| HAIR LOSS | PEER-REVIEW
but lack sufficient supporting data for their efficacy. Common marketed herbs include black cohosh (Actaea racemosa), dong quai (Angelica sinensis), chaste berry (Vitex agnus-castus), false unicorn (Chamaelirium luteum) and saw palmetto (Serenoa repens)19,48
. The purified extract of Serenoa
repens contains around 90% fatty acids and sterols, with an abundance of tannin, carotenoids,
lipases,
sugars, and fatty acids such as palmitic acid, oleic acid, caprylic acid, and beta sitosterol.
The
combination of saw palmetto’s liposterolic extract and beta sitosterol has been claimed to provide improvement in AGA but evidence is lacking49
. A two year study
compared the effectiveness of finasteride
versus
importance that physicians especially
dermatologists understand the physiological
process and the available methods
for its management to be able to help.
Serenoa repens in male AGA. It showed that while Serenoa repens could lead to an improvement of AGA, finasteride confirmed its efficacy. Finasteride was shown to have an influence in both the vertex and the front area, whilst Serenoa repens was mostly effective on the vertex50
patients in the most effective way.
. References
1. Fischer TW. Alopecia - Diagnostic and Therapeutic Management. Akt Dermatol. 2008;34:209–25
2. Trueb RM. Molecular mechanisms of androgenetic alopecia. Exp Gerontol. 2002;37:981–90
3. Wang TL, Zhou C, Shen YW, Wang XY, Ding XL, Tian S, Liu Y, Peng GH, Xue SQ, Zhou JE, Wang RL, Meng XM, Pei GD, Bai YH, Liu Q, Li H, Zhang JZ Prevalence of androgenetic alopecia in China: a community-based study in six cities. Br J Dermatol. 2010;162(4):843-7
4. Quan QD, Sinclair R. Female pattern hair loss: Current treatment concepts Clin Interv Aging. 2007; 2(2): 189–199
5. Stough D, Stenn K, Haber R, Parsley WM, Vogel JE, Whiting DA, et al. Psychological effect, pathophysiology, and management of androgenetic alopecia in men. Mayo Clin Proc 2005;80:1316-22.
6. Norwood OT. Male pattern baldness. Classification and incidence. South Med J 1975;68:1359-65
7. Hamilton JB. Patterned loss of hair in man: Types and incidence. Ann N Y Acad Sci 1951;53:708-28
8. Hoffmann R, Happle R. Current understanding of androgenetic alopecia. Part I: Etiopathogenesis. Eur J Dermatol. 2000;10:319–27
9. Trueb RM. Das Haar im Alter. Haut. 2008;4:152–5
10. Mahé YF, Michelet JF, Billoni N, Jarrousse F, Buan B, Commo S, et al. Androgenetic alopecia and microinflammation. Int J Dermatol. 2000;39:576–84
11. Trüeb RM. Oxidative stress in Ageing of Hair. Int J Trichol. 2009;9:6–14
12. Trüeb RM. Association between smoking and hair loss: another opportunity for health education against smoking? Dermatology. 2003;206:189–91
13. Su LH, Chen TH. Association of androgenetic alopecia with smoking and its prevalence among Asian men: A community-based survey. Arch Dermatol.
2007
14. Camacho F, Moreno JC, Garcia-Hernandez MJ. Telogen alopecia from UV rays. Arch Dermatol.1996;132:1398–9
15. Lu ZF, Fischer TW, Hasse S, Sugawara K, Kamenisch Y, Krengel S, et al. The human hair follicle as a model for exploring the effects of ultraviolet radiation in a complex tissue interaction system in situ. J Invest Dermatol. 2009;129:1790–1804
16. Heilmann S, Brockschmidt FF, Hillmer AM, Hanneken S, Eigelshoven S, Ludwig KU, Herold C, Mangold E, Becker T, Kruse R, Knapp M, Nöthen MM. Evidence for a polygenic contribution to androgenetic alopecia. Br J Dermatol. 2013;169(4):927- 30
17. McElwee KJ, Shapiro J. Promising therapies for treating and/or preventing androgenic alopecia. Skin Letter Therapy. 2012;17(6)
18. Mella JM, Perret MC, Manzotti M, et al. Efficacy and safety of finasteride therapy for androgenetic alopecia: a systematic review. Arch Dermatol. 2010 Oct;146(10):1141–50
19. Blumeyer A, Tosti A, Messenger A, Reygagne P, Del Marmol V, Spuls PI, et al. Evidence-based (S3) guideline for the treatment of androgenetic alopecia in women and in men. J Dtsch Dermatol Ges 2011;9:S1-57.
