Prevalence of hair shedding among women

Kovacevic, Maja; Goren, Andy; Shapiro, Jerry; Sinclair, Rodney; Lonky, Neal M.; Situm, Mirna; Bulat, Vedrana; Bolanča, Željana; McCoy, John

doi:10.1111/dth.12415

Cited by 9 publications

(13 citation statements)

References 5 publications

(6 reference statements)

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“…male pattern alopecia reaching a prevalence of 50% by the age of 50 years) and increased hair shedding in female patients may be related to various aetiologies, including dermatological, endocrinological, nutritional disorders, stress, inflammatory and infectious disorders, or drug administration. [23][24][25] Although hair abnormalities have previously been attributed to PC, especially PC-2 associated with KRT17 mutations, based on the results of the current study and other previous reports, 26 it is impossible to draw any conclusions regarding a direct association between PC and hair anomalies. Corneal findings and hearing loss were previously attributed to PC in isolated reports; 11,14,22,27 however, ocular anomalies were rare in patients with PC (4%).…”

Section: Other Clinical Featurescontrasting

confidence: 76%

Revisiting pachyonychia congenita: a case‐cohort study of 815 patients

et al. 2020

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Summary Background Pachyonychia congenita (PC) is a group of autosomal dominant disorders caused by mutations in one of five keratin genes (KRT6A, KRT6B, KRT6C, KRT16, KRT17). The establishment of an international registry containing clinical and molecular data led to the development of a disease classification based on the mutant gene and associated features. Objectives To harness the same resource to clarify the prevalence of PC‐associated clinical features, delineate phenotype–genotype correlations and identify prognostic features for disease severity. Methods In total, 815 individuals with confirmed keratin mutations registered in the International Pachyonychia Congenita Research Registry were surveyed for clinical findings associated with PC. Data were analysed using various statistical methods, including the Student's t‐test, χ2‐test and anova tests for differences in means/proportions. Spearman correlation and logistic regression were used for phenotype–genotype correlations. Results KRT6A mutations were associated with oral leucokeratosis, hoarseness, youngest age or highest number of fingernails/toenails involved, and use of walking aids. KRT17 mutations were most commonly associated with cysts and natal teeth. Using logistic regression, we found that oral leucokeratosis was correlated with earlier toenail involvement, walking aids, nursing difficulties and hoarseness. Cysts were correlated with oral leucokeratosis, natal teeth and ear wax. Natal teeth predicted earlier toenail involvement, walking difficulties and cyst formation. Hoarseness was correlated with an increased number of involved fingernails. Conclusions Here, we establish phenotype–genotype correlations in the largest cohort of patients with PC described to date and reveal novel and clinically useful predictors of disease course and manifestations. What's already known about this topic? Pachyonychia congenita (PC) is a group of autosomal dominant disorders caused by mutations in one of five keratin genes (KRT6A, KRT6B, KRT6C, KRT16, KRT17). The main clinical features are nail dystrophy, palmoplantar keratoderma, oral leucokeratosis and cysts. The establishment of an international registry containing the clinical and molecular data of patients with PC led to the development of a disease classification based on the mutant gene and associated features. What does this study add? Data were collected via an international registry to clarify the prevalence of PC‐associated clinical features, delineate phenotype–genotype correlations and identify prognostic features for disease severity. This is the largest cohort of patients with PC described to date. The earliest clinical manifestations of PC are nail dystrophy and palmoplantar keratoderma. Diagnosis can be suspected and confirmed in preschool years. Painful plantar keratoderma has the most profound and debilitating effect on quality of life and daily function. Linked Editorial: Steele and O’Toole. Br J Dermatol 2020; 182:521–522. Linked Comment: Mordaunt. Br J Dermatol 2020; 182:537.

