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Facial Plastic Surgery Clinics of North... May 2023Hair loss is a common problem among men and women. Hair replacement surgery (HRS) has become increasingly popular as technological advancements have been made producing... (Review)
Review
Hair loss is a common problem among men and women. Hair replacement surgery (HRS) has become increasingly popular as technological advancements have been made producing remarkably natural results when performed by a skilled surgeon. Although complications from HRS are low compared with other esthetic surgeries, they can still occur even with the best-trained and qualified surgeon or staff. The process of hair restoration can be a long road for some patients and active patient participation and education is key for successful results. In this article, we seek to discuss the surgical risks of HRS and discuss methods to prevent them in your practice.
Topics: Male; Humans; Female; Hair Follicle; Hair; Alopecia; Surgery, Plastic
PubMed: 37001929
DOI: 10.1016/j.fsc.2023.01.009 -
Journal of Cosmetic Dermatology Jun 2022Trichoscopy in dermatology has opened up the new concept in overcoming the optical challenge faced clinically. It reveals the diagnostic details to the depth of... (Review)
Review
Trichoscopy in dermatology has opened up the new concept in overcoming the optical challenge faced clinically. It reveals the diagnostic details to the depth of superficial dermis, and thereby increasing the clinician's diagnostic accuracy and the level of confidence. The importance of trichoscopy in cicatricial alopecia is very evident in the current scenario for its precise diagnosis. The clinical picture in delineating lichen planopilaris (LPP) and frontal fibrosing alopecia (FFA) from each other and also from other close mimickers such as androgenetic alopecia, alopecia areata, female patterned hair loss, and other cicatricial alopecia is bewildered due to its varied presentation and co-existence with the above disease. The indecisive comparative findings on histopathology make the situation even more perplexed. In this article, we have reviewed the characteristic trichoscopy patterns that can differentiate LPP and FFA and from their close mimickers.
Topics: Alopecia; Alopecia Areata; Cicatrix; Female; Humans; Lichen Planus
PubMed: 34661965
DOI: 10.1111/jocd.14457 -
Journal of Cosmetic Dermatology Mar 2024Topical minoxidil is the recommended first-line pharmacologic treatment for male and female pattern hair loss. However, low-dose oral minoxidil has been used off-label... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
Topical minoxidil is the recommended first-line pharmacologic treatment for male and female pattern hair loss. However, low-dose oral minoxidil has been used off-label with good clinical efficacy and safety.
AIM
To compare the effectiveness and safety of topical minoxidil as a first-choice treatment of androgenetic alopecia versus 1 mg daily oral minoxidil.
METHOD
Sixty-five AGA patients were randomly allocated to receive either 5% topical solution or 1 mg/day oral minoxidil for 6 months. Treatment efficacy was evaluated by measuring hair diameter, photographic assessment, and patient self-assessment questionnaires. The safety of treatment was checked through history taking and physical examination.
RESULTS
Both topical and oral minoxidil groups showed significant improvement in hair diameter after 6 months of treatment (p < 0.001). However, there was no significant difference between the two groups. The photographic assessment demonstrated a significant improvement in hair density in the topical minoxidil group in all marked points located at 12 cm (p = 0.025), 16 cm (p = 0.034), and 24 cm (p = 0.014) distance from the glabella but not in the oral minoxidil group. Nevertheless, the difference between the two groups was not significant. In each group, over 60% of patients expressed satisfaction with their treatments, and no significant difference was detected between the two groups.
CONCLUSION
Although topical minoxidil has a better overall therapeutic effect than 1 mg oral minoxidil, the difference between the two groups was not significant. Therefore, 1 mg oral minoxidil may be as effective and safe as standard topical minoxidil in female and male pattern hair loss.
Topics: Humans; Female; Male; Minoxidil; Alopecia; Treatment Outcome; Hair; Photography
PubMed: 38031516
DOI: 10.1111/jocd.16086 -
Journal of Drugs in Dermatology : JDD Jul 2023Alopecia is one of the most common dermatologic conditions affecting black patients, with a significantly negative impact on quality of life.1,2 Timely and accurate...
