Hair Loss

So has there ever been any literature we can pull info from to understand which synthetic steroids are worse for the hairline?

There's some things that still just don't make sense for me. For example, it's commonly stated that masteron is one of the worst for your hairline because "its DHT bro" - except its not DHT. Its DHT derived, but so is anavar, and I've never seen anyone suggest anavar was aggressive on the hairline.

Tren is supposed to be bad for hairline.

Here is Fed's opinion:

Limited hair loss
1. tbol
2. var

moderate hair loss
1. primo
2. eq
3. deca
4. test with propecia

Hello baldy!!!
1. test
2. halo
3. tren (the worst)
4. winny
 
Khidhir KG, Woodward DF, Farjo NP, et al. The prostamide-related glaucoma therapy, bimatoprost, offers a novel approach for treating scalp alopecias. Faseb J 2013;27(2):557-67. The prostamide-related glaucoma therapy, bimatoprost, offers a novel approach for treating scalp alopecias

Balding causes widespread psychological distress but is poorly controlled. The commonest treatment, minoxidil, was originally an antihypertensive drug that promoted unwanted hair. We hypothesized that another serendipitous discovery, increased eyelash growth side-effects of prostamide F(2alpha)-related eyedrops for glaucoma, may be relevant for scalp alopecias. Eyelash hairs and follicles are highly specialized and remain unaffected by androgens that inhibit scalp follicles and stimulate many others. Therefore, we investigated whether non-eyelash follicles could respond to bimatoprost, a prostamide F(2alpha) analog recently licensed for eyelash hypotrichosis. Bimatoprost, at pharmacologically selective concentrations, increased hair synthesis in scalp follicle organ culture and advanced mouse pelage hair regrowth in vivo compared to vehicle alone. A prostamide receptor antagonist blocked isolated follicle growth, confirming a direct, receptor-mediated mechanism within follicles; RT-PCR analysis identified 3 relevant receptor genes in scalp follicles in vivo. Receptors were located in the key follicle regulator, the dermal papilla, by analyzing individual follicular structures and immunohistochemistry. Thus, bimatoprost stimulates human scalp follicles in culture and rodent pelage follicles in vivo, mirroring eyelash behavior, and scalp follicles contain bimatoprost-sensitive prostamide receptors in vivo. This highlights a new follicular signaling system and confirms that bimatoprost offers a novel, low-risk therapeutic approach for scalp alopecias.


Possible Mechanism For The Stimulation Of Hair Growth By Bimatoprost

Bimatoprost stimulates eyelash growth in vivo, human scalp hair growth in organ culture, and mouse pelage hair growth in vivo. In our hypothesis, these effects are due to bimatoprost binding to appropriate receptors on the plasma membrane of cells in the regulatory dermal papilla in the hair bulb (middle panel). This probably stimulates intracellular signaling pathways, which trigger alterations in the gene expression of paracrine signals and their extracellular release. Some of these factors would leave the dermal papilla, crossing the basement membrane, isolating it from the rest of the follicle, to stimulate the coordinated activity of the keratinocytes and melanocytes to produce increased hair growth and pigmentation. Red dots indicate FP and/or prostamide F2? receptors, blue arrows indicate direction of movement of paracrine factors.

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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. Low-Level Light Therapy for Androgenetic Alopecia: A 24-Week, Randomized, Double-Blind, Sham Device–Controlled Multicenter Trial - Kim - 2013 - Dermatologic Surgery - Wiley Online Library

BACKGROUND: Androgenetic alopecia (AGA) is a common disorder affecting men and women. Finasteride and minoxidil are well-known, effective treatment methods, but patients who exhibit a poor response to these methods have no additional adequate treatment modalities.

OBJECTIVE: To evaluate the efficacy and safety of a low-level light therapy (LLLT) device for the treatment of AGA.

METHODS: This study was designed as a 24-week, randomized, double-blind, sham device-controlled trial. Forty subjects with AGA were enrolled and scheduled to receive treatment with a helmet-type, home-use LLLT device emitting wavelengths of 630, 650, and 660 nm or a sham device for 18 minutes daily. Investigator and subject performed phototrichogram assessment (hair density and thickness) and global assessment of hair regrowth for evaluation.

