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Turkish Journal of Medical Sciences Feb 2022Vitamins and minerals are thought to play an essential but not entirely clear role in developing, preventing, and treating nonscarring alopecia. Telogen effluvium,...
BACKGROUND
Vitamins and minerals are thought to play an essential but not entirely clear role in developing, preventing, and treating nonscarring alopecia. Telogen effluvium, androgenetic alopecia, and alopecia areata are the most common forms of nonscarring alopecias. We would like to present a different perspective on laboratory abnormalities in patients with nonscarring alopecia.
METHODS
A total of 467 patients (287 females, 180 males) were included retrospectively: One hundred and sixty patients in the telogen effluvium group, 101 patients in the androgenetic alopecia group, 99 patients in the alopecia areata group, and 107 patients in the hair loss group (patients who could not be diagnosed with any nonscarring alopecia and wanted to have an analysis due to the complaint of hair loss). Sociodemographic data, diagnostic distribution, and laboratory findings (hemoglobin, ferritin, vitamin B12, vitamin D, and TSH) were evaluated and compared.
RESULTS
The most common diagnosis was telogen effluvium in females and androgenetic alopecia in males. In women, hemoglobin (12.2% vs. 1.1%) and ferritin deficiencies (22.3% vs. 8.9%) were significantly higher than in men (p < 0.001, p < 0.001) Ferritin, hemoglobin, and vitamin B12 levels were significantly lower, and the number of patients with vitamin D, ferritin, hemoglobin and vitamin B12 deficiencies were significantly higher in the telogen effluvium group compared to the other groups. Laboratory abnormalities were detected least in the hair loss group.
Topics: Male; Humans; Female; Alopecia Areata; Scalp; Retrospective Studies; Alopecia; Ferritins; Hemoglobins; Vitamins; Vitamin D
PubMed: 34688244
DOI: 10.3906/sag-2106-28 -
Indian Journal of Dermatology,... 2016Androgenic alopecia has been associated with an increased risk of coronary heart disease in various studies. The relationship between androgenic alopecia and metabolic...
BACKGROUND
Androgenic alopecia has been associated with an increased risk of coronary heart disease in various studies. The relationship between androgenic alopecia and metabolic syndrome, a known risk factor for atherosclerotic cardiovascular disease, is still poorly understood.
AIM
To study the association between metabolic syndrome and early-onset androgenic alopecia.
METHODS
A hospital-based analytical cross-sectional study was done on men in the age group of 18-55 years. Eighty five clinically diagnosed cases with early-onset (<35 years) androgenic alopecia of Norwood grade III or above, and 85 controls without androgenic alopecia were included. Data collected included anthropometric measurements, arterial blood pressure and history of chronic diseases. Fasting blood and lipid profile were determined. Metabolic syndrome was diagnosed as per the new International Diabetes Federation criteria. Chi-square and Student's t-test were used for statistical analysis using Statistical Package for the Social Sciences (SPSS) version 17.00.
RESULTS
Metabolic syndrome was seen in 19 (22.4%) patients with androgenic alopecia and 8 (9.4%) controls (P = 0.021). Abdominal obesity, hypertension and lowered high-density lipoprotein were significantly higher in patients with androgenic alopecia versus their respective controls.
LIMITATIONS
The limitations of our study include small sample size in subgroups and the lack of evidence of a temporal relationship between metabolic syndrome and androgenic alopecia.
CONCLUSION
A higher prevalence of metabolic syndrome is seen in men with early-onset androgenic alopecia. Early screening for metabolic syndrome and its components is beneficial in patients with early-onset androgenic alopecia.
Topics: Adolescent; Adult; Alopecia; Cross-Sectional Studies; Humans; Male; Metabolic Syndrome; Middle Aged; Young Adult
PubMed: 27279298
DOI: 10.4103/0378-6323.174421 -
Acta Dermatovenerologica Alpina,... Mar 2005Androgenetic alopecia (AGA) is a common dermatological condition affecting both men and women. In the case of men, up to 30% over the age of 30 and more than 50% over... (Review)
Review
Androgenetic alopecia (AGA) is a common dermatological condition affecting both men and women. In the case of men, up to 30% over the age of 30 and more than 50% over the age of 50 are affected. AGA also affects women although clinical signs are usually milder and associated with diffuse thinning of the scalp hair. AGA invariably causes serious psychological problems especially in women. By far the most promising approaches to the treatment of baldness in men are drug therapies, such as topical minoxidil and finasteride administered systemically. Mild to moderate AGA in women can be treated with antiandrogens and/or topical minoxidil with good results in many cases.