Alopecia is one of the most common dermatologic conditions affecting black patients, with a significantly negative impact on quality of life.1,2 Timely and accurate diagnosis is therefore critical in order to reverse or halt progression of disease.3 Unfortunately, lack of representation of skin of color (SOC) patients in the current literature may contribute to misdiagnosis as providers may be unfamiliar with the clinical spectrum of alopecia presenting in darker scalps.4 Some scarring alopecia subtypes such as Central Centrifugal Cicatricial Alopecia (CCCA) are more prevalent in certain racial groups. However, focusing solely on patient demographics and gross clinical findings may obscure accurate diagnoses. To distinguish alopecia findings in Black patients, a dedicated approach using a combination of clinical exam findings and patient history, along with trichoscopy and biopsy, is essential to prevent misdiagnosis and improve clinical and diagnostic outcomes. We present three cases of alopecia in patients of color which the initial suspected clinical diagnosis did not correspond with trichoscopic and biopsy results. We challenge clinicians to reexamine their biases and fully evaluate patients of color with alopecia. An examination should include a thorough history, clinical examination, trichoscopy, and potentially a biopsy, particularly when findings do not correlate. Our cases highlight the challenges and disparities that exist in diagnosis of alopecia in Black patients. We emphasize the need for continued research regarding alopecia in skin of color and the importance of a complete workup for alopecia to improve diagnostic outcomes.Balazic E, Axler E, Nwankwo C, et al. Minimizing bias in alopecia diagnosis in skin of color patients. J Drugs Dermatol. 2023;22(7):703-705. doi:10.36849/JDD.7117.  .
Topics: Humans; Alopecia; Quality of Life; Scalp; Black or African American; Bias
PubMed: 37410034
DOI: 10.36849/JDD.7117 -
Facial Plastic Surgery Clinics of North... May 2020Hair restoration in women involves mastering both the medical and the surgical treatment. Preoperatively, women should be thoroughly evaluated for biochemical causes of... (Review)
Review
Hair restoration in women involves mastering both the medical and the surgical treatment. Preoperatively, women should be thoroughly evaluated for biochemical causes of hair loss along with a complete history and physical examination taken. The physician must recognize the clinical presentation of scarring alopecias and maintain a low threshold for biopsy to rule out this condition. Postoperative hair shock loss is a common feature following hair transplant in women, and the surgeon should understand the preoperative counseling and preventative measures needed, the intraoperative methods to reduce the incidence, and the postoperative strategies to handle the situation.
Topics: Alopecia; Biopsy; Combined Modality Therapy; Eyebrows; Female; Hair; Humans; Preoperative Care; Skin; Skin Transplantation; Tissue and Organ Harvesting
PubMed: 32312508
DOI: 10.1016/j.fsc.2020.01.007 -
Dermatologic Therapy Jul 2021The coronavirus disease 2019 (COVID-19) has become the most emerging health issue globally. A prompt investigation regarding disease management and treatment is crucial... (Review)
Review
The coronavirus disease 2019 (COVID-19) has become the most emerging health issue globally. A prompt investigation regarding disease management and treatment is crucial for decreasing the burden of the disease. Many explorations and hypotheses have been posed, but the definite treatment has not been determined for COVID-19. Recent studies described a substantial prevalence of COVID-19 and also a higher rate of morbidity and mortality in men afflicted with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. The gender-related discordance in COVID-19 infection may be due to hormonal differences, socioeconomic factors, genetic susceptibility, gender-related comorbidities, and habits like alcohol consumption. On the other hand, several studies proposed that androgens could improve the immune system and have a protective role in COVID-19, and decreased levels of androgens might be associated with unsatisfactory outcomes. In the field of dermatology, androgenetic alopecia (AGA) is correlated with a hyperandrogenic state and may be related to COVID-19 severity. Furthermore, recent research has assessed the plausible association of AGA and COVID-19. In this review, we investigate all evidence on AGA and its relationship with COVID-19, including the possible role of androgens in COVID-19 severity and outcomes as well as candidate androgen-related drugs for the treatment of COVID-19.
