Pierced
Member
Study after study has shown that there is no casual connection between fina and ED.
MESO-Rx
Anabolic Steroids
Hair Loss
- Thread starter billydidit
- Start date
Bundy55
Banned
I've been using fin for about 4 months with no sides to speak of yet
A while back you asked if I was seeing hair loss and I told you it was to early to give an honest answer. Well, still thick hair at 45 years old. However, I think I’m just lucky. I’m scared to even tell you my last cycle. Still thick, full with no hair loss showing. Just my experience.
Conventional and Novel Stem Cell Based Therapies for Androgenic Alopecia
The prevalence of androgenic alopecia (AGA) increases with age and it affects both men and women. Patients diagnosed with AGA may experience decreased quality of life, depression, and feel self-conscious. There are a variety of therapeutic options ranging from prescription drugs to non-prescription medications.
Currently, AGA involves an annual global market revenue of US$4 billion and a growth rate of 1.8%, indicating a growing consumer market. Although natural and synthetic ingredients can promote hair growth and, therefore, be useful to treat AGA, some of them have important adverse effects and unknown mechanisms of action that limit their use and benefits.
Biologic factors that include signaling from stem cells, dermal papilla cells, and platelet-rich plasma are some of the current therapeutic agents being studied for hair restoration with milder side effects. However, most of the mechanisms exerted by these factors in hair restoration are still being researched.
In this review, we analyze the therapeutic agents that have been used for AGA and emphasize the potential of new therapies based on advances in stem cell technologies and regenerative medicine.
Talavera-Adame D, Newman D, Newman N. Conventional and novel stem cell based therapies for androgenic alopecia. Stem Cells Cloning 2017;10:11-9. https://www.dovepress.com/conventional-and-novel-stem-cell-based-therapies-for-androgenic-alopec-peer-reviewed-fulltext-article-SCCAA
The prevalence of androgenic alopecia (AGA) increases with age and it affects both men and women. Patients diagnosed with AGA may experience decreased quality of life, depression, and feel self-conscious. There are a variety of therapeutic options ranging from prescription drugs to non-prescription medications.
Currently, AGA involves an annual global market revenue of US$4 billion and a growth rate of 1.8%, indicating a growing consumer market. Although natural and synthetic ingredients can promote hair growth and, therefore, be useful to treat AGA, some of them have important adverse effects and unknown mechanisms of action that limit their use and benefits.
Biologic factors that include signaling from stem cells, dermal papilla cells, and platelet-rich plasma are some of the current therapeutic agents being studied for hair restoration with milder side effects. However, most of the mechanisms exerted by these factors in hair restoration are still being researched.
In this review, we analyze the therapeutic agents that have been used for AGA and emphasize the potential of new therapies based on advances in stem cell technologies and regenerative medicine.
Talavera-Adame D, Newman D, Newman N. Conventional and novel stem cell based therapies for androgenic alopecia. Stem Cells Cloning 2017;10:11-9. https://www.dovepress.com/conventional-and-novel-stem-cell-based-therapies-for-androgenic-alopec-peer-reviewed-fulltext-article-SCCAA
Charles C Yates
New Member
Hmmm
Kurtzman DJB, Alexander CE. Image Gallery: Dissecting cellulitis of the scalp following anabolic steroid use. Br J Dermatol 2017;177(4):e160. Image Gallery: Dissecting cellulitis of the scalp following anabolic steroid use
Dissecting cellulitis of the scalp (DCS) is an uncommon inflammatory dermatosis that results in disfiguring alopecia. Follicular occlusion likely contributes to its development,1 but its pathogenesis remains poorly understood. The disproportionate prevalence of DCS among young men, along with reports of benefit from antiandrogen therapy,2 suggests that androgens may play a role.
In our clinic, a 38-year-old man presented with the abrupt onset of DCS (a, b), just a few weeks after starting anabolic steroids for recreational performance enhancement. With cessation of anabolic steroid use along with isotretinoin 0.5 mg/kg daily, the patient experienced marked improvement. This case serves to support the distinct role of androgens in the pathogenesis of DCS.
1. Badaoui A, Reygagne P, Cavelier-Balloy B et al. Dissecting cellulitis of the scalp: a retrospective study of 51 patients and review of the literature. Br J Dermatol 2016;174:421–3.
