Reply to: “The effect of intradermal botulinum toxin on androgenetic alopecia and its possible mechanism”

Carloni, Raphaël; Gandolfi, Silvia; Postel, Francois; Bertheuil, Nicolas; Pechevy, Lolita

doi:10.1016/j.jaad.2020.07.092

Cited by 3 publications

(4 citation statements)

References 5 publications

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“…However, there have not been any documented clinical trials focusing on these paracrine mediators. 13 Botulinum toxin intramuscular injections have shown increase in hair counts, however, there is no mechanistic research to support Emotionally, 24 patients experienced embarrassment and humiliation, which was in agreement with Gupta et al, 15 who also reported how AGA negatively impacts the patient's social life, mental health, and quality of life. Hence, at the end of treatment, patients' satisfaction levels were also assessed.…”

Section: Discussionmentioning

confidence: 52%

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Assessment of efficacy of different botulinum toxin A concentrations in the treatment of androgenetic alopecia assessed by dermoscopy

Seoudy,

Metwally,

Elfangary

et al. 2023

J of Cosmetic Dermatology

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BackgroundAndrogenetic alopecia (AGA) is the most common type of progressive hair loss in men and women. AGA is characterized by the miniaturization of the hair follicle, leading to the transformation of terminal hair to vellus hair.ObjectiveTo evaluate the efficacy and safety of injecting two different concentrations of botulinum toxin A (BTA) for the treatment of AGA in Egyptian patients.MethodsAdult male (Hamilton–Norwood I–VII) and female (Ludwig I–III) patients (N = 32) were assigned to receive two different concentrations BTA (33.3 and 25 U/mL) on each side of the scalp; in total, there were 15 injections administered on each side, with injection volume of 0.1 mL containing 3.3 U for the right half and 2.5 U for the left half. Treatment efficiency was assessed at baseline, Month 3 and Month 6, by degree of clinical improvement and dermoscopy assessment.ResultsBy Month 6, proportion of male patients (N = 5) classified as Hamilton–Norwood Grade II increased from 0% to 60% (3/5), proportion of female patients (N = 27) classified as Ludwig Grade I also increased from 14.8% (4/27) to 70% (19/27). Dermoscopy result showed a significant increase in vellus hair density from baseline to Month 6 on the right side (33.3 U/mL), while no change was observed on the left (25 U/mL); however, vellus hair density was higher at Month 3 compared to Month 6. There were changes in yellow spots and peripilar sign more on the right side. Adverse reactions reported include irritation, headache, injections site pain, and nausea.ConclusionThe results of the present study showed that BTA is a safe and effective treatment for AGA in both genders. These findings offer a cutting‐edge conceptual structure and therapeutic strategy for the management of AGA in Egyptian population.

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Section: Discussionmentioning

confidence: 52%

“…DHT‐induced paracrine mediator synthesis, including the production of Dkk‐1, interleukin‐6, and TGF‐1 in balding DPCs, may contribute to AGA and offer an alternative therapeutic target. However, there have not been any documented clinical trials focusing on these paracrine mediators 13 …”

Section: Discussionmentioning

confidence: 99%

Assessment of efficacy of different botulinum toxin A concentrations in the treatment of androgenetic alopecia assessed by dermoscopy

Seoudy,

Metwally,

Elfangary

et al. 2023

J of Cosmetic Dermatology

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“…However, inconsistencies in injection sites and depths warrant attention. Some studies have demonstrated a preference for intradermal injections in areas affected by hair loss, leveraging BoNT's ability to modulate the production of transforming growth factor-β1 (TGFβ1) by dermal papilla cells (DPC)-a critical factor in the pathogenesis of AGA [8][9][10][11]. Conversely, other approaches have utilized intramuscular or subcutaneous injections targeting periscapular muscles such as the frontalis, temporalis, and occipitalis [12][13][14][15][16].…”

Section: Introductionmentioning

confidence: 99%

Intradermal Injection in Balding Region Versus Intramuscular Injection in Surrounding Muscles: A Split-Scalp, Randomized Trial on BoNT for Androgenetic Alopecia

Li,

Zhang,

Zhao

et al. 2024

Dermatol Ther (Heidelb)

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Introduction:Recent advancements in androgenetic alopecia (AGA) treatment have highlighted the efficacy of botulinum toxin (BoNT). However, inconsistencies in injection sites and depths warrant attention. It remains unclear which injection strategy is most beneficial for patients. Methods: This split-scalp randomized controlled trial divided each enrolled participant's scalp along the midline: one side was randomized to receive intramuscular BoNT injections in the surrounding muscles, while the other side received intradermal BoNT injections directly into the balding areas. This study evaluated the impact of treatment on hair density and diameter through trichoscopic examinations conducted at baseline and 12 weeks post treatment. Additionally, assessments of pain and overall safety were integrated into the study protocol. Results: Twenty-nine patients completed the study, with significant improvements in hair density observed in the intramuscular injection group compared to the intradermal group (p < 0.001). Both groups exhibited increases in hair diameter, but no significant difference was found between the two methods (p = 0.433). Pain evaluation revealed that intradermal injections in balding areas were more painful than intramuscular injections (p = 0.036), with no severe adverse reactions reported except for a single case of alopecia areata following injection. Conclusion: Our research revealed that both BoNT injection strategies enhanced hair diameter 12 weeks post-treatment, with intramuscular injections significantly improving hair density more effectively. Despite the promising outcomes, the variability in patient responses underscores the necessity for personalized approaches and further research to refine injection protocols for optimized efficacy and safety. Trial Registration Number: ChiCTR2400080190.

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“…To the Editor: We read the reply of Carloni et al 1 to ''The effect of intradermal botulinum toxin on androgenetic alopecia and its possible mechanism'' and are grateful for their interest and the comments on our research.…”

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confidence: 99%

Author's reply to the comment on: “The effect of intradermal botulinum toxin on androgenetic alopecia and its possible mechanism”

Park

Shon

2020

Journal of the American Academy of Dermatology

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Reply to: “The effect of intradermal botulinum toxin on androgenetic alopecia and its possible mechanism”

Cited by 3 publications

References 5 publications

Assessment of efficacy of different botulinum toxin A concentrations in the treatment of androgenetic alopecia assessed by dermoscopy

Assessment of efficacy of different botulinum toxin A concentrations in the treatment of androgenetic alopecia assessed by dermoscopy

Intradermal Injection in Balding Region Versus Intramuscular Injection in Surrounding Muscles: A Split-Scalp, Randomized Trial on BoNT for Androgenetic Alopecia

Author's reply to the comment on: “The effect of intradermal botulinum toxin on androgenetic alopecia and its possible mechanism”

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