Background:In the search for alternative agents to oral finasteride and topical minoxidil for the treatment of androgenetic alopecia (AGA), melatonin, a potent antioxidant and growth modulator, was identified as a promising candidate based on in vitro and in vivo studies.Materials and Methods:One pharmacodynamic study on topical application of melatonin and four clinical pre-post studies were performed in patients with androgenetic alopecia or general hair loss and evaluated by standardised questionnaires, TrichoScan, 60-second hair count test and hair pull test.Results:Five clinical studies showed positive effects of a topical melatonin solution in the treatment of AGA in men and women while showing good tolerability: (1) Pharmacodynamics under once-daily topical application in the evening showed no significant influence on endogenous serum melatonin levels. (2) An observational study involving 30 men and women showed a significant reduction in the degree of severity of alopecia after 30 and 90 days (P < 0.001) based on questionnaires completed by investigators and patients. (3) Using a digital software-supported epiluminescence technique (TrichoScan) in 35 men with AGA, after 3 and 6 months in 54.8% to 58.1% of the patients a significant increase of hair density of 29% and 41%, respectively was measured (M0: 123/cm2; M3: 159/cm2; M6: 173/cm2;) (P < 0,001). (4) In 60 men and women with hair loss, a significant reduction in hair loss was observed in women, while hair loss in men remained constant (P < 0.001). (5) In a large, 3-month, multi-center study with more than 1800 volunteers at 200 centers, the percentage of patients with a 2- to 3-fold positive hair-pull test decreased from 61.6% to 7.8%, while the percentage of patients with a negative hair-pull test increased from 12.2.% to 61.5% (P < 0.001). In addition, a decrease in seborrhea and seborrheic dermatitis of the scalp was observed.Conclusions:Since safety and tolerability in all of the studies was good, the topical application of a cosmetic melatonin solution can be considered as a treatment option in androgenetic alopecia.
A freeze-fracture study of affected and unaffected psoriatic skin has demonstrated the presence of marked modification of the plasma membrane in the psoriatic lesion. In the lower layers of the epidermis, an increase of membrane associated particles was observed in many keratinocytes, possibly representing the morphological intramembranous equivalent of changes in the outer cell membrane demonstrated with cytochemical techniques. Furthermore, in the malphighian layer, numerous gap junctions have been found, which may be interpreted as a phenomenon compensating the uncontrolled proliferation, and may represent a point of differentiation between cell proliferation in psoriasis and neoplasia. This technique confirmed the poor tendency to adhesion of keratinocytes in extrajunctional areas, which had already been shown by other morphological techniques.
MAS064D appears to be an effective and well tolerated cream for the treatment of mild to moderate SD of the face. Further clinical evaluation of MAS064D in SD is warranted.
The appearance of facial expression wrinkles is the result of chronic contraction of mimic muscles. Nifedipine is a dihydropyridinic calcium antagonist which blocks muscular cells' calcium channels, therefore inhibiting their contraction. We assumed that topical nifedipine was able to relax mimic muscular fibres in the same way, thus reducing the depth of wrinkles. We performed a clinical and experimental study, enrolling 64 female patients with periocular wrinkles. They applied a cream containing 0.5% nifedipine (Antrox; Bracco, Milan, Italy) once daily for 90 days. The length and depth of wrinkles (measured by a digital profilometer), moisturizing of periocular skin (measured by a corneometer), and trans-epidermal water loss (TEWL; measured by a tewameter), were evaluated. All parameters were measured before the beginning of treatment, and 45 and 90 days later. At the end of the study, topical nifedipine proved statistically effective in reducing the depth of wrinkles. No significant differences in the length of wrinkles were recorded. No significant changes were observed in moisturizing. TEWL gradually improved, although without statistical significance. On the basis of the results of this study, 0.5% nifedipine cream seems to be effective in reducing the depth of periocular wrinkles. Other studies are necessary in order to confirm these results.
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