2. Goldsmith PC, Dowd PM. Successful therapy of the follicular occlusion triad in a young woman with high dose oral antiandrogens and minocycline. J R Soc Med 1993;86:729–30.
Dissecting cellulitis of the scalp (DCS) is an uncommon inflammatory dermatosis that results in disfiguring alopecia. Follicular occlusion likely contributes to its development,1 but its pathogenesis remains poorly understood. The disproportionate prevalence of DCS among young men, along with reports of benefit from antiandrogen therapy,2 suggests that androgens may play a role.
In our clinic, a 38-year-old man presented with the abrupt onset of DCS (a, b), just a few weeks after starting anabolic steroids for recreational performance enhancement. With cessation of anabolic steroid use along with isotretinoin 0.5 mg/kg daily, the patient experienced marked improvement. This case serves to support the distinct role of androgens in the pathogenesis of DCS.
1. Badaoui A, Reygagne P, Cavelier-Balloy B et al. Dissecting cellulitis of the scalp: a retrospective study of 51 patients and review of the literature. Br J Dermatol 2016;174:421–3.
2. Goldsmith PC, Dowd PM. Successful therapy of the follicular occlusion triad in a young woman with high dose oral antiandrogens and minocycline. J R Soc Med 1993;86:729–30.
New-Generation Therapies for the Treatment of Hair Loss
Key Points
· Selection of hair transplantation methodology depends on patients’ goals, type of hair loss, and quality of hair.
· Robotic hair transplantation is the latest frontier in hair restoration.
· Platelet-rich plasma, low-level laser therapy, and stem cells can be used together with hair transplantation to enhance graft survival.
Sadick NS. New-Generation Therapies for the Treatment of Hair Loss in Men. Dermatologic Clinics 2018;36(1):63-7. New-Generation Therapies for the Treatment of Hair Loss in Men - ScienceDirect
Key Points
· Selection of hair transplantation methodology depends on patients’ goals, type of hair loss, and quality of hair.
· Robotic hair transplantation is the latest frontier in hair restoration.
· Platelet-rich plasma, low-level laser therapy, and stem cells can be used together with hair transplantation to enhance graft survival.
Sadick NS. New-Generation Therapies for the Treatment of Hair Loss in Men. Dermatologic Clinics 2018;36(1):63-7. New-Generation Therapies for the Treatment of Hair Loss in Men - ScienceDirect
Hey no shit brothers my hair dresser told me the vitamin b7 also known as biotin works well and it's working for me it's cheap I'm also using tea tree oil , I can see growth after 3 days at 2grams a day it only costs me 10buck, every thing else is a scam 99percent of the time she sells tons of hair products and knows it's all business just like most supplements at the local gym store promising big gains all b.s
[OA] Evidence-Based (S3) Guideline for The Treatment of Androgenetic Alopecia
Androgenetic alopecia is the most common hair loss disorder, affecting both men and women. Initial signs of androgenetic alopecia usually develop during teenage years leading to progressive hair loss with a pattern distribution. Moreover, its frequency increases with age and affects up to 80% Caucasian men and 42% of women. Patients afflicted with androgenetic alopecia may undergo significant impairment of quality of life.
The European Dermatology Forum (EDF) initiated a project to develop evidence-based guidelines for the treatment of androgenetic alopecia. Based on a systematic literature research the efficacy of the currently available therapeutic options was assessed and therapeutic recommendations were passed in a consensus conference. The purpose of the guideline is to provide dermatologists with an evidence-based tool for choosing an efficacious and safe therapy for patients with androgenetic alopecia.
Kanti V, Messenger A, Dobos G, et al. Evidence-based (S3) guideline for the treatment of androgenetic alopecia in women and in men - short version. J Eur Acad Dermatol Venereol. 2017 Nov 27. Evidence‐based (S3) guideline for the treatment of androgenetic alopecia in women and in men – short version
Androgenetic alopecia is the most common hair loss disorder, affecting both men and women. Initial signs of androgenetic alopecia usually develop during teenage years leading to progressive hair loss with a pattern distribution. Moreover, its frequency increases with age and affects up to 80% Caucasian men and 42% of women. Patients afflicted with androgenetic alopecia may undergo significant impairment of quality of life.
