Background:Female pattern hair loss (FPHL) is a very common problem in women. The underlying pathophysiology remains unclear, and there are no universally agreed treatment guidelines.Objective:We explored the clinical features, relevant medical and family history, laboratory evaluation, and treatment and compliance of 210 patients with FPHL.Methods:Data analysis from case notes was performed on 210 patients with a diagnosis of FPHL seen from January 2011 to December 2011.Results:The youngest individual was 8 years old and the oldest was 86 years old. Nearly, 85% of the patients had a family history of androgenetic alopecia. Hypothyroidism and hypertension are the most common medical problems. Telogen effluvium (TE) is the most common concurrent hair loss condition. Only 38% of the patients were found to have normal Vitamin D level, 71% had ferritin level above 30 μg/L, and 85% had normal zinc level at the first consultation. Fifty-nine percent of the patients failed to attend any follow-up appointments.Limitations:One of the limitations of this study is its retrospective nature. Moreover, the severity of FPHL in terms of Ludwig score was not routinely documented in the medical charts.Conclusion:History of TE, hypothyroidism and hypertension, and low serum Vitamin D is common in our patients with FPHL.
Background
Platelet‐rich plasma (PRP), processed from autologous peripheral blood, is used to treat androgenetic alopecia (AGA).
Objective
To determine the efficacy of PRP for hair growth promotion in AGA patients in a randomized, blinded, placebo‐controlled, pilot clinical trial (NCT02074943).
Methods
The efficacy of an 8 week, five session, PRP treatment course was determined by measuring hair density and hair caliber changes in 10 AGA affected patients. For each PRP sample, the concentrations of selected growth factors were determined using a multiplex assay system. The clinical results were then correlated with the growth factor concentrations in PRP.
Results
At 16 weeks, 8 weeks after the last PRP injection, treated areas exhibited increased mean hair density (+12.76%) over baseline compared to placebo (+0.99%). Mean hair caliber decreased in both treated and placebo regions (−16.22% and −19.46%, respectively). Serial analysis of PRP significant variability in concentrations between patients. Overall, there was a positive correlation between GDNF concentration and hair density (P = .004). Trends, though not statistically significant, were also observed for FGF2 and VEGF.
Limitations
Small sample size and lack of comparative cohorts receiving protocol variations limit confidence in the study data.
Conclusions
This small pilot clinical trial suggests PRP treatment may be beneficial for AGA. However, the variable hair growth responses between patients indicate there is a significant opportunity to improve PRP therapy protocols for hair growth promotion. The variability in growth factor concentration in PRP suggests standardization of growth factors postprocessing might improve hair growth responses.
Scarring or cicatricial alopecias represent a group of poorly understood and uncommon disorders that cause permanent hair loss. Scarring alopecias are regarded as trichologic emergencies as hair loss is irreversible, rapidly progressive, and can be disfiguring. Patients could experience tremendous anxiety, low self-esteem, and extreme psychosocial stress. Hence, prompt diagnosis and aggressive treatment are essential in the management of active primary scarring alopecias as early intervention may slow down or prevent further hair loss. This article will review different types of primary scarring alopecia in hopes of helping clinicians accurately diagnose these conditions as well as provide appropriate treatment.
QuestionHow effective is intralesional injection of triamcinolone acetonide compared with topical treatments in inducing and maintaining hair growth in patients with alopecia areata?
Clinical scenarioA 23-year-old man with an 18-month history of patch-type alopecia areata (AA) of his scalp has failed to respond to topical clobetasol propionate and tacrolimus ointments. He enquired about intralesional steroid injections and wondered if this would be helpful in the treatment of his condition, which is causing a lot of concern and having a considerable psychological impact to the extent of preventing an active social life owing to embarrassment and low self-esteem.
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