Topics: Alopecia; Androgens; COVID-19; Genetic Predisposition to Disease; Humans; Male; SARS-CoV-2
PubMed: 34033224
DOI: 10.1111/dth.15004 -
The Journal of Investigative Dermatology Sep 2023Because hair follicles (HFs) are highly sensitive to ionizing radiation, radiotherapy-induced alopecia (RIA) is a core adverse effect of oncological radiotherapy. Yet,... (Review)
Review
Because hair follicles (HFs) are highly sensitive to ionizing radiation, radiotherapy-induced alopecia (RIA) is a core adverse effect of oncological radiotherapy. Yet, effective RIA-preventive therapy is unavailable because the underlying pathobiology remains underinvestigated. Aiming to revitalize interest in pathomechanism-tailored RIA management, we describe the clinical RIA spectrum (transient, persistent, progressive alopecia) and our current understanding of RIA pathobiology as an excellent model for studying principles of human organ and stem cell repair, regeneration, and loss. We explain that HFs respond to radiotherapy through two distinct pathways (dystrophic anagen or catagen) and why this makes RIA management so challenging. We discuss the responses of different HF cell populations and extrafollicular cells to radiation, their roles in HF repair and regeneration, and how they might contribute to HF miniaturization or even loss in persistent RIA. Finally, we highlight the potential of targeting p53-, Wnt-, mTOR-, prostaglandin E-, FGF7-, peroxisome proliferator-activated receptor-γ-, and melatonin-associated pathways in future RIA management.
Topics: Humans; Hair Follicle; Alopecia; Drug-Related Side Effects and Adverse Reactions; Stem Cells
PubMed: 37294241
DOI: 10.1016/j.jid.2023.02.041 -
Current Opinion in Pediatrics Aug 2021The current review will address the different causes of localized hair loss in infancy. The data presented here will provide clinicians with the latest understanding of... (Review)
Review
PURPOSE OF REVIEW
The current review will address the different causes of localized hair loss in infancy. The data presented here will provide clinicians with the latest understanding of different disorders leading to localized hair loss and will provide recommendations for further management of infants who present with alopecia.
RECENT FINDINGS
Localized hair loss in infancy is common, but its underlying causes vary greatly. Alopecia in infants can be categorized into congenital, genetic, inflammatory, mechanical, and physiologic causes. Decisions regarding further management are complex, as they often involve not only cosmetic concerns, but also work-up of possible systemic medical issues related to hair loss.
SUMMARY
Clinicians must be able to distinguish between the different causes of infantile hair loss so that appropriate work-up and further management can be pursued. Factors such as physical appearance, timing of presentation, dermoscopic exam, histopathology, and associated systemic features can help lead clinicians to the correct diagnosis in the case of an infant with localized alopecia.
Topics: Alopecia; Humans; Infant
PubMed: 34016809
DOI: 10.1097/MOP.0000000000001025 -
Journal of the American Academy of... Jun 2024There is no established standard of care for treating central centrifugal cicatricial alopecia (CCCA), and treatment approaches vary widely.
BACKGROUND
There is no established standard of care for treating central centrifugal cicatricial alopecia (CCCA), and treatment approaches vary widely.
OBJECTIVE
To develop consensus statements regarding the use of various pharmacological therapies in treating adults with CCCA.
METHODS
We invited 27 dermatologists with expertise in hair and scalp disorders to participate in a 3-round modified Delphi study between January and March 2023. Statements met strong consensus if 75% of respondents agreed or disagreed. Statements met moderate consensus if 55% or more but less than 75% agreed or disagreed.
RESULTS
In round 1, 5 of 33 (15.2%) statements met strong consensus, followed by 9 of 28 (32.1%) in round 2. After the final round 3 meeting, strong consensus was reached for 20 of 70 (28.6%) overall statements. Two statements achieved moderate consensus.
LIMITATIONS
This study included only English-speaking, US-based dermatologists and did not consider nonpharmacological therapies.
CONCLUSION
Despite varying opinions among dermatologists, consensus was reached for several statements to help clinicians manage CCCA. We also highlight areas that lack expert consensus with the goal of advancing research and therapeutic options for CCCA.
Topics: Humans; Alopecia; Delphi Technique; Consensus; Cicatrix; Dermatologists
PubMed: 38341148
DOI: 10.1016/j.jaad.2023.12.073 -
Dermatologic Clinics Jul 2021Hair loss affects millions of people worldwide and can have devastating effects on an individual's psychoemotional well-being. Today hair restoration technologies... (Review)
Review
Hair loss affects millions of people worldwide and can have devastating effects on an individual's psychoemotional well-being. Today hair restoration technologies through hair transplantation have advanced with the use of robots and follicular unit extraction and grafting that it is possible to offer to patient's excellent clinical results. Adjuvant modalities such as platelet-rich plasma injections, lasers, and stem cells can further enhance the durability, health, and appearance of hair transplants.
Topics: Alopecia; Female; Hair; Humans; Skin Transplantation
PubMed: 34053590
DOI: 10.1016/j.det.2021.03.002