RESULTS: After 24 weeks of treatment, the LLLT group showed significantly greater hair density than the sham device group. Mean hair diameter improved statistically significantly more in the LLLT group than in the sham device group. Investigator global assessment showed a significant difference between the two groups, but that of the subject did not. No serious adverse reactions were detected.

CONCLUSION: LLLT could be an effective treatment for AGA.
 
Valente Duarte de Sousa IC, Tosti A. New investigational drugs for androgenetic alopecia. Expert Opin Investig Drugs. An Error Occurred Setting Your User Cookie

Introduction: Androgenetic alopecia (AGA) is the most common form of hair loss, however current treatment options are limited and moderately effective. In the past few years, there has been an increased interest in deciphering the molecular mechanisms responsible for this disorder, which has opened the possibility of novel treatments that promise to not only stimulate hair growth, but also to induce formation of new hair follicles. Areas covered: The future holds more effective topical treatments with less systemic side effects (such as topical 5-alfa-reductase inhibitors), prostaglandin analogs and antagonists, medications which act through the Wnt signaling pathway, stem cells for hair regeneration, platelet-rich plasma (PRP) and more effective ways of transplanting hair. A comprehensive search was made using PubMed, GoogleScholar and Clinicaltrial.gov using different combination of key words, which included AGA treatment, new treatments for AGA, Wnt pathway, prostaglandins, PRP and stem cells for hair regrowth. Expert opinion: In the near future, treatments with topical 5-alfa-reductase inhibitors and prostaglandin agonists or antagonists are expected. More evidence is needed to verify the efficacy of PRP. Although hair follicle bioengineering and multiplication is a fascinating and promising field, it is still a long way from being available to clinicians.
 
Eroz R, Tasdemir S, Dogan H. Is there any relationship between decreased AgNOR protein synthesis and human hair loss? Biotech Histochem 2012;87(8):494-8. An Error Occurred Setting Your User Cookie

Argyrophilic nucleolar organizing region associated proteins (AgNORs) play roles in cell proliferation and a variety of diseases. We attempted to determine whether decreased NOR protein synthesis causes human hair loss. We studied 21 healthy males who suffered hair loss on the frontal/vertex portion of the head. Hair root cells from normal and hair loss sites were stained for AgNOR. One hundred nuclei per site were evaluated and the AgNOR number and NORa/TNa proportions of individual cells were determined using a computer program. The cells from normal sites had significantly higher AgNOR counts than those from hair loss sites. Also, the cells from the normal sites had significantly higher NORa/TNa than cells from the hair loss sites. In the normal sites, the cells demonstrated more NOR protein synthesis than cells in hair loss sites. Therefore, decreased NOR protein synthesis appears to be related to hair loss in humans.
 
Moon PG, Kwack MH, Lee JE, et al. Proteomic analysis of balding and non-balding mesenchyme-derived dermal papilla cells from androgenetic alopecia patients using on-line two-dimensional reversed phase-reversed phase LC-MS/MS. J Proteomics. ScienceDirect.com - Journal of Proteomics - Proteomic analysis of balding and non-balding mesenchyme-derived dermal papilla cells from androgenetic alopecia patients using on-line two-dimensional reversed phase-reversed phase LC-MS/MS

Androgenetic alopecia (AGA) is the most common and progressive disorder of hair loss with psychological effects. However, the exact mechanisms of baldness have not yet been elucidated. Until now, there has been no report using current proteomic approaches to examine balding and non-balding mesenchyme-derived DPCs simultaneously. To achieve the goal of identifying differentially expressed proteins in balding DPCs compared to non-balding DPCs, we present a strategy combining gel-assisted digestion and automatic on-line two-dimensional reversed phase-reversed phase (2D RP-RP) LC MS/MS with informatics-assisted label-free protein quantitation. This strategy efficiently quantified the proteins of balding and non-balding DPCs from patients, and 128 up-regulated and 12 down-regulated proteins among 690 distinct proteins were identified in balding DPCs compared to non-balding DPCs. Up-regulated proteins belonging to these pathways in the balding DPCs, including argininosuccinate synthase 1 (ASS1), phosphoribosylaminoimidazole carboxylase (PAICS; ADE2), cytoskeleton-associated protein 4 (CKAP4), gelsolin (GSN), Ras GTPase-activating-like protein (IQGAP1), and S-phase kinase-associated protein 1 (SKP1), were confirmed by Western blot analysis. Gelsolin (GSN), Ras GTPase-activating-like protein (IQGAP1), plectin-1 (PLEC1), and nonerythroid alpha-spectrin (SPTAN1) were confirmed by immunofluorescence analysis. This proteomic approach to DPCs should help in understanding the pathogenesis of AGA.