The European Dermatology Forum (EDF) initiated a project to develop evidence-based guidelines for the treatment of androgenetic alopecia. Based on a systematic literature research the efficacy of the currently available therapeutic options was assessed and therapeutic recommendations were passed in a consensus conference. The purpose of the guideline is to provide dermatologists with an evidence-based tool for choosing an efficacious and safe therapy for patients with androgenetic alopecia.
Kanti V, Messenger A, Dobos G, et al. Evidence-based (S3) guideline for the treatment of androgenetic alopecia in women and in men - short version. J Eur Acad Dermatol Venereol. 2017 Nov 27. Evidence‐based (S3) guideline for the treatment of androgenetic alopecia in women and in men – short version
[OA] Kanti V, Messenger A, Dobos G et al. S3 - European dermatology forum guideline for the treatment of androgenetic alopecia in women and in men 2017. URL http://www.euroderm.org/edf/index.php/edf-guidelines/category/5-guidelines-miscellaneous?download=21:guideline-androgenetic-alopecia
Androgenetic alopecia is the most common hair loss disorder, affecting both men and women. Initial signs of androgenetic alopecia usually develop during teenage years leading to progressive hair loss with a pattern distribution. Moreover, its frequency increases with age and affects up to 80% Caucasian men and 42% of women. Patients afflicted with androgenetic alopecia may undergo significant impairment of quality of life.
The European Dermatology Forum (EDF) initiated a project to develop evidence-based guidelines for the treatment of androgenetic alopecia. Based on a systematic literature research the efficacy of the currently available therapeutic options was assessed and therapeutic recommendations were passed in a consensus conference.
The purpose of the guideline is to provide dermatologists with an evidence-based tool for choosing an efficacious and safe therapy for patients with androgenetic alopecia.
Androgenetic alopecia is the most common hair loss disorder, affecting both men and women. Initial signs of androgenetic alopecia usually develop during teenage years leading to progressive hair loss with a pattern distribution. Moreover, its frequency increases with age and affects up to 80% Caucasian men and 42% of women. Patients afflicted with androgenetic alopecia may undergo significant impairment of quality of life.
The European Dermatology Forum (EDF) initiated a project to develop evidence-based guidelines for the treatment of androgenetic alopecia. Based on a systematic literature research the efficacy of the currently available therapeutic options was assessed and therapeutic recommendations were passed in a consensus conference.
The purpose of the guideline is to provide dermatologists with an evidence-based tool for choosing an efficacious and safe therapy for patients with androgenetic alopecia.
gruntstyle18d
New Member
i gave up with the hair batttle. i still have hair but receding started. dutasteride is not good in the long range. has bad side effects that can permetely mess you up. all rhese products posted above do almost nothing when used with anything except test. anything else ypu run your hair will still fall out
Michel L, Reygagne P, Benech P, et al. Study of gene expression alteration in male androgenetic alopecia: evidence of predominant molecular signalling pathways. Br J Dermatol 2017;177:1322-36. http://onlinelibrary.wiley.com/doi/10.1111/bjd.15577/abstract
BACKGROUND: Male androgenetic alopecia (AGA) is the most common form of hair loss in men. It is characterized by a distinct pattern of progressive hair loss starting from the frontal area and the vertex of the scalp. Although several genetic risk loci have been identified, relevant genes for AGA remain to be defined.
OBJECTIVES: To identify biomarkers associated with AGA.
METHODS: Molecular biomarkers associated with premature AGA were identified through gene expression analysis using cDNA generated from scalp vertex biopsies of hairless or bald men with premature AGA, and healthy volunteers.
RESULTS: This monocentric study reveals that genes encoding mast cell granule enzymes, inflammatory mediators and immunoglobulin-associated immune mediators were significantly overexpressed in AGA. In contrast, underexpressed genes appear to be associated with the Wnt/beta-catenin and bone morphogenic protein/transforming growth factor-beta signalling pathways.
Although involvement of these pathways in hair follicle regeneration is well described, functional interpretation of the transcriptomic data highlights different events that account for their inhibition.
In particular, one of these events depends on the dysregulated expression of proopiomelanocortin, as confirmed by polymerase chain reaction and immunohistochemistry. In addition, lower expression of CYP27B1 in patients with AGA supports the notion that changes in vitamin D metabolism contributes to hair loss.
