Background: Throughout history, wigs have often had a relevant cultural and social importance with correlations to wealth and position of power. Wigs help minimize the psychological consequences of different types of hair loss. They may reduce potential experiences of stigmatization, and improve social confidence and quality of life, besides enhancing self-esteem and social adjustment. In dermatology, wigs may have a positive impact on the global treatment of patients suffering from alopecia as they offer an immediate and efficient cosmetic result. However, the medical literature on wigs is not extensive. Aims: This review aims to discuss synthetic wigs and nonsynthetic custom-made hair systems, highlighting different hair fibers, foundations, various types of prosthesis, and the most common methods of attachments used to make wigs. Methods: The terms "wigs", "hair" AND "camouflage", "alopecia" AND "camouflage", and "hair prosthesis" were used to perform a literature search in MEDLINE through PubMed until April 8th, 2020. The search was limited to English-language peer-reviewed journal articles about humans, and it included only nonsurgical alternatives to camouflage alopecia. Conclusions: This article will help physicians, especially those who care for patients with hair loss, to provide appropriate advice for their patients about the wide variety and peculiarities of wigs and hairpieces currently available.
Pain evaluation during local injections is a complex process. Injections cause patient's distress, especially when the target is a sensitive area such as scalp. Nonpharmacological methods as vibration before and during the procedure have been used to reduce pain. Mesotherapy has become a popular nonsurgical procedure for nonscarring alopecia, such as androgenetic alopecia (AGA) and alopecia areata (AA). Vibration has been successfully used in dermatological procedures, pediatrics, and dentistry. No study was found on vibration anesthesia during scalp mesotherapy. To analyze the effect of a vibration anesthetic device (VAD) during scalp mesotherapy on the patients’ comfort.This is a randomized split‐scalp study; thirty patients received mesotherapy with or without VAD on half of their scalp. Numerical rating scale (NRS) was used to measure self‐reported pain. To test difference in means and medians in comparing device use and by treatment (AGA or AA), Student's t tests and Wilcoxon signed rank tests were used. Overall mean pain score on the no vibration‐assisted side was 8.0 ± 1.0 while pain score for the vibration side was 2.3 ± 1.5, for AGA (P < .001) and 7.4 ± 1.2 and 2.1 ± 1.3, respectively, for AA (P < .001). Findings were similar for medians. No complications were found following procedure. To the best of our knowledge, this is the first study analyzing the effect of VAD in patients undergoing scalp mesotherapy. The VAD technique was found to be safe, effective, simple, and suitable for scalp procedures.
Hair represents an important aspect of human individuality. The possibility of having an easy to handle hairstyle and changing it from time to time promoted an increasing search for chemical hair transformations, including permanent wavings (PW). PW is the chemical process used to convert straight into curly hair. Significant findings have been made in this field within the last three decades. In the past few years, PW has come back up to date, helping to define curls in wavy and curly hair and to create waves in straight hair. “Afro permanent” and “Beach waves” are some popular names for these new uses of PW. The primary safety concerns for PW generally arise from misuse or failure to comply with the product's usage instructions. Skin irritation, hair breakage, oral toxicity, sensitization, and scarring alopecia have been reported in the literature. Therefore, dermatologists need to understand well this matter to properly advise patients on how to get the best outcome without hazards. This review aims to discuss the main types of reducing agents used, the different techniques, the consequences to hair shafts, and the most important patients’ recommendations on this topic.
Androgenetic alopecia (AGA) is the most common form of non-cicatricial alopecia in both genders. Currently approved drugs for the treatment of AGA include topical minoxidil in women and topical minoxidil and oral finasteride in men. Other routes of administration of approved drugs have been proposed to enhance therapeutic results for AGA, including intradermal injections, known as mesotherapy. Mesotherapy-or intradermotherapy-is a non-surgical procedure, consisting of multiple intradermal injections of pharmacological substances diluted in small doses. Although minimally invasive, mesotherapy may be related to mild side effects like burning, erythema and headaches, as a few reports indicate. Among the most serious adverse events, subcutaneous necrosis, scalp abscesses, and angioedema have been described. This multicenter retrospective, descriptive study aims to report 14 cases of frontal edema resulting from mesotherapy for AGA treatment. In our patients, the edema mostly arose in the first two sessions and lasted between 1 and 4 days, with a favorable outcome after a local cold compress. In all our cases of edema, lidocaine was the anesthetic used. Minoxidil and dutasteride might also play a role as causative agents. To the best of our knowledge, this is the largest case series focused on frontal edema after mesotherapy for AGA and gives clinicians helpful information for when performing this technique. Dermatologists should already consider and be conscious of this possible mesotherapy side effect, as it can be remarkably disruptive to affected patients.
Cicatricial alopecia (CA) encompasses a heterogeneous group of conditions characterized by the permanent destruction of hair follicles (HF), and irreversible hair loss. CA is classified in primary cicatricial alopecia (PCA) and secondary cicatricial alopecia (SCA). PCA includes multiple inflammatory diseases that primarily affect and destroy the HF. SCA is the follicular destruction caused by infections, neoplastic conditions, burns, or trauma. 1 Although SCA is a benign condition, permanent hair loss can be devastating to the patient's self-esteem. 2 Hair restoration surgery (HRS) has been used as an option for androgenetic alopecia (AGA) and stable PCA with favorable outcomes. 3,4 However, little is known about HRS for SCA, especially to affected areas other than the scalp. This paper presents three uncommon successful cases of SCA treated with HRS.A 35-year-old Caucasian man presented with SCA on the left eyebrow after a pressure injury due to prolonged hospitalization in the prone position. Follicular unit excision (FUE) was performed to harvest follicular units (FU) from the left parietal area. A total of 120 FU of one and two hairs were implanted on the eyebrow, using a 0.65 mm
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