Topics: 5-alpha Reductase Inhibitors; Alopecia; Enzyme Inhibitors; Female; Finasteride; Hair; Hair Follicle; Humans; Male; Minoxidil; Vasodilator Agents
PubMed: 15818439
DOI: No ID Found -
Skin Therapy Letter Jun 2012Androgenetic alopecia (AGA) may affect up to 70% of men and 40% of women at some point in their lifetime. While men typically present with a distinctive alopecia pattern... (Review)
Review
Androgenetic alopecia (AGA) may affect up to 70% of men and 40% of women at some point in their lifetime. While men typically present with a distinctive alopecia pattern involving hairline recession and vertex balding, women normally exhibit a diffuse hair thinning over the top of their scalps. The treatment standard in dermatology clinics continues to be minoxidil and finasteride with hair transplantation as a surgical option. Here we briefly review current therapeutic options and treatments under active investigation. Dutasteride and ketoconazole are also employed for AGA, while prostaglandin analogues latanoprost and bimatoprost are being investigated for their hair growth promoting potential. Laser treatment products available for home use and from cosmetic clinics are becoming popular. In the future, new cell mediated treatment approaches may be available for AGA. While there are a number of potential treatment options, good clinical trial data proving hair growth efficacy is limited.
Topics: Alopecia; Female; Finasteride; Hair; Humans; Laser Therapy; Male; Minoxidil; Sex Factors
PubMed: 22735503
DOI: No ID Found -
Indian Journal of Dermatology,... 2013Telogen effluvium (TE) is one of the most common causes of diffuse nonscarring hair loss. In its acute form, it generates a lot of anxiety in the patient, which can be... (Review)
Review
Telogen effluvium (TE) is one of the most common causes of diffuse nonscarring hair loss. In its acute form, it generates a lot of anxiety in the patient, which can be significantly allayed with a confident diagnosis. In its more chronic form, however, the hair loss may go unnoticed for long periods of time. Here in, the dermatologist's role in differentiating it from the more common patterned hair loss is significant. Differentiating TE from other causes of diffuse nonscarring hair loss can indeed be a daunting task and TE is often used as a waste basket diagnosis. A number of factors have been implicated in the causation of TE, however, clear evidence in their support is lacking. The role of stress as a causative factor as well as the result of hair loss needs to be adequately understood. This review aims at summarizing our current level of knowledge with respect to this very common cause of hair loss. An attempt is made to help the readers reliably differentiate TE from other causes of diffuse nonscarring hair loss. The possible causative factors, pathogenetic mechanisms, clinical presentation, and possible treatment options are discussed.
Topics: Acute Disease; Alopecia; Anemia, Iron-Deficiency; Diagnosis, Differential; Humans; Stress, Psychological
PubMed: 23974577
DOI: 10.4103/0378-6323.116731 -
Actas Dermo-sifiliograficas Apr 2015The diagnosis of disorders of the hair and scalp can generally be made on clinical grounds, but clinical signs are not always diagnostic and in some cases more invasive... (Review)
Review
The diagnosis of disorders of the hair and scalp can generally be made on clinical grounds, but clinical signs are not always diagnostic and in some cases more invasive techniques, such as a biopsy, may be necessary. This 2-part article is a detailed review of the histologic features of the main types of alopecia based on the traditional classification of these disorders into 2 major groups: scarring and nonscarring alopecias. Scarring alopecias are disorders in which the hair follicle is replaced by fibrous scar tissue, a process that leads to permanent hair loss. In nonscarring alopecias, the follicles are preserved and hair growth can resume when the cause of the problem is eliminated. In the first part of this review, we describe the histologic features of the main forms of nonscarring alopecia. Since a close clinical-pathological correlation is essential for making a correct histologic diagnosis of alopecia, we also include a brief description of the clinical features of the principal forms of this disorder.
Topics: Alopecia; Alopecia Areata; Beauty Culture; Biopsy; Hair; Hair Follicle; Humans; Microscopy; Stress, Mechanical; Syphilis; Trichotillomania
PubMed: 25444580
DOI: 10.1016/j.ad.2014.07.006 -
Indian Journal of Dermatology,... 2018Hair disorders are common in clinical practice and depending upon social and ethnic norms, it can cause significant psychosocial distress. Hair growth, cycling and... (Review)
Review
Hair disorders are common in clinical practice and depending upon social and ethnic norms, it can cause significant psychosocial distress. Hair growth, cycling and density are regulated by many endogenous factors, mainly circulating hormones. Thus, diseases affecting the endocrine system can cause varied changes in physiological hair growth and cycling. Diagnosis and treatment of these disorders require a multidisciplinary approach involving a dermatologist, gynecologist and an endocrinologist. In this review, we briefly discuss the influence of hormones on the hair cycle and hair changes in various endocrine disorders.
Topics: Alopecia; Endocrine System Diseases; Female; Hair Diseases; Hirsutism; Humans; Hypertrichosis; Male
PubMed: 30027913
DOI: 10.4103/ijdvl.IJDVL_671_17 -
Indian Journal of Dermatology,... 2023Background Men with early-onset androgenetic alopecia (AGA) often have an abnormal hormonal milieu. Objective To ascertain the clinico-phenotypic characteristics and the...
