Female Pattern Hair Loss: a clinical and pathophysiological review

Ramos, Paulo Müller; Miot, Hélio Amante

doi:10.1590/abd1806-4841.20153370

Cited by 130 publications

(150 citation statements)

References 121 publications

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“…6,15,17 This should not be underestimated, and psychological support could be helpful for these patients. Their level of anxiety and depression was also higher than for the controls.…”

Section: Discussionmentioning

confidence: 99%

‘The psychosocial burden of alopecia areata and androgenetica’: a cross‐sectional multicentre study among dermatological out‐patients in 13 European countries

Titeca

Goudetsidis

Francq

et al. 2019

Acad Dermatol Venereol

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Background Hair diseases play an important burden on patients’ lives, causing significant emotional and psychosocial distress. However, the impairment due to different hair conditions, such as alopecia areata (AA) and androgenetic alopecia (AGA), has rarely been compared. Objective The aim of this study was to assess the psychological burden of subgroups of patients with different hair diseases and to compare them to a healthy population. Methods In this study, we analysed a subgroup of patients with hair diseases from patients of a large multicentre study including 3635 dermatological patients and 1359 controls from 13 European countries. In the subgroup of patients with hair diseases, we analysed the socio‐demographic characteristics, the stress level, and the impact of hair diseases on quality of life (QoL), anxiety, and depression and we compared them among patients with AA, AGA and healthy controls. Results The study population included 115 patients (77% women, 23% men) with hair diseases, 37 of whom with AA and 20 with AGA. Patients with hair diseases had a lower education level than healthy controls (medium educational level: 43% vs. 28%). Overall, 41% of the patients reported stressful life events during the last 6 months compared with 31% of the controls. Patients with the same age, sex, depression level and comorbidities had a worse QoL when suffering from AA than from AGA (Mean Dermatology Life Quality Index score: 5.8 vs. 2.5). Conclusion Patients with hair diseases are more anxious, depressed and have a lower QoL than controls.

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“…6,15,17 This should not be underestimated, and psychological support could be helpful for these patients. Their level of anxiety and depression was also higher than for the controls.…”

Section: Discussionmentioning

confidence: 99%

‘The psychosocial burden of alopecia areata and androgenetica’: a cross‐sectional multicentre study among dermatological out‐patients in 13 European countries

Titeca

Goudetsidis

Francq

et al. 2019

Acad Dermatol Venereol

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“…Statistic associations were noticed among an increased risk for AGA and high body mass index, high fasting glucose, earlier puberty, 3 or fewer childbirths, oral contraceptive use for 1 year or longer and ultraviolet exposure more than 16 hr per week. Some factors such as sun radiation, pollutants, skin, and intrafollicular microbiota may be responsible, in part, for the micro inflammation in the upper part of the follicle in FPHL (Ramos & Miot, 2015). The UV radiation photo-activation of porphyrins produced by Propionibacterium sp.…”

Section: The Role Of Environmental and Lifestyle Factorsmentioning

confidence: 99%

Physiopathology and current treatments of androgenetic alopecia: Going beyond androgens and anti‐androgens

Katzer

Leite²,

Beck

et al. 2019

Dermatologic Therapy

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Androgenetic alopecia (AGA) is the most diagnosed hair loss dysfunction. Its physiopathology comprises a genetic predisposition affording an exacerbated response of the hair follicles cells to androgens aggravated by scalp inflammation and extrinsic factors. This paper presents a review of the mechanisms and extrinsic factors involved in the AGA physiopathology as well as its conventional and emerging treatments. The research focused on reports regarding AGA physiopathology and treatments published between January 2001 and July 2019 in medical and related journals. The most used medical treatments for AGA—minoxidil and finasteride—present non satisfactory results in some cases. Currently, the low‐level laser therapy is recognized as a safe and effective treatment for AGA. Some minimally invasive techniques—mesotherapy, microneedling, carboxytherapy, and platelet‐rich plasma—are also used to stimulate hair growth. Pharmaceutical substances with mechanisms differing from the anti‐androgen activity are under current investigation and many of them have botanical origins; however, formulations with higher performance are required, and the hair follicles ability of being a drug and nanoparticle reservoir has been researched. The association of different strategies, that is, substances with synergic mechanisms and the use of advantageous technologies associated with lifestyle changes could improve the treatment outcomes.