20. Moinpour CM, Darke AK, Donaldson GW, Thompson IM Jr, Langley C, Ankerst DP, Patrick DL, Ware JE Jr, Ganz PA, Shumaker SA, Lippman SM, Coltman CA Jr. Longitudinal analysis of sexual function reported by men in the Prostate Cancer Prevention Trial. J Natl Cancer Inst. 2007; 99(13):1025-35
21. Glaxo Smith Kline Glaxo Smith Kline Clinical Trial Register. 2006. Accessed August 8th, 2006. URL:
http://ctr.gsk.
co.uk/Summary/dutasteride/studylist.asp
22. Kaliyadan F, Nambiar A, Vijayaraghavan S. Androgenic alopecia:an update. 2013;79(5):613-25
23. Olsen EA, Whiting D, Bergfeld W, et al. A multicenter, randomized, placebo-controlled, double-blind clinical trial of a novel formulation of 5% minoxidil topical foam versus placebo in the treatment of androgenetic alopecia in men. J Am Acad Dermatol. 2007 Nov;57(5):767–74
24. Khandpur S, Suman M, Reddy BS. Comparative efficacy of various treatment regimens for androgenetic alopecia in men. J Dermatol 2002;29:489-98
25. Diani AR, Mulholland MJ, Shull KL, Kubicek M F, Johnson GA, Schostarez HJ, et al. Hair growth effects of oral administration of finasteride, a steroid 5 alpha-reductase inhibitor, alone and in combination with topical minoxidil in the balding stumptail macaque. J Clin Endocrinol Metab 1992;74:345-50
26. Tanglertsampan C1. Efficacy and safety of 3% minoxidil versus combined 3% minoxidil / 0.1% finasteride in male pattern hair loss: a randomized, double-blind, comparative study. J Med Assoc Thai. 2012 Oct;95(10):1312-6
27. Banaszek A. Company profits from side effects of glaucoma treatment. CMAJ. 2011 Oct 4;183(14):E1058
28. Blume-Peytavi U, Lonnfors S, Hillmann K, et al. A randomized double-blind placebo-controlled pilot study to assess the efficacy of a 24-week topical treatment by latanoprost 0.1% on hair growth and pigmentation in healthy volunteers with androgenetic alopecia. J Am Acad Dermatol. 2012;66(5):794–800
29. Pierard-Franchimont C, De Doncker P, Cauwenbergh G, et al. Ketoconazole shampoo: effect of long-term use in androgenic alopecia. Dermatology. 1998;196(4):474–7
30. Magro CM, Rossi A, Poe J, et al. The role of inflammation and immunity in the pathogenesis of androgenetic alopecia. J Drugs Dermatol. 2011;10(12):1404–11
31. Inui S, Itami S. Molecular basis of androgenetic alopecia: From androgen to paracrine mediators through dermal papilla. J Dermatol Sci. 2011;61(1):1–6
32. Leavitt M, Perez-Meza D, Rao NA, Barusco M, Kaufman KD, Ziering C. Effects of finasteride (1 mg) on hair transplant. Dermatol Surg 2003;31:1268-76
33. Bregy A, Trueb RM. No association between serum ferritin levels >10 microg/l and hair loss activity in women. Dermatology 2008;217:1-6
34. Unger WP, Unger RH. Hair transplanting: an important but often forgotten treatment for female pattern hair loss. J Am Acad Dermatol. 2003; 49(5):853-60
35. Avram MR, Cole JP, Gandelman M, et al. The potential role of minoxidil in the hair transplanting setting. J Dermatol Surg.2002;28:894–900
36. Uremia S, Umar SH, Li CH. Prevention of temporal alopecia following rhytidectomy: the prophylactic use of minoxidil: a study of 60 patients. Dermatol Surg. 2002;1:66–74.