BIOLOGICAL SIGNIFICANCE: The results demonstrated the first deep proteomic approach to mesenchyme-derived dermal papilla cells (DPCs), which are a useful model system to investigate the mechanisms of baldness, from human hair and also identified differentially expressed proteins in balding DPCs compared to non-balding DPCs. This study should help in understanding the pathogenesis of androgenetic alopecia (AGA) and furthermore some proteins differentially expressed could be studied as therapeutic targets for AGA.
 
Gatherwright J, Liu MT, Amirlak B, Gliniak C, Totonchi A, Guyuron B. The contribution of endogenous and exogenous factors to male alopecia: a study of identical twins. Plast Reconstr Surg 2013;131(5):794e-801e. The Contribution of Endogenous and Exogenous Factors to Male... : Plastic and Reconstructive Surgery

BACKGROUND: The purpose of this study was to investigate the potential contribution of environmental factors and testosterone on male alopecia.

METHODS: Ninety-two identical male twins were recruited from 2009 to 2011. A comprehensive questionnaire was completed followed by the acquisition of sputum samples for testosterone analysis and standardized digital photography. Frontal, temporal, and vertex hair loss was assessed from these photographs. Hair loss was then correlated with survey responses and testosterone levels between twin pairs. Two independent, blinded observers also rated the photographs for hair thinning.

RESULTS: Increased smoking duration (p < 0.001) and the presence of dandruff (p = 0.028) were significantly associated with increased frontal hair loss. Increased exercise duration (p = 0.002), consumption of more than four alcoholic drinks per week (p = 0.042), and increased money spent on hair loss products (p = 0.050) were all associated with increased temporal hair loss. Daily hat use (p = 0.050), higher body mass index (p = 0.012), and higher testosterone levels (p = 0.040) were associated with decreased temporal hair loss. Factors that were significantly associated with increased vertex hair loss included abstinence from alcohol consumption (p = 0.030), consumption of more than four alcoholic drinks per week (p = 0.004), increased smoking duration (p = 0.047), increased exercise duration (p = 0.050), and increased stress duration (p = 0.010). Lower body mass index, more children, increased caffeine consumption, history of skin disease, and abstinence from alcohol were significantly associated with increased hair thinning scores (p < 0.05).

CONCLUSION: This study offers substantial evidence that exogenous factors may have a clinically significant impact on hair loss.
 
Bimatoprost (Lumigan/Latisse) for Androgenetic Alopecia [Male Pattern Baldness]

“Regarding Bimatoprost Scalp hair growth, the results of the Phase II trial in male and female hair loss indicated that the formulation was well-tolerated but did not provide sufficient efficacy to proceed directly to Phase III. As a consequence, we are extending the Phase II program to include trials with an approximately tenfold higher concentration of bimatoprost in the current formulation and also in an oval formulation. These trials will start enrolling male patients with androgenic alopecia in the third quarter of 2013.” Allergan Management Discusses Q1 2013 Results - Earnings Call Transcript - Seeking Alpha

Allergan http://www.allergan.com/index.html
 
Gay D, Kwon O, Zhang Z, et al. Fgf9 from dermal ?? T cells induces hair follicle neogenesis after wounding. Nat Med;advance online publication. Fgf9 from dermal [gamma][delta] T cells induces hair follicle neogenesis after wounding : Nature Medicine : Nature Publishing Group

