOR]

Frontal fibrosing alopecia (FFA) is a primary cicatricial alopecia characterized by hairline recession, pruritus, and facial papules (FP). Various therapies are used to stabilize disease activity and induce remission. However, FP of FFA is resistant to treatment in many cases. In this review, we searched the PubMed and Google Scholar databases to screen the published literature on treatment options for FP in the context of FFA. Overall, 12 studies were included in this review. Available literature suggests a noticeable improvement in resistant‐to‐treatment FP in FFA patients with oral isotretinoin. The available evidence is limited and is derived from retrospective studies and case reports/series. Systemic isotretinoin can be considered a promising therapeutic regimen for treating resistant‐to‐treatment FP of FFA patients. However, more extensive, well‐designed studies are necessary for confirmatory evidence. [ABSTRACT FROM AUTHOR]

OnabotulinumtoxinA (BT-A) is used in different medical fields for its beneficial effects. BT-A, a toxin originally produced by the bacterium Clostridium botulinum, is widely known for its ability to temporarily paralyze muscles by blocking the release of acetylcholine, a neurotransmitter involved in muscle contraction. The literature continually reports new hypotheses regarding potential applications that do not consider blockade of acetylcholine release at the neuromuscular junction as a common pathway. In this opinion article, it is our aim to investigate the different pathway targets of BT-A in different medical applications. First of all, the acetylcholine effect of BT-A is used to reduce wrinkles for cosmetic purposes, in the treatment of urological problems, excessive sweating, temporomandibular joint disorders, obesity, migraine, spasticity in neurological diseases, and in various cases of muscle overactivity such as cervical dystonia, blepharospasm, and essential head tremor. In another potential pathway, glutamate A, CGRP, and substance P are targeted for pain inhibition with BT-A application in conditions such as migraine, trigeminal neuralgia, neuropathic pain, and myofascial pain syndrome. On the other hand, as a mechanism different from acetylcholine and pain mediators, BT-A is used in the treatment of hair loss by increasing oxygenation and targeting transforming growth factor-beta 1 cells. In addition, the effect of BT-A on the apoptosis of cancer cells is also known and is being developed. The benefits of BT-A applied in different doses to different regions for different medical purposes are shown in literature studies, and it is also emphasized in those studies that repeating the applications increases the benefits in the long term. The use of BT-A continues to expand as researchers discover new potential therapeutic uses for this versatile toxin. [ABSTRACT FROM AUTHOR]

Hair is a biofilament with unique multi-dimensional values. In human, in addition to physiologic impacts, hair loss and hair related disorders can affect characteristic features, emotions, and social behaviors. Despite significant advancement, there is a dire need to explore alternative novel therapies with higher efficacy, less side effects and lower cost to promote hair growth to treat hair deficiency. Glucocorticoid-induced leucine zipper (GILZ) is a protein rapidly induced by glucocorticoids. Studies from our group and many others have suggested that a synthetic form of GILZ, TAT-GILZ, a fusion peptide of trans-activator of transcription and GILZ, can function as a potent regulator of inflammatory responses, re-establishing and maintaining the homeostasis. In this study, we investigate whether TAT-GILZ could promote and contribute to hair growth. For our pre-clinical model, we used 9–12 week-old male BALB/c and nude (athymic, nu/J) mice. We applied TAT-GILZ and/or TAT (vehicle) intradermally to depilated/hairless mice. Direct observation, histological examination, and Immunofluorescence imaging were used to assess the effects and compare different treatments. In addition, we tested two current treatment for hair loss/growth, finasteride and minoxidil, for optimal evaluation of TAT-GILZ in a comparative fashion. Our results showed, for the first time, that synthetic TAT-GILZ peptide accelerated hair growth on depilated dorsal skin of BALB/c and induced hair on the skin of athymic mice where hair growth was not expected. In addition, TAT-GILZ was able to enhance hair follicle stem cells and re-established the homeostasis by increasing counter inflammatory signals including higher regulatory T cells and glucocorticoid receptors. In conclusion, our novel findings suggest that reprofiling synthetic TAT-GILZ peptide could promote hair growth by increasing hair follicle stem cells and re-establishing homeostasis. [ABSTRACT FROM AUTHOR]

The minimal adverse-effect profile and positive clinical response of low-dose oral minoxidil (LDOM) have recently caused the drug to gain popularity for the treatment of hair disorders in adults. However, in the pediatric population, hesitancy still surrounds the use of oral minoxidil given the wide profile of potential side effects the drug offers. This review aims to characterize the safety and use of oral minoxidil in children for the treatment of all disorders to equip physicians with ample knowledge when prescribing oral minoxidil in the pediatric population. A total of 41 studies (19 case reports, 10 cohort studies, 7 retrospective chart reviews, and 5 case series) that reported data on 442 pediatric patients for whom oral minoxidil was used for treatment were included. Conditions for which treatment with minoxidil was described were hair disorders (83.9%, 371/442) and hypertension (11.3%, 50/442); accidental usage (4.8%, 21/442) was also noted in the literature and included in this review. This review is broken down by dosage and describes the safety and efficacy of oral minoxidil in pediatric patients aged 0 to 18 years old for the treatment of hair disorders. This review found that LDOM may represent a safe option for the treatment of hair disorders in children. This study also suggests moderate and high doses of oral minoxidil may not be safe for use in children. Additional studies are needed to further understand this drug's efficacy and safety in children. [ABSTRACT FROM AUTHOR]