Hair Loss

Hair loss treatment at the Proctor clinic.

edited for hair loss blog

Hair follicle in normal scalp and male pattern hair loss.
The number of cell nuclei in the matrix and the papilla of balding scalp was found to be 30% and 50% smaller, respectively, than those of normal scalp. Finally, a morphometric study revealed enlarged nuclei in the matrix and papilla, as shown by their increased areas, perimeters, and maximal diameters.

hair loss blog

Dermatologica. 1985;171(5):327

Increased number of OKT6-positive dendritic cells in the hair follicles of patients with alopecia areata.

Kohchiyama A, et al

edited
In 6 patients with untreated hair loss secondary to alopecia areata in the progressive stage, 6 in the stationary stage, and 6 normal individuals as controls, an in situ analysis of OKT6-positive dendritic cells in hair follicles, and peribulbar and intrabulbar infiltrates was performed using the avidin-biotin-peroxidase method with monoclonal antibodies. …snip… This indicates that the number of OKT6-positive dendritic cells increases in the hair follicles of progressive alopecia areata and that these cells may play an important role in cooperation with T cells in the pathogenesis of alopecia areata.

Cancer Res. 1982;42(5):1888

Protective effects of S-2-(3-aminopropylamino)ethylphosphorothioic acid against radiation damage of normal tissues and a fibrosarcoma in mice.Milas L, Hunter N, Reid BO, Thames HD Jr.

S-2-(3-Aminopropylamino)ethylphosphorothioic acid (WR-2721) was investigated for its protective effect against radiation-produced damage of jejunum, testis, lung, hair follicles, and a fibrosarcoma of C3Hf/Kam mice. Most of these tissues were radioprotected, and the degree of radioprotection depended on the dose of WR-2721 and the time interval between administration of WR-2721 and radiation treatment. WR-2721 increased resistance of jejunal epithelial cells and spermatogenic cells to single doses of gamma-rays by factors of 1.64 and 1.54, respectively. Protection against hair loss was less pronounced; the dose-modifying factor here was 1.24. ..snip..

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hair loss blog

J Hered. 1976;67(5):284

Fuzzy, a hypotrichotic mutant in linkage group I of the Norway rat.

Palm J, Ferguson FG.

A new recessive hypotrichosis gene in the rat designated fuzzy (fz) is described. Fuzzy is linked to albino (c) in linkage group I with a 18.13 +/- 3.05 percent recombination. After an initial sparse hair coat, the fuzzy animals rapidly become devoid of hair. Histologically the skin of these animals has poorly developed, and often cystic hair follicles that contain accumulations of keratinacious material.

Arch Dermatol. 1997 Sep;133(9):1089-93.

Loose anagen hair.

Tosti A, et al

OBJECTIVE: To review clinical and pathologic features and the long-term follow-up of patients with loose anagen hair (LAH). DESIGN: Clinical evaluation and long-term follow-up. … snip…. RESULTS: In 4 children and 1 adult the condition remained stable; in 2 children and 1 adult, a considerable improvement in hair density was noticed. The pathologic study of hair from 5 patients did not reveal morphological abnormalities of the hair follicles except for a high incidence of fragmentations of the inner root sheath. CONCLUSIONS: Analysis of our patients with LAH reveals that the condition does not develop exclusively during childhood but can occasionally manifest itself later in life. The development of LAH may be sporadic, occur in association with developmental or acquired conditions, or, less commonly, be a familial disorder. While adult-onset LAH may not be exceptional, it can be easily misdiagnosed as telogen hair loss. The pathologic findings of LAH do not demonstrate any specific features and are of little value in the diagnosis of this condition.

Fertil Steril. 1994 Feb;61(2):281-7.Links

Comparison of flutamide and spironolactone in the treatment of hirsutism: a randomized controlled trial.
Cusan L, et al

OBJECTIVE: To compare the clinical efficacy and safety of the pure antiandrogen flutamide and the steroidal derivative spironolactone in the treatment of hirsutism in women. DESIGN: Fifty-three premenopausal women suffering from moderate to severe hirsutism were randomized into two groups and received either flutamide or spironolactone in association with a triphasic oral contraceptive (OC) pill. Hirsutism, acne, seborrhea, alopecia, and side effects were monitored monthly for a treatment period of 9 months and a follow-up after treatment period of 6 months. Blood samples were taken at each visit for assessment of endocrine, biochemical, and hematologic parameters. RESULTS: After only 6 months of therapy, flutamide caused a maximal reduction in the hirsutism score to a value within almost normal range; during the same period, spironolactone caused only a 30% reduction of the hirsutism score. Whereas flutamide caused a dramatic (80%) decrease in total acne, seborrhea, and hair loss score after only 3 months of therapy, spironolactone caused only a 50% reduction in acne and seborrhea, with no significant effect on the hair loss score. Four patients in the spironolactone group but only one in the flutamide group stopped the medication because of adverse side effects. CONCLUSION: The present data obtained in a randomized prospective study clearly demonstrate that the pure antiandrogen flutamide is superior to spironolactone in the treatment of female hirsutism and its related androgen-dependent symptoms and signs in women.

hair loss blog

Ann N Y Acad Sci. 1991 Dec 26;642:148-64; discussion 164-6.