Understanding molecular mechanisms for regeneration of hair follicles provides new opportunities for developing treatments for hair loss and other skin disorders. Here we show that fibroblast growth factor 9 (Fgf9), initially secreted by ?? T cells, modulates hair follicle regeneration after wounding the skin of adult mice. Reducing Fgf9 expression decreases this wound-induced hair neogenesis (WIHN). Conversely, overexpression of Fgf9 results in a two- to threefold increase in the number of neogenic hair follicles. We found that Fgf9 from ?? T cells triggers Wnt expression and subsequent Wnt activation in wound fibroblasts. Through a unique feedback mechanism, activated fibroblasts then express Fgf9, thus amplifying Wnt activity throughout the wound dermis during a crucial phase of skin regeneration. Notably, humans lack a robust population of resident dermal ?? T cells, potentially explaining their inability to regenerate hair after wounding. These findings highlight the essential relationship between the immune system and tissue regeneration. The importance of Fgf9 in hair follicle regeneration suggests that it could be used therapeutically in humans.
 
Re: The big 4 (now 5) for preventing hair loss.

Very good article bro! Thanks for posting this! :)

Nice stuff indeed! You have provided very good information with details regarding hair loss. It is really very useful. I love the information and appreciate your hard work.
 
Fischer TW, Trueb RM, Hanggi G, Innocenti M, Elsner P. Topical melatonin for treatment of androgenetic alopecia. Int J Trichology 2012;4(4):236-45. Topical Melatonin for Treatment of Androgenetic Alopecia Fischer TW, Trüeb RM, Hänggi G, Innocenti M, Elsner P - Int J Trichol

BACKGROUND: In the search for alternative agents to oral finasteride and topical minoxidil for the treatment of androgenetic alopecia (AGA), melatonin, a potent antioxidant and growth modulator, was identified as a promising candidate based on in vitro and in vivo studies.

MATERIALS AND METHODS: One pharmacodynamic study on topical application of melatonin and four clinical pre-post studies were performed in patients with androgenetic alopecia or general hair loss and evaluated by standardised questionnaires, TrichoScan, 60-second hair count test and hair pull test.

RESULTS: FIVE CLINICAL STUDIES SHOWED POSITIVE EFFECTS OF A TOPICAL MELATONIN SOLUTION IN THE TREATMENT OF AGA IN MEN AND WOMEN WHILE SHOWING GOOD TOLERABILITY: (1) Pharmacodynamics under once-daily topical application in the evening showed no significant influence on endogenous serum melatonin levels. (2) An observational study involving 30 men and women showed a significant reduction in the degree of severity of alopecia after 30 and 90 days (P < 0.001) based on questionnaires completed by investigators and patients. (3) Using a digital software-supported epiluminescence technique (TrichoScan) in 35 men with AGA, after 3 and 6 months in 54.8% to 58.1% of the patients a significant increase of hair density of 29% and 41%, respectively was measured (M0: 123/cm(2); M3: 159/cm(2); M6: 173/cm(2);) (P < 0,001). (4) In 60 men and women with hair loss, a significant reduction in hair loss was observed in women, while hair loss in men remained constant (P < 0.001). (5) In a large, 3-month, multi-center study with more than 1800 volunteers at 200 centers, the percentage of patients with a 2- to 3-fold positive hair-pull test decreased from 61.6% to 7.8%, while the percentage of patients with a negative hair-pull test increased from 12.2.% to 61.5% (P < 0.001). In addition, a decrease in seborrhea and seborrheic dermatitis of the scalp was observed.

CONCLUSIONS: Since safety and tolerability in all of the studies was good, the topical application of a cosmetic melatonin solution can be considered as a treatment option in androgenetic alopecia.
 
Role of Platelet-rich Plasma in the Management of Androgenetic Alopecia (AGA) - Many growth factors play a fundamental role in the life-long cyclic transformation of the hair follicle functioning as biologic switches that are turned on and off during the different phases, controlling the active phase and promoting apoptosis to induce catagen and telogen. The main growth factors involved in the establishment of hair follicle are vascular endothelial growth factor (VEGF), epidermal growth factor (EGF), insulin 1-like growth factor, and fibroblast growth factor (FGF). Platelets release large amounts of platelet-derived growth factor (PDGFaa, PDGFbb, and PDGFab), transforming growth factor beta (TGF?1 and ?2), EGF, and VEGF.

