PEER-REVIEW | DERMATOLOGY | Table 1


The Ludwig Pattern of hair loss TYPE I


Figure 1 Pull test


10 9 8 7 6 5 4 3 2 1


0 T0 T30 T60 T120


Results of pull test evaluations at baseline (T0) and after 1 month (T30), 2 months (T60), 4 months (T120)


Early thinning that can be easily comouflaged with proper grooming. Type I patients have too little hair loss to consider surgical hair restoration.


TYPE II


 Very rarely, the male model (androgen-dependent Hamilton pattern) is observed, with a receding hair line on the forehead and thinning on the vertex3 In non-androgen-dependent female hormonal hair


.


loss, observation of the skin of the scalp reveals areas featuring thinning of the hair owing to the presence of empty follicles as a result of a lack of synchronism between a hair falling out and the appearance of a newly formed hair to take its place. At least in the initial stages, replacement takes place only after a fairly long period of time. The consequence of this is a smaller number of hairs


Significant widening of the midline part and noticeably decreased volume. Hair transplantation may be


indicated if the donor area in the back and side of the scalp is stable.


TYPE III


in the growth (anagen) phase, which lasts less than usual (shorter and finer hair) and an increasingly high number of hairs entering the telogen phase, which also lasts for a longer period of time (i.e. alopecia)4, 5


. Actual The cause of female hormonal hair loss is, essentially,


the absence of oestrogens (oestrone) or their failure to work, with progressive miniaturisation of the hairs (papilla, matrix and shaft), so that only fine and thinned hair grows all over the scalp (mainly on the vertex and in the frontal area), with normal menstruation and fertility, no excess of circulating androgens, and the absence of indices of telogen effluvium. Rather than alopecia, the clinical appearance is that of hypotrichia.


Polynucleotides The possible treatment strategies are aimed, on the one hand, at limiting the action of the hormones on the hair follicles and on the other, at providing effective stimulation of cell proliferation and of growth of the hair adnexum. It is well known that polynucleotides (PN) have the


trophic effect of stimulating cell proliferation on a number of different cell core types, including fibroblasts and adipocytes8–10


. PN are fractions of DNA with a low It is well known that


molecular weight, of natural origin. They are obtained by means of a process of extraction from trout sperm using high-temperature purification and sterilisation, without the interaction of peptides or pharmacologically-active proteins. This compound contains a mixture of deoxyribonucleotide polymers with chain lengths ranging between 50 and 2000 bp, and can also be the source of purine and pyrimidine deoxynucleosides/ deoxyribonucleotides and bases. The trophic effect of PNs appears


polynucleotides have the


trophic effect of stimulating cell proliferation on a number of different cell core types,


baldness rarely occurs, but almost always, areas of alopecia arranged in mosaic-like fashion are observed, in which the number of hairs is smaller and there is a lower proportion featuring a normal structure mixed with fine hairs (vellus)6, 7


. Figure 2 Trichogram


A thin, see-through look on the top of the scalp. This is often associated with generalized thinning.


100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0%


T0 T30


Results of Trichogram evaluations at baseline (T0) and after 1 month (T30), 2 months (T60), 4 months (T120)


18  July/August 2014 | prime-journal.com T60 T120


Telogen Anagen


including fibroblasts and adipocytes.


to be mediated by stimulation of the A2 purinergic receptors (adenosine receptors), thus promoting the metabolic activity of the cells. Furthermore, nucleotides promote the metabolic ‘salvage’ pathway, rather than the traditional ‘ex novo’ synthesis starting from amino acids8, 11 Since purinergic receptors are


.


present also in the hair follicles, and trophic stimulation appears to be useful in the event of female hormonal hair loss for facilitating the hair growth phase12–14


, the authors


assessed the effects of PN administered by intradermal infiltration.


Materials and methods Patient selection The authors selected 20 female patients aged between 25 and 65 years, all suffering from non-androgen-dependent female hormonal alopecia (i.e. female hormonal


hair


loss). The exclusion criteria were current or previous systemic diseases capable of increasing


hair loss (low


serum iron levels, fever, endocrine diseases, liver diseases), medical history of current or recent slimming diets, current or recent conditions of psychophysical stress, and pharmacological systemic treatments and/or contraceptive pills. Of these 20 patients, five had already undergone treatment with local stimulating lotions (not otherwise specified) and supplements. The others had not received any previous treatment.


% of anagen and telogen hair


Number of hairs


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