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“…Androgenetic alopecia (AGA) represents an important cause of hair loss affecting 73% of men and 57% of women until the age of 80 years [1][2][3], with an age-dependent increase in frequency, and the perspective of rising incidence due to a general increase in life expectancy [2]. Due to its emotional impact with a negative effect on patient's quality of life, it is important to establish an early diagnosis and treatment plan in order to avoid progression of hair loss.…”

Section: Dear Editorsmentioning

confidence: 99%

Use of Minoxidil Sulfate versus Minoxidil Base in Androgenetic Alopecia Treatment: Friend or Foe?

Dias

Miot

Trüeb

et al. 2018

Skin Appendage Disord

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In Brazil, alternatively, there has been a rise in the prescription and use of MXS-based formulations due to its pharmaceutical solubility [6,7]. However, in addition to the issue of its higher molecular weight, MXS is naturally unstable in aqueous solution, negatively affecting its bioavailability to the hair follicle and increasing its irritation potential to the scalp. Therefore, efficacy of MXS compared to MX base for the treatment of AGA may be impaired, and the same efficacy may not be expected as in the original clinical trials with MX base.The MX sulfotransferase activity is not the same in every individual. MXS represents an alternative with advantage over MX in individuals with low MX sulfotransferase activity, since the demonstration of an association between MX response and the degree of MX sulfatation [8]. However, in order to compensate such decreased response, MXS would have to be used at higher concentrations (10-15%) due to its decreased capacity of transcutaneous absorption and packaged in small volumes, because of its high degree of degradation.Indeed, a Swiss retrospective study of 44 patients with AGA (13 males with Hamilton-Norwood type AGA class III or above and 31 females with Ludwig type AGA I-III) unresponsive to a minimum of 6 months of 5% MX solution b.i.d. showed increase in hair growth in 97.7% using a 10% MXS solution once daily during a mean treatment period of 4.09 months. The treatment was well tolerated by patients, among whom 6.8% suffered from irritation, erythema, and folliculitis of the scalp. No major adverse effect was noted [9].We aim to emphasize the differences between topical formulations of MX and MXS available on the Brazilian market, i.e., penetration and stability issues for MXS formulations, and the problem of low sulfotransferase activity for MX prescriptions. Our opinion is that topical MX base remains the first-line topical agent for treatment of male and female AGA, unless the patient proves to be unresponsive, then a formulation of MXS at probably higher concentrations may present an alternative with enhanced efficacy. For this purpose, a novel enzymatic assay may predict MX response [10].Comparative clinical trials and pharmacological studies with different formulations, either ready for use or custom made, with MX base or MXS, should be conducted in order to make final recommendations for optimal use in AGA treatment. Disclosure StatementThe authors have no conflicts of interest to disclose. Dear Editors,Androgenetic alopecia (AGA) represents an important cause of hair loss affecting 73% of men and 57% of women until the age of 80 years [1][2][3], with an age-dependent increase in frequency, and the perspective of rising incidence due to a general increase in life expectancy [2]. Due to its emotional impact with a negative effect on patient's quality of life, it is important to establish an early diagnosis and treatment plan in order to avoid progression of hair loss.The drugs currently available for treatment of AGA with approval of the US Food and Drug A...

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Female Pattern Hair Loss: a clinical and pathophysiological review

Cited by 130 publications

References 121 publications

‘The psychosocial burden of alopecia areata and androgenetica’: a cross‐sectional multicentre study among dermatological out‐patients in 13 European countries

‘The psychosocial burden of alopecia areata and androgenetica’: a cross‐sectional multicentre study among dermatological out‐patients in 13 European countries

Physiopathology and current treatments of androgenetic alopecia: Going beyond androgens and anti‐androgens

Use of Minoxidil Sulfate versus Minoxidil Base in Androgenetic Alopecia Treatment: Friend or Foe?

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