The beneficial effects of Platelet-Rich Plasma (PRP) in AGA can thus be attributed to various platelet-derived growth factors causing improvement in the function of hair follicle and promotion of hair growth. It is safe, cheap, and non-allergic and it appears to be a useful adjuvant in the management of AGA.

Role of Platelet-rich Plasma in the Management of Androgenetic Alopecia Chaudhari ND, Sharma YK, Dash K, Deshmukh P - Int J Trichol
 
Sakr FM, Gado AM, Mohammed HR, Adam AN. Preparation and evaluation of a multimodal minoxidil microemulsion versus minoxidil alone in the treatment of androgenic alopecia of mixed etiology: a pilot study. Drug Des Devel Ther 2013;7:413-23. Preparation and evaluation of a multimodal minoxidil microemulsion ver

BACKGROUND: The variable success of topical minoxidil in the treatment of androgenic alopecia has led to the hypothesis that other pathways could mediate this form of hair loss, including infection and/or microinflammation of the hair follicles. In this study, we prepared a multimodal microemulsion comprising minoxidil (a dihydrotestosterone antagonist), diclofenac (a nonsteroidal anti-inflammatory agent), and tea tree oil (an anti-infective agent). We investigated the stability and physicochemical properties of this formulation, and its therapeutic efficacy compared with a formulation containing minoxidil alone in the treatment of androgenic alopecia.

METHODS: We developed a multimodal oil/water (o/w) microemulsion, a formulation containing minoxidil alone, and another containing vehicle. A three-phase diagram was constructed to obtain the optimal concentrations of the selected oil, surfactant, and cosurfactant. Thirty-two men aged 18-30 years were randomized to apply 1 mL of microemulsion containing the multimodal formulation (formulation A, n = 11), minoxidil alone (formulation B, n = 11) or placebo (formulation C, n = 10) twice daily to the affected area for 32 weeks. Efficacy was evaluated by mean hair count, thickness, and weight on the targeted area of the scalp. Global photographs were taken, changes in the area of scalp coverage were assessed by patients and external investigators, and the benefits and safety of the study medications were evaluated. The physical stability of formula A was examined after a shelf storage period of 24 months.

RESULTS: Formulation A achieved a significantly superior response than formulations B and C in terms of mean hair count (P < 0.001), mean hair weight (P < 0.001), and mean hair thickness (P < 0.05). A patient self-assessment questionnaire demonstrated that the multimodal minoxidil formulation significantly (P < 0.001) slowed hair loss, increased hair growth, and improved appearance, and showed no appreciable side effects, such as itching and/or inflammation of the scalp compared with the minoxidil alone and placebo formulations. These improvements were in agreement with the photographic assessments made by the investigators. Formula A was shown to be an o/w formulation with consistent pH, viscosity, specific gravity, and homogeneity, and was physically stable after 24 months of normal storage.

CONCLUSION: A multimodal microemulsion comprising minoxidil, diclofenac, and tea tree oil was significantly superior to minoxidil alone and placebo in terms of stability, safety, and efficacy, and achieved an earlier response in the treatment of androgenic alopecia compared with minoxidil alone in this 32-week pilot study.
 
Henley DV, Lipson N, Korach KS, Bloch CA. Prepubertal Gynecomastia Linked to Lavender and Tea Tree Oils. New England Journal of Medicine 2007;356(5):479-85. MMS: Error

Most cases of male prepubertal gynecomastia are classified as idiopathic. We investigated possible causes of gynecomastia in three prepubertal boys who were otherwise healthy and had normal serum concentrations of endogenous steroids. In all three boys, gynecomastia coincided with the topical application of products that contained lavender and tea tree oils. Gynecomastia resolved in each patient shortly after the use of products containing these oils was discontinued. Furthermore, studies in human cell lines indicated that the two oils had estrogenic and antiandrogenic activities. We conclude that repeated topical exposure to lavender and tea tree oils probably caused prepubertal gynecomastia in these boys.
 