37. Munck A, Gavazzoni MF, Trueb R. Use of low-level laser therapy as monotherapy or concomitant therapy for male and female androgenic alopecia. Int J Trichology. 2014;6(2):45-49
38. Avci P, Gupta GK, Clark J, Wikonkal N, Hamblin MR. Low-level laser (light) therapy (LLLT) for treatment of hair loss. Lasers Surg Med. 2014;46(2):144-51
39. Leavitt M, Charles G, Heyman E, Michaels D. HairMax LaserComb laser phototherapy device in the treatment of male androgenetic alopecia: A randomized, double-blind, sham device-controlled, multicentre trial. Clin Drug Investig. 2009;29(5):283-92
40. Kim H, Choi JW, Kim JY, Shin JW, Lee SJ, Huh CH. Low-level light therapy for androgenetic alopecia: a 24-week, randomized, double-blind, sham device-controlled multicenter trial. Dermatol Surg. 2013;39(8):1177-8
41. Tsuboi R, Itami S, Inui S, Ueki R, Katsuoka K, Kurata S, et al. Guidelines for the management of androgenetic alopecia (2010). J Dermatol 2012;39:113-20
42. Lepaw MI. Therapy and
histopathology of complications from synthetic fiber implants for hair replacement. A presentation of one hundred cases. J Am Acad Dermatol 1980;3:195-204
43. Freund BJ, Schwartz M. Treatment of male pattern baldness with botulinum toxin: A pilot study. Plast Reconstr Surg 2010;126:246e-8
44. Avram MR, Leonard RT, Jr., Epstein ES, et al. The current role of laser/light sources in the treatment of male and female pattern hair loss. J Cosmet Laser Ther. 2007;9(1):27–8
45. Rose PT. The latest innovations in hair transplantation. Facial Plast Surg. 2011;27(4):366–77
46. Takikawa M, Nakamura S, Nakamura S, et al. Enhanced effect of platelet-rich plasma containing a new carrier on hair growth. Dermatol Surg. 2011 Dec; 37(12):1721–
47. Khatu SS, More YE, Gokhale NR, Chavhan DC, Bendsure N. Platelet-rich plasma in androgenic alopecia: myth or an effective tool. J Cutan Aesthet Surg. 2014;7(2):107-10
48. Rogers NE, Avram MR. Medical treatments for male and female pattern hair loss. J Am Acad Dermatol. 2008 Oct;59(4):547–66
49. Murugusundram S. Serenoa Repens: Does It have Any Role in the Management of Androgenetic Alopecia? J Cutan Aesthet Surg. 2009;2(1):31-2
50. Rossi A, Mari E, Scarno M, Garelli V, Maxia C, Scali E, Iorio A, Carlesimo M. Comparitive effectiveness of finasteride vs Serenoa repens in male androgenetic alopecia: a two-year study. Int J Immunopathol Pharmacol. 2012;25(4):1167-73
51. Kren R, Ogushi S, Miyano T. Effect of caffeine on meiotic maturation of porcine oocytes. Zygote 2004; 12: 31–38
52. Fischer W, Hipler U.C, Elsner P. Effect of caffeine and testosterone on the proliferation of human hair follicles in vitro. Int J of Derm. 2007;46(1):27-35
prime-journal.com | January/February 2016 It is of utmost Key points
Androgenic alopecia or male pattern hair loss is the most common cause of hair loss in men and it is affected by both genetic and environmental influences
Oral finasteride and topical minoxidil are the only two therapeutic agents approved to date by the FDA and EMEA
Hair transplantation is the most common hair restoration surgery and it could be used in those who have sufficient donor hair sites
Studies using low level
light therapy have shown that this treatment might stimulate hair growth with an increase in hair density and mean hair diameter.
Caffeine is a phosphodiesterase inhibitor. Therefore by
increasing the cAMP, cell metabolism is promoted; a mechanism which would counteract testosterone/DHT- induced miniaturization of the hair follicle51
. . An in vitro
study demonstrated that caffeine acts as a stimulator of human hair growth and this may have an important clinical impact in the management of AGA52
Conclusion AGA can be a significant psychological issue to most patients and it is one of the most common dermatological complaints for which patients seek treatment.
It is of
utmost importance that physicians especially dermatologists understand the physiological process and the available methods for its management to be able to help patients in the most effective way.
Declaration of interest The author declares no potential
conflicts of interest Funding The author of this paper has no financial or personal
relationship with other people or organizations that could inappropriately influence or bias the content of the paper
Figure 1 © Supplied by the author and redrawn for Prime Journal by Kevin February
23
Page 1 |
Page 2 |
Page 3 |
Page 4 |
Page 5 |
Page 6 |
Page 7 |
Page 8 |
Page 9 |
Page 10 |
Page 11 |
Page 12 |
Page 13 |
Page 14 |
Page 15 |
Page 16 |
Page 17 |
Page 18 |
Page 19 |
Page 20 |
Page 21 |
Page 22 |
Page 23 |
Page 24 |
Page 25 |
Page 26 |
Page 27 |
Page 28 |
Page 29 |
Page 30 |
Page 31 |
Page 32 |
Page 33 |
Page 34 |
Page 35 |
Page 36 |
Page 37 |
Page 38 |
Page 39 |
Page 40 |
Page 41 |
Page 42 |
Page 43 |
Page 44 |
Page 45 |
Page 46 |
Page 47 |
Page 48 |
Page 49 |
Page 50 |
Page 51 |
Page 52 |
Page 53 |
Page 54 |
Page 55 |
Page 56 |
Page 57 |
Page 58 |
Page 59 |
Page 60 |
Page 61 |
Page 62 |
Page 63 |
Page 64 |
Page 65 |
Page 66 |
Page 67 |
Page 68