An in vitro model for the study of human hair growth.
Philpott MP, et al

Human anagen hair follicles were isolated by microdissection from human scalp skin. Isolation of the hair follicles was achieved by cutting the follicle at the dermosubcutaneous fat interface using a scalpel blade. Intact hair follicles were then removed from the fat using watch makers’ forceps. Isolated hair follicles maintained free floating in supplemented Williams E medium in individual wells of 24-well multiwell plates showed a significant increase in length over 4 days. The increase in length was seen to be attributed to the production of a keratinized hair shaft, and was not associated with the loss of hair follicle morphology. [Methyl-3H]thymidine autoradiography confirmed that in vitro the in vivo pattern of DNA synthesis was maintained; furthermore, [35S]methionine labeling of keratins showed that their patterns of synthesis did not change with maintenance. Serum was found to inhibit hair follicle regrowth in vitro; and when follicles were maintained in serum-free medium, they grew for up to 10 days, suggesting that in vitro the hair follicles are able to regulate their own growth, possibly by the production of relevant growth factors. This may prove useful in identifying the autocrine/paracrine mechanisms that operate in the hair follicle. The importance of this model to hair follicle biology is further demonstrated by the observations that TGF-beta 1 has a negative growth regulatory effect on hair follicles in vitro and that EGF and its other receptor ligand TGF-alpha mimic the in vivo depilatory effects of EGF that have been reported for sheep and mice.

Braz J Med Biol Res. 2003 Oct;36(10):1447-54.

The 5 alpha-reductase type 1, but not type 2, gene is expressed in anagen hairs plucked from the vertex area of the scalp of hirsute women and normal individuals.

Oliveira IO, et al
(edited)
…To determine the expression of the genes for type 1 (SDR5A1) and type 2 (SDR5A2) 5alpha-reductase isoenzymes in scalp hairs plucked from 33 hirsute patients (20 with polycystic ovary syndrome and 13 with idiopathic hirsutism) and compare it with that of 10 men and 15 normal women. SDR5A1 and SDR5A2 expression was estimated by RT-PCR using the gene of the ubiquitously expressed protein 2-microglobulin as an internal control. The results are expressed as arbitrary units in relation to beta2-microglobulin absorbance (mean SEM). SDR5A2 expression was not detected in any hair samples analyzed in this study. No differences were found in SDR5A1 mRNA levels between men and normal women (0.78+/-0.05 vs 0.74+/-0.06, respectively). SDR5A1 gene expression in the cells of hair plucked from the scalp of normal women (0.85+/-0.04) and of women with polycystic ovary syndrome (0.78+/-0.05) and idiopathic hirsutism (0.80+/-0.06) was also similar. These results indicate that SDR5A1 gene expression in the follicular keratinocytes from the vertex area of the scalp seems not to be related to the differences in hair growth observed between normal men and women and hirsute patients. Further studies are needed to investigate the expression of the 5 alpha-reductase genes in other scalp follicular compartments such as dermal papillae, and also in hair follicles from other body sites, in order to elucidate the mechanism of androgen action on the hair regrowth process and related diseases such as male pattern hair loss.

It is difficult to predict the effect of minoxidil liniment on hair loss

Anderson C, Berne B, Juhlin L, Skogh M, Strand A, Vahlquist A.

Lakartidningen. 1990 Jan 10;87:16.

PMID: 2405223

JAMA. 1979 Jan 5;241(1):53-4.

Pseudofolliculitis barbae. No ‘pseudoproblem’.

Conte MS, Lawrence JE.

Pseudofolliculitis barbae possibly affects 45% of all black servicemen and is a source of much misunderstanding and social unrest in the military. A recent study of 96 cases of pseudofolliculitis barbae has elucidated a successful shaving technique. It employs a 30-day period of beard regrowth to eliminate ingrown hairs, twice-daily use of a new polyester skin-cleansing pad, and use of solely electric hair clippers for facial hair removal. Ninety-six percent of those using this technique could thereafter conform to the Air Force grooming code.

Arch Dermatol. 1981 Jul;117(7):384-7.

Topical treatment of alopecia areata.
Swanson NA, Mitchell AJ, Leahy MS, Headington JT, Diaz LA.

It has been shown previously that hair loss due to alopecia areata can be treated with dinitrochlorobenzene (DNCB) and other contact allergens. Whether these agents work by inducing immunologic stimulation or simply a nonspecific inflammatory reaction has not been definitively demonstrated. To test the relative importance of these two mechanisms, we have randomly studied 22 patients with alopecia areata to whom either DNCB or croton oil was applied topically. Sixty-three percent of patients without spontaneous regrowth of hair regrew hair after DNCB application. None of those treated with croton oil regrew hair when treated later with DNCB. Therefore, a proved contact allergen was shown to be required for therapeutic success. Patient acceptance of the induced contact dermatitis was excellent. In light of recent data on the mutagenicity of DNCB to bacteria, other contact allergens for topical immunotherapy are being sought.

N Engl J Med. 1994 Jan 13;330(2):120-5.

Finasteride.
Rittmaster RS.
Department of Medicine, Dalhousie University, Halifax, NS, Canada.

PMID: 7505051

Hair loss and hair loss treatment