CONCLUSIONS: This study provides compelling evidence for distinct molecular events contributing to alopecia that may pave the way for new therapeutic approaches.
BACKGROUND: Male androgenetic alopecia (AGA) is the most common form of hair loss in men. It is characterized by a distinct pattern of progressive hair loss starting from the frontal area and the vertex of the scalp. Although several genetic risk loci have been identified, relevant genes for AGA remain to be defined.
OBJECTIVES: To identify biomarkers associated with AGA.
METHODS: Molecular biomarkers associated with premature AGA were identified through gene expression analysis using cDNA generated from scalp vertex biopsies of hairless or bald men with premature AGA, and healthy volunteers.
RESULTS: This monocentric study reveals that genes encoding mast cell granule enzymes, inflammatory mediators and immunoglobulin-associated immune mediators were significantly overexpressed in AGA. In contrast, underexpressed genes appear to be associated with the Wnt/beta-catenin and bone morphogenic protein/transforming growth factor-beta signalling pathways.
Although involvement of these pathways in hair follicle regeneration is well described, functional interpretation of the transcriptomic data highlights different events that account for their inhibition.
In particular, one of these events depends on the dysregulated expression of proopiomelanocortin, as confirmed by polymerase chain reaction and immunohistochemistry. In addition, lower expression of CYP27B1 in patients with AGA supports the notion that changes in vitamin D metabolism contributes to hair loss.
CONCLUSIONS: This study provides compelling evidence for distinct molecular events contributing to alopecia that may pave the way for new therapeutic approaches.
Fattest_animal
Well-known Member
I'm going to use Rogaine amd vitamin b7 and hope for the best...
Serum androgens and PSA levels in androgenetic alopecia - is there a difference between frontal and vertex baldness?
BACKGROUND: Androgenetic alopecia (AGA) seems to be a marker of increased risk of prostate cancer (PCa).
OBJECTIVE: We sought to investigate potential pathophysiological differences between frontal and vertex balding that might have the impact on the incidence of PCa.
METHODS: Serum concentrations of testosterone (T), dihydrotestosterone (DHT) and prostate-specific antigen (PSA) were measured in 88 subjects with AGA.
RESULTS: We have examined sixty patients with frontal baldness and 28 patients with vertex baldness. The subgroups did not differ significantly in age, BMI and as regards age of AGA onset, duration of AGA and comorbidities. The mean value of DHT in serum of the men with vertex baldness was higher than those in the men with frontal baldness with statistical significance (p<0,05). The groups did not show significant differences in mean value of serum T and PSA levels, and DHT/T ratio. No correlation was found between the serum PSA level and serum androgen levels as well as DHT/T ratio.
CONCLUSIONS: Vertex baldness may signal higher exposures to circulating DHT. Serum PSA level cannot serve as surrogate diagnostic marker of increased androgenic activity in men with AGA. This article is protected by copyright. All rights reserved.
Lis-Swiety A, Arasiewicz H, Ranosz-Janicka I, Brzezinska-Wcislo L. Serum androgens and PSA levels in androgenetic alopecia - is there a difference between frontal and vertex baldness? J Eur Acad Dermatol Venereol 2017. Serum androgens and PSA levels in androgenetic alopecia ‐ is there a difference between frontal and vertex baldness?
BACKGROUND: Androgenetic alopecia (AGA) seems to be a marker of increased risk of prostate cancer (PCa).
OBJECTIVE: We sought to investigate potential pathophysiological differences between frontal and vertex balding that might have the impact on the incidence of PCa.
METHODS: Serum concentrations of testosterone (T), dihydrotestosterone (DHT) and prostate-specific antigen (PSA) were measured in 88 subjects with AGA.
RESULTS: We have examined sixty patients with frontal baldness and 28 patients with vertex baldness. The subgroups did not differ significantly in age, BMI and as regards age of AGA onset, duration of AGA and comorbidities. The mean value of DHT in serum of the men with vertex baldness was higher than those in the men with frontal baldness with statistical significance (p<0,05). The groups did not show significant differences in mean value of serum T and PSA levels, and DHT/T ratio. No correlation was found between the serum PSA level and serum androgen levels as well as DHT/T ratio.
CONCLUSIONS: Vertex baldness may signal higher exposures to circulating DHT. Serum PSA level cannot serve as surrogate diagnostic marker of increased androgenic activity in men with AGA. This article is protected by copyright. All rights reserved.
Lis-Swiety A, Arasiewicz H, Ranosz-Janicka I, Brzezinska-Wcislo L. Serum androgens and PSA levels in androgenetic alopecia - is there a difference between frontal and vertex baldness? J Eur Acad Dermatol Venereol 2017. Serum androgens and PSA levels in androgenetic alopecia ‐ is there a difference between frontal and vertex baldness?
Delaney SW, Zhang P. Systematic review of low-level laser therapy for adult androgenic alopecia. Journal of cosmetic and laser therapy: official publication of the European Society for Laser Dermatology 2017:1-8. http://www.tandfonline.com/doi/abs/10.1080/14764172.2017.1400170?journalCode=ijcl20
Alopecia is a common disorder affecting over half of the world's population. Within this condition, androgenic alopecia (AA) is the most common type, affecting 50% of males over 40 and 75% of females over 65. Anecdotal paradoxical hypertrichosis noted during laser epilation has generated interest in the possibility of using laser to stimulate hair growth.
In this study, we aimed to critically appraise the application of low-level laser therapy for the treatment of AA in adults. A systematic review was performed on studies identified on Medline, EMBASE, Cochrane database, and clinicaltrials.org. Double-blinded randomized controlled trials were selected and analyzed quantitatively (meta-analysis) and qualitatively (quality of evidence, risk of bias).
Low-level laser therapy appears to be a promising noninvasive treatment for AA in adults that is safe for self-administration in the home setting. Although shown to effectively stimulate hair growth when compared to sham devices, these results must be interpreted with caution. Further studies with larger samples, longer follow-up, and independent funding sources are necessary to determine the clinical effectiveness of this novel therapy.
Alopecia is a common disorder affecting over half of the world's population. Within this condition, androgenic alopecia (AA) is the most common type, affecting 50% of males over 40 and 75% of females over 65. Anecdotal paradoxical hypertrichosis noted during laser epilation has generated interest in the possibility of using laser to stimulate hair growth.
In this study, we aimed to critically appraise the application of low-level laser therapy for the treatment of AA in adults. A systematic review was performed on studies identified on Medline, EMBASE, Cochrane database, and clinicaltrials.org. Double-blinded randomized controlled trials were selected and analyzed quantitatively (meta-analysis) and qualitatively (quality of evidence, risk of bias).
Low-level laser therapy appears to be a promising noninvasive treatment for AA in adults that is safe for self-administration in the home setting. Although shown to effectively stimulate hair growth when compared to sham devices, these results must be interpreted with caution. Further studies with larger samples, longer follow-up, and independent funding sources are necessary to determine the clinical effectiveness of this novel therapy.
IwantToGetBig.Frank
Well-known Member
Hi Dr Scally,
I know there needs to be more of a larger sample testing on low level laser therapy on hair grow, however do you know which device was used for this study?
Thanks,
Frank
Maneuvers
New Member
There are natural ways as well. I have began to thin and my receding hairline is moving so I began to research. Dr Axe has a homemade shampoo that I tried. I'm seeing results now. It contains aloe Vera juice gel, baking soda, rosemary essential oil and olive oil. Dandruff gone and hair beginning to thicken by the week. I also mix tea tree oil, aloe gel and rosemary oil for a 20 min soak once a week.
Burke SP, Henderson AD, Lam BL. Central Retinal Artery Occlusion and Cerebral Infarction Following Stem Cell Injection for Baldness. Journal of neuro-ophthalmology: the official journal of the North American Neuro-Ophthalmology Society 2017;37:216-7. https://journals.lww.com/jneuro-oph...Retinal_Artery_Occlusion_and_Cerebral.21.aspx
We read with interest the recent article by Ragam et al (1) on “Ipsilateral ophthalmic and cerebral infarctions following cosmetic polylactic acid injection into the forehead.” We present a case of a different injected material, also used for cosmetic purposes, which produced vision loss and neurologic complications.
A 57-year-old man was injected with stem cells into the left frontotemporal region of the scalp in a facility outside the United States, with the aim of enhancing hair growth. He immediately developed shortness of breath and severe pain at the injection site. He then experienced acute loss of vision in the left eye and paralysis of the right hand. He was admitted to an intensive care unit, where he was diagnosed with a cerebral infarct. Vision in the left eye worsened to no light perception over 5 days, and the right hand paralysis resolved over 15 days.
The patient was referred by a neuro-ophthalmologist in his home country to our institution 1 month later. At this time, he had mild pain of the left upper eyelid and eyebrow and intermittent frontal headaches. A large depressed fibrotic scar of the left frontal region of the scalp was evident. Visual acuity was 20/20, right eye, and no light perception, left eye, with an amaurotic left pupil. The right fundus appeared normal, but the left fundus showed changes consistent with a central retinal artery occlusion (Fig. 1). Review of the patient's brain MRI demonstrated an acute left frontal cerebral infarct (Fig. 2).
Although central retinal artery occlusion and cerebral infarction have not previously been reported with stem cell injection, there have been cases of central retinal artery occlusion after dermal injection of cosmetic fillers to the forehead (1,2). Rich anastomoses between the external carotid and internal carotid systems are present in the scalp (3). We propose that, upon forceful intra-arterial injection into the scalp, retrograde flow allowed toxic material contained in the stem cell injection to gain access to the internal carotid system through these anastomoses. After crossing into the internal carotid circulation, the material likely propagated to the ophthalmic, central retinal, and intracerebral arteries. The patient's retinal findings are consistent with an acute intravascular toxic injury.
Our case adds to the growing literature of the risks associated with unregulated stem cell therapy. These therapies have wide appeal, claims of efficacy in treating a host of conditions, and the lay perception that the benefits outweigh the risks (4). However, as many countries offer stem cell treatments without oversight of medical regulatory agencies, the procedures may or may not contain stem cells and may cause devastating consequences to the patient through toxic impurities and microbial contamination.
We read with interest the recent article by Ragam et al (1) on “Ipsilateral ophthalmic and cerebral infarctions following cosmetic polylactic acid injection into the forehead.” We present a case of a different injected material, also used for cosmetic purposes, which produced vision loss and neurologic complications.
A 57-year-old man was injected with stem cells into the left frontotemporal region of the scalp in a facility outside the United States, with the aim of enhancing hair growth. He immediately developed shortness of breath and severe pain at the injection site. He then experienced acute loss of vision in the left eye and paralysis of the right hand. He was admitted to an intensive care unit, where he was diagnosed with a cerebral infarct. Vision in the left eye worsened to no light perception over 5 days, and the right hand paralysis resolved over 15 days.
The patient was referred by a neuro-ophthalmologist in his home country to our institution 1 month later. At this time, he had mild pain of the left upper eyelid and eyebrow and intermittent frontal headaches. A large depressed fibrotic scar of the left frontal region of the scalp was evident. Visual acuity was 20/20, right eye, and no light perception, left eye, with an amaurotic left pupil. The right fundus appeared normal, but the left fundus showed changes consistent with a central retinal artery occlusion (Fig. 1). Review of the patient's brain MRI demonstrated an acute left frontal cerebral infarct (Fig. 2).
Although central retinal artery occlusion and cerebral infarction have not previously been reported with stem cell injection, there have been cases of central retinal artery occlusion after dermal injection of cosmetic fillers to the forehead (1,2). Rich anastomoses between the external carotid and internal carotid systems are present in the scalp (3). We propose that, upon forceful intra-arterial injection into the scalp, retrograde flow allowed toxic material contained in the stem cell injection to gain access to the internal carotid system through these anastomoses. After crossing into the internal carotid circulation, the material likely propagated to the ophthalmic, central retinal, and intracerebral arteries. The patient's retinal findings are consistent with an acute intravascular toxic injury.
Our case adds to the growing literature of the risks associated with unregulated stem cell therapy. These therapies have wide appeal, claims of efficacy in treating a host of conditions, and the lay perception that the benefits outweigh the risks (4). However, as many countries offer stem cell treatments without oversight of medical regulatory agencies, the procedures may or may not contain stem cells and may cause devastating consequences to the patient through toxic impurities and microbial contamination.
[OA] A hypothetical pathogenesis model for androgenic alopecia: clarifying the dihydrotestosterone paradox and rate-limiting recovery factors.
Androgenic alopecia, also known as pattern hair loss, is a chronic progressive condition that affects 80% of men and 50% of women throughout a lifetime. But despite its prevalence and extensive study, a coherent pathology model describing androgenic alopecia’s precursors, biological step-processes, and physiological responses does not yet exist.
While consensus is that androgenic alopecia is genetic and androgen-mediated by dihydrotestosterone, questions remain regarding dihydrotestosterone’s exact role in androgenic alopecia onset.
What causes dihydrotestosterone to increase in androgenic alopecia-prone tissues?
By which mechanisms does dihydrotestosterone miniaturize androgenic alopecia-prone hair follicles?
Why is dihydrotestosterone also associated with hair growth in secondary body and facial hair?
Why does castration (which decreases androgen production by 95%) stop pattern hair loss, but not fully reverse it?
Is there a relationship between dihydrotestosterone and tissue remodeling observed alongside androgenic alopecia onset?
We review evidence supporting and challenging dihydrotestosterone’s causal relationship with androgenic alopecia, then propose an evidence-based pathogenesis model that attempts to answer the above questions, account for additionally-suspected androgenic alopecia mediators, identify rate-limiting recovery factors, and elucidate better treatment targets.
The hypothesis argues that:
(1) chronic scalp tension transmitted from the galea aponeurotica induces an inflammatory response in androgenic alopecia-prone tissues;
(2) dihydrotestosterone increases in androgenic alopecia-prone tissues as part of this inflammatory response; and
(3) dihydrotestosterone does not directly miniaturize hair follicles.
Rather, dihydrotestosterone is a co-mediator of tissue dermal sheath thickening, perifollicular fibrosis, and calcification – three chronic, progressive conditions concomitant with androgenic alopecia progression.
These conditions remodel androgenic alopecia-prone tissues – restricting follicle growth space, oxygen, and nutrient supply – leading to the slow, persistent hair follicle miniaturization characterized in androgenic alopecia.
If true, this hypothetical model explains the mechanisms by which dihydrotestosterone miniaturizes androgenic alopecia-prone hair follicles, describes a rationale for androgenic alopecia progression and patterning, makes sense of dihydrotestosterone’s paradoxical role in hair loss and hair growth, and identifies targets to further improve androgenic alopecia recovery rates: fibrosis, calcification, and chronic scalp tension.
English RS, Jr. A hypothetical pathogenesis model for androgenic alopecia: clarifying the dihydrotestosterone paradox and rate-limiting recovery factors. Medical hypotheses 2018;111:73-81. http://www.medical-hypotheses.com/article/S0306-9877(17)31041-1/fulltext
Androgenic alopecia, also known as pattern hair loss, is a chronic progressive condition that affects 80% of men and 50% of women throughout a lifetime. But despite its prevalence and extensive study, a coherent pathology model describing androgenic alopecia’s precursors, biological step-processes, and physiological responses does not yet exist.
While consensus is that androgenic alopecia is genetic and androgen-mediated by dihydrotestosterone, questions remain regarding dihydrotestosterone’s exact role in androgenic alopecia onset.
What causes dihydrotestosterone to increase in androgenic alopecia-prone tissues?
By which mechanisms does dihydrotestosterone miniaturize androgenic alopecia-prone hair follicles?
Why is dihydrotestosterone also associated with hair growth in secondary body and facial hair?
Why does castration (which decreases androgen production by 95%) stop pattern hair loss, but not fully reverse it?
Is there a relationship between dihydrotestosterone and tissue remodeling observed alongside androgenic alopecia onset?
We review evidence supporting and challenging dihydrotestosterone’s causal relationship with androgenic alopecia, then propose an evidence-based pathogenesis model that attempts to answer the above questions, account for additionally-suspected androgenic alopecia mediators, identify rate-limiting recovery factors, and elucidate better treatment targets.
The hypothesis argues that:
(1) chronic scalp tension transmitted from the galea aponeurotica induces an inflammatory response in androgenic alopecia-prone tissues;
(2) dihydrotestosterone increases in androgenic alopecia-prone tissues as part of this inflammatory response; and
(3) dihydrotestosterone does not directly miniaturize hair follicles.
Rather, dihydrotestosterone is a co-mediator of tissue dermal sheath thickening, perifollicular fibrosis, and calcification – three chronic, progressive conditions concomitant with androgenic alopecia progression.
These conditions remodel androgenic alopecia-prone tissues – restricting follicle growth space, oxygen, and nutrient supply – leading to the slow, persistent hair follicle miniaturization characterized in androgenic alopecia.
If true, this hypothetical model explains the mechanisms by which dihydrotestosterone miniaturizes androgenic alopecia-prone hair follicles, describes a rationale for androgenic alopecia progression and patterning, makes sense of dihydrotestosterone’s paradoxical role in hair loss and hair growth, and identifies targets to further improve androgenic alopecia recovery rates: fibrosis, calcification, and chronic scalp tension.
English RS, Jr. A hypothetical pathogenesis model for androgenic alopecia: clarifying the dihydrotestosterone paradox and rate-limiting recovery factors. Medical hypotheses 2018;111:73-81. http://www.medical-hypotheses.com/article/S0306-9877(17)31041-1/fulltext
Singh S, Neema S, Vasudevan B. A Pilot Study to Evaluate Effectiveness of Botulinum Toxin in Treatment of Androgenetic Alopecia in Males. Journal of cutaneous and aesthetic surgery 2017;10:163-7. A Pilot Study to Evaluate Effectiveness of Botulinum Toxin in Treatment of Androgenetic Alopecia in Males
Introduction: Androgenetic alopecia is a common form of alopecia with multifactorial etiology. Finasteride and minoxidil are approved by the FDA for the treatment of androgenetic alopecia. Balding scalp is believed to have relative microvascular insufficiency. Blood vessels in the scalp travel through the intramuscular plane. Intramuscular injection of botulinum toxin relaxes muscles and thereby increases blood flow in balding scalp. We conducted a pilot study to evaluate the efficacy of botulinum toxin in androgenetic alopecia management.
Material and Methods: The study was conducted in a tertiary care center. A total of 10 male patients with androgenetic alopecia meeting inclusion criteria of the study were included. In the scalp, 30 sites were injected with 5 U of botulinum toxin in each site. Preprocedure photograph taken and evaluation was done, which was repeated after 24 weeks. Efficacy was assessed by photography and self-assessment scoring was done by patients.
Results: Of 10 patients, 8 had good to excellent response on photographic assessment. At the end of 24 weeks, 1 patient showed poor and 1 showed fair response to treatment. As per self-assessment, 7of 10 patients showed good to excellent response. Two patients had fair response and 1 patient showed poor response to treatment.
Conclusion: Botulinum toxin was found to be safe and effective therapy for the management of androgenetic alopecia in this pilot study. Studies with larger sample size and randomized controlled trials are required to establish the role of botulinum toxin in the management of androgenetic alopecia.
Introduction: Androgenetic alopecia is a common form of alopecia with multifactorial etiology. Finasteride and minoxidil are approved by the FDA for the treatment of androgenetic alopecia. Balding scalp is believed to have relative microvascular insufficiency. Blood vessels in the scalp travel through the intramuscular plane. Intramuscular injection of botulinum toxin relaxes muscles and thereby increases blood flow in balding scalp. We conducted a pilot study to evaluate the efficacy of botulinum toxin in androgenetic alopecia management.
Material and Methods: The study was conducted in a tertiary care center. A total of 10 male patients with androgenetic alopecia meeting inclusion criteria of the study were included. In the scalp, 30 sites were injected with 5 U of botulinum toxin in each site. Preprocedure photograph taken and evaluation was done, which was repeated after 24 weeks. Efficacy was assessed by photography and self-assessment scoring was done by patients.
Results: Of 10 patients, 8 had good to excellent response on photographic assessment. At the end of 24 weeks, 1 patient showed poor and 1 showed fair response to treatment. As per self-assessment, 7of 10 patients showed good to excellent response. Two patients had fair response and 1 patient showed poor response to treatment.
Conclusion: Botulinum toxin was found to be safe and effective therapy for the management of androgenetic alopecia in this pilot study. Studies with larger sample size and randomized controlled trials are required to establish the role of botulinum toxin in the management of androgenetic alopecia.
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