Background Men with early-onset androgenetic alopecia (AGA) often have an abnormal hormonal milieu. Objective To ascertain the clinico-phenotypic characteristics and the prevalence of hormonal and metabolic changes in men with early-onset AGA. Methods Consecutive male patients less than 30 years of age with a Norwood-Hamilton grade ≥3 AGA were recruited in this comparative cross-sectional study. After endocrine evaluation they were classified into two groups, that is, Group A consisting of subjects with an altered hormonal profile and Group B with normal hormonal profiles. The groups were assessed for differences in disease phenotype and severity (Norwood-Hamilton grade), insulin resistance and parameters of metabolic syndrome (ATP III guidelines). Results Altered hormonal profiles were seen in 34 of the 100 subjects with AGA, while insulin resistance and metabolic syndrome were noted in 44 and 26 respectively. Altered hormonal profiles were significantly associated with insulin resistance and severe alopecia (grade 4 and above Hamilton-Norwood Scale). Insulin resistant Group A patients had a significantly higher prevalence of severe alopecia (>grade 4) (P = 0.0036). The prevalence of metabolic syndrome was similar in both groups. Limitation The cross sectional study design was a drawback of this study. Further, a control arm without AGA was not included and the sample size of 100 was selected arbitrarily. Conclusion An altered hormonal profile and insulin resistance was noted in a third of the males with early-onset AGA. Subjects with altered hormonal profiles had a higher prevalence of insulin resistance and were likely to have severe grades of AGA.
Topics: Male; Humans; Metabolic Syndrome; Insulin Resistance; Cross-Sectional Studies; Alopecia; Insulins
PubMed: 36688892
DOI: 10.25259/IJDVL_949_2021 -
Expert Opinion on Drug Discovery Mar 2015Hair loss or alopecia affects the majority of the population at some time in their life, and increasingly, sufferers are demanding treatment. Three main types of... (Review)
Review
INTRODUCTION
Hair loss or alopecia affects the majority of the population at some time in their life, and increasingly, sufferers are demanding treatment. Three main types of alopecia (androgenic [AGA], areata [AA] and chemotherapy-induced [CIA]) are very different, and have their own laboratory models and separate drug-discovery efforts.
AREAS COVERED
In this article, the authors review the biology of hair, hair follicle (HF) cycling, stem cells and signaling pathways. AGA, due to dihydrotesterone, is treated by 5-α reductase inhibitors, androgen receptor blockers and ATP-sensitive potassium channel-openers. AA, which involves attack by CD8(+)NK group 2D-positive (NKG2D(+)) T cells, is treated with immunosuppressives, biologics and JAK inhibitors. Meanwhile, CIA is treated by apoptosis inhibitors, cytokines and topical immunotherapy.
EXPERT OPINION
The desire to treat alopecia with an easy topical preparation is expected to grow with time, particularly with an increasing aging population. The discovery of epidermal stem cells in the HF has given new life to the search for a cure for baldness. Drug discovery efforts are being increasingly centered on these stem cells, boosting the hair cycle and reversing miniaturization of HF. Better understanding of the molecular mechanisms underlying the immune attack in AA will yield new drugs. New discoveries in HF neogenesis and low-level light therapy will undoubtedly have a role to play.
Topics: Administration, Topical; Alopecia; Animals; Drug Discovery; Hair; Hair Follicle; Humans; Immunotherapy; Pharmaceutical Preparations; Stem Cells
PubMed: 25662177
DOI: 10.1517/17460441.2015.1009892 -
Indian Journal of Dermatology,... 2013Female pattern hair loss (FPHL) is a common cause of hair loss in women characterized by diffuse reduction in hair density over the crown and frontal scalp with... (Review)
Review
Female pattern hair loss (FPHL) is a common cause of hair loss in women characterized by diffuse reduction in hair density over the crown and frontal scalp with retention of the frontal hairline. Its prevalence increases with advancing age and is associated with significant psychological morbidity. The pathophysiology of FPHL is still not completely understood and seems to be multifactorial. Although androgens have been implicated, the involvement of androgen-independent mechanisms is evident from frequent lack of clinical or biochemical markers of hyperandrogenism in affected women. The role of genetic polymorphisms involving the androgen and estrogen receptors is being increasingly recognized in its causation and predicting treatment response to anti-androgens. There are different clinical patterns and classifications of FPHL, knowledge of which facilitates patient management and research. Chronic telogen effluvium remains as the most important differential diagnosis. Thorough history, clinical examination, and evaluation are essential to confirm diagnosis. Patients with clinical signs of androgen excess require assessment of biochemical parameters and imaging studies. It is prudent to screen the patients for metabolic syndrome and cardiovascular risk factors. The treatment comprises medical and/or surgical modalities. Medical treatment should be initiated early as it effectively arrests hair loss progression rather than stimulating regrowth. Minoxidil continues to be the first line therapy whereas anti-androgens form the second line of treatment. The progressive nature of FPHL mandates long-term treatment for sustained effect. Medical therapy may be supplemented with cosmetic concealment in those desirous of greater hair density. Surgery may be worthwhile in some carefully selected patients.
Topics: 5-alpha Reductase Inhibitors; Alopecia; Androgen Antagonists; Female; Finasteride; Humans; Minoxidil; Vasodilator Agents
PubMed: 23974580
DOI: 10.4103/0378-6323.116732