Fischer TW, Trueb RM, Hanggi G, Innocenti M, Elsner P. Topical melatonin for treatment of androgenetic alopecia. Int J Trichology 2012;4(4):236-45. Topical Melatonin for Treatment of Androgenetic Alopecia Fischer TW, Trüeb RM, Hänggi G, Innocenti M, Elsner P - Int J Trichol

BACKGROUND: In the search for alternative agents to oral finasteride and topical minoxidil for the treatment of androgenetic alopecia (AGA), melatonin, a potent antioxidant and growth modulator, was identified as a promising candidate based on in vitro and in vivo studies.

MATERIALS AND METHODS: One pharmacodynamic study on topical application of melatonin and four clinical pre-post studies were performed in patients with androgenetic alopecia or general hair loss and evaluated by standardised questionnaires, TrichoScan, 60-second hair count test and hair pull test.

RESULTS: FIVE CLINICAL STUDIES SHOWED POSITIVE EFFECTS OF A TOPICAL MELATONIN SOLUTION IN THE TREATMENT OF AGA IN MEN AND WOMEN WHILE SHOWING GOOD TOLERABILITY: (1) Pharmacodynamics under once-daily topical application in the evening showed no significant influence on endogenous serum melatonin levels. (2) An observational study involving 30 men and women showed a significant reduction in the degree of severity of alopecia after 30 and 90 days (P < 0.001) based on questionnaires completed by investigators and patients. (3) Using a digital software-supported epiluminescence technique (TrichoScan) in 35 men with AGA, after 3 and 6 months in 54.8% to 58.1% of the patients a significant increase of hair density of 29% and 41%, respectively was measured (M0: 123/cm(2); M3: 159/cm(2); M6: 173/cm(2);) (P < 0,001). (4) In 60 men and women with hair loss, a significant reduction in hair loss was observed in women, while hair loss in men remained constant (P < 0.001). (5) In a large, 3-month, multi-center study with more than 1800 volunteers at 200 centers, the percentage of patients with a 2- to 3-fold positive hair-pull test decreased from 61.6% to 7.8%, while the percentage of patients with a negative hair-pull test increased from 12.2.% to 61.5% (P < 0.001). In addition, a decrease in seborrhea and seborrheic dermatitis of the scalp was observed.

CONCLUSIONS: Since safety and tolerability in all of the studies was good, the topical application of a cosmetic melatonin solution can be considered as a treatment option in androgenetic alopecia.

what the hell? The pineal gland hormone ? The sleep inducer ?

That is weird.
 
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Buonocore D, Nobile V, Michelotti A, Marzatico F. Clinical efficacy of a cosmetic treatment by crescina((R)) human follicle stem cell on healthy males with androgenetic alopecia. Dermatol Ther (Heidelb) 2013;3(1):53-62. Clinical Efficacy of a Cosmetic Treatment by Crescina® Human Follicle Stem Cell on Healthy Males with Androgenetic Alopecia - Springer

INTRODUCTION: Androgenetic alopecia (AGA) is the most common cause of hair loss among males, characterized by progressive thinning of the scalp hairs and defined by various patterns. The main factors underling hair loss in AGA are genetic predisposition and increased sensitivity of the hair follicles to androgens, leading to a shortening of the anagen phase. In the present study, the authors investigated the efficacy of a commercially available cosmetic lotion, Crescina((R)) HFSC (human follicle stem cell; Labo Cosprophar AG, Basel, Switzerland), in promoting hair growth and in decreasing hair loss.

METHODS: A placebo-controlled, randomized trial was carried out on healthy males suffering from alopecia grade II to IV. Anagen rate and hair resistance to traction (pull test) were assessed after 2 and 4 months of treatment using phototricogram and pull test technique.

RESULTS: Crescina((R)) HFSC applied for 4 months was effective in promoting hair growth and in decreasing hair loss. After 2 and 4 months of treatment, the anagen rate was increased by 6.8% and 10.7%, respectively. Hair resistance to traction was decreased by 29.6% and 46.8%, respectively.

CONCLUSIONS: The present study demonstrated the positive effect of Crescina((R)) HFSC in modulating the activity of the hair follicle and promoting hair growth.
 

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I currently crush up (15 )100mg aldactone pills & mix them with 50% rubbing alcohol and apply to hairline. Will i get added benefit by crushing up some melatonin pills and applying it?
 

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