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Section: Other Clinical Featurescontrasting

confidence: 76%

Revisiting pachyonychia congenita: a case‐cohort study of 815 patients

et al. 2020

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“…A significant amount of women report excessive shedding after washing their hair . To date, no treatment is available for the reduction of hair shedding caused by the mechanical stress of everyday washing and styling.…”

Section: Discussionmentioning

confidence: 99%

“…A significant amount of women report excessive shedding after washing their hair. 3 To date, no treatment is available for the reduction of hair shedding caused by the mechanical stress of everyday washing and styling. Previously, our group demonstrated that a solution containing synephrine hydrochloride significantly reduced hair shedding during brushing.…”

Section: Con Clus Ionsmentioning

confidence: 99%

“…Normally, women shed between 50 and 150 hairs in a 24‐hour period, while shedding in excess of 150 hairs can indicate thinning . In a survey of 300 women visiting a public hospital for conditions other than alopecia, approximately 40% reported experiencing excessive hair shedding subsequent to hair washing (as defined by the Sinclair Hair Shedding Scale) . Increased shedding in women can sometimes be attributed to underlying medical conditions ; however, even in healthy individuals, many common hair styling practices can lead to excess shedding.…”

Section: Introductionmentioning

confidence: 99%

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Novel shampoo reduces hair shedding by contracting the arrector pili muscle via the trace amine‐associated receptor

Kovacevic¹,

McCoy²,

Goren³

et al. 2019

J of Cosmetic Dermatology

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Background Approximately 40% of women experience excessive hair shedding when washing their hair. Previously, we have demonstrated that a topically applied α1 adrenergic receptor agonist can be used to contract the arrector pili muscle of the follicular unit (ie, produce “goose bumps”), increasing the force required to pluck hair by as much as 400%. Subsequently, we reported a topical cosmetic solution containing an α1 adrenergic receptor agonist that reduced hair shedding during brushing by a maximum of 77%. Aims In this communication, we explore a novel mechanism to contract the arrector pili muscle. Trace amine‐associated receptors (TAAR) have been shown to regulate smooth muscle tone in blood vessels, but have not been reported to be present in the skin. Here, we report on the anti‐shedding efficacy of a shampoo containing a selective TAAR agonist, tyramine hydrochloride. Methods A single‐blinded crossover study was designed to test the efficacy of the novel shampoo versus placebo in reducing hairs lost during brushing. Results In this study, the novel TAAR shampoo reduced hair shedding during brushing by 31% in a cohort of 24 women with a maximum reduction of 77%. Conclusions A shampoo formulated with a selective TAAR agonist was demonstrated to contract the arrector pili muscle and reduce hair shedding subsequent to washing.

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“…To aid physicians in their assessment of shedding, a visual‐analog scale was developed, the Sinclair Hair Shedding Scale (Sinclair, ). In a survey of 300 subjects visiting a public hospital for conditions other than alopecia, approximately 40% reported experiencing excessive hair shedding as defined by the Sinclair Hair Shedding Scale (Kovacevic et al, ).…”

Section: Introductionmentioning

confidence: 99%

Styling without shedding: Novel topical formula reduces hair shedding by contracting the arrector pili muscle

McCoy¹,

Goren

Kovacevic

et al. 2017

Dermatologic Therapy

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Approximately 40% of women experience excessive hair shedding during styling (e.g., hair brushing). Previously, we demonstrated that topically applied phenylephrine, a potent α adrenergic receptor agonist, can be used to contract the arrector pili muscle of the follicular unit; thus, increasing the force required to pluck hair and reducing shedding during brushing. While demonstrating efficacy, phenylephrine has several drawbacks when applied to the scalp, including the possibility cardiovascular events. We hypothesized that a high concentration of a weak α agonist would allow for: (a) rapid penetration through the stratum corneum eliciting a quick response; (b) a low probability of cardiac adverse events owing to the low receptor binding affinity; and (c) an efficacy of the weak α agonist similar to that of phenylephrine at the local site of application. Accordingly, we developed a novel topical solution, AB-102, containing a high concentration of a weak α agonist. Several studies were conducted to test the safety and efficacy of AB-102. In a dose escalating safety study, utilizing a wearable holter monitor, we observed no cardiac or hemodynamic adverse events. In addition, in a controlled efficacy study, AB-102 reduced the number of hairs shed during brushing by up to 77% (average of 38%).

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Prevalence of hair shedding among women

Cited by 9 publications

References 5 publications

Revisiting pachyonychia congenita: a case‐cohort study of 815 patients

Revisiting pachyonychia congenita: a case‐cohort study of 815 patients

Novel shampoo reduces hair shedding by contracting the arrector pili muscle via the trace amine‐associated receptor

Styling without shedding: Novel topical formula reduces hair shedding by contracting